Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2020
Baroness Wheatcroft Excerpts(3 years, 5 months ago)
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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The noble Baroness, Lady McIntosh, has withdrawn, so I call the next speaker, the noble Baroness, Lady Uddin.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(3 years, 5 months ago)
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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(3 years, 6 months ago)
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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(3 years, 7 months ago)
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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(3 years, 7 months ago)
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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(3 years, 7 months ago)
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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.
Hospitals and Nursing Homes: Do Not Resuscitate Notices
Baroness Wheatcroft Excerpts(3 years, 7 months ago)
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Baroness Wheatcroft (Non-Afl) [V]
My Lords, the Minister has already said that he quite understands that there will be people, particularly the elderly, who do not wish to be resuscitated. One easy way of ensuring that resuscitation does not happen is for people to have a living will. Will the Minister undertake to try to encourage GPs to ensure that all their patients understand this and that they have the potential to have a living will?
Lord Bethell (Con)
My Lords, the benefits of living wills are enormous, both for those entering the last stages of their life and their loved ones. It is something that we are keen to encourage. I do not know the precise arrangements for how GPs play a role in that, but I will be glad to write to the noble Baroness and explain what provisions are in place for encouraging the use of living wills.
Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020
Baroness Wheatcroft Excerpts(3 years, 7 months ago)
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Baroness Wheatcroft (Non-Afl) [V]
My Lords, as other noble Lords have indicated, to be debating the statutory instruments now puts us in an Alice in Wonderland situation. However, for those who have been subjected to the swathes of new regulations, it is the illogicality of the Government’s messaging—their policies and policy changes—which generates confusion. For instance, in areas where households are not allowed to mix, they are still able to go to the pub or a restaurant as long as they leave by 10 pm.
This morning, I listened to the Deputy Chief Medical Officer, Professor Van-Tam, who made it very clear that the hospitality industry did help fuel the spread of the disease. At the beginning of this debate, the noble Lord, Lord Blunkett, raised the question of whether Eat Out to Help Out had played a part in pushing up infection rates. Then there is the confusion over test and trace; not just the availability of the test—although that remains a huge issue—but the purpose. On Tuesday, in the other place, the Prime Minister said:
“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.”—[Official Report, Commons, 22/9/20; col. 822.]
If testing and tracing has very little or nothing to do with the spread or transmission of the disease, why are we putting such an effort and so much stress on it? I would much appreciate it if the Minister could explain that.
Finally, we are being told to work from home “if we can”. But what is the Government’s own interpretation of that? What are they saying to civil servants? Earlier this year, we demonstrated in this House that we could work remotely very effectively—certainly as effectively as we are doing now with the hybrid House. So, can the Minister explain why there are noble Lords who are in the Chamber today instead of working from home?
Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) Regulations 2020
Baroness Wheatcroft Excerpts(3 years, 7 months ago)
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Baroness Wheatcroft (Non-Afl) [V]
My Lords, I absolutely understand the need for stricter regulation in these badly hit areas, but as the noble Lord, Lord Hunt, has just pointed out, they do not appear to be working. That may be because of failings with test and trace—I am sure that the Minister will respond to that suggestion—but perhaps he will explain why it makes sense to keep the hospitality industry going during these tougher restrictions. I have looked at the instructions to those in that sector. They are told to take steps to ensure that people do not socialise outside of their households, either inside or outside their premises. I cannot see how they can do that and I would be grateful if he could explain.
Covid-19 Update
Baroness Wheatcroft Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
My Lords, I do not like telling anyone what to do. I do not like telling anyone that they should lock themselves up or stay away from the people they love—of course I do not—but in this epidemic we have learned that my health affects your health and your health affects my health. If you wander around catching the disease and giving it to other people, the impact on the whole of society is enormous. We all have to get used to this fundamental public health truism.
Baroness Wheatcroft (Non-Afl) [V]
My Lords, we know that Covid attacks the most vulnerable in society so, while I sympathise with the noble and gallant Lord, Lord Craig, I wonder whether the Minister sees merit in sending a clear message to those over 70 or with underlying conditions that they should consider isolating. This message would not be simply to protect them but to protect the NHS and allow the country to keep its schools and economy working.
Lord Bethell (Con)
My Lords, a clear message could not have been more emphatically sent to those over 70 about the dangers of this disease. The problem we have today is not one of irresponsible over-70s; it is a problem of prevalence among the young. We need to think thoroughly about how we address the issue of young people, who rarely get symptoms or even know they have the disease, transporting that disease in a dangerous way to those who are more vulnerable.