All 3 Baroness Barker contributions to the Coronavirus Act 2020

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Tue 24th Mar 2020
Coronavirus Bill
Lords Chamber

2nd reading (Hansard continued) & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords & 2nd reading (Hansard - continued)
Wed 25th Mar 2020
Coronavirus Bill
Lords Chamber

Committee stage:Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords & Committee stage
Wed 25th Mar 2020
Coronavirus Bill
Lords Chamber

3rd reading & 3rd reading (Hansard) & 3rd reading (Hansard) & 3rd reading (Hansard): House of Lords

Coronavirus Bill

Baroness Barker Excerpts
2nd reading & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords
Tuesday 24th March 2020

(4 years ago)

Lords Chamber
Read Full debate Coronavirus Act 2020 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 110-I Marshalled list for Committee - (24 Mar 2020)
Baroness Barker Portrait Baroness Barker (LD)
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My Lords, I, too, pay tribute not just to the staff of the NHS, who are doing a truly wonderful job, but to the army of cleaners, drivers and shop assistants who are playing an incredible role in the most difficult of circumstances.

I start by echoing what my noble friend Lord Newby —and, to a certain extent, the noble and learned Lord, Lord Falconer of Thoroton—said about the need for scrutiny and for this House in particular to scrutinise legislation. Speaker after speaker has said that at any other time, this legislation would simply not pass.

It is extremely important that when the Government have to take extreme measures—and they do—they do so in an open way and that there is detailed discussion involving people who themselves have the relevant experience and information, or who have access to outside expertise, as do we in this House. That way, we will go beyond the level of a television interview. We need to deal with matters in great detail and be part of the information and education programme that will be necessary throughout all this, to ensure public support for and recognition of the need for extreme legislation.

Secondly, we must recognise that the Bill comes before us at a moment when we do not have large-scale testing programmes or vaccination, and that that has a direct effect on everything in it. If we have both in a few months—as I very much hope we will—life will be very different, and it will be important then to revisit some of the assumptions built into the Bill.

I want to make a point that may seem obvious, but nobody has yet said it today. When we talk about the NHS and local government, we are talking about completely different systems. The NHS is a centralised system which is largely run on a not particularly democratic basis; it is run more on the basis of expertise. It is a command-and-control system that enjoys a political standing in this country which practically no other body does. Local government is different. It is based on an open democratic procedure, with elected officials, and it does not, by and large, enjoy the same standing. Therefore, local government is, quite naturally, often very defensive and cautious, and for good reason—it gets taken to town by the Daily Mail quite frequently. We are suddenly expecting those two systems to function together in the same way. I go back to the point that my noble friend Lord Scriven made earlier, which may seem terribly technical but is in fact very important. There needs to be a general power of direction for local government, so that it can take the decisions that will have a bearing on the health and social care outcomes of its local population.

It is really interesting to see what, even in an emergency situation, government considers to be important and not important. Three things in the Bill are problematic. The first is the removal of the duty on local authorities to provide adult social care. Everybody understands that local government will go through the most massive transformation; it will never be the same again. It will probably have to reorientate everything towards this for years to come, and certainly for a year. However, to remove that duty completely is wrong, because from it flows not just the way in which vulnerable people are dealt with now, during the emergency, but the recovery process for local services and so on. It would be preferable if local government retained its relevant social care duties, but that their application was amended so that it was required to implement them only so far as is reasonably practical. As the noble Baroness, Lady Verma, said, domiciliary care is under immense strain. If local authorities do not make those investments now because they think they will not have the money, the impact on the NHS in a few months’ time will be even greater.

When I talk to local government colleagues, as I am sure we all do, they say that one of the big issues worrying them is indemnity for volunteering. The Bill refers to volunteering for a local authority only in relation to health and social care. It may well be that, just to fulfil the health and social care duties, local authorities will have to rely on volunteers to do all manner of other things, such as carrying out some of their environmental responsibilities. They are really bothered, because local authorities have traditionally spent an awful lot of staff time doing DBS checks because of the nature of what they do. We need not only a fast-track system—for example, not allowing somebody who has ever been barred to be checked—but a much faster system. We should also have an indemnity for a local authority that has to reconfigure very quickly a number of its central functions.

The other point that it is important to make at this stage is that, more so than the NHS, local authorities have had whole ranks of staff taken out. They have a few central managers, and front-line staff. They do not have very much; in fact, unlike in the NHS, most of their services are not provided in-house, so they do not have the ability to command or summon up capacity in the same way the NHS does.

We are expecting that charities will step into that breach, but that sector, as people heard during the debate on the Question answered by the noble Baroness, Lady Barran, this afternoon, is on a cliff edge. Charities do not run with great margins or large amounts of reserves, and they cannot quickly scale up on nothing. You cannot have an entirely voluntary workforce; volunteers need to be managed, which is a skill in itself. Can the Minister talk about the need for there to be grant funds—some via the NHS, some via local authorities, and some direct to charities—in order to build up that capacity?

The Government have taken drastic action in respect of the Mental Health Act. Mental health tribunals are now to be a single judge on a phone—if we are talking in that way, we ought to require them at least to be videophones—and the three-month treatment rule will be changed. I, along with organisations like Mind and Rethink Mental Illness, accept that in a time of great stress on the NHS we cannot run the system as we do now. However, there are misgivings about people being sectioned under Sections 2 and 3 of the Mental Health Act. Having taken away some very fundamental safeguards with regard to people being deprived of liberty and incarcerated, will the Government reconsider the length of time before which somebody can have their case reviewed and make it much quicker, so that anybody who has been detained by one doctor instead of two will automatically go to the front of the queue for a swift review?

Having said that, one thing that has caused much remark in the social care sector is that there is no mention at all here of the mental capacity legislation. There are two problems with that. First, in emergency medicine there is still a requirement to establish that somebody has mental capacity and to ascertain their wishes. I understand that, at a time like this, an A&E department will not be able to go through such a comparatively bureaucratic process, and that it is possible to do a simplified version of that just for these purposes.

The other, bigger, problem is that we will have lots and lots of very vulnerable people in care homes without access to any sort of representation, or even assessment. So I say to the Minister, and this is a very difficult admission, that the Government may wish to take out some of the bureaucracy and form-filling that was in the Mental Capacity (Amendment) Act, which some of your Lordships worked on. We should be requiring people who run homes to enable relatives at the very least to have some kind of contact—remote contact, telephone contact, or something like that—if it is not possible to go in and visit. To ignore this completely sends out a really bad message to people.

I fully understand the Government seeing the need to free up medical resources by going down to only one doctor. I imagine that across the NHS people are looking at ways to free up time for medical staff, cut down visits and make sure that people are not going on public transport unnecessarily. As the Minister knows, I am concerned about women’s access to early medical abortions. We already have an agreement in England, Wales and Scotland that women can take at home the second of the two pills that they need, provided that they have ongoing support and access by phone to a medical practitioner. I ask the Minister to consider whether women can have a telemedecine interview with the staff of a clinic. They could then very quickly get the medicines that they need and take them safely at home. I am not asking for any other change to the grounds on which that might be done. It is simply an administrative procedure, but it would make an enormous difference to the ability of women, most of them young, to receive that healthcare.

On the next point, I declare an interest: my brother is shortly to retire as a police officer—this week, I think—having served in the Greater Manchester Police for over 30 years. All the provisions in the Bill are about health and social care workers, particularly health workers, returning. All the issues about their pensions apply to other people in public service. I rather suspect that there may come a time when we need police officers who are not long retired to come back, not least because they are first responders, they have some medical training, and all of that. I do not think anyone else has mentioned this issue. It is not a personal plea on behalf of my family in any way at all; it is a genuine point.

On the provisions to review this legislation, it seems wrong that the Government are going to say that the Bill cannot be amended in future. That is a mistake, a point that was made by David Davis in the Commons. As I said, the Bill has been made now on existing knowledge, but the position may well be very different in three or six months’ time. Inevitably, some of the proposals that the Government have put in the Bill will turn out to have been necessary, but some will not. It would be in the Government’s best interests to retain the flexibility for this Bill to be amended in the light of experience. I hope I have demonstrated, as other noble Lords have, that we say this in the spirit of seeking to be helpful to the Government, not to attack them or to try to achieve any kind of political advantage, and I hope the Minister and his colleagues will reconsider.

The Government have said that there are various powers in the Bill and they will be switched on and off as necessary. That is potentially very confusing. Have the Government thought about having a website, a place to which anyone who has to refer to the Bill can go, with a rolling update on which provisions of the Bill were active and which were not? I can see a number of people who will have to try to make this legislation work having problems doing so.

That said, sadly the Bill is very necessary. We will work hard, and although we will, I hope, be back here, we will work smart and in different ways to provide ongoing scrutiny and to help the Government, and indeed the country, to get through these extraordinarily difficult times.

Coronavirus Bill Debate

Full Debate: Read Full Debate
Department: Leader of the House

Coronavirus Bill

Baroness Barker Excerpts
Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Wednesday 25th March 2020

(4 years ago)

Lords Chamber
Read Full debate Coronavirus Act 2020 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 110-I Marshalled list for Committee - (24 Mar 2020)
Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle
- Hansard - - - Excerpts

My Lords, first, I want to follow up on a point I made yesterday and compliment the noble Lord, Lord Bethell, and through him the Government. I asked about MOTs; this morning, there was an announcement of a six-month extension, so thank you.

We have already heard some accounts of the terribly difficult situations that people around the country are in. I will begin with another, that of a woman in Lincolnshire with an autoimmune disease. Under the Government’s recommendations, for her health and well-being and to protect our NHS resources, she should remain at home and self-isolate for 12 weeks. However, she needs an abortion. She also has at home a two year-old with a heart condition—another reason why she should not leave the house—but she must leave the house and go to a clinic or approved place to take the first of the pills for an early medical abortion under our current law. I am sure that every Member of your Lordships’ House will agree that this is a terrible situation. It is also an utterly medically unnecessary situation.

Taking the pill at a clinic is not a medical necessity; the provision is in the 1967 Abortion Act—an Act that was passed 25 years before medical abortions were even introduced. In the next 13 weeks, based on the average figures, 44,000 women will have to travel to a clinic—to an approved place—to take that pill, which is utterly medically unnecessary. In countries such as the United States, Australia and Canada, it is possible for women to take both the pills necessary for an early medical abortion at home.

This amendment provides for—and I stress this—temporary modifications to the Abortion Act 1967. It provides for a woman to take both those pills at home, as happens in the countries I mentioned, and it removes the two-doctor rule whereby two doctors have to sign off on an abortion. Only a small number of doctors and health professionals provide these services. We have discussed time and again in your Lordships’ House just how much pressure our medical professionals and NHS services are under and how precious a resource those doctors are, most of whom do other services as well.

The amendment calls for allowing nurses and midwives, who are already professionally qualified and who do much of the work now, to certify these abortions to allow them to go ahead. One nurse, midwife or doctor would then report back to the Chief Medical Officer as usual. There are some points to stress about the general provisions of the Bill that perhaps we have not talked about very much. The Bill, and this amendment, would give the Government the power to switch provisions on and off as they wish. They can also do so regionally—again, we have not talked about this very much—or the nations can do so according to the needs of place and time. If, for example, there was a real problem with provision in the south-west, the Government could take a small-scale decision for a particular place and time to make sure that abortions are available for the people who need them.

The argument for having this provision—as with many such provisions—is that it is about protecting everybody. If 44,000 women have to make extra journeys, it means more chances for the coronavirus to spread. We would be playing into the virus’s hands. We have all heard, seen and have been using the slogan “Stay at home. Save lives”; this provision allows that to happen. We would be protecting our precious medical professionals. The people who are increasingly operating remotely need to be able to operate through telemedicine remotely. We would be protecting NHS resources, which we know there is already enormous pressure on. If people are not able to secure an early medical abortion, they will seek surgical abortions, which will put much more pressure—absolutely unnecessary pressure—on the NHS.

I ask the Minister to accept and incorporate this amendment into the Bill. Doing that will not force the Government to do anything; it simply creates the possibility for the Government to act. As the noble Lord, Lord Adonis, who is not in his place, said, we will not be here for a very long time to make other legal changes. We would expect that to be the time of maximum pressure from the virus, so please can this temporary change be put in place to deal with this crisis?

Baroness Barker Portrait Baroness Barker (LD)
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My Lords, I have attached my name to this amendment, which has support on Benches across the House. In moving this amendment, the noble Baroness described exactly what this is: a power that the Government could and should take unto themselves in order to use it if necessary. Why do we think it might be necessary? “We” includes the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Faculty of Sexual and Reproductive Healthcare—all the providers and people within the health service who know this piece of work better than anybody else. Why do we need it? As of this morning, 25% of BPAS clinics are closed because they do not have the staff to open. That means things are becoming much more difficult for women. Yesterday, women in York needed to travel two miles to secure an earlier medical abortion. As of today, they will have to travel 40 miles.

--- Later in debate ---
Baroness Barker Portrait Baroness Barker
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Can the Minister concede that we are tabling this amendment because of how the NHS and medical services are affected by the Bill. We are not asking for any change in the criteria for abortion. We are asking simply for the process of the administration of decision-making to change.

That is being done right across the whole of the health service. The Minister has explained that telemedicine is being rolled out at a surprising rate. I do not understand why an experienced clinician or a midwife cannot make the judgments that he was talking about via video. They see women all the time and they will be able to make the same judgments. I do not understand that. If the Government do not accept this proposal, I ask him to accept that they should at least be under an obligation to continue to meet very regularly with the Royal Colleges and the organisations involved in this situation day to day, and they should be willing to come back with the power to make this change under a separate piece of legislation—because if, in seven weeks’ time, there is a clear pattern of women being failed, we cannot let it continue.

Lord Bethell Portrait Lord Bethell
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I completely recognise that the noble Baroness’s intentions are totally and 100% benign. She has the interests of the women concerned at heart. That intention is completely clear to me and I utterly endorse it. Where there is a difference of opinion and where we have taken a huge amount of advice—we have worked with the scientific advice in the department —is in the fact that the changes being offered are a fundamental change to the way abortions are regulated and administered in this country. Those regulations and administration arrangements have been worked on for years and are subject to an enormous amount of consensus. Her point on monitoring the situation is exactly the one that the noble Baroness, Lady Watkins, made earlier. I commit the department to monitoring it. We will remain engaged with the Royal College of Obstetricians and Gynaecologists and other stakeholders. She is absolutely right that we can return to the subject with two-monthly reporting back, and it can be discussed in Parliament in the debates planned on a six-monthly basis.

Coronavirus Bill

Baroness Barker Excerpts
3rd reading & 3rd reading (Hansard) & 3rd reading (Hansard): House of Lords
Wednesday 25th March 2020

(4 years ago)

Lords Chamber
Read Full debate Coronavirus Act 2020 Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 110-I Marshalled list for Committee - (24 Mar 2020)
Baroness Thornton Portrait Baroness Thornton (Lab)
- Hansard - - - Excerpts

My Lords, on behalf of these Benches, I thank the Minister for the way he has conducted the Bill. It has been a perfect exercise in consultation and work across the House. I thank not just the parties but other noble Lords who have taken part in this Bill for co-operating and working together in a way that has allowed us to scrutinise it as best we possibly could. I think we raised every issue that we could during its passage. It is important to have those things on the record because, as we move forward, we will need to know that we have asked those questions, and the Government will need to address them.

I thank my team, particularly my noble and learned friend Lord Falconer, who got drawn into this about a week ago, and my noble friend Lady Wheeler. I also thank the people in the office, who of course do all the work. In our case, that is Rhian Copple, who has done a brilliant job in keeping us informed and on the go.

I thank all my noble friends and noble Lords who are not here, but who gave us their views and have been patient. I know that they would have wanted to be here.

Baroness Barker Portrait Baroness Barker (LD)
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My Lords, from these Benches I too thank the Minister, the Bill team and all the civil servants who have worked with them for the collaborative and inclusive way that they have conducted the Bill through this House. I thank Members on other Benches for their immense understanding and patience as at times we have had to rattle through some very difficult issues that normally, in other circumstances, we would not have dealt with in that way.