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Toby Harris on ensuring the UK is better prepared for the consequences of an increasingly volatile and unstable world

Many of us will – to our cost – have realised that putting a task on your ‘TO DO’ list is not the same as actually getting it done. We will also have sat in meetings where the risk register is the final item on the agenda, rushed through in the last few minutes as people are packing up their papers and getting ready to leave.  Indeed, it sometimes feels that organisations think they have dealt with a potential problem through the act of putting it on their register. But surely a government wouldn’t behave like that?

The latest version of the UK’s National Risk Register was quietly published on 18 December, on the UK equivalent of “Take Out the Trash Day”, as Parliament rose for the Christmas Recess.

To be fair, the 2020 Register is more substantive than its predecessors. 140 pages summarise 38 major risks facing the country, with a ranking by both impact and likelihood.  These range from pandemics (inevitably), cyber-attacks, flooding, widespread power failures, terrorist incidents, and widespread public disorder. The Register identifies some things the public should do to prepare, such as signing up for first aid training and keeping basic supplies at home. And against each of the major risk categories there is a list of initiatives being taken or planned to mitigate the consequences of what might happen.

I chair the newly established National Preparedness Commission which brings together the government with representatives of UK business, academia, and civil society; and aims to promote better preparedness for a major crisis or incident. 

In November, at our first meeting, we were warned that the world is increasingly volatile and unstable. A series of global trends are likely to impact directly or indirectly on the UK in the coming years: climate change, increased competition for natural resources and supply insecurities, and a changing world order. At home, meanwhile, we face the vulnerability of our ageing critical infrastructure plus a reliance on ever more complex and interconnected systems that are susceptible to cascading failures.

The published Register focuses on what could happen in the next few years. Inevitably, perhaps, the risks that are still developing do not get the attention they might deserve – even where our effective management of such issues may require action now.

But is enough being done to deal with the risks that are considered?  Tomorrow in the House of Lords, I will be asking the government if it will report to Parliament each year on the state of our national preparedness for the top-tier risks in the national Register.

There will, of course, be some preparations that it would not be in the public interest to disclose. For example, we would not wish to tell a would-be terrorist what measures are being taken to thwart an attack that they might be planning. The Intelligence and Security Committee exists so that such matters can be disclosed and discussed.

Other information, however, can and should be in the public domain. Is the £5bn programme of spending on flood defences sufficient and proportionate to the risk of flooding? Is the civil nuclear sector’s regulatory framework enough to minimise the risk of a serious accident at a plant, and are the plans for responding to such an event adequate? And so on. 

An annual report would allow the relevant parliamentary committees to scrutinise the plans in detail, including calling for witnesses and evidence. Above all, it would raise the level of public awareness of the need for better preparedness, and that in turn may mean we are all better equipped to deal with crises – whatever they may be and whenever they arise.

Lord Toby Harris of Haringey is Chair of the National Preparedness Commission and a Labour Peer. He tweets @LordTobySays 

Published 2nd February 2021

Risking it

Toby Harris on ensuring the UK is better prepared for the consequences of an increasingly volatile and unstable world

Margaret Wheeler on the government’s continued dithering over proper funding for the social care sector

A three-hour debate in the House of Lords this week on the devastating impact of Covid-19 on adult social care, saw the government repeat its promise to publish a plan for the urgent reform of the sector.

On becoming Prime Minister 18 months ago, Boris Johnson pledged to “fix the crisis in social care once and for all with a clear plan that we have prepared to give every older person the dignity and security they deserve”. But the Minister replying to the debate showed there never was and still isn't a ‘clear plan’ – just a series of broken promises, a raft of excuses, and panicked, sticking plaster cash injections to prevent the system from collapse. So, this latest promise of a plan – sometime this year, apparently – is not much of a reassurance.

The hook for the debate was a report from the Lords’ Economic Affairs Committee – Social Care Funding: time to end a national scandal. Reflecting on the scale of funding needed to begin to address both current and unmet need, and future demand, the Committee’s recommendations include a call for local authority funding for social care to be restored to 2010 pre-austerity levels; the ending of councils’ dependence on locally raised finance; a new £7bn a year system to help those receiving free personal care more mobile and active in their communities; and a New Deal for the workforce involving major investment.

The additional funding called for by the Committee is based on research from the Health Foundation, the Kings Fund and ADASS, the association representing social care directors. Together, they suggest £1.5bn extra is needed this year to allow councils to maintain levels of service provision from five years ago, as well as a further £2.4bn to stop the funding gap from widening even further.

While welcoming periodic cash injections into social care, they are often announced during the depths of a crisis – arriving too late to make a real difference, and merely buying a few months more of shoring up already fragile services. Local authorities, meanwhile, are being asked to do the impossible.

As expected, this crucial point was studiously avoided by the Minister. Even though the report was “remarkable”, and the Committee had performed a “huge service”, it was obviously – in the government’s view – wrong.  Despite strong evidence presented to the contrary, the Minister insisted that councils’ Care Act responsibilities meant they were properly funded and able to meet all eligible current and unmet care needs. And able to negotiate a fair rate of pay for domiciliary and care home staff, and care staff.

Labour’s calls for reassurances that the domiciliary home care services – the front line of social care - will be urgently expanded to meet increased need arising from Covid-19 and unmet demand, went unanswered. So too was a call for a full breakdown of the social care services and activities suspended under the Coronavirus Act; along with questions on the financial unsustainability of the residential system, with local authorities unable to meet the real costs of care places.

The Government has said it is looking for consensus on a way forward for social care. Yet this already exists, and the Committee’s report is backed by stakeholders, those working in the community, and politicians on all sides and none. Indeed, at Parliament, the message is clear that the time for consultations and green paper promises is over. What we need now, and urgently so, is white paper solutions and actions followed by legislation to deal with what is clearly a national scandal.

Baroness Margaret Wheeler is Shadow Social Care Minister in the House of Lords 

Published 29th January 2021

More empty promises?

Margaret Wheeler on the government’s continued dithering over proper funding for the social care sector

Philip Hunt on the need to urgently improve the process for funding research into brain tumours

No one who was there could possibly forget the extraordinarily brave speech made in the House of Lords by Tessa Jowell a few months before her untimely death in 2018. A speech in which she movingly talked about her experience since developing a brain tumour.

Tessa warned that cancer is a tough challenge to all health systems, particularly to our cherished NHS. The UK has the worst survival rate in western Europe, partly because diagnosis is often too slow. Brain tumours grow very quickly, and they are incredibly hard to spot. She also told her fellow Peers that less than 2% of cancer research funding is spent on such tumours, and no new vital drugs have been developed in the past 50 years.

The Minister at the time, Lord O’Shaughnessy, was very sympathetic and acknowledged that we have lagged for a long time behind the best performing countries in Europe. Subsequently, the government announced, through the National Institute for Health Research (NIHR), an extra funding commitment of £20 million for brain tumour research over the following five years – doubling the total to £40 million.

The money was much needed. Brain tumours are indiscriminate and disproportionally affect younger members of society. There are no preventative steps to avoid a brain tumour diagnosis, and we remain largely in the dark about the causes. But sadly, by July 2020, only £5.7 million of the government’s promised extra money had been allocated.

This was not down to a paucity of research funding applications. In 2018/19, there were 27 submission (up from 17 the previous year), but a mere four were successful. The picture in 2019/20 was similar, with a further 27 submissions for only three receiving support.

The charity Brain Tumour Research alongside the Neuropathologist Dr Kathreena Kurian have made suggestions on how to best improve the application process to facilitate a greater strike rate; as well as more effective and helpful approach to rejected submissions.

In addition to the support offered by the NIHR, the UK government could also support discovery science through UK Research and Innovation (UKRI) and the Medical Research Council (MRC). Few organisations are willing to take on early stage, high-risk research, which is why Brain Tumour Research plays a critical role. Indeed, it reports that only 14% of UK spend is from the government, with the remaining 86% from the charity sector.

Somewhere between the NIHR and the UKRI / MRC lies a funding solution for brain tumour research. Responsibility, however, must not be shuffled around and passed on between these different agencies if we are to better help those living with a diagnosis.

In the Lords this week, I will urge ministers to knock heads together to ensure much more research into brain tumours gets underway.  We owe it to Tessa’s memory and the thousands of patients so grievously affected by this devastating disease.

Lord Philip Hunt of Kings Heath is a Labour Peer and former Health Minister. He tweets @LordPhilofBrum

Published 18th January 2021

Applied science

Philip Hunt on the need to urgently improve the process for funding research into brain tumours

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