That the Bill be now read a second time.
Relevant document: 9th Report from the Delegated Powers Committee
My Lords, I bring this Bill to the House with a huge sense of regret about the challenge we are facing and foreboding about the cost to the country of this terrible virus.
The Bill contains key administrative measures that are absolutely essential in helping us to fight the pandemic. It is not everything that we are doing, but it is essential for what we are doing. I am deeply conscious that many Peers are not present for the debate, because they are, quite rightly, following the official medical advice on social distancing and isolation. We have sought to give this Bill a proper level of scrutiny during our extensive engagement. In my remarks, I intend to reflect on some of the concerns that absent noble Lords have raised with me in recent days.
Before getting into the detail of the Bill, let me start by taking a step back and saying a word about its purpose. Fundamentally, this Bill is about buying time. You might not think it from looking at those alarming graphs charting the growth of the disease, but time can help us. With each day that passes, the science gets better. Each day, the models are refined and improved as more data becomes available. Each day brings us closer to faster, more accurate testing capabilities and, ultimately, a vaccine. The infection rate is exponential, but so too is our scientific understanding.
Many commentators have been drawing comparisons between the current pandemic and the grave situation facing our country in 1940. There is value in that, but the historical parallel I would draw is that of the Great War. In 1914, the military planners relied on tactics and technology that would have been familiar to Napoleon. By 1918, the tactics developed would have been recognisable to a veteran of the Gulf War. The learning curve was exponential. I believe it will be the same with this pandemic.
Think how little we knew about coronavirus back in December. The genome had not been sequenced, there was no serology test to tell you if you had already been infected, and we did not even know whether there was human-to-human transmission. Imagine what we will know in six months’ time, once the world’s most advanced economies, including our own, have applied their best minds to solving this problem.
I am an optimist. I am hopeful about our ingenuity and the progress we can make in fighting this virus. That is why time matters. Each day that we can slow the rate of transmission is a small victory that will lead to the ultimate defeat of the virus. We need to buy time for the NHS, flattening the infection curve and raising the capacity line, moving the peak away from the most dangerous winter months. We need to buy time for our society too, saving as many lives as possible and keeping essential public services running as we weather the storm. That is our plan and that is what this Bill contributes to.
There are five main parts to the Bill, and I will take each in turn. The first part is about increasing the available health and social care workforce, shoring up the system as far as possible as it comes under pressure. It allows for the temporary registration of NHS staff and social care workers, for instance those who may have recently retired. It allows recently retired staff to return to the NHS and social care without a negative impact on their pensions. It provides additional indemnity cover, if necessary, to key workers who are called upon to undertake additional duties as part of the response, and it protects the income and employment rights of our dedicated army of NHS volunteers. I know that everyone wishes to thank each and every one of those NHS and social care workers, who are going above and beyond on behalf of the country. We can thank them with deeds as well as words: not buying more than we need, not taking public transport if it is not essential, staying at home to protect the NHS.
The second part of the Bill concerns measures to keep essential services running while easing the burden on front-line staff. This includes introducing flexibility into education legislation, such as temporarily allowing for larger class sizes once schools reopen. It includes expanding the circumstances in which audio and video can be used in the court system. It allows the Home Secretary to suspend airport and port operations if the level of Border Force staff falls below a safe level. To ensure that the Treasury can transact its business at all times, it allows a single Minister or commissioner to sign or act on behalf of the others.
The Bill also ensures that our national security investigatory powers regime remains fully operational during the course of the epidemic, allowing for the temporary appointment of additional judicial commissioners who can sign off vital investigation warrants for our police and security services. Such appointments will be made only at the request of the Investigatory Powers Commissioner. It also allows the Home Secretary to extend the lifespan of a warrant from five to 12 days. Again, this power would be activated only at the request of the Investigatory Powers Commissioner.
Because of the unprecedented pressure on front-line staff, there are some areas where we will have to temporarily relax strict legal requirements for the duration of the emergency. We do not take these measures lightly; they will be triggered only in order to keep people safe and on the basis of expert clinical advice, and they will be relinquished as soon as the danger period has passed. The Bill will allow mental health professionals to secure the advice of one doctor, instead of the usual two, when applying to detain a person with a mental health disorder for the protection of themselves or others. These clauses also allow for flexibilities in the time limits governing the short-term detention of mental health patients. These emergency powers would be activated only in circumstances where there were so few mental health staff available that having to wait for a second doctor would endanger patient safety. Even when enacted, the powers would be used only at the discretion of local mental health trusts, and they would be switched off by government as soon as reasonably possible.
NHS England and NHS Improvement are currently preparing detailed guidance setting out the exact circumstances in which such powers would be used. During the peak period, we also need to ensure that patients are rapidly discharged from hospital when they are medically fit to be. The Bill supports this by allowing the NHS and local authorities to delay continuing healthcare assessments, which can take weeks, until after the pandemic. People who need this support will still receive NHS funding in the interim, but it will mean that local authorities might not meet all the individual’s assessed care needs in full. Instead, under powers in this Bill, local authorities will be required to prioritise people’s most urgent and serious needs and keeping people safe.
Local authorities will still be expected to do as much as they can to meet everybody’s needs during this period, and this will be underpinned by a duty for them to meet needs where not doing so would breach an individual’s human rights. Again, these powers would be triggered only in circumstances in which staff shortages meant not prioritising was putting vulnerable people in danger and they can be switched off while still in the emergency period if circumstances allow. In any event, they would last only for the duration of the emergency.
The third part of the Bill contains measures for delaying transmission of the virus. It gives us the power to restrict or prohibit events and public gatherings and, where necessary, to shut down premises. I know that this will not be easy, particularly for our world-leading creative industries. Yet I have no doubt that the months and years after the pandemic will be a time of extraordinary cultural flourishing for our nation. Consider that William Shakespeare wrote “King Lear”, “Macbeth” and “Antony and Cleopatra” while London theatres were shut down because of plague in 1606. This part of the Bill also allows us to close down educational settings or childcare providers and gives us the power to postpone elections due to take place this year in England until May 2021.
To ensure enforcement of the public health advice, this part of the Bill strengthens the isolation powers of the police and immigration officials, allowing them to detain those at risk of spreading the virus for screening or assessment and to isolate people if necessary. The police or immigration officials would use these powers only in cases in which they had reasonable grounds for thinking that an individual was at risk of spreading the virus, such as due to their travel history or symptoms. It goes without saying that the powers will last only for the duration of the public health emergency. I sincerely hope that they will not have to be widely used because everybody will follow the public health advice, if not to protect themselves, to protect others and the NHS.
The fourth part of the Bill is about managing the deceased. These are not pleasant matters to think about but, as the Health Secretary has said throughout this crisis, we must plan for the worst and work for the best. It expands the list of people who can register a death to include funeral directors. It means that coroners have to be notified only when there is no medical professional available to sign a death certificate. It allows death certificates to be emailed instead of physically presented and removes the need for a second confirmatory medical certificate in order for a cremation to take place.
All of this is designed to ensure that the deceased can be treated with dignity and respect at a time when bereaved families may be self-isolating and many of the professionals who would normally be involved in the process may be unwell. In extreme circumstances, if the level of mortality were to overwhelm the capacity of local funeral services, the Bill contains powers that would allow local authorities to take control of parts of the process. This could include operating crematoria for longer than usual or drafting in parts of the wider public sector to assist. It would be triggered only if there were a risk to public health from not acting.
The fifth part of the Bill contains measures to support people to get through this crisis. It will ensure that statutory sick pay is paid from day one, applying retrospectively from 13 March. It enables small businesses with fewer than 250 employees to get a full refund for sick pay relating to coronavirus during the course of the emergency. It requires industry to provide information about food supplies should it fail to do so voluntarily.
Lastly, the Bill contains clauses that will make it easier to make changes to national insurance contributions, giving us the freedom and the tools to respond to a changing situation if necessary.
This is a Bill for the whole country, jointly agreed by all four Governments of the UK. We understand that it significantly increases government power in some areas, while temporarily scaling back some areas of government responsibility. This is why the Bill has been constructed in a way which means that the different measures can be switched on and off as the clinical situation requires. We have tabled an amendment to give this House an opportunity every six months to confirm that these powers are still required. This gives us the flexibility to respond to the course of the disease. The Bill also requires Ministers to update Parliament regularly on how these powers have been used across the UK. Finally, the Bill will expire after two years unless Parliament decides to extend it.
This is an extraordinary Bill for an extraordinary moment in the history of our country. It gives us the legislative and regulatory toolkit that we need to respond to a constantly evolving situation. It balances public safety with democratic accountability. In a situation where time is the most precious commodity, it gives us more time. I beg to move.
My Lords, I thank the Minister for his clear description of the Bill and the openness with which he has treated our team engaged in it; personal trust is very important in these matters. I declare an interest: my youngest son is a doctor in an NHS hospital in London, which is now almost exclusively devoted to treating those with Covid-19.
Her Majesty’s loyal Opposition support this Bill. In normal times, it would be utterly unacceptable, but these are not normal times. As long as the emergency lasts and these powers are necessary, they should be available to the Government. We also support the instructions, to be backed subsequently by legal enforcement powers, that the Prime Minister announced last night. Inevitably, more detail is needed about the measures announced by the Prime Minister, but there is no doubt that there needs to be immediate compliance by the public with the “stay at home” message. Legitimate issues about the limits do not detract from the Government’s message to the country: stay at home unless you have a very good reason for leaving. Can the Minister provide details of the legal powers that will be introduced to back up the Prime Minister’s message last night? When will they be introduced and what is the basis for them?
Again, we in the Opposition will assist as necessary in ensuring that effect can be given to the Prime Minister’s statement. The Bill before us today can be improved to make it more effective in fighting the virus, to give more support to those on the front line in the struggle and to provide better economic security for the public. We recognise that full scrutiny cannot be given to the Bill—the needs are too urgent and the time too short. We will focus on the key issues and table only a small number of amendments in Committee tomorrow. In these circumstances, the right course for the Opposition is to assist in getting the Bill on to the statute book with focused amendments on the key issues, but also to ensure that each power lasts only as long as is necessary to fight the virus and that there are regular time-restricted limits on its continuation. If it needs to continue beyond the sunset clause, the time before sunset should be taken to improve it, as, inevitably, time will reveal it can be improved.
Parliament has a critical role in the weeks and months to come in legislating, scrutinising the Government and providing national leadership. It cannot function as normal: we cannot meet like this, debate like this and do our job like this as the crisis develops. We need urgently to work out remote and different ways of doing our job—but our job is to hold the Government to account, to provide national leadership and to legislate when the country needs it. The country will need more scrutiny, more leadership and more legislation than it has at the moment. In this national effort, we need to ensure that the Government are moving fast enough and clearly enough, and that they are giving the right leadership. We will press hard to achieve that. There need to be clear messages to be public and they need to be well publicised. The Government need to recognise that doing their best to alleviate the most acute economic anxieties for the employed, the self-employed and those in the gig economy alike is vital to deliver compliance with those messages. We will press hard to ensure that proper security is given and that the Government move as fast as they should.
We are very conscious that part of what the Government must do is to ensure that the public comply with their instructions to stop the virus spreading. We in opposition must take especial care not to undermine the chances of those instructions being acted upon. We are under no illusions that an epic struggle is currently being waged on all our behalf by the NHS. Hospitals up and down the country have been reconfigured incredibly fast to fight the Covid-19 virus. Large teaching hospitals have devoted whole floors to the disease. Smaller district hospitals have effectively reduced their non-Covid-19 workload as much as possible to accommodate the cases and become largely Covid-19 hospitals. Medical staff have had in many cases to reskill from their normal specialties. They are seeing a frightening influx of patients with the disease that is growing every day. The risk to medical staff is significant. If the patients are hospitalised, they will have a serious illness with Covid-19, and those patients deteriorate often very rapidly and are then required to be moved to ITU and ventilation. The demands on the NHS staff are immense; the pressure is huge.
To ensure that staff have access to all the personal protective equipment they need, make sure that they are all trained in the use of PPE, and to start to test all NHS staff to see whether they have or have had the virus when the antibody testing becomes available are critical measures. It has taken too long to sort out the PPE issues, and the testing of NHS staff has not started. Can the Minister give us an update on the testing capacity and how it is to be rolled out?
The debt of gratitude we owe as a country to the NHS staff engaged in this struggle is incalculable. When the history of this appalling period comes to be written, they will be the true heroes. The rest of us— parliamentarians, Ministers and members of the public—must not let them down. The risk by now is very well known that the NHS will be overwhelmed by the number of cases. There will not be the staff, critical care beds or ventilators to deal with the pandemic. We must do everything to ensure that that does not happen.
I also recognise and pay tribute to the work being done in central government to craft our response to this crisis. The pressure on them is immense. We have an excellent Civil Service, which has worked on as the illness has reduced its number. This is a collective battle; we fight as one nation. The co-operation with the devolved Administrations has been close and effective. I pay tribute to them for the incredibly impressive work they have done.
The noble Lord, Lord Bethell, told us yesterday that there are currently 3,700 critical care beds and that the total usage was currently 2,428, of which 237 are Covid-19 related. He told us that the Government’s ambition is
“to increase this dramatically to perhaps 30,000 in time for the crisis arriving in full.”—[Official Report, 23/3/20; col. 1634.]
Will he update the House as to the number of critical care beds currently available, what the total usage is, how many are being used for Covid-19—that is, the increase from yesterday—and the dates on which the increase of 25,000-plus are expected to come on stream?
On the detail of the Bill, my noble friend Lady Thornton will deal in her speech with issues relating to the health and social care workforce, the reduction of administrative burdens, and financial support. There are education issues, which my noble friend Lord Watson will deal with. I will deal with the other issues.
First, on the sunset clause, there is understandably huge pressure to get the Bill into law so that the Government have the necessary powers to tackle the coronavirus pandemic. Given these circumstances, a sunset clause is necessary and vital, and a prudent mechanism. The position is that there is now a two-year sunset clause, but a power in the Commons to stop the continuation of the Bill after six months, 12 months, 18 months and two years.
Moreover, there is provision for a debate in both Houses and the power to stop after 12 months. That power, the six-month power, is an all-or-nothing one. It is inevitable that some of these provisions will work while others will not. Can the Minister indicate why there is no power to stop some of these powers at six months, 12 months and 18 months as we learn more about how they are working? Will the Government consider whether they would introduce such a power?
I move from the sunset clause to the provisions for containing and delaying the spread of the virus—social distancing. The Bill sets out provisions to restrict potentially infectious people from being in contact with each other as well as a power to restrict or prevent them from moving around, or to detain them. It also contains powers to prevent events and gatherings, to close premises and to restrict port activities. It does not contain powers to stop people going to work or to stay in their homes, which were the key measures announced yesterday. We would be willing to assist in incorporating those powers. Can the Government tell us what their intentions are?
On immigration, can the Minister indicate what the Government are doing to maintain the health and safety of people currently detained in immigration detention centres? Can he also confirm that people will not be held in detention centres if they cannot be removed due to airport closures and travel restrictions related to the coronavirus?
I turn to the courts. We broadly agree with the provisions related to increasing the circumstances in which video links can be used. Can the Minister give an assurance that they will be used only in the interests of vulnerable defendants and those who are digitally excluded? Will those who are unable to get legal advice be properly protected?
I would be grateful if the Minister would touch on the issue of prisons. What is happening there gives rise to especial difficulties. Can he indicate what is being done in relation to the prison population? Can he further confirm what powers the Government have to deal with this position and what are their intentions in relation to the exercise of those powers?
The Bill contains measures related to the management of death. We understand that there may be reduced capacity to register and manage deaths as a result of the pandemic and that it may be necessary to relax the rules around the registration of deaths and cremations to ease the burden on the NHS and to deal with the issue. Again, we agree to these, but only for as long as the emergency lasts. The House will be aware that concerns have been raised about how cremations could conflict with some religious teachings. Cremation is forbidden in Islam and Judaism, and therefore the possibility of forcing a cremation on a loved one from those communities would add further anguish and trauma to bereaved families who may themselves be in self-isolation. We understand that these provisions are designed to deal with a potential surge in deaths and a lack of grave space capacity. What steps will the Government take on this? In particular, are there plans to consult the deceased person’s family and local faith representatives to find suitable alternative arrangements?
I turn to supporting the homeless. The coronavirus outbreak presents specific risks to the homeless because they are a high-risk group. Rough sleepers and those living and sleeping in shared spaces such as hostels, night shelters and day centres are at particular risk as they are unable to self-isolate. Further, these services cannot close down because the people they support are then forced back on to the streets where they are at even greater risk. Can the Minister indicate what steps the Government are taking as regards the homeless in light of the announcement last Friday that the Welsh Government will make £10 million available to Welsh councils in order to block purchase rooms in hotels, bed and breakfasts and student accommodation to act as additions to the existing provisions for the homeless? Are the Government doing the same in relation to England?
The Bill contains provisions related to the giving of information about food supplies. The public are understandably worried about perceived shortages of essential products, empty shelves and securing online delivery slots. The supermarkets are doing all the right things, including redeploying their existing staff and hiring new team members to ensure swift restocking where supplies exist, as well as establishing schemes to assist the elderly and key workers.
Supply chains are stepping up their efforts to ensure that sufficient quantities of essential products are available for sale. These efforts are appreciated and will continue to be vital in the weeks ahead.
The Bill includes powers to compel food supply chain operators to provide information on, and assessments of, any disruption to food supplies. We understand that such information is currently being provided voluntarily, meaning that it is intended as a reserve power. We agree with this approach but note that it does not, in itself, do anything to guarantee the availability of food and other items. What discussions are the Government having with supermarkets and supply chains to maintain public confidence?
We will explore all these issues in Committee. We will play our part in supporting the fight against this virus. Sometimes, that will involve telling the Government that they are wrong; always, it will involve giving the country confidence that we in the Opposition—and we in Parliament—are working together as best we can to provide security and safety for the country, which rightly expects the best from us. We are determined to give it.
My Lords, we meet today in truly extraordinary and worrying times. The pace at which the pandemic has spread and the range of measures which are now widely accepted as necessary to fight it are unprecedented. As a result, we are not just faced with this Bill but must consider how we as a Parliament operate in the weeks and months ahead. If we are to work effectively, we have to reconsider all our ways of doing things.
We on these Benches of course support the Bill but, as we do so, we need to be clear what we see as the role of Parliament in the period ahead. It seems to us crucial that we maintain our role of scrutinising legislation and holding the Government to account. This is partly because the Government are being asked to exercise, on a daily basis, the judgment of Solomon. We fear that they lack a Solomon, so we think it vital that Ministers remain answerable to Parliament for their decisions. But Parliament also has a major part to play in improving public policy development, by feeding into the process and drawing to the Government’s attention what is really happening on the ground across the country, and by probing their responses.
While we on these Benches are fully supportive of the House adjourning early for the Easter Recess, we do not support an extension of that Recess beyond our planned resumption date of 21 April. If by then the situation in respect of self-isolation and social distancing remains broadly as it is today, which seems highly likely, we will need to look at how we conduct our business to ensure that the House can operate effectively.
Many service-sector companies have closed their offices altogether yet are carrying on their business by use of the phone, internet and conference calling. I believe that your Lordships’ House should do the same to the maximum extent possible, particularly as almost half our number will—or should—be unable to attend by virtue of their age, while others have underlying health conditions which makes their attendance impossible or, at the very least, imprudent. We will need to change our ways.
In my view there is, for example, no reason why committees should not sit via videoconferencing straightaway. I believe that we should also look at ways in which the business in the Chamber could be done differently. If a radio station can do it, I do not see why Members should not be able to phone or email in their Questions for Oral Answer, for example, or why some speeches could not be submitted in writing in advance, for inclusion on the record. On our return, to allow us to ask Questions in a timely manner while minimising the demands on ministerial time, we should also have half an hour of Covid-19 questions at a convenient point after the Prime Minister has done his daily press conference. If the frequency or timing of these press conferences changes, we could obviously adapt to reflect this.
The alternative is an unsatisfactory preponderance of coronavirus Questions on the Order Paper and a daily series of requests to the Lord Speaker for Private Notice Questions. We have raised these suggestions via the House of Lords Commission and the usual channels, and are having very constructive engagement with them. I believe the same process is now taking place in the House of Commons.
I realise that for some Members all these suggestions will produce the kind of shocked response associated with a Bateman cartoon but, unless we move in this direction, proper scrutiny will simply be impossible. Scrutiny will be particularly important because of the wide-reaching measures which the Government are adopting. They are measures which we support in principle. As a result of today’s Bill, the Government will gain large new powers exercisable by statutory instrument, which should be debated, and further new powers will need to be taken to implement yesterday evening’s announcement. We have only to look at the extraordinary, irresponsible action of Sports Direct today to see that exhortation of not just individuals but of companies will be inadequate. I too would like to know what legal basis the Government will use to introduce these necessary powers.
Other legislation is already being introduced giving the Government new powers by statutory instrument. For example, on Saturday a regulation was made under the Public Health (Control of Disease) Act 1984 to close all restaurants, cafés, bars, cinemas, theatres and virtually every other premises where people meet. They came into force the same day, have a lifespan of six months and, in theory, need parliamentary approval, but such approval obviously requires Parliament to be in session. The same will apply to all the other SIs which are required, and the Government may well find that they need more primary legislation to be introduced at short notice before this crisis is over, so we need to find ways to do this with the country in lockdown and we need to do so quickly.
We accept the need for today’s Bill and the need to pass it speedily. We do not propose to divide the House but this is a very long and complex Bill and, as is always the case, it raises very many specific questions to which no answers have yet been provided. In saying that, I am not criticising the Government. I have huge sympathy for the challenge the Minister faces in explaining an unprecedented raft of business, and I would not want him to think that in making that point I am being critical, but the country wants to know and needs clarity on many issues, and Parliament is the best way of doing that.
However, our proceedings today and tomorrow do not in reality allow us to subject this Bill to the normal scrutiny that we would expect so, like the Opposition, we on these Benches will limit our amendments to a relative handful on which we wish to probe the Government. There are a lot more issues that we would in ordinary circumstances raise, but in the course of a day—tomorrow—it is simply impossible to do so.
The issues that we will raise are as follows. On social care, we want to ensure that the Government provide local authorities with the resources necessary to provide appropriate levels of care for those discharged from hospital, particularly those with complex needs. On social security, we want to suspend the sanctions regime, which we believe could bear down unfairly on those who are ill. We want to give local authorities the power of direction they will need if they are to implement government policy effectively. We want to scrutinise the civil liberties implications of the increased detention powers. We want to examine the scope for providing much better levels of support for the self-employed, and we want to ensure that your Lordships’ House plays its full part in considering the extension of the emergency powers beyond the initial six months. My colleagues will explain our detailed concerns on these points during the course of today’s debate.
This is an unprecedented Bill to deal with an unprecedented crisis. Over the coming months, every aspect of the way that we do things in Britain will come under strain. As in wartime, we will have to change the way that we do things, and when it is all over things will not revert to business as usual. Some things will have changed for ever, and the way that we do business here will assuredly fall into that category. I am sure that everyone in your Lordships’ House wishes the Government well as they grapple with coronavirus. But democracies never give the Executive a blank cheque. As a Parliament, we must retain our critical faculties and, if we do so, it will help the Government and the country to get through this crisis together.
My Lords, I draw noble Lords’ attention to my registered interests. I am trustee of the British Institute of Human Rights and a vice-president of the LGA, among others.
We are in challenging times, with a significant number of noble Lords not in their usual place. With a Bill of this magnitude, the Chamber would normally be full. I strongly support the comments made by the noble Lord, Lord Newby, that this has proved more than anything that we need to find more modern ways of working, especially when we have had no time to discuss the Bill outside the Chamber. Even more so, the review point for this Bill is incredibly important.
I sincerely thank the House staff who are here today and the NHS and front-line staff for what they are doing. For me, it was a big, personal decision to be here today, especially with the release of the clinical frailty scale. Many would see me, as a wheelchair user, as being no higher than number 7 on that scale. I am delighted that NICE yesterday confirmed that the clinical frailty scale would not be used for certain groups, including those with learning disabilities and cerebral palsy, but many disabled people are still very worried by the Bill. Decisions will be taken by someone else about our usefulness in the next few months that we will have no control over. I am starting to worry that disabled people might be seen as expendable during this pandemic. There is a real fear that this will graduate towards a move to register disabled people and that that will be used to decide future provision.
There is a need for part of this emergency Bill; however, the draconian measures outlined made it a personal necessity for me to be here today. This is a health and social care obliteration Bill by a different name. Alan Benson captured many views when he said that we have been fighting for rights for 30 years and now it is about survival. Inclusion London has said that, “buried deep” in the Bill is
“the complete removal of social care responsibilities, for at least two years.”
I apologise because I will ask the Minister a series of questions. I will email them to his department because there are many. I will also cover presentations and questions that have been sent to me by other noble friends.
What will happen to those stuck in the PIP decision appeal process while we are going through these difficult times?
What will be done to look after or support victims of domestic violence, who we know will be at greater risk?
What specific measures will be put in place for the emergency registration of healthcare professionals for those over 65, some of whom may be considered vulnerable?
What about unpaid carers and child carers? What about the self-employed? There will be additional pressure on them at this time that will be impossible to step back from.
When the Prime Minister and Her Majesty’s Government make announcements on TV, will they commit to having a British Sign Language interpreter so that everybody can understand what is going on?
The Bill is a temporary suspension of most of the duties contained in the Care Act 2014. Is this any more than just a cost-saving exercise? If local authorities are no longer required to meet care needs under the Care Act, will the Minister explain why local authorities would carry out any assessments at all if they did not have to? How will they prioritise?
In yesterday’s debate in another place, a human rights safeguard was raised numerous times. The Government stated that they considered the Bill to be compatible with human rights. However, the analysis was released late on Friday 20 March, after the Bill was laid before Parliament on 19 March, and while some of the analysis is welcome, some of the most worrying clauses have simply not been dealt with. Will the Minister explain what analysis has been done about the unintended consequences on the NHS at this difficult time of removing social care or prioritising health over social care?
Will the Minister advise how social care is guaranteed, because, as I understand it, there is no human right to social care or a positive obligation under the European Convention on Human Rights to meet care needs? Are people to be protected from inhumane or degrading treatment within the provisions of Article 3 or perhaps Articles 8 or 14? I would like to understand that. How will the Secretary of State ensure that social care is protected and what support will be given to decision-makers such as social workers to ensure that they identify and avoid breaches? Given that human rights training is not mandatory, is that something that could be considered?
What happens when a disabled child turns 18 and their adult social care package is unavailable? Does provision just stop?
My noble friend Lady Hollins, who is unable to be in her place, asked me to raise the following questions, which are really important for disabled individuals. If we look to home care for disabled people, what provision are Her Majesty’s Government putting in place for European care workers who have not been able to return to the UK? What personal protective equipment will be made available for carers? Can Her Majesty’s Government look at parking charges, so that carers who do not want to use public transport are able to drive? Will there be extra funding for disabled employers or home care agencies to enable them to pay an additional income premium or quarantine payment? What about carers who have to self-isolate in their employer’s home to ensure they do not put their disabled employer at risk? How will care agencies or disabled employers fund these periods of advisory self-isolation? Will the Government require local authorities to keep a record of those who have had their support reduced or cut, so that their support packages can be reinstated when this emergency is over?
What about people with dementia? Can the Government assure us that they will not be discharged to inappropriate care homes without staff who have had dementia training? Can the Government give a financial guarantee to families living with dementia—that they will not be retrospectively charged for inappropriate care home placements once the pandemic is over?
The St John Ambulance contacted me this morning. It said that it is ready and wants to help and would very much welcome a call with the Minister. What about paid leave and access to emergency volunteering certificates for it?
The changes to the Mental Health Act are just as concerning. Does the Minister consider it proportionate for individuals to be sectioned by only one medical professional, who is no longer required to be acquainted with the individual? I hope no amendments will be tabled that amend other major pieces of legislation. This is a time for unity, not for introducing other far-reaching changes on highly contested issues.
At different times, in-patients in mental health care facilities may face increased restraint and seclusion. The powers in this Bill could lead to a deterioration in an individual’s conditions where carers or families cannot manage, leading to individuals being admitted to an in-patient unit in crisis. No one should be admitted because of a failure of social care. Can the Minister assure the House that, should the powers in this Bill be activated and as a consequence should people be admitted to in-patient settings because of a failure of care, an independent care and treatment review will be carried out as soon as this emergency has ended, and not just for people detained in long-term segregation? The Bill’s provision to relax the measures around NHS continuing healthcare assessments could see some of these people discharged from hospital without the right support, putting them at additional risk of readmission. Delays to NHS continuing healthcare assessments will undermine this programme of work.
Like many others, I have huge sympathy for what the Government are trying to do right now, but a Bill of this magnitude will be life-changing for disabled people. I look forward to hearing the Minister’s response.
My Lords, in these days I have been reflecting on the words of the Hebrew psalmist who, at the time of his people’s exile, articulated the question:
“How can we sing the Lord’s song in a strange land?”
In many ways we are entering into a strange land, and indeed in some ways a land of exile: a land in which we are exiled from many of our normal patterns of living, in which people of faith are not able to attend their places of worship and in which many people find themselves having to live life in entirely new ways.
This is a small thing, but I am grateful for the inclusion in the other place of Clause 84, which solved a little conundrum about the legality of the General Synod of the Church of England under these circumstances. Rather more importantly, and in relation particularly to what the Prime Minister said last night, we in the faith communities absolutely accept that our places of worship are now closed. Such things as weddings are suspended and postponed until a later time. But though the buildings are closed, I hope the communities and people are not closed. Particularly in relation to our caring and charitable activities, I hope that people of faith, alongside others, will continue to engage.
Reference has already been made to the care of the homeless and the importance of shelters, food banks and those kinds of things. I am grateful for the discussions happening around those. I think I am right in saying that work is under way in London to transfer residents of shelters to budget hotels.
The care of the vulnerable has just been spoken of powerfully by the noble Baroness, and I have other categories in mind, including trafficked people and victims of domestic abuse—of course, the Bill to support such people has now been delayed again—those who are isolated and perhaps especially those who are or sadly will be bereaved in the coming days.
That brings me to Schedule 28 which deals with funerals and is very far-reaching in its effects, potentially, but it is important and I accept the need for it. However, I hope that alongside all this we can maintain our sense of dignity, which is really important, around issues of death, bereavement and the way we treat the dying, the dead and the bereaved. The point has been made about the need for sensitivity to the funerary practices of different faith communities and I know that conversations have been going on with Downing Street about that. We trust that local authorities and others will act in appropriate ways. I think I can speak for all the churches, faith communities and indeed civil celebrants when I say that for as long as we possibly can, we will wish to provide people to officiate at funeral services, even if those services are attended only by the deceased person in their coffin and the officiant—that is part of treating these situations with dignity. I confidently express our commitment on these Benches to do that for as long as we possibly can and to enter into discussions that are needed in order to do it.
On the theme of treating people with dignity, reference has already been made to prisons and other places of detention—immigration removal centres and suchlike. We know that they will be under huge pressure at this time, not least if staff numbers are restricted due to infection. For as long as possible I know that, in prisons and other such places, our multifaith chaplaincy teams will continue to work as they are today. That underlines the importance of giving prisoners, particularly if they are not able to gather for their worship, access to faith provision of some kind at this time, when they are cut off, very often, from other forms of contact.
That brings me to two particular questions in relation to prisons. One is about communication with the outside world now that prison visits have understandably been curtailed. Is there any intention to increase the availability of such things as Skype, whereby families, and perhaps particularly the children of those who are in prison, can maintain relationships and contact with them? The other question concerns those who might be released. There has been some talk about this and I would value an update from the Minister as to the thinking. I am thinking, for example, of low-risk, elderly prisoners, who are in any case difficult to care for in prison and may become more difficult to care for. Another group might be those pregnant women who are currently in prison. Can special provision be made for early release for those groups and, no doubt, others as well?
A few minutes ago, I referred to the Hebrew psalmist. The lesson from that time is that the cry
“How shall we sing the Lord’s song in a strange land?”
was answered some decades later by the fact that people did actually learn to do it. During that period of exile, they learned to express their worship and their solidarity with one another in new and different ways that set patterns for many centuries to come. I have a quiet confidence, actually, that with all the difficulties and challenges, we will, as a society, learn to sing our songs in new ways. Maybe, as has been indicated, the workings of this House will be one of those songs that we sing in a new way. Above all, we must learn to sing the songs of human dignity and maintain them, and perhaps also those songs that celebrate human ingenuity, compassion and relatedness, which will be incredibly important virtues in these coming days.
Noble Lords will be familiar with the profound words of John Donne written in 1624. That was a time of recurrent outbreaks of bubonic plague, so he knew about death and the plague:
“No man is an island entire of itself … any man’s death diminishes me … And therefore never send to know for whom the bell tolls; it tolls for thee.”
Each death from Covid-19 is a tragedy for the individual, obviously, and for every bereaved family, and we should mourn every death because anyone’s death diminishes us.
I attended two very informative briefings by the Chief Medical Officer, Chris Whitty, earlier this month. He was calm, balanced and logical. He inspired confidence. I understood—I think—the concept of herd immunity. I understood why it would be counterproductive to close schools and why it was unnecessary to ban large gatherings. I understood the concept of flattening the curve to prevent the NHS being swamped. All that seemed pragmatic and sensible.
The weekend before last, everything changed after an Imperial College study and modelling exercise estimated that there would be 250,000 deaths unless we changed tack and policy. A quarter of a million deaths is a very large number. I also understand the international situation, where other countries are taking more extreme measures that, to a certain extent, put the Government under pressure. These deaths are largely among the elderly, the frail and the sickly—people with what I have learned to call “underlying health conditions”. Each one is an individual to be valued. I also understand that it is likely that 80% of us sitting here today will contract the virus, and I have a mere 16 months before I reach my allotted span, according to the psalmist in Psalm 90, of “threescore years and ten”—memento mori.
However, it is not callous or uncaring to point out that last year 623,000 people died in the UK. On average, every day 1,700 people die. As of this morning, there have been 335 deaths from the coronavirus outbreak. Therefore, this is not the Black Death, the great plague of 1665, the Spanish flu nor war. It is a very real health crisis which should be taken very seriously indeed, but I suggest that it should also be kept in proportion. Referring to war, which people have been doing, the Blitz spirit was best summed up by the slogan “We never closed”.
The Chief Medical Officer thinks that there are many thousands more cases than the 6,650 confirmed today. My right honourable friend Jeremy Hunt, former Health Secretary and chairman of the Health Select Committee in the Commons, yesterday suggested that there were 300,000-odd cases in the UK. My untutored and entirely anecdotal guess is that there are very many more. For instance, my son at Sandhurst has had it; my daughter, 50 miles away in Oxford, has it, as has my niece in Gloucestershire; three out of 12 jurors in the trial of the alleged murderers of PC Harper have self-isolated; and there are lots more cases besides, of which we all know. They have not been tested but it seems likely that the number of additional cases is huge. Therefore, what are the implications for herd immunity and what is the likely percentage of deaths?
Now we have in this Bill draconian and oppressive restrictions. I understand the impossible position of the Government, but how long will this lockdown be imposed? The Imperial College study, which so worried the Government, says that
“this type of intensive intervention package … will need to be maintained until a vaccine becomes available (potentially 18 months or more)—given that we predict that transmission will quickly rebound if interventions are relaxed.”
It goes on to say that
“experience in China and now South Korea show that suppression is possible in the short term”,
“it remains to be seen whether it is possible long-term”.
I am not an epidemiologist, nor a doctor, but I have questions on government policy. Do the Government have any real idea of the numbers infected and, now, possibly developing immunity? I understand that a test for antibodies is being developed. How long will the restrictions be in force? Three weeks was mentioned yesterday. Will it be 18 months or more? Will a lockdown be effective? Will it work? And will the numbers rebound if the lockdown is lifted? Therefore, will it really achieve its stated aim of preventing transmission and saving lives in the long term?
Will these measures lead to a recession or, much worse, to another global depression? We should remember the lives destroyed in the desolation of the 1930s and, indeed, the rise of extremist parties. Will younger generations—our children, with their future in front of them and not already behind them, as in my case—think that the impact on the long-term good and prosperity of the country, on their education and on their standard of living and quality of life is worth it, especially if these oppressive restrictions do not beat the virus and people continue to die? These are rhetorical questions, because nobody knows. Only time will tell—perhaps six months, a year, or many years.
Perhaps this will be seen as a contrary view. I wish my noble friend the Minister and the Government well in this hugely difficult crisis but certainly do not like this legislation. The restrictions and closing down of our country are disproportionate. I will not oppose this, but giving these powers to the state is unprecedented outside wartime; they are draconian in so many aspects and based on a premise that may turn out to be incorrect. In my 68 years, I have learned that it is very rarely the case that the gentleman in Whitehall knows best.
My Lords, I too pay tribute to those on the front line: those in intensive care and social care, but also those serving in food shops and those in local government keeping services going. I also pay tribute to those in the Civil Service and in this House who are ensuring that our democracy can continue. Our democracy, as has just been said, is vital in being able to challenge, ask questions and perhaps sometimes put a different point of view—not merely via a question online or a telephone call, but in debate, which is what democratic parliaments are all about.
I have tried to approach this issue from a lifetime of experience, having been Home Secretary at the time of the attack on the World Trade Center and much afterwards. I realise, as the Minister has said, that this is on a different scale. We are talking about the experience and challenge of the Great War. In my view, the Minister has handled his brief incredibly well since taking it over and I pay tribute to him for doing so.
Over the last few weeks I have asked myself what I would do if I were in Cabinet today. Would I try to maintain that proportionality and balance which we debated at great length nearly 20 years ago? Yes, I would. Would I be absolutely clear that democracy demanded that Parliament continue to work? Yes, I would. Would I take incremental steps that took people with us? Yes, I would, because the balance between the philosophy of John Stuart Mill and Rousseau’s social contract has underpinned everything we have done in this country and should do in future. The nature of the state will be debated now and in the future; though perhaps in a different way, it will still be about the balance between the actions we need to take as a Government and a state and the responsibility we carry as individuals.
I am here today because I have lifelong experience, some areas of which are more relevant to this debate than others. I do not mind saying that, while others will rightly take a decision to isolate and protect themselves, as demanded of all of us, some have to be there on the line, saying things and debating matters from the perspective of their age and experience. I make an appeal for social responsibility and care to print, broadcast and responsible social media, because it is vital at this time that people continue to be there to ensure that the papers are printed and that broadcasters can still broadcast—it is not all down to social media. The most dangerous things we face, other than the virus itself, are anxiety and fear—people’s confidence in their own mental and physical well-being being undermined. I make a plea to the media: inform, interrogate, sometimes entertain, but never fear, because that anxiety can be incredibly dangerous at this moment in time. That is why enforcing the measures in this Act must be done with great care.
I say to my colleagues, including my noble and learned friend Lord Falconer, and the noble Lord, Lord Newby: be very careful about the demanding of yet more power and enforcement, the media demanding every day that more people be more fearful. Yes, there will be particular areas of our country where intensive care services and all around them will be under pressure, as they are at the moment in London and the south-east, but listening to interviews from Queen’s in north-east London on Sunday’s edition of “The World This Weekend”, I realised that what we needed was the calming voice of those who had been through experiences of this kind.
My wife Margaret has been a doctor for 35 years and has just retired. I do not speak for her, but I learn from her about the dangerous and difficult decisions that she has taken over a lifetime: of whether people should die at home or be transferred into hospital. That is why we should listen to the noble Lord, Lord Robathan. Proportionality requires us to take a deep breath. Yes, we respect the scientists, but we need more of them, from a wider sphere, to come forward and to be heard. I respect those who came forward quickly with their modelling, but we need wider modelling to ensure that we get this right. We need more testing more quickly. If we had more testing, we would know much more quickly who had had the virus and who was reasonably immune, and we would be able to distinguish those who had not had the virus but thought they had. We could then continue in a more reasonable fashion—yes, of course, working from home, but without that anxiety and fear.
I have talked a lot about anxiety because my daughter-in-law, who is a teacher, spent the whole of last Friday talking to the students in her secondary school not about exams but about their anxiety about their parents and grandparents and what was going to happen to them. Recovery plans as Theresa May has described will therefore be really important. Behind the scenes, I hope that that work is taking place.
It is important to use the letter that has been sent out by the Communities and Local Government Secretary to reassure people in local government that they will be supported. Local government has lost more in the austerity measures than any other part of our public services. The capacity does not exist. What the noble Baroness, Lady Grey-Thompson, said needs to be underlined and understood.
I shall finish, as did the right reverend Prelate, by quoting from my favourite hymn. “Dear Lord and Father of Mankind” ends with:
“O still, small voice of calm.”
That still, small voice of calm is needed now as it has never been needed before.
My Lords, what extraordinary times we live in. Those who have followed Sheffield politics will know that the noble Lord, Lord Blunkett, and I tend to disagree quite a lot on things, but on this occasion, I agree with quite a lot of what he had to say.
This Bill has jaw-dropping and eye-popping powers, which, if we were to have them explained to us in the normal run of the mill, would lead us to think that a military dictatorship had just come in and was trying to get control. However, we are not in normal circumstances when it comes to some of the powers needed to deal with this public health crisis—that is what we need to call it; let us stop using the words of war and talk about the battle to keep people alive and safe. We are in a public health crisis and some of the powers will be needed.
The role of this Parliament and this House over the next two days will be to try to improve the Bill wherever we can and, I hope, to persuade the Government to accept some of the suggestions that will come from around this Chamber. Our role is also to make sure that the powers that the Government and individual Ministers wish to take are reasonable and proportionate to the public health crisis that we face. Some of them will be tough measures, and we understand why, but we will also have to make sure that the Bill’s powers are for the minimum length of time possible and are to deal only with the coronavirus.
A number of provisions in the Bill, particularly those to do with local elections and their suspension, do not refer to coronavirus—in the clauses or the schedules. I understand that the Bill may have been written in haste, but we need to be clear. Every clause and every schedule needs to refer to coronavirus. The power in the Bill for Ministers to extend, for two years, also had no reference to extending purely because of coronavirus.
I would like to explore this issue with the Minister: why six months? If the powers are so broad, why does Parliament and this House not get a say every three months, not just to debate the issue but to get a vote on some of the issues? The powers are so wide and have such effects on individual lives that such a vote is needed.
The social care provisions will mean that the lives of some of the most vulnerable people will become intolerable. If the pressure on local authorities means that they cannot make such provision, which they have to legally, individual lives and families could be shattered. These powers are so wide, with their effects on individuals and families, that three months is long enough. What, in dealing with this public health crisis, would prevent a review at three months?
I declare my interests in the register as a vice-president of the Local Government Association and, like the noble Lord, Lord Blunkett, a former leader of Sheffield City Council. Those of us who have been council leaders will know that many issues arise in a local community in the normal run of things, and local government does not always have the power to deal with them, even though communities look to local government to do so. In fact, local government is probably best placed to make clever, local interventions to deal with the problems that people face. Local government will have to deal with many issues that are not in the Bill. What if the vast majority of refuse collectors get the virus? How will the refuse be collected? If it is not, it will lead to another public health issue, for environmental health officers.
It would be wise to give local authorities a general power of direction on burials and on death so that, if they give an instruction, bodies in their jurisdiction have to act. It will go much wider than death; there will be many things that great planners and people who work in Whitehall have not thought of because the consequences are probably unintended or have not been thought through, but it will be down to somebody in each local area to make significant decisions about what is needed. If we are to help local communities to survive as best they can and deal with the issues that no one has thought of, we will have to give somebody—I suggest that it should be a local authority—a general power of direction. I urge the Minister to look at that carefully.
Finally, I thank the many hundreds of thousands, if not millions, of individuals up and down this country who are volunteering and supporting their local community in trying to get through this, especially the great people on the front line of our NHS and the people who are keeping our shelves stocked. Those local efforts and individual interventions will help communities to get through this.
My Lords, I will raise two unconnected points in connection with the Bill. First, I admit to being very surprised to see no mention in it of prisons, which the noble and learned Lord, Lord Falconer, and the right reverend Prelate the Bishop of Rochester, have already mentioned, or of probation. Both are state-run activities and require state employees to have face-to-face contact with offenders who have been sentenced by the courts, which are mentioned, as are the police, who are responsible for the investigation of criminal acts.
I remember that, when the Prison Officers Association went on strike in 1989 and I was commanding the United Kingdom field Army, the Army was required to set up, and externally guard, two temporary prisons in existing army accommodation. When there was a suggestion that soldiers were to be required to censor prisoners’ letters, I appealed to the then Home Secretary, Lord Hurd of Westwell, that soldiers should not be put in such close contact with prisoners, to which he immediately agreed. I was therefore interested to see a report in yesterday’s Times that the Royal Navy would be called on to cover any drastic shortfalls in the number of prison officers, after the police had made it clear that they were unable to, including being responsible for delivering ready meals to prisoners in their cells.
I know that these are extraordinary times, and that extraordinary measures need to be taken, but service personnel do not have the same training as policemen or prison staff, and I appeal to the Government not to deploy Armed Forces personnel to anywhere where they will come into such close contact with convicted criminals. When I was Chief Inspector of Prisons, my deputy, who governed HMP Holloway, was faced with a strike of prison officers, and ran the prison using teachers and other volunteers already working in the prison.
No thought appears to have been given to the supervision of offenders in the community. No plans have been announced to suspend sentences or arrange other supervisors if probation staff should fall victim to the virus. All probation sentences begin with an assessment, made following a face-to-face interview, and require personal contact throughout their completion. Will work on A Draft Target Operating Model for the Future of Probation Services in England and Wales, published earlier this month, be suspended until the future is clearer? This matter will be discussed in detail in both Houses in the context of the promised royal commission on improving the effectiveness and efficiency of the criminal justice system. Unless this is carefully thought through, I am afraid that any extraordinary measures made necessary by the impact of coronavirus can only deepen the existing crisis in the delivery of probation services following the rushed and ill-thought-through transforming rehabilitation exercise.
Before making my second point, I declare an interest as co-chair of the All-Party Parliamentary Group on Speech and Language Difficulties. I realise that, compared with the other demands on NHS staff, speech and language therapists may come lower in the list. However, how do the Government plan to ensure that information about the virus and the provisions of the Bill are made accessible to those with speech, language and communication needs? Therapists, who are essential in this process, should be issued with protective equipment and added to the list of key workers.
My Lords, I begin by declaring my interest as chair of NHS Improvement. At my pre-appointment hearing two and a half years ago, I said I would be very cautious about speaking on health matters while in this role, but I hope noble Lords will forgive me for doing so as I feel in these extraordinary times it would be wrong not to speak.
First, I express my deepest sympathy for those who have already lost loved ones because of Covid-19 and I send my very best wishes to those currently in hospital or with relatives in hospital or at home fighting the disease. I shall speak today about why this Bill matters so much, why it matters to our NHS people and why it matters to all of us. I shall start by reading a statement from my noble friend and sort of job-share partner at NHS England and NHS Improvement, my noble friend Lord Prior, who is not in his place today as he and I are endeavouring not to be in the same room at all and are working shifts. My noble friend says: “In its extraordinary history of over 70 years, the NHS has never faced such a momentous challenge. Our country has never depended so heavily on its most loved and respected institution. I”—in fact, we—“know that the remarkable people who work for and with the NHS will more than do their duty; they will do their absolute best. It is a privilege and an honour for me”—us—“to work with them.”
As my noble friend says, our NHS people will do everything in their power to look after us and care for us: our consultants, paramedics, healthcare assistants, junior doctors, nurses, midwives, porters, cleaners, scientists, physios, engineers technologists and procurement teams. There are so many professions, I cannot list them all, as I mean everyone working in our health and care system. There are those directly employed in the NHS, but those working in social care, volunteers, the voluntary sector and, yes, even the independent healthcare sector They are all our National Health Service right now, and my goodness they are working hard and fast to face up to this challenge. They need us to help them. They need us all in this country to play our part, as the Prime Minister said last night. They need us to play our part personally in abiding by the rules the Government have set out, and they need us to play our part practically in sourcing personal protective equipment, making ventilators, expanding testing capacity and coming to work with them, if we have the skills. They need us to care for them, to make sure that they can eat at the end of a long and challenging shift, that they can get to and from work and that their loved ones are okay while they are at work, and they need us to support and cherish them when things go wrong.
They need all of this, and they also need us in this House to play our part constitutionally by passing this Bill to give the Government the powers they need to guide us through this immensely challenging time and to provide our NHS people with the support they need so they can save lives. There are powers in this Bill that many noble Lords have said that in normal times all of us in this House would wish to question, challenge and test, but this is not a normal time. Our NHS people need us to act now. Time is not on our side, and they need all of us to join in this fight with them because right now, this is the ultimate national effort from our NHS, that most cherished British institution. Right now, we, all of us, are the National Health Service in one united effort from everyone in the country, with healthcare professionals in the front line backed up and supported by the whole country, as a genuine united National Health Service.
My Lords, like many others in this debate, I pay tribute to the many thousands of people who are working immensely hard to counter the effects of the coronavirus.
This huge Bill gives unprecedented power to the Government. Whether all these powers will be needed is uncertain. There are still questions about the severity of the disease and its future trajectory. The CMO has assessed a death rate of 1%. New research from the University of Oxford suggests 0.7%. In Germany, where far more testing has been done, it is 0.3%. We know that in the UK the average age of death from the virus is 78.5 years, and it is a fair assumption that, very regrettably, of those who succumb, quite large numbers would have died anyway. The measures in the Bill and those already taken, exacerbated by last night’s announcement, are leading to massive fear and anxiety in much of the population. More must be done to explain the demographics, reduce unnecessary fear and protect mental health. We in this House might need to worry about our survival but, fortunately, most of the population does not.
The other general point I want to make concerns the economy. A global recession will lead to the death of many children in poor countries, and it is undisputed that the supply of goods and services will be greatly reduced: first, by closing down production with large lay-offs; and, secondly, by restrictions imposed to keep a large part of the workforce at home. At the same time, in the UK, huge amounts of money are being pumped into the economy for understandable reasons. Are the Government assessing the serious implications for high inflation in the medium term? Will they be considering price controls at a later date?
I turn now to my main focus: how we sustain our education system and protect our children and young people from long-term damage as a result of school closures and the cancellation of public exams. History will judge whether or not the wider measures that have been taken to combat the coronavirus were proportionate. My view is that the decision to cancel GCSEs and A-levels was disproportionate and made without sufficient preparation and the requisite advice on what would be put in place instead. While recognising, as I really do, how difficult it is for the Government in these circumstances, answers are desperately sought by teachers, parents and pupils. Many pupils have said that they feel “gutted”; having spent the past two years working hard to reach their potential and get good grades, they feel cheated that they have been denied the opportunity to do so.
The Government have said that alternative assessments will be just and fair. Teachers will have to draw on many sources, including predicted grades, class work and mock exams results. I am sure that they will do their best. Nevertheless, there are bound to be large variations in the judgments they make. Some will be generous, and others tougher, so it will not always be just and fair. Moreover, universities will face difficult decisions about who to admit; at least a collapse in international student numbers could allow them to admit more home students and veer towards a generous admissions policy. But, given that all secondary schools will be open to allow the children of key workers to be looked after, I think it is a pity that 16 to 19 year-olds cannot work at home until the exams begin, and then come to school to take them. I believe that that is what should have happened.
The other concern about many children being forced to remain at home is the likely outcome of increased social inequality. Schools do not just educate children; they also provide them with a safe haven, a structure to their day and a chance to be creative and to learn about sharing. Schools are a leveller, in that they provide a similar environment for all their pupils, in contrast to the huge inequality in their homes. I am not sure how head teachers will define vulnerable children—presumably it will include those with disabilities, those who have been abused and those who are in children’s homes—but it is doubtful that they will be able to embrace the 4 million children who live in poverty and the many children who live in appalling accommodation, with overcrowding and limited resources.
When the schools reopen, will the Government provide extra resources to schools with many disadvantaged pupils, to allow them to give additional help, particularly to those who have suffered most from possibly many months of being unable to go to school? Will PGCE students be able to complete their courses this summer, to ensure an adequate supply of new teachers?
To conclude, ways must be found to ensure that the drastic decision to close our schools indefinitely does not have life-changing consequences for children and young people, such as increasing their vulnerability to gang violence and crime, as well as to mental illness and anxiety, while trashing our hopes for more social mobility.
My Lords, the only bright spot in this crisis is that experts are being listened to; long may that continue.
Obviously, the overarching concern is that the powers in the Bill should last no longer than is strictly necessary, should not overreach and should not set unwelcome precedents—one thinks, for example, of the reduction to one doctor for the exercise of Mental Health Act powers and the problems around care assessments. Moreover, the powers should not impact unfairly on disadvantaged minorities or marginalised groups, and should not go further than can be truly justified. It is not entirely clear why the Civil Contingencies Act or the Public Health Acts were insufficient in various areas.
In Schedule 21, there is a test of necessity and proportionality which is strangely absent from Schedule 20—the one that affects directions to people. From these Benches, we will therefore table an amendment to require that all the powers in the Bill should be exercised in accordance with the principle of necessity, proportionality and non-discrimination, respecting the European Convention on Human Rights and other human rights instruments. We also want the Government to keep the powers under frequent review and to publish reasons and explanations for any measures introduced under the Bill.
Although the right to life—Article 2 of the ECHR—underpins the response to this pandemic, human rights issues under several articles of the convention are engaged: Article 5 on the right to liberty; Article 8 on the right to family life, as relating to isolation, quarantining and restriction of family visits; Article 11 on freedom of assembly and association, relating to the prohibition of public meetings and gatherings. These are just some of the examples. I am glad that the Joint Committee on Human Rights, chaired by the right honourable Harriet Harman—I declare an interest as a member—is conducting an inquiry into the human rights implications of the response to Covid-19.
There have been shocking cases of victimisation and blaming of certain people due to their perceived ethnic or national origin, particularly those of Chinese and other east Asian appearance. The power for local authorities not to meet some assessed care needs and to avoid the duty to conduct a care needs assessment will impact on the vulnerable. The Government should, at a minimum, notify the Council of Europe and the United Nations, as stewards of the ECHR and international human rights instruments respectively, that the UK is enduring a national emergency, and of the measures being taken. Do they in fact need to formally derogate? Perhaps the Minister could tell us.
People need to be able to assess, scrutinise and, if necessary, question and challenge the Government. It is not helpful to have a Minister on Twitter call someone by a rather vulgar term because they had the temerity to raise questions about the Government’s approach, as happened yesterday. Apparently, there have been no advertisements on social media. I am on only Twitter so I do not see Facebook, Instagram or any of the others but, considering that a lot of money was spent on Brexit no-deal ads on social media, this omission seems anomalous.
Assessing Schedules 20 and 21 is a bit difficult, as we do not yet know how the Government will give effect to the measures heralded in the Prime Minister’s announcement last night. I imagine that is still being worked through. Schedule 20 does raise a lot of concerns. Where are people to be directed or detained? Is a police station envisaged or just home? What screening is to take place, especially given the lack of current testing capacity? Will there be any judicial authorisation of detention or any provision for appeals? What about people who, for one reason or another, do not have a home to go to—the street homeless, sofa surfers, victims of domestic abuse, some immigrants and refugees, who get little or no support? Surely imposing isolation and quarantining restrictions on people living in abusive or dangerous environments would place them in an impossible situation. As concerns Schedule 21, are the closure of premises regulations issued just last Saturday under the public health Act—they were mentioned by my noble friend Lord Newby—to be revoked in the same way as the February regulations on direction and detention of persons are repealed by this Act in Schedule 20?
I want briefly to mention one or two other things. I entirely agree with the noble Lord, Lord Falconer, and the right reverend Prelate the Bishop of Rochester, who raised issues about funerals and religious beliefs as concerns the need for burial and not cremation. As someone who organised my late husband’s funeral just five months ago, and a memorial service four months ago, this is very important to me. I will perhaps have more chance tomorrow to raise concerns about immigration powers as they affect people in immigration detention as well as in prison. Also, the fear of data sharing with the Home Office could deter people from seeking health treatment. Will the Home Office undertake to suspend that data sharing?
There are also some concerns about video hearings in court. Much as one accepts that they are necessary in the circumstances, various safeguards would be required. There are also concerns about changes to the Investigatory Powers Act and the extension to 12 days for a warrant. From experience, we know that there is a ratchet effect of expansion of state powers, as terrorism legislation has shown. We will need to be vigilant to prevent spillover.
My Lords, I declare an interest as a freelance television producer.
I very much appreciate the extraordinary work that the Government and especially the Chancellor have already carried out to mitigate the effects of the present crisis on the economy and the nation’s workers. However, as other noble Lords have said, we are in an unprecedented situation, with bankruptcy and unemployment sweeping through our nation. I want to concentrate my comments on Clauses 39 to 44, which extend statutory sick pay.
Quite rightly, the Government’s efforts so far have concentrated on the job retention scheme, supporting businesses and employees to ensure that there is an economy to build on when these terrible times are over. However, my concern is for the 5 million self-employed and freelance workers, many of whom have had their contracts cancelled with only a week’s notice—if that. They have been sent home to worry about paying ongoing bills without any prospect of returning to work in the foreseeable future.
This group of freelancers and self-employed people is far-ranging. It includes 37% of people in the creative industries, who are highly skilled and highly paid and work in what is one of the fastest-growing areas of the economy. It also includes sole traders, such as plumbers, electricians and agricultural workers, as well as an increasing number of supply teachers and agency social care workers. I am also concerned about zero-hours workers who are independent contractors and are often semi-detached from companies. Many claim that they should be defined as employees and entitled to the same rights as employees, including having access to the job retention compensation scheme.
I have been told about a number of cases involving these workers. One is a cycle instructor teaching Bikeability classes in London schools. He is defined as a self-employed worker on a zero-hours contract; in reality, he does public sector work without any of the protections of a public sector employee. Normally, March to July is his busiest time, earning him up to £2,000 a month. With the schools closing, all his work has dried up. A 24-hour cancellation policy has left him with no work and no prospect of work. At the moment, he is not part of the job retention scheme and faces a very uncertain future.
I understand that supporting these people is very complicated. When I asked a question on this subject on Thursday, the noble Lord, Lord Callanan, explained that the Government were looking for a comprehensive package which was co-ordinated and coherent and would take time to roll out. Of course, I very much welcome the Chancellor going some way to help the self-employed by rolling out universal credit, allowing self-assessed tax payments to be postponed until January 2021, and encouraging interruption loans.
However, universal credit pays only £94 a week and even less if people have been prudent enough to save a nest egg. As has often been said in this House, UC takes five weeks to roll out. The tax holiday and interruption loans are also helpful but, in the end, they simply kick the problem down the road and the debt still has to be paid. We have no idea how long this crisis period will continue and, in the meantime, these hard-working people from across the country and across society face mounting debts and a very frightening future.
I know that the Government are looking at what is happening abroad and talking to stakeholders about how to support the self-employed through the crisis. Norway is paying self-employed workers grants equivalent to 80% of their average income over the past three years. Belgium’s self-employed workers will have access to an income replacement scheme.
I would like to draw the Minister’s attention to an idea supported by many across the self-employed sector, which, at the very least, would go some way to compensating for lost wages. I would like to see the Government extend their job retention scheme and pay 80% of expected earnings up to the cap of the median wage. Rolling this out will be difficult but the Government could use the person’s last three years’ tax returns to decide how much support they should be paid within this limit. It is estimated that four-fifths of the self-employed and freelancers earn less than the median wage and so would benefit hugely. Maybe the resulting grants could be made through the payment on account scheme, as is used at present for tax rebates. I quite understand that new software would need to be rolled out at HMRC to administer this system. That is often expensive and not entirely successful. Perhaps the DWP and other departments could help out.
At this time of unprecedented worry for every single person in this nation, we must think about the millions of workers who are the backbone of this country, who have lost their livelihoods—workers who are now sitting at home worrying about how they are going to get through the coming months without incurring huge debts, which could take years to pay back. Action is needed now to ensure that they do not sink into destitution and despair.
My Lords, I begin by paying tribute to my noble friend Lord Bethell for the way he has stepped in to a difficult brief at a difficult time. He is stepping up to the challenge. The way that he is keeping us informed is very much appreciated by us all. I also appreciated the opening remarks of the noble and learned Lord, Lord Falconer, particularly his statement that this is a collective battle, which we fight together as one nation.
As someone with a little experience of legislation, I also think it is appropriate that, as legislators, we should pay tribute to those who prepared the legislation before us—321 pages, 87 clauses and 27 schedules. I have known such legislation to take more than a year, and certainly many months, but it has actually been produced for us within a few weeks. I thank the civil servants, the parliamentary draftsmen and the clerks who have been party to that effort.
In any crisis, no matter how bleak, there are opportunities for us to reflect on who we are, how we work, what values we cherish and how we can improve ourselves, so that once we emerge from the crisis—as we shall—we do so in better shape than we entered it. Looking for those opportunities and making changes empowers us at a time when we can feel powerless, and it gives us hope when things can seem hopeless.
I will focus on just one area—volunteering—referred to in Schedule 6 to the Bill. As a nation, we often seem at our best when we are giving, be it of our time or our money, in pursuit of some great cause. Your Lordships can see this in events such as the Great North Run and the Children in Need telethon, or the efforts at times of crisis of the British Red Cross, St John’s Ambulance and the Salvation Army. Who can forget the 70,000 Games makers who made the spirit of 2012 something which raised our national morale? The British people are indeed a generous people, in both time and money. This is relevant because if we are going to get through this crisis together and emerge stronger, it will require a herculean collective effort—everyone pulling together and lending a hand.
It is estimated that each year some 20 million people volunteer their time in Britain. It is part of our national social capital. We are already seeing this beginning to happen organically, with thousands of local groups of volunteers forming up and down the country, wishing to help their neighbours with shopping, collecting prescriptions or post, or just a friendly telephone call. I declare an interest as a member of my local Covid-19 mutual aid team. I know that many of the volunteers in my local group would be very grateful for guidance as to how the new restrictions announced by the Prime Minister last night will impact on their volunteering activities.
I know also that the DCMS is doing incredible work with major charity organisations like the British Red Cross, the NCVO and others, supported by General Sir Nick Parker. But my concern is that what we are now witnessing is a mass grass-roots surge of altruism not through the traditional channels but across social media platforms such as Facebook and WhatsApp, and apps like Nextdoor. This surge of good will needs to be harnessed, informed and trained; it does not need to be frustrated or discouraged by an overly bureaucratic process. Extraordinary times call for extraordinary measures, and that applies to those wanting to help too. The mass outpouring of altruism towards each other that we are witnessing in our country can help not only to get us through this crisis but to bind some of the wounds of our recent past, so that we can emerge stronger and more resilient as a society than we entered it. This precious resource flow must not be wasted, but it must be directed.
My Lords, it is always a pleasure to follow the noble Lord, Lord Bates. We all owe a massive debt to the brave and skilled workers who are battling this crisis, including a close relative of mine on the NHS front line who is trying to keep her patients, as well as her husband and three small children, safe. Care workers who are without proper personal protective equipment are looking after another close relative who is in her 90s and in a care home under lockdown.
I thank my noble friend Lady Thornton for her diligent leadership, expertise and hard work, because key questions affecting this Bill remain. First, everyone in government has known for years about the probability of a pandemic at some point. Although I was never a Health Minister, as a Cabinet Minister 17 years ago I recall being alerted during the SARS outbreak. My noble and learned friend Lord Falconer might remember that too. Given that, why was it only last week that the Health Secretary appealed for companies to help produce many more ventilators? Why was this not done much earlier, especially after Chinese scientists gave deadly warnings about the pandemic? Why were plans not put in place for proper testing, especially for front-line NHS staff and care workers? Why were no preparations made to ensure the supply of sufficient personal protection equipment for doctors, nurses and carers?
Secondly, there have been mixed messages. For instance, the Prime Minister suggested that he would be seeing his mother on Mother’s Day, but that was later hastily corrected by No. 10. The contrast with the sober authority of Wales’s First Minister, Mark Drakeford, Scotland’s First Minister, Nicola Sturgeon and the Mayor for London, Sadiq Khan, has been striking.
Thirdly, although I congratulate the Chancellor on acting quickly, providing hundreds of billions of pounds in extra and vital funding to protect employees and businesses—although the self-employed still remain to be protected—and surely with even more to come, the Government must promptly make much more funding available to local councils and voluntary groups because they too are on the front line. However, they have suffered budget cuts of around a third over the past 10 years.
In his novel, The Corridors of Power, C.P. Snow wrote that,
“political memory lasts about a fortnight.”
A fortnight since the Budget, its contents have been eclipsed by the Chancellor’s subsequent coronavirus announcements. He is rightly injecting hundreds of billions of pounds of Keynesian stimulus into an economy that is facing certain recession and perhaps even depression. The scale bears comparison with our Labour Government’s response to the 2008 global banking crisis—a response lambasted by Conservatives ever since. The Chancellor has rightly abandoned all the Tory borrowing rules and spending ceilings because the urgent action needed to stave off disaster requires intervention on a scale that only government can provide. The Chancellor was right to turn away from 10 years of Tory austerity and to throw the power of the state at the most acute crisis we have faced since World War Two.
However, that previous Tory insistence on non-intervention and shrinking the public sector has left us battling the coronavirus with an NHS in England that is short of 10,000 doctors, 40,000 nurses and 110,000 adult social care workers. It did not have to be like this. The Government have been able to borrow at record low interest rates for years and there was no need to wait until catastrophe stared us in the face before discarding the financial straitjacket. Why start spending and investing only in a terrible crisis like this? Despite gargantuan levels of national debt and borrowing to defeat Hitler, Keynesian policies after World War Two—led by both Conservative and Labour Governments—rebuilt this country through huge public investment and spending, generating healthy growth and a buoyant private sector. When the coronavirus outbreak is over, let us not repeat the mistake made after the financial crisis in 2010 of reverting in knee-jerk style to austerity and starving public services of support in a futile attempt to balance the budget, with only feeble growth accompanying it.
After the 1956 Suez debacle, Tory Minister Anthony Nutting wrote: “It has taught us no end of a lesson. It will do us no end of good.” The Conservative Party did not thank him for saying so. Today, after 10 years of avoidable austerity, this coronavirus crisis has reminded everyone what Keynes taught us about the vital role for an active, investing state in a modern enterprising economy.
My Lords, I direct the House to my medical and research interests noted in the register. The Minister, in his excellent introduction to the debate, referred to the lessons from the 1914-18 war. I understand that reference and have some sympathy for it. However, my friend the anthropologist Scott Atran has pointed out that there are certain dangers in using the terminology of war, because it tends to turn people towards various “isms”: racism, chauvinism, ethnocentrism and xenophobic nationalism—exactly the opposite of the things that we want to find in our global community at the moment.
In truth, a more accurate reflection would be to address the lessons of the 1918-20 flu pandemic, which crossed the world and led to the deaths of tens of millions of people. However, two things about that experience are different from our own. One is that people experienced it immediately after the war, when tens of millions of people had died. To some extent, they were emotionally almost numbed by the whole business of massive death. Secondly, unlike us, who are used to antibiotics, vaccination and an expectation that people will not die of infections, people at that time were very much aware that people died of infections, sometimes in large numbers.
These facts contribute to what another colleague of mine, Dr Kerry Sulkowicz, the president-elect of the American Psychoanalytic Association, has referred to as the second pandemic of the moment, which was referred to by the noble Lord, Lord Blunkett, and other noble Lords: a pandemic of anxiety. It is not that he suggests that this is an inappropriate or pathological anxiety. On the contrary, it is a very realistic anxiety, because what is ahead of us is profoundly dangerous and challenging. We do not even know how dangerous and challenging, so anxiety is not an unreasonable response; it is a natural, human response. However, it produces problems in reaction. It leads some people to be so overwhelmed that they deny the reality. Even coming through London today in my car, not by public transport for safety reasons, I still noted groups of people out on the street in much more than twos and threes, not taking seriously the very sensible advice that they have been given publicly by the Prime Minister, Ministers and other experts.
Sometimes it leads to people being paralysed by the anxiety so that they do not know how to deal with things, but it also often causes illness—not just psychiatric and emotional illnesses of various kinds, but physical illnesses. Many people will be falling ill, physically and mentally, as a result not of the coronavirus directly, but of the psychological sequelae of it. There are many sequelae, not just anxiety. Reflect, for example, on what it will mean for many people, particularly older people on their own, to face three months or more without ever having touched a person or been touched by them. As human beings, the physical dimension of life is of enormous importance. They will be losing that and undoubtedly reacting in ways we do not know, because it has never happened in this wise before.
Many years ago, I was called to do work at a hospice where the staff were finding difficulty in continuing their work. It became apparent that this was because of the repeated, incessant, unremitting experience of the deaths of those they were working with. Reflect for a second on what it will mean for health service staff, who have been relatively well used to getting people better, to find that hundreds and hundreds of their patients will die. How will they manage, psychologically as well as physically? Can the Minister say how much thought has been given to addressing these problems?
There are many other things that I could mention but I will say two. One is that there are, in the voluntary, private and community sectors, employee assistance programmes that have been relieving the health service of having to deal with many of these problems. They are not going to be able to survive financially if there is no assistance for them. The noble Baroness, Lady Hollins, who is not in her place, has asked that we also remember the problems, as have been mentioned, for those who are vulnerable because of learning disability. Finally, because there will be more people admitted on formal orders, can we monitor how many more patients come in than would normally be the case on such orders, so that we have a sense of the increased burden on the psychiatric services?
My Lords, I begin by drawing attention to my interests in the register. I have a series of questions for the Minister, most of which he will probably not be able to answer. However, I hope that he can write to us as appropriate.
I congratulate the Government and the TUC on the way they have worked together on this problem. They have shown that when it is needed, both sides are able to stand aside and work in the national interest. The TUC, as the Minister will know, has mentioned a wage subsidy for the self-employed. It has made the sensible suggestion that the subsidy should be based on the previous three years of tax returns, because of course we all believe that every self-employed person declares every penny that they have earned. This is an excellent suggestion from the TUC, and I hope that the Minister will be able to proceed with talks with it, not necessarily to agree it exactly as put forward but for some sort of help. We tend to think of the self-employed as people with big businesses but I am thinking of people such as musicians, actors and authors: people who work singly and are represented by Equity, BECTU and other unions. They are often sole workers, and very often earning not that much.
The second point, which I made recently in a debate, is the need to clarify what happens when companies goes into liquidation. They often do so with wages owing immediately to the staff, but, under the rules as presented at the moment, they have to be paid out by the administrator in bankruptcy. It would be very useful if some way could be found of according them the emergency relief afforded to other workers.
I turn briefly to the airline industry, not unsurprisingly. I place on record my thanks to the DfT Ministers, who I know have worked ceaselessly with the industry. They have had numerous telephone calls with BALPA, the union of which I am president, and other unions within the industry, as well as with the employers, of course. All airlines need some level of support. It is not for me to measure it out, but it is needed sooner rather than later. I suggest, as a guiding principle, that the support must end up not with the shareholders and directors but with the companies to strengthen them.
I never thought I would say that there was a positive gain from leaving the European Union, but one that does present itself is the ability for the Government in directing the rescue package for the airlines to make public service routes available and to subsidise them, which of course would not be permitted under EU rules but could now be. They could look at the many regional airlines that have been impacted by recent events.
Another aspect that can come out of this is promoting good employment practices, for instance better maternity leave. That is a demand on a number of airlines, which, because they have been male dominated for most of their history, have some of the worst maternity arrangements in the industry.
Perhaps I might mention just two or three points arising out of the brief from UNISON, which represents many health service workers. It is concerned, as I am sure the Minister is, that the use of healthcare students and returning workers has to remain on a voluntary principle; they cannot be directed back. If they do go back, the final-year students must be able to return to their learning without any penalties for leaving or interrupting the course. I am sure the Government have this on board, but I would just like to read it into the record.
There is a small technical point in the briefing I have been given. Apparently, staff who retired under the 1995 NHS Pension Scheme can work for a maximum of only 16 hours per week for the first four weeks and continue to receive their pension. I hope the Minister will be able to look into suspending this rule. I am sure he will be happy to assure the House that he will continue to talk to UNISON about the many problems it wishes to help the Government solve. There is no doubt about that.
My final point is on behalf of charities. The way in which wages are being subsidised is very good for business, but charities have very different income streams. I hope the Minister will consult with both the National Council for Voluntary Organisations and the Charity Commission to ensure that the rescue packages that have been put forward for business and are at least notionally available to the charitable sector are tailored in such a way that the charitable sector can make use of them.
With that string of questions, can I say how much I admire the Minister’s tenacity and hard work in doing the job he is doing? Please carry on.
My Lords, I draw the House’s attention to my list of interests in the register; in particular, that I am a registered nurse. We are here today at a time of public health challenge unknown to date on our globe. I will be brief and start with my support for the Bill, which is widely echoed by many Members who cannot be here today as a result of the social distancing advice to reduce the spread of Covid-19. However, they are following the Bill online and have aided my contribution. They include my noble friends Lord Patel, Lady Hollins, Lady Boycott, Lady Bull, Lady Hunt of Bethnal Green and Lord Bird. In addition, our Convenor has been in contact with our Members throughout the week. His message has been that while on first reading some of the measures in this Bill appear draconian, under the circumstances they are necessary. Knowing his concerns about the use of Henry VIII powers, this opinion should carry considerable weight in our deliberations.
The Royal College of Nursing and the British Medical Association have provided detailed briefings, as have many other parties, including the Royal College of Psychiatrists. In principle, they support the measures outlined in the Bill to protect the public and essential workers. However, they want reassurance that the measures will have regular parliamentary review, preferably at least every two to three weeks, to ensure the effectiveness and relevance over time. Can the Minister outline the plans for review once the Bill is enacted?
Nurses and other healthcare staff who have recently retired and those about to qualify have been encouraged to return to work or commence employment earlier than planned. We are assured that they will have the same employment rights as other workers. Sadly, we know from the management of previous infectious diseases that some healthcare workers will catch Covid-19 while carrying out their duties. Will these staff be entitled to proper sick pay in line with NHS employment rules? In the exceptional circumstances of such an individual dying, will death-in-service benefits be generous? These benefits often relate to length of service, so it may be necessary to change the current terms. Does the Minister agree?
Other noble Lords have spoken of the challenges in social care and the potential for some people to have, in effect, the current level of service reduced as demand rises. A range of groups associated with long-term disability ask: will any reductions be re-instigated after the emergency period? Can the Minister reassure the House on this issue, the details of which were brought up extremely effectively in the powerful speech of my noble friend Lady Grey-Thompson?
The changes to the Mental Health Act are supported by the Royal College of Psychiatrists and will be necessary to protect people with serious mental health problems and to ensure rapid access to treatment. However, some human rights organisations are concerned that that will result in higher numbers of detentions than normally, particularly among disadvantaged groups. As a former acute ward psychiatric sister, I remind the House that once a patient is admitted, other professionals assess that patient quickly, and that treatment orders can be rescinded rapidly if appropriate. Will the Minister consider echoing this point to reassure those who are so worried?
NICE has given guidelines to prioritise patients for effective treatment and critical care, and these of course need to guide clinicians and be enacted by them in their work. However, there are some concerns that the guidelines from NICE on this issue refer to frailty. Can the Minister further assure the House that frailty with regard to physical and learning disability and severe and enduring mental illness will not disproportionately disadvantage these groups? My noble friend Lady Grey-Thompson raised this issue in detail, and I will not cover it further. I thank her again for her powerful speech on a range of social care challenges and the rights of people with a range of long-term conditions. I await the Minister’s reply to her questions.
Finally, will the Minister ask the Government to consider debt relief for the fees of healthcare students who are entering the workplace this year and who will work in our healthcare settings, probably for several years in the future? It is extraordinary that we are asking them back. They have paid their fees this year; they are willing to come back—we need some intergenerational fairness on this issue.