Glenys Thornton speech to House of Lords, 24th March 2020
My Lords, what a strange and frightening time we are living in. Can I congratulate Noble Lords on their speeches and questions today.
As always, our thoughts are with those who have lost loved ones to this virus. And also, all of us would praise again the extraordinary efforts of our NHS staff and other dedicated public servants, and indeed shopworkers and farmers included.
We are forever in their debt. My nephew Oliver Carr is a newly qualified doctor at the Royal Free, here in London. I can’t say how proud we are of him, but we are also concerned for his safety – like thousands of families every where whose loved ones work in our NHS.
Today we are being asked to make decisions of a magnitude we would never have dreamt of only weeks ago. None of us came here to put powers onto statute that curtail so many basic freedoms our forebears fought so hard for and that we take for granted.
As my hon Friend Jonathan Ashworth said yesterday: “this virus spreads rapidly, exploits ambivalence and thrives on inequality.”
The statement last night from the PM that social isolation and distancing must be enforced is welcome –and is necessary because too many were not following the advice.
We have all seen the pictures this weekend of bustling markets, packed tube trains and packed beaches and parks – with incredulity and horror. So, I’m afraid the public health message was not heard loud and clear – we now have to see if will.
Everyone who can should be at home, everyone who can must work from home. That includes us my Lords.
There are 6 or 7 speakers today who should not be here with us. They are breaking the government guidelines and now instructions. They endanger themselves, which is really worrying. I know they do have a contribution to make but I do not think this reflects well on this House after the magnificent example set by Lord Speaker himself. Hundreds of our colleagues are not here have been sending messages and advice, for which I am sure we are all grateful.
I happen to think our Parliament must continue to sit as best we can and hold the government to account. Not least because this is almost inevitably a bill which will have its flaws, and which does not adequately cover some very serious areas which we have discussed today. Not least the homeless, the self-employed and renters.
So I feel, the emergency powers, whilst draconian are needed, but that does not mean government cannot be accountable on regular basis. And as the NL the Minister has said, powers should only be in the context of Coronavirus infection.
Turning to the health and social care workforce, we now know unambiguously that nobody can be unaware of the importance of care workers in our community as a result of this pandemic. Social care awareness is there and has to be accepted, and of course properly funded.
The next few months will present a significant level of challenge for the NHS and anyone working in caring professions. There will be increased numbers of people becoming ill and some of these people will require medical treatment in hospital.
The additional patient volumes will place enormous pressure on our health and social care system, in all sectors. There will be pressures from increased staff absence, if staff are unwell or self-isolating with their households. So testing, testing, testing is absolute vital, as is adequate PPE.
I want to just divert slightly from the health and social care workforce. If we’re putting on statute book, as we are, things that might mean you are breaking the law that may involve our police, then what protection are we giving them?
I just want to read out onto the record what a police officer has said in a message I have received:
“We need masks for every officer and prisoner. At least four washable masks for police officers. One to use, one to have in a bag for three days to decontaminate before washing, and two to change during shift. Shower facilities for police officers – there's not enough showers. Gloves!
“Where do we take prisoners who are symptomatic? Where do we take people in a domestic situation? What happens to child contact arrangement orders? Can a person on bail not sign for bail if self-isolating? What's the process for breach of bail?
“What about registered sex offenders? Do they have to tell us if they intend on being at a different address? They have to attend police stations and register where they are. What do they do if they are symptomatic away from home?”
And she goes on. Serving warrants. All the issues that our police have to face on a daily basis. This bill doesn’t address these issues but the government has to.
The Bill includes provisions for regulators to register suitable healthcare professionals, such as nurses, midwives or paramedics, as well as social workers, including those who have recently retired or are on career breaks.
To facilitate the return of skilled and experienced staff, rules that prevent retired NHS professionals from working more than 16 hours per week and effect their pension benefit entitlement we understand have been suspended. We must ensure that the wellbeing of these people is prioritised.
The government will also be registering final year year nursing and medical students who are near the end of their training. The students must be supported and supervised and be properly remunerated. And I absolute back what the NL the Baroness Watkins said about the debt that nurses are facing.
We recognise that it will also be appropriate and necessary for doctors, nurses and other registered health professionals to work outside of their usual scope of practice and specialisms, and that a far wider range of staff than usual will be involved in directly supporting Covid-19 patients with respiratory needs.
The Bill includes indemnity provisions for those undertaking these services.
It is vital that NHS staff working outside of their usual scope of practice are trained how to care for vulnerable patients. So, can the NL the Minister outline what training will be available and what it will entail? How many staff will need to be trained to use ventilators?
We also recognise that health staff will to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging but time-bound circumstances at the peak of an epidemic. Can the NL the Minister advise that guidance will be issued to assist clinical staff to make these calls, and assure the House that they will be kept in constant review?
Can I echo the words of the NL the Lord Adebowale of the importance of social enterprises and it’s based on the role that they have in the delivery of social care in this country. Can I ask the Minister to commit that he and his colleagues will meet with Social Enterprise UK and their colleagues to discuss this matter urgently?
The Bill also includes provisions for drafting in volunteers, but I think that we have to recognise that people with disabilities and chromic conditions often have some of the most complex care needs. It is very unlikely that volunteers will be able to provide the care need. We need reassurances that these people will continue to receive appropriate care from professionals.
The Bill will allow NHS providers to delay undertaking the assessment process for NHS continuing healthcare for individuals being discharged from hospital until after the outbreak has ended. We understand that this will allow hospitals to discharge all in-patients who are clinically fit to leave without delay. Sir Simon Stevens had advised that this could potentially free up to 15,000 acute beds.
However, My Lords, it is important that these measures are only be brought into operation for the shortest possible time at the peak of the outbreak. The increase the burden on social care services was already creaking before the pandemic and means that they will not be able to cope.
We are concerned that the sector will be unable to cope. This is understandably be a great worry for many existing service users, who will know just how dependent they are on social care on a daily basis, moving from client to client, providing the link to the outside work for people who dependent on them – particularly if they are without family and care support.
So can the NL the Minister assure us that, for example, the 15 minute visits will be extended to ensure the care worker can take the effective Covid-19 precautions, as well as being able to see to people’s needs, reassure them and address any problems? What guidance has been issued on this?
And finally, the risk to care and nursing homes with older people living in them cannot be overstated. There is a huge responsibility on managers and staff to keep the virus out. Does the NL the Minister anticipate that care workers may be required to self-isolate with residents in the event of a quarantine or lock-down?
If the pandemic takes hold in a single care home, that could take up most of the ICU beds in an area.
Turning to mental health and the powers to detain and treat patients who need urgent treatment under the Mental Health Act to be exercised using just one doctor’s opinion, rather than two. Can the NL the Minister clarify what the thresholds are for “impracticality” or “unhelpful delay”?
On the issue of the deprivation of liberty, pressure on care homes is already significant.
One of the side effects of this Bill is that it will possibly reduce terminations. And the government really need to address the issue of why two medical signatures will be required when there is such a shortage of medical staff.
All the evidence suggests that domestic violence may increase during this time. And children are particularly vulnerable. What is the government doing to recognise this issue? Are they improving funding for the sector and are they considering the most vulnerable – including ensuring new immediate funding as well as replacing income lost by refuges which have had to close?
On renters, it should go without saying that nobody should have to lose their home because of the virus and its impact. The government themselves have acknowledged that with their action on mortgage holidays and yet, they have failed to protect those in the rented sector.
Despite suggestions otherwise, this Bill fails to legislate for a ban on evictions. I hope the NL the Minister can confirm that the government intends to amend the Bill to this effect or introduce further primary legislation. There is an overwhelming case for action: 20 million people in England rent, 6 million of whom have no savings whatsoever. They are particularly vulnerable if they lose their job or have their hours cut, as a result of this virus.
Last week, Shelter estimated that 50,000 households could face eviction through the courts in the next six months – thereby creating another crisis.
We remain extremely concerned that the three-month pause on evictions will only defer the crisis to the end of the period where many landlords will demand the total rent arrears from tenants who may not have been paid for work during that period.
Turning to the homeless, I think the government needs to address specifically about people with No Recourse to Public Funds.
As NLs will know people experiencing homelessness, particularly those who are rough sleeping, are especially vulnerable in this outbreak. They are three times more likely to experience a chronic health condition including asthma and COPD. Many of the people we work with are unable to access healthcare or housing because of No Recourse to Public Funds (NRPF) and benefit restrictions.
This includes people who are appeals rights exhausted, EU and EEA migrants, people with existing visas, those whose status is not regularised, domestic workers and other migrant workers, and victims of trafficking and torture. It is critical that that is resolved.
Turning to income support, we need income protection for those in precarious employment. Apart from anything else, they can stop packing the Tubes. Many of those travelling at the moment are in very low paid jobs. Like other Noble Lords, we remain concerned that this Bill fails to give many people the financial support they need to get through this crisis. People should not be expected to make a choice between their health and hardship.
Several Noble Lords have correctly talked about support for the self-employed. And the government can also act now to assist millions of people by through the universal credit system by increasing it, suspending sanctions and scrapping the five-week wait for the first payment. We await urgently to hear what the Chancellor will announce.
I think the issue of food is actually very important. There is clearly stockpiling still taking place and people are not being reassured that there is enough food to go around, and the most vulnerable are losing out. I really think the government has to take this very seriously.
Now we understand that the military are being bought in to help with food chain logistics. Can the NL the Minister explain what their role would be? Additionally, in terms of our food supply, we have to get 80,000 seasonal workers needed to pick our fruit and vegetables this summer so need a trained and reliable workforce.
On disabled people, the government’s plans in this Bill will roll back 30 years of progress for Disabled people. Whilst we may tolerate this for a short amount of time, we cannot do so for very long. All of the years that we have fought for disabled peoples’ rights to social care are undermined by this.
I think food banks are suffering from shortages and would like to play tribute to some of our major retailers – The CoOp in particular – are ensuring deliveries are going through the Fair shares scheme.
I saw a message from a manager in Boots complimenting their staff on dealing with a level of abuse which is totally unacceptable – particularly when they run out of Calpol. This will be repeated in our shops and supermarkets, so I want to pay tribute to the staff and managers who have a very hard job, along with shop keepers and farmers.
In conclusion my Lords, as my NF said in his opening remarks on these benches, we will lend our support to the government and to put this legislation on the statute book without delay. But not without comment or scrutiny. This is just the beginning my Lords of the challenges and crisis facing our nation and our democracy.
Baroness Glenys Thornton is a Shadow Health Minister and responded to the debate