NHS: Hospital Visiting

Lord Bethell Excerpts

Wednesday 15th September 2021 Lords Chamber

[Lord Farmer]

To ask Her Majesty’s Government what steps they are taking to ensure visiting arrangements in all NHS hospitals resume as soon as possible.

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

My Lords, we absolutely recognise the importance of people’s ability to visit their loved ones. Over the pandemic, NHS guidance advised all NHS hospitals to welcome visiting in a Covid-secure way. Now that we are not in a national lockdown, visiting arrangements are set out locally by NHS trusts and other NHS bodies. The health, safety and well-being of patients, staff and communities remains the priority, but careful visiting policies remain appropriate to ensure safe hospital visits.

[Lord Farmer (Con)]

My Lords, I thank the Minister for his Answer. Do the Government collect statistics on the number of in-patients whose mental well-being deteriorates during their stay in hospital? Also, what assessment, if any, has been made of the impact of visits on patients’ mental well-being and recovery?

[Lord Bethell (Con)]

My noble friend raises an important question. Mental well-being is affected by visiting. We know that particularly from social care, where this has been a particularly onerous problem for those in care and their loved ones. I am not aware of any statistics being assessed but I will look into it and write to him. He makes an extremely important point. We do, however, take statistics on nosocomial infection. I am afraid that is a massive issue, which we must balance at the same time.

[Lord Hunt of Kings Heath (Lab)]

My Lords, of course I understand the reason for very great care in relation to infection control in our hospitals, but it is notable that a press release by NHS England in July, at the time of the announcement of a reduction in restrictions by the Government, said that hospital visiting guidance is set to remain in place for all staff and visitors. The concern is that the health service will never change this guidance. Surely there should be some review of the general guidance, given what is happening in society as a whole and the autumn and winter plan that the Government announced yesterday.

[Lord Bethell (Con)]

My Lords, we brought in harsh guidance at the early stage of the pandemic. That was lifted quickly, for exactly the reasons the noble Lord gave, and we keep the current restrictions under review all the time. But it is up to local trusts to put the right infection control measures in place. Although we have some guidance in place, it encourages visiting, for the reasons the noble Lord points out, and we leave it to trusts to make the ultimate decisions.

[Lord Shinkwin (Con)]

My Lords, I will always remember how my spirits rose the moment my mother appeared at the entrance to the children’s ward when, as a child, I was confined to bed with yet another fracture. Given that the isolation of lockdown has highlighted the importance of human contact to good mental health, I ask my noble friend how the Government are advising hospital trusts on taking the mental health of visitors and those they are visiting into account.

[Lord Bethell (Con)]

What a touching piece of testimony from my noble friend. The feelings he had as a child are felt by a great number of people, not only those in hospital and social care but their loved ones. We are mindful of the impact of visiting on the mental health and the good feeling of those in hospital. Visiting was suspended on 4 April last year, but that suspension was lifted on 5 June. Since then, we have sought wherever possible to put careful visiting policies in place. In October last year, the number of visitors was limited to one family contact or somebody important to the patient; since then, we have made huge strides in trying to lift those restrictions wherever we can. It is left to trusts to implement exactly those restrictions that are suitable to maintain infection control in their area.

[Baroness Brinton (LD) [V]]

My Lords, in his Answer to the noble Lord, Lord Farmer, the Minister said it was vital to keep hospitals safe from Covid infections. There are now over 8,400 Covid patients in hospital with around 1,000 daily admissions and rising. SAGE is concerned that, in a month, there could be 8,000 patients a day. Paragraph 36 of yesterday’s autumn and winter plan says that the UK HSA is reviewing easing specific infection prevention and control and social distancing to better manage activity. Can the Minister give assurances that this will not happen while cases in hospital continue to increase at this rate?

[Lord Bethell (Con)]

We are trying to have visiting policies that are proportionate to the situation. To reassure the noble Baroness, as she probably knows, the number of visitors at the bedside is currently limited to one close family contact and somebody important to the patient. Those are the guidelines we have in place. As I said, we leave it to trusts to run their own infection control measures. She is entirely right that the potential for nosocomial infections within hospitals, which was such a serious feature of the pandemic last year, is one that we are extremely wary of and careful about.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

As a Christian minister who has visited the sick for over 50 years, I believe that a vital part of the healing process of any patient is not only the care given by medical professionals, but the individual’s peace of mind. That healing is greatly enhanced by the visit of a family friend or loved one. One of the tragedies of the Covid pandemic was that many had to die without the touch of a loved one’s hand or tender words of comfort and love, as they were about to pass away. Will the Minister do everything he can to change that situation?

[Lord Bethell (Con)]

My Lords, the noble Lord makes an incredibly powerful point. I agree with him. The point about visitors to the dying was one of the most poignant and hurtful aspects of the pandemic. The stories I have heard personally and in the Chamber on that point have been some of the most moving I have heard in the entire year. He is right that being ill is horrible; being ill and away from the people you love is doubly horrible. We are trying our hardest. Infections in hospitals cost a lot of lives last year. We are mindful of that damage. Another area where we are very mindful is maternity units, where to prevent post-birth depression it is really important that partners are there. We have put in allowances for all partners to be at scans and at the birth, but we are working to try to balance these two competing difficulties.

[Baroness Greengross (CB)]

My Lords, have the Government considered using vacant hospital land owned by the NHS or unused buildings near NHS hospitals for patient accommodation while rehabilitating, rather than having long stays in medical wards? Have the Government considered the benefits for patients and families? Visiting may be safer and more suitable in this type of accommodation compared with visiting medical wards.

[Lord Bethell (Con)]

The noble Baroness’s point is entirely right. The focus on hospitals puts huge pressure on hospital administrators to have safe, contagion-free environments. That makes visiting extremely difficult. That is why we are trying to move as much care and diagnostics as we can back into the community, where we have smaller hubs and visiting is much more accessible. Some of that can be done on vacant NHS land. There are also opportunities on the high street, which is not as occupied as it used to be, for those kinds of services. We have £3.3 billion available for discharge. If we have safe, quick discharge, that also achieves the same objective.

[Lord Flight (Con)]

My Lords, I question the wisdom of seeking to restore all visiting arrangements as soon as possible. For the time, surely visitor resource priority should go to those who are seriously ill, whether with Covid or other serious illness. Visiting should be limited, for the time being, both for the seriously ill and for limited slots of groups of limited size.

[Lord Bethell (Con)]

My Lords, it is a question of balance. We certainly have to be extremely careful about people visiting those with Covid because of the obvious contagiousness of that disease. As I said, the guidance is currently to limit the size of groups to one close family member, but we are mindful of the mental health impact of that, so trusts are trying to get the right balance between contagion control and the mental health implications of people being ill and alone in hospital.

[Baroness Thornton (Lab)]

It is very nice to see the Minister in his place; I wish him good luck right now. May I say how much we welcome the measures relating to visits in care home premises from 16 August? Welcoming anyone into care homes poses risks and it is important that those risks are managed and mitigated. In the face of the winter plans that have been announced, is there any expectation that there will be a review of these guidelines for care homes under plan A or plan B?

[Lord Bethell (Con)]

My Lords, I am pleased to say that 91% of care homes in England have been able to accommodate residents receiving visitors, compared to 40% in March. That is huge progress and answers a very large amount of concern that I have heard here in the Chamber. It is our objective not to change or review these measures. We want to try to keep care homes open to visiting in a safe way, as we do presently. If it becomes necessary, though, we will take the steps to protect life.