Covid-19: Self-Isolation

Baroness Wheatcroft Excerpts

Wednesday 10th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are extremely concerned about the mental health impacts of Covid on all those who are feeling the effects most harshly. A substantial amount of money has been invested by NIHR into the mental health effects of Covid, and it is up to the institute to find out the impacts to which my noble friend refers.

[Baroness Wheatcroft (CB) [V]]

My Lords, it is a legal requirement to self-isolate if you test positive or are told to self-isolate by NHS Test and Trace. However, Test and Trace counts as having been traced those who live with someone who tests positive. I believe that this is a dubious method of counting. Will the Minister tell the House whether those people who have not been contacted directly by Test and Trace can therefore be penalised if they fail to self-isolate?

[Lord Bethell (Con)]

The method of counting is done in the way that it is at the moment because we did try the way that the noble Baroness recommends and that led to all sorts of confusion. It led to people having dozens of SMSs and being called relentlessly by the same staff because other members of their household had been identified. It led to a very large number of complaints, including from noble Lords on the Opposition Benches who read to me at great length the complaints of their contacts. We rationalised the system along the lines we currently implement, and that has led to a much more effective system. The feedback from our questionnaires to households is entirely positive. Having isolated myself, with my considerable household of seven people, I can tell noble Lords that it is a huge relief that the account management system is now around households rather than individuals.

Health: Eating Disorders

Baroness Wheatcroft Excerpts

Tuesday 19th January 2021 Lords Chamber

[Baroness Wheatcroft (CB) [V]]

My Lords, parents of adult children suffering from the most extreme eating disorders say they are often desperate to help but powerless because of an insistence on patient confidentiality. The desire to give autonomy to patients too often extends to those whose sickness with eating disorders makes them unable to take sensible decisions for themselves. Will the Minister agree to examine the conflict between these two wishes and how it could be resolved?

[Lord Bethell (Con)]

My Lords, the noble Baroness alludes to a conflict for which there is no easy answer. I completely sympathise with any parent whose child is exhibiting eating disorder issues. It is the most awful and frustrating situation for any parent to see their child in a self-destructive loop for which there seems to be no intervention possible, but patient safety is patient safety, and this is the conundrum that faces any mental health situation. The Mental Health Act is undergoing review at the moment—I am grateful to Sir Simon Wessely for his report, which we debated yesterday—and these are exactly the kinds of issues that we are looking at. I express profound sympathy for all those who find themselves in this awful situation.

Mental Health Act Reform

Baroness Wheatcroft Excerpts

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I confess that the noble Baroness has me on the hop there, because I had not noticed that LGBT issues are not mentioned in Sir Simon’s report. I share the noble Baroness’s surprise about that. Let me return to the document and I will address her point in correspondence.

[Baroness Wheatcroft (CB) [V]]

My Lords, Sir Simon found excessive use of restrictive practices in mental health institutions. Many of us will be familiar with the appalling case of Bethany, the autistic teenager who spent three years in what can be described only as a cell, in an appallingly inhumane regime that kept her locked up in solitary confinement and with no physical contact with other people. Only when her father went to court did she escape, and she is now living happily in an open-plan institution. Can the Minister assure us that such treatment will never be condoned again? We cannot wait for legislation on this.

[Lord Bethell (Con)]

My Lords, I certainly do not condone that treatment in any circumstances, but I acknowledge the noble Baroness’s point: there have been some instances in the past—reasonably rare but consistent—where those with autism and learning difficulties have been subject to the most inappropriate regimes and where a completely different type of support, therapy and accommodation from the kind found in mental health institutions was needed. The campaign to which the noble Baroness alluded is entirely right and we are moving quickly to address those points.

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

Baroness Wheatcroft Excerpts

Thursday 7th January 2021 Lords Chamber

[Baroness Wheatcroft (CB) [V]]

My Lords, the rules are clear. Those who can work from home must do so. Businesses must do everything that they can to ensure that remote working is made possible. However, there is no doubt that some organisations still prefer to have their staff in the office where they can see them. Some estate agents, for instance, are keeping staff in the office when it is hard to see why that is necessary.

If the Government tell people that they should work from home but employers insist that they travel to the workplace, will they choose to obey the Government or risk disobeying their employer and losing their job? There are penalties for individuals who flout the rules, but can the Minister say what sanctions there are on an employer who puts their staff and the community at risk by insisting that they attend the office?

I echo the question of the noble Lord, Lord Berkeley of Knighton—[Inaudible.] Today, for instance, there are 13 Back-Benchers speaking in this debate from the Chamber, but parliamentary staff have done a remarkable job in ensuring that Peers can work from home. Of course, it is a privilege to debate from the Chamber, but is it essential that so many parliamentarians must work from Westminster?

Finally, on test and trace, could the Minister tell the House just how many people have been traced via the app, and what the average cost of each successful contact is? If he does not have the information to hand, perhaps he could write to me.

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

Baroness Wheatcroft Excerpts

Thursday 10th December 2020 Grand Committee

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

My Lords, I thank the noble Lord, Lord Bourne, who always makes very perceptive comments and asks piercing questions, and I thank the Minister for introducing these statutory instruments. I echo the feeling that he works very hard and now has an extra burden; I hope that his family will recover soon.

I understand why there is a need for private sector testing—the NHS simply cannot cope—but I have concerns about the risk that these instruments could enable widespread private sector testing. Too often during the course of this pandemic, we have seen the private sector as the first port of call, with massive contracts going, for example, to Serco and Deloitte. Deloitte, it should be remembered, was running the testing centre at Chessington World of Adventures. Perhaps it was in the spirit of adventure that it approached the task, but it came in for criticism after losing the test results of NHS staff.

I share concerns that the private sector will see this as a money-making opportunity and cut corners. Like the noble Lord, Lord Hunt, I wonder whether the UKAS has the scope to cope with policing the new burdens being placed on it. I echo the fears of the noble Baroness, Lady Altmann, that there will be scope for fraudsters to enter this market.

There was some consultation before these proposals were made, and we are told that the feedback was “largely” in favour. Can the Minister tell us the concerns of those who were not in favour and how they are being addressed? I think, for instance, that the BMA has grave concerns about this. While we are told that the list of gold-standard providers will be available on the government website, I wonder how the Government propose to make all those who want tests aware of this. Certainly, on my very brief attempt, I failed to find the information on the website.

Can the Minister address the issue of costs? Will there be an upper limit or will providers just be able to prey on those who are desperate for a test for various reasons?

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

The noble Baroness, Lady McIntosh, has withdrawn, so I call the next speaker, the noble Baroness, Lady Uddin.

Department of Health and Social Care: Unpaid Advisers

Baroness Wheatcroft Excerpts

Tuesday 17th November 2020 Lords Chamber

[Lord Bethell (Con)]

I always take the words and advice of former Attorney-General Dominic Grieve extremely seriously, and I value his opinion greatly.

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

My Lords, I understand why the Government need as much help as possible in securing PPE in a time of emergency, but I struggle to understand why there still seems to be such a demand for public relations help. We recently learned that Kate Bingham, who is in charge of the vaccine programme, spent £690,000 on external PR help. Is it not the case that the Department of Health and Social Care has extensive PR expertise on its team? Is the problem that this Government is still too involved in fighting an election campaign rather than fighting Covid?

[Lord Bethell (Con)]

It is a reasonable question and let me be clear. This year, we are seeing a massive change in the behaviours of our entire population—from the big macro challenges such as the rule of six, social distancing and adherence to infection control procedures, through to different uses of NHS and medtech. This morning, I spent my time looking at the marketing for “111 First”—the important new way of using 111 that will give people guidance on using the service before they get to A&E. This has been possible only because of the change in the use of medtech and the changing attitude to telephones and the internet brought about by the pandemic. The noble Baroness is right that there is a big focus on communications right now, but that is because things are changing so quickly and we need to get the message across to the population in clear, persuasive terms, to provide the guidance they need to protect and save themselves.

Covid-19

Baroness Wheatcroft Excerpts

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Lord that his friend’s notification came from a new feature of Apple phones called “Exposure Notifications Express”. This is something that we have worked hard to incorporate in the existing app. I slightly suspect that, if she has a new version of the NHS app, she will not receive these notifications any more. We are grateful to Apple for enabling its phones to work in developing countries, but there has been some turbulence with our own app, which we think we have resolved.

On quarantines, I say that, as a follower of these debates, the noble Lord will know that the CMO’s view is that testing on arrival will capture only 7% of infections, and it is very difficult to apply quarantines to get people to commit to staying longer. However, we are committed to running pilots to try to open the kinds of schemes that he describes, and I would be happy to report back on their development.

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

My Lords, at the beginning of this debate, the Minister gave a very spirited defence of the test and trace system. This morning, my daughter and her 15 month-old daughter were tested, and it was very efficiently done, but they were told that they should expect results in two to three days’ time. The Minister mentioned 24 hours; what timetable are the Government trying to operate on for test and trace because, clearly, if there are two days that are fallow, an awful lot of people risk being infected?

I will also address the issue of gyms. The noble Baroness, Lady Thornton, talked about the lack of clarity at the beginning of this debate. If people are to stick to the rules, they need clarity. I do not understand why gyms are open at all, quite honestly. It seems to me—as the Minister indicated—that they are potential hotbeds for coronavirus. However, we are told that discretion is given to local authorities to decide what they do and do not allow. I recall that Manchester was absolutely determined that it would like to stop alcohol sales at the same time that, if not sooner than, pubs were forced to close, but it was not given discretion over that. I would be grateful if the Minister could explain when local authorities do and do not have discretion.

I also wonder whether the Minister could tell the House the position on travel to work. Office workers are told to work from home if it is possible for them not to work from the office, but there does not seem to be a ruling that says, “Do not go to work in an office unless you absolutely have to”. What counts as essential? What instructions are the Government giving to civil servants about whether they should travel to work? We are told that gatherings that are “reasonably necessary” can take place in office environments with no limit on the numbers involved. In the circumstances, that seems crazy. If the Minister could clarify the position, I would be grateful.

[Lord Bethell (Con)]

I reassure the noble Baroness that 24 hours is our objective, and it is clear that a 24-hour target is right. Having swift turnaround is conducive to effectiveness, and that is what we are trying to do. There has been a very large increase in demand in the last 11 weeks, which has put pressure on our operations and pushed back some of our turnaround times. We are working extremely hard to address that; new capacity is coming on-stream all the time, and we are hopeful that that can be turned around very quickly.

The noble Baroness is entirely right to raise her point on clarity, which is very similar to those raised by others, including the right reverend Prelate. There is a really important balance that we have to get right here because to have communal buy-in to our measures, we need to somehow mobilise leaders that people trust, from their faith community, their local community or other leadership groups that they subscribe to.

However, to give people a role in the decision-making about what measures are to take place in one area or another, there will be an uneven application of regulations—what happens in one place will not be the same in another. We have made a commitment to a partnership between national and local government, and we are trying to manage that complex partnership at the moment. As noble Lords know from the discussions in the other place and our conversations with Manchester, this is an extremely bumpy affair and it does not always work out well.

However, we are committed to doing this precisely for the reasons the noble Baroness described: to have buy-in, we need to mobilise all the country and all the people who are respected by those who adhere to the rules. That is why we take the approach we do. It means that gyms will be open in Lancashire but not in Merseyside. It is argued that this is a complexity that the British public can handle. It also takes us into very public conversations about funding, the allocation of resources and the establishment of new testing facilities. We believe it is worth the administrative and political effort to try to do that. There are also delays to the implementation of some of the restrictions. The British public will form their own judgment on their politicians and whether that is worth their while. These are the prices and friction costs to the local/national partnership that we are committed to, which has been advocated on the Benches of this Chamber for many months.

Health Protection (Coronavirus, Restrictions) (North East of England) Regulations 2020

Baroness Wheatcroft Excerpts

Monday 12th October 2020 Lords Chamber

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

My Lords, I share the sentiments of the noble Lord, Lord Bourne, about the weight on the Minister’s shoulders, and I have every sympathy with him. However, I share the qualms of the noble Baroness, Lady Morrissey, that we might be pursuing the wrong course, inflicting untold damage on our country in misguided efforts to fight the virus. But having embarked on this course, the Government have done so in a manner that has just caused confusion, because they themselves act in a confused manner. It is no wonder that the country is bemused.

Others have stressed the unsatisfactory test and trace system. Back in May, when the system was launched, we were told that test and trace was going to be the way that we would solve this problem. It was crucial. We were going to have a world-beating system. When that did not appear to be the case, the Prime Minister stated on 22 September:

“Testing and tracing has very little or nothing to do with the spread or the transmission of the disease. The spread and the transmission of the disease is caused by contact between human beings and all the things that we are trying to minimise.”


He went on to say:

“Of course NHS Test and Trace is vital”.—[Official Report, Commons, 22/9/20; col. 822.]

Test and trace is vital, and simply changing the rhetoric does not mean that it is any less important than it was in May, when it was launched. We need to get it working properly, which certainly is not the case at the moment.

The lack of logic in what the Government do is what really leaves people puzzled and often failing to comply with the regulations. For instance, we know that we are about to hear some fairly drastic changes to the way in which the Covid regulations are working, with a three-tier system. But we first got wind of that three-tier system a week ago. Seven days is a long time in a fight against a virus. Why did we have to wait seven days listening to rumour and conjecture before this becomes operative? If it is important and it needs doing, why not have a sense of urgency and move fast?

The lack of logic is in every aspect. We have heard time after time in this Chamber how local authorities, which have to cope with the 10 pm curfew, would like to see a clamp-down on off-licence and supermarket sales of alcohol, instead of encouraging people to leave restaurants and pubs at 10 pm and simply go drinking in groups elsewhere. There is no logic in that. We need to start applying common sense.

Finally, how can we expect anybody to stick to regulations that simply resort to gobbledygook? In those that we are currently looking at, it states that

“food or drink sold by a hotel or other accommodation as part of room service is not to be treated as being sold for consumption on its premises.”

This is nonsense. How can we expect anybody to comply with such gobbledygook?

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020

Baroness Wheatcroft Excerpts

Monday 12th October 2020 Lords Chamber

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

My Lords, I spoke in the earlier statutory instrument debate so will keep my remarks brief on this one. The noble Lord, Lord Greaves, urged shopkeepers to refuse to serve customers who are not wearing masks, but I have every sympathy with those who serve in shops or work on public transport who see people not wearing masks but are highly reluctant to confront them. They face being told that the people concerned cannot wear a mask but have no evidence of that—they just do not want to wear masks.

The majority of people are playing by the rules, but not everybody. The Government’s advice is that:

“No person needs to seek advice or request a letter from a medical professional about their reason for not wearing a face covering.”


As long as that remains the case, it is difficult for anybody to challenge those who are not wearing face coverings. If the Government believe that it would help in reducing the rate of Covid if everybody who can do so wears a face covering, is it not worth considering making it obligatory—because we are in a time of emergency—so that those who do not want to wear a face covering cannot just decide that they will not?

Those who cannot wear face coverings surely should have no difficulty in getting a GP, or maybe even a pharmacist, to give them something indicating that they are exempt. Then people who are behind the counter, manning the turnstiles or driving a bus would feel confident in challenging those who simply were not wearing a face covering, and insisting that they complied with the rules or would not be served or carried on public transport, et cetera. I would be grateful to hear the thoughts of the Minister on that point.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020

Baroness Wheatcroft Excerpts

Tuesday 6th October 2020 Lords Chamber

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

My Lords, these regulations came into effect 28 minutes after they were laid. That is far from satisfactory. The Minister himself accepted that there were many inconsistencies in the regulations now. As others have pointed out, the lack of logic is what makes people so angry about the ever-changing rules with which they are expected to comply.

The noble Lord, Lord Lamont, raised many valid questions, including the contrasting rules between weddings and funerals. A friend of mine, a priest, is suggesting that there should not be any split families over Christmas: the host simply has to slaughter a turkey and stage a humanist funeral. Such jokes arise because the regulations do not make sense. I can see the point in limiting the mingling of households, but where is the sense in preventing grandparents, from one home, meeting with a second household of their son, his partner and their three children? Regulations need to make sense, but they also have to be based on a degree of humanity if people are to abide by them.

Many families are now facing problems with childcare. It is fine under the regulations for them to send their offspring to a nursery or to a registered childminder, but how much more sense might it make for those children—maybe from two different households—to go to the home of their grandparents to be looked after while their parents contribute to the economy? Would that not be a healthier solution? It would limit the mixing of households, but it is not allowed. We need some common sense.