Health and Care Bill

Baroness Hayman Excerpts

Lords Hansard - Part 2 & Committee stage
Thursday 13th January 2022 Lords Chamber

Moved by

[Baroness Hayman]

15: Clause 5, page 3, line 15, at end insert—
“(d) how the decision is likely to contribute to—(i) compliance with the duty imposed by section 1 of the Climate Change Act 2008 (UK net zero emissions target),(ii) adaptation to climate change, and(iii) meeting other environmental goals (such as restoration or enhancement of the natural environment).”Member’s explanatory statement
The purpose of this amendment is to include, as part of NHS England’s duties, a requirement that when making a decision about the exercise of its functions, it must have regard to how any decision is likely to contribute to the UK’s climate change and environmental goals.

[Baroness Hayman (CB)]

My Lords, in moving Amendment 15 I will speak also to Amendments 43, 101 and 153 in my name. I also support Amendments 201 and 210 in the name of my noble friend Lord Stevens of Birmingham. I am grateful to him, the noble Lord, Lord Prior of Brampton, and the noble Baroness, Lady Young of Old Scone, for adding their names to my amendments. I should declare my interest as co-chair of Peers for the Planet, and my regret that I was not able to be present at Second Reading of the Bill.

I doubt that this debate will mirror the length and enthusiasm of so many participants around the Committee in the outstanding earlier debate. However, I should say that the issues that prompt these amendments are equally serious. The Government spent much of last year in preparation for the COP 26 climate meeting and all year, before and since, they stressed the gravity of the climate crisis that the country and the world face, the importance of making progress internationally and on our own domestic targets, which are statutory, and the importance of taking action across all departments and all sectors of the economy and the country’s activities.

The aim of these amendments is to embed consideration of the UK’s climate change and environmental goals throughout the Bill, in much the same way in which the noble Baroness, Lady Thornton, described how earlier amendments attempted to integrate throughout the Bill the issue of inequalities. I am disturbed, despite the Government’s commitments and despite the experience with other Bills—I look at the noble Earl, Lord Howe, who knows well that we have had similar debates on the Financial Services Bill. Those ended happily, and I hope that we can do the same on this Bill. But it is disturbing that we are still getting legislation through the House as if we were not in the midst of a climate crisis and as if we did not have the most challenging targets on net zero, biodiversity and environmental change.

We turn to the NHS. I suggest to the Committee that the NHS has a vital role to play if the Government are to achieve their key strategic priority of net zero by 2050. The NHS is responsible for approximately 5% of the UK’s carbon emissions and around 40% of all public sector emissions. Recognising that, and with the outstanding leadership of my noble friend Lord Stevens of Birmingham, the NHS has committed to an ambitious net-zero plan. It was the first national health service to make net-zero commitments, and at COP 26 last year 14 other countries followed the NHS’s lead and set net-zero emissions targets for their own health services, illustrating how important domestic action can be on the global stage.

My amendments seek to integrate that overarching NHS plan into the new structures set up in this Bill and to join the dots between high-level policy and the new integrated care boards and care partnerships. They seek to embed climate and environmental considerations into the responsibilities and activities of NHS England, ICBs and ICPs, so that, throughout the NHS, climate action, environmental goals and climate adaptation are taken into account.

I should make clear that contributing to the achievement of net zero is important for the NHS not only in contributing to national targets for reducing the volume of emissions; it is also an important element in improving public and individual health. Rising global temperatures and air pollution, for example, directly contribute to rates of major diseases, including asthma, heart disease and cancer. Again, the link to the earlier debate about inequalities is very clear.

The Government themselves have recognised the link between reducing emissions and improving health, talking in their own net-zero strategy of the

“physical and mental health benefits”

of that strategy. The Climate Change Committee, in its progress report to Parliament last year, spoke of

“significant, tangible improvements to public health”

from reaching net zero. These views were echoed in the report from the Academy of Medical Sciences and the Royal Society, A Healthy Future: Tackling Climate Change Mitigation and Human Health Together, which was published last year. It is in the interests of the health of the country, as well as of the Government achieving their targets, to ensure that the NHS plays its part.

As I said earlier, the NHS itself has recognised the importance of this issue on both those counts and is committed to taking action, but we need to embed that commitment throughout the structures of the service. If my amendments are agreed to, this Bill can contribute by providing strategic direction and a clear policy framework at all levels of the NHS.

Amendment 15 adds to the list of the wider effects that NHS England has a duty to have regard to when making a decision about the exercise of its functions. Having heard the Minister respond to the earlier debate, I know that this will not necessarily be an attractive proposition to him, but I think it is important. If Amendment 15 is agreed, in addition to the matters set out in Clause 5, NHS England would have a duty to have regard to how its decisions are likely to contribute to the UK’s climate change and environmental targets.

Noble Lords will recognise that the wording is broader than simply the achievement of our statutory net-zero commitments, but it may reassure noble Lords, and Ministers in particular, to know that it mirrors the terms of an amendment the Government introduced after a similar debate on the Skills and Post-16 Education Bill. Importantly, the wording includes the “adaptation to climate change” necessary to build resilience within the healthcare sector and protect the health of our current and future populations. This reflects the recognition in the NHS’s own net-zero strategy and adaptation report that climate breakdown may affect the healthcare system with increasingly adverse environmental conditions. It is sobering to note that, over the last 15 years, at least 15 hospitals have experienced major flooding incidents, causing disruption to patient services or hospital support services. Attention to vulnerability in this area needs to be an important focus for NHS England.

Amendment 101 would impose a similar new duty on integrated care boards to contribute to the same three objectives set out in Amendment 15, ensuring that trickle-down of policy objectives through the system.

Amendment 43 also deals with integrated care boards, mandating that their constitutions must provide for a member to be designated—not appointed, I should make clear, but for an appointed member to be designated—as having responsibility for climate change and the environment. This would reflect the NHS’s net-zero plan, which highlights the importance of

“ensuring that every NHS organisation has a board-level net-zero lead”.

This amendment implements that part of the plan in relation to the new framework of ICBs, created in the Bill, and having a board-level lead is an approach which has proved successful in other sectors.

--- Later in debate ---

[Baroness Hayman (CB)]

My Lords, I am extremely grateful to all Members who contributed to this debate, which got slightly more feisty than I expected it to do in some areas. I am sure that the Committee will be grateful if I do not respond on the issue of electric charging points in your Lordships’ House, which has concerned me for four years, but there are one or two important things to be said here. There are two dangers. One danger—I fear the Minister nearly got there—is to suggest that those who are concerned about climate are not concerned about fairness or inequality and do not realise the dangers, on everything from heating to electric vehicles or whatever. However, there is not that layer of people who are concerned only with the climate in theory. Most of us who are active in this area are extremely concerned about a fair transition and the implications of individual policies.

The other false dichotomy is that either you work on the absolutely granular local stuff or you make highfalutin legislation that is not relevant to anyone. We need both. We need to go throughout the system. We are legislators. Legislation matters and words matter. Sometimes legislation matters because Governments and policies change but legislation is there in statute—the words are on the page.

Of course I will seek to withdraw my amendment and of course I will have conversations with the Minister, but it is essential that we tackle this, the most serious of issues facing the world. Covid is the crisis of our time but the climate is the crisis of our age and we absolutely need to address it at all the levels that we can—and there are many. As I say, we are legislators and we can start some of that trickle-down. We have a responsibility to monitor and ensure that we end up with exactly the level of granularity that we need—and that we learn from the local. I am happy to delay conversations with the Minister for a later date. I beg leave to withdraw my amendment.

Amendment 15 withdrawn.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Baroness Hayman Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Hannan of Kingsclere (Con)]

My Lords, I envy the moral certainty of some of the loudest voices on both sides of this debate. As the noble Lord, Lord Fowler, just explained, it is bound to be an issue on which there is a range of strong opinions. The only opinion that I really discount is glibness, in particular a facile imputation of base motives to the other side. It is absurd to argue either that the proponents of these measures are engaged in some plot to create an authoritarian panopticon state or that their opponents are all lunatic conspiracy theorists. We are debating the most basic question of politics, going back to Aristotelian theory: how do people live together while preserving the freedom of the individual?

The answer must hinge on whether these measures are proportionate. I say that very seriously. My noble friend the Minister makes a good argument to the effect that these measures were judiciously chosen to disrupt as little as possible, in the face of an identified threat. It would be silly to dismiss the claim that we try to slow things up while increasing the opportunity for people to get a booster jab. But I keep coming back to one question: why would that logic not now apply to every future variant or, indeed, to every disease as yet unencountered by our doctors? Are we in danger of permanently tilting the balance, so that we have pre-emptive stay-at-home orders or other restrictions, on the off-chance, every time there is something that may or may not turn out to be a severe public health risk?

It is here that we have to make our stand. Over the last 18 months, what has most alarmed me is a reversal in the burden of proof. When proposing to take away people’s elemental freedoms, the onus must be on the proponents of change to prove their case. It is not for defenders of the status quo ante, defenders of our traditional freedoms, to show why restrictions are not necessary. I am not sure that has happened in this case. Even if it has, how are we not opening the door to the same reasoning in future, so that we have a see-saw of constant lockdowns or other bans and restrictions, every time something happens, just to be on the safe side? That would be a fundamental alteration in the relationship between state and citizen.

As my noble friend Lord Cormack said, this was largely a Conservative Party debate in the other place. I tuned in and watched it: I saw 17 successive Conservative speakers, and that was not for a want of people from the other side or a bias in the Chair. The debate was largely confined to the government Benches and I do not see that as a bad thing. I am proud to be a member of a party that takes questions of personal freedom seriously. That is why I finish by saying that, on this or other issues, we must not reverse the way in which we normally determine guilt or innocence. We usually have a very high burden of proof before we confine people to house arrest and we should not lower that, either in this or in more general cases. Freedom should always be our default.

[Baroness Hayman (CB)]

My Lords, I was interested in the comments we have just heard from the noble Lord, Lord Hannan of Kingsclere, and slightly surprised at how much of his speech I agreed with—in the sense that there is a danger from a constant stream of new variants, each provoking tactical responses in our own country. Therefore, I repeat the point I made yesterday at Question Time: it is in our national self-interest to ensure not only that people in this country are protected by vaccination but that people across the world are protected, because that will protect us in the future. It will stop us having these debates every two months, six months or year, ad infinitum.

The other point I will make in response to what the noble Lord said is that he is correct that we should not make this a debate between extreme positions, where you are either 100% right or 100% wrong. I am not 100% in favour of the detail of everything that is in these three SIs—but I am 100% sure that I am going to vote for them if the noble Lord, Lord Robathan, decides to divide the House.

There is a process by which we reach compromises and balances: between the threat to health from the virus and that of not having an NHS functioning as it normally does; or between the threats to mental health from the fear of contracting the virus and those from isolation—not being able to participate and work, and all those things. How we draw those balances is a very delicate exercise and it starts, as others have said, with medical and scientific advice. That must be the rock and the foundation, but of course there is a political dimension—a value weighing-up and a judgment to be made about the comparative harms and how we get our best way through.

I will make one last point about the dangers of an extremist position—and I think that the noble Lord, Lord Robathan, actually takes an extremist position. The danger comes when, after the advice, the Government’s view and their proposals, and then parliamentary scrutiny and challenge, to get it as right as we can on balance, there is a sense in the public that the political is playing too large a part; and that a Government—this Government—will actually be deterred from taking the action that they need, and are advised, to take, and which we need them to take to protect ourselves.

Other noble Lords will have seen the streams of responses to the email of the noble Lord, Lord Robathan, from people saying, “I’m sorry I can’t be there but I’m in bed with Covid”. On public confidence, let us face it: the current public adherence, on which we all depend, to the regulations before us will be damaged by the fear that they are not based fundamentally on the science but on fears of losing political support in the very narrow environment in which we operate. That would undermine public confidence. As others have said, it is absolutely vital that we go through this process with scientific advice, government recommendations and parliamentary scrutiny, and do the best that we can in those circumstances.

[Lord Trefgarne (Con)]

My Lords, I have had the privilege of being a Member of your Lordships’ House for a very long time. I was sitting on the Benches opposite back in 1977, when my late noble friend Lord Carrington, then Leader of the Opposition, and the late Earl Jellicoe moved the cancellation of sanctions on Rhodesia. That was a mistake, and it would be a mistake to vote down the regulations today.

Folic Acid

Baroness Hayman Excerpts

Tuesday 13th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely understand and appreciate the sense of frustration and urgency that my noble friend expressed, but I emphasise that this is a massive national measure. It has to be conducted in a way that takes the nations with us, that people feel confident that the right processes have been adhered to and that there is no doubt about the safety of the measure. This is not a question of foot dragging, quite the opposite. We are doing this in a thorough way that reflects the practicalities and realities of the machinery of the United Kingdom Government.

[Baroness Hayman (CB) [V]]

My Lords, I understand the frustration the Minister must feel being brought to the House again and again on this issue, but can he understand the frustration just expressed by the noble Lord, Lord McColl of Dulwich, that British science of 40 years ago has influenced the activities of countries across the world, New Zealand being the latest, and yet somehow in this country we have not managed to act on the science that was produced here and families have paid the price for that? Will the Minister understand the urgency and the frustration of those of us who have been raising this issue for years and will he look again at a timetable for implementation?

[Lord Bethell (Con)]

My Lords, I completely understand the frustration. I pay tribute to all noble Lords who have campaigned assiduously for this measure. It speaks extremely highly of this House that it is so focused on getting over the line an important and emblematic measure that puts preventive medicine at the heart of our healthcare system. Personally, I do not feel any disappointment or anger. I am completely committed to this measure, as are the British Government.

Folic Acid

Baroness Hayman Excerpts

Wednesday 23rd June 2021 Lords Chamber

[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.

[Baroness Hayman (CB) [V]]

My Lords, the Government have had an awfully long time to dot the “i”s and cross the “t”s. When the MRC research first came out, my children were the age that my grandchildren are now. Some 80 other countries have moved more speedily than the UK on the evidence provided by the UK-funded MRC research. As well as the noble Lord making progress on this before the Summer Recess, will the Government look at what the barriers were that made us as a country so slow to come to the decision to fortify flour?

[Lord Bethell (Con)]

My Lords, this Government’s progress on this really came to a head in the consultation in September 2019, and we have been on course to implement these measures since then. It is unfortunate that the Covid pandemic intervened at that point and we had to put work on this project on hold until April of this year. Since April, we have had to deal with the elections in the devolved Administrations. That, unfortunately, creates an insuperable barrier to taking the measures through all the necessary checks and alignments. I reassure the noble Baroness that we are totally committed to this policy, we are moving at pace and I look forward to further progress shortly.

Folic Acid

Baroness Hayman Excerpts

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Lord and others who have pressed this point that it is a departmental priority. There has of course been a pandemic and that has slowed things down. I cannot avoid that fact, but we are very much returning to the prevention agenda in the round and the issue of folic acid in particular.

[Baroness Hayman (CB) [V]]

My Lords, the Minister will understand the frustration in the House at the repeated delays in implementing a policy that has the opportunity substantially to reduce the scale of suffering that goes on, because of our failure to implement the implications of research that, I remember and as has been said, showed the benefits of fortification in the 1980s. It is desperately dispiriting to know that that research has been taken up by other countries, but not the UK. I press the Minister and suggest that it would be extremely helpful if the meetings that he has said need to take place with the devolved Administrations could be arranged now. Perhaps he could write to the noble Lord, Lord Rooker, copying the letter to other noble Lords, to tell us exactly when the meetings that he has described are scheduled.

[Lord Bethell (Con)]

I hear the frustration loud and clear and reassure the noble Baroness that we are working on this at pace.

Health and Social Care Update

Baroness Hayman Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Hayman (CB) [V]]

My Lords, a descent into a tit-for-tat vaccine war would obviously be disastrous, given the global nature of both vaccine supply chains and the pandemic itself. Given the worrying developments that we have seen in this area, what research has been done and consideration given to the possibility of mixing and matching second doses with a different vaccine—something which was talked about originally and might become necessary in the light of particular difficulties in supply chains?

[Lord Bethell (Con)]

My Lords, I completely agree with the noble Baroness that a descent into some type of vaccine war would be extremely regrettable, and the British Government are doing everything they can to continue in a spirit of partnership with overseas Governments. We have not reached the possibility of taking on a mixing and matching approach. We believe that the supply chain we have in place is ample to achieve the targets we have already published. However, to answer her question directly, there is some evidence that mixing and matching may prove to be even better than having two of the same vaccine—that it may stimulate the immune system in ways that give you a more developed response to the virus. Therefore, we continue to look carefully at this possibility.

Covid-19 Vaccines Deployment

Baroness Hayman Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid that is not the view of the scientists at the moment. I am extremely glad about all those who have had their first jab, but the very strong recommendation is that everyone has to abide by the lockdown rules at the moment. The transmissibility is still there: a person who has had the jab can still, and often may well, be infected by the disease, carry it and communicate it to someone who has not had the jab. They remain a danger to the community and, until a very large number of the population have had the jabs, those protocols will remain in place.

[Baroness Hayman (CB) [V]]

My Lords, I will first follow up on an earlier question. I am not sure that the Minister managed to reply on the issue of when and if we are expecting evidence on the interval levels between doses on the Pfizer, rather than the AstraZeneca, vaccine?

My main question is about how, given the impressive and successful vaccine programme, we have to recognise that it has mobilised enormous effort and resources. There is growing evidence that Covid will be with us long-term, so it is not a one-off exercise. Can the Minister share government thinking on the sustainability of the programme—for example, the potential for future programmes to be combined with the annual flu vaccination drive or for a single bivalent vaccine against both diseases?

[Lord Bethell (Con)]

My Lords, I reassure the noble Baroness that the interval protocols for the Pfizer vaccine have been completely endorsed by the JCVI, the CMO and the MHRA. They are extremely clearly endorsed by the British authorities, and she should feel enormous confidence in our approach to that.

However, the noble Baroness is right: I do not know, and cannot say for certain, what the long-term prognosis is. We do not know what the transmissibility of the disease will be with the current vaccine. We are working on new versions of it that should address the South African variant, but we do not know for sure whether that will prove dominant in the UK. It is the view of the CMO, Jon Van-Tam, that it will not beat either Covid classic or Covid Kent—but it is not certain whether that is the case right now.

We do not know whether there will be a rolling programme of mutations that roll on to the shore and require us to update the vaccine regularly—or whether we will have to hold our borders as they are now until we have the kind of vaccine development programme that can turn around refreshed vaccines within, say, 100 days. Those are all possibilities; we are putting in place the necessary plans in case that should be required, but it is my confident hope that the current vaccine will have a massive impact on Covid and that we can return to something that approaches normal in the very near future.

Vaccine Rollout

Baroness Hayman Excerpts

Monday 25th January 2021 Lords Chamber

[Lord Bethell (Con)]

It is not a question of one place taking precedence over another. I take a moment to applaud and pay tribute to GPs in Sheffield, and to all those who have proceeded at pace and got through their allocation as quickly as they could. That is absolutely the right priority and the right approach, and it is how we are going to get through the population very quickly. However, some people will get through their list more quickly than others, and it would be a mistake then to start asking them to move down the list when there are still those with very high priority who need to be vaccinated. Although I understand that it may be frustrating for a GP to stand idle, those are the practicalities of what we are doing. The mass vaccination centres are essential to deal with the very large numbers of people that we plan to vaccinate over the next few months. That is why the Sheffield vaccination centre is such good news.

[Baroness Hayman (CB) [V]]

My Lords, I support the Government’s utilitarian public health approach to the spacing of vaccine doses, but does the Minister accept that the argument is dependent on an understanding of the full implications of different dosage regimes, and that a lack of specific data on this particular point in relation to the Pfizer vaccine is fuelling concerns? Will the Government now undertake research on this specific point as part of a vaccine rollout programme, to underpin robust and well-supported policy implementation, both here and in many other countries that could benefit from this data?

Covid-19: Vaccine

Baroness Hayman Excerpts

Tuesday 12th January 2021 Lords Chamber

[Lord Bethell (Con)]

I congratulate my noble friend and Lady Eccles on their double vaccinations. It is one of the most heartening experiences of a pretty dreadful year to witness the rollout of this vaccination and the joy and reassurance it brings to those who have been vaccinated. I reassure my noble friend that the NHS is absolutely putting the resources in place not only to roll out the single and second vaccinations to everyone over 18 who will step up for those but also for the pharmacovigilance to ensure that any adverse effects are recorded through the Yellow Card scheme and that those records are analysed and acted upon so that any changes or tweaks, as sometimes happen, are enacted by the NHS to get the best possible outcome for as many people as possible.

[Baroness Hayman (CB) [V]]

My Lords, may I ask the Minister another question about evidence? When do the Government expect to have clear advice on the possible transmission risk from those who have been vaccinated? Everyone I know who has received the vaccine—they have been delighted to do so and impressed by the efficiency of the NHS—is now talking about meeting their Pfizered friends, seeing grandchildren and returning to volunteering or to your Lordships’ House. Does the Minister acknowledge that there will need to be cogent and clearly communicated advice for those who have been vaccinated, many of whom have been in virtual isolation for nearly a year?

[Lord Bethell (Con)]

The noble Baroness delivers tough news to her friends and to the Chamber, and I completely agree with her analysis. The frustrating truth is that, while the efficacy of the vaccine has been tested on hundreds of thousands in clinical trials, and we can lean on that data extremely well, the transmissibility of those who are immune is not yet clear. We have put in place trials and testing regimes to understand and get to the bottom of this point. But she is entirely right: it is possible, although not proven at the moment, that those who are themselves immune are not sterile but vectors of infection. Were they, for instance, to return to this Chamber, they would potentially infect those of us such as my noble friend Lord Parkinson, who is extremely young and does not qualify for the vaccine any time soon, and who could catch the virus off an octogenarian noble Lord in an instant.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020

Baroness Hayman Excerpts

Tuesday 1st December 2020 Lords Chamber

[Baroness Hayman (CB) [V]]

My Lords, first, I apologise to the Minister because IT problems meant that I could not hear some of his introductory speech. What I did hear, earlier this afternoon, was some of the debate in another place on these regulations. No one listening could be left in doubt about the divisiveness of the proposals before us today, especially in relation to boundaries for the new tiers. These have created a deep sense of injustice and division between regions, areas and communities within regions.

For a variety of understandable reasons, the Government abandoned the clarity and sense of the whole nation being subject to the same constraints that we have had since early November. However, they have patently failed to convince people that the variants in restrictions are properly tailored and appropriate to the situations in the communities in which they live and with which they identify. A lack of respect for local leadership, knowledge and capacity has, I fear, been a recurring feature of the response to Covid, particularly in relation to test, trace and isolate. We must not make the same mistakes when it comes to the rollout of vaccinations.

When the tiers are reviewed on 16 December, I would urge a review of the basis of the boundaries so that they are seen to be more justifiable and fairer, which would engender better compliance. Data is available at the district and borough level on incidents, hospital admissions and all the issues that the Government say they will take into account. This data should be used to produce boundaries based much more on social geography and local conditions than on administrative areas. I recognise that, even if there is greater granularity and that reduces the sense of injustice, it will not eliminate it. The Government need fundamentally to improve the information and communication that they present.

For example, as others have said, the impact statement for today’s debate hardly engenders confidence in the very difficult, nuanced judgments the Minister and his colleagues are making, although I have huge sympathy for them. They can afford to be honest with the population. At the beginning of this pandemic, maybe there were many people who thought there would be an answer—that if they followed “The Science”, we would know what to do. We know that is not the case. We know that we must weigh up a number of factors and balance a number of different harms to try to find the least bad solutions to working our way through this. It is a complex and contested field, and the public are grown up enough to understand that.

I urge that in assessing what boundaries we use and the immediate effects on health—the dangers of Covid and how we protect people from it, as against the longer-term and indirect effects on health and well-being from unemployment and lack of access to normal health services—we respect individuals in our society enough to be frank about how those judgments are made and assessed.

Before I finish, I will say two things. First, most people want to do the right thing; they want to protect themselves and those they love. The Government need to help us do that. They need to empower us with access to testing, by ensuring that the test, trace and isolate systems are effective and working, and by making sure that people do not suffer from being good citizens and obeying what they are asked to do if they have been in contact with others.

Lastly, I was struck by what Dame Sally Davies said yesterday. We ask ourselves all the time why we have seen so many deaths and so much difficulty in coping with this as a country. She pinpointed the underlying public health issues this country faces: deprivation, obesity, dependence on alcohol and the issues that lead to social disadvantage and all that bundle of disadvantages that create ill health and vulnerability. When we review what has happened, I hope we will recognise social injustice as an underlying cause. [Inaudible.] This is not just about PPE but about reversing some of the social injustices in our society.

[Baroness Penn (Con)]

My Lords, now is a good moment to remind speakers of the time limit for this debate, which is six minutes for Back-Bench contributions.