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Covid-19: Medically Vulnerable People

Volume 803: debated on Wednesday 22 April 2020

Question

Asked by

To ask Her Majesty’s Government what assessment they have made of the impact of the restriction of movement on those defined on medical grounds as extremely vulnerable from COVID-19; and what plans they have to change those restrictions.

The Question was considered in a Virtual Proceeding via video call.

My Lords, we recognise that though shielding is for individuals’ own protection, it is an immense undertaking. Decisions to advise shielding were taken after very careful consideration. The implications for those concerned are profound. We constantly review all social distancing measures and will continue balancing the need to protect the clinically extremely vulnerable from contracting Covid-19 against the restrictions that this places on their lives.

My Lords, I appreciate greatly the work that the Minister, his team and his colleagues are doing. I know that he will join me in appreciating the hundreds of thousands of volunteers, and mutual aid programmes at local level across the country as well, who are supporting people who are trapped in their homes. I wonder whether the Minister will discuss with his colleagues whether particular measures, which would not put at further risk those who are most vulnerable, could be adjusted to enable people to be treated in hospital for other conditions, given the concerns of Cancer Research UK and the British Heart Foundation, among others. Could we also take into account that two weeks ago, when I hope we reached the peak of deaths from the virus, there were 2,300 estimated additional deaths not related to Covid-19, which must be a great worry to all of us?

I completely agree with the noble Lord’s concerns, both about those who are clinically vulnerable and about the potential for a rise in non-Covid excess deaths. The second is a matter of extreme concern. The example of those with cancer who are going to hospital to have operations is a very good and clear example. These matters are very much at the highest level of the Government’s mind.

I thank the Minister. According to media reports, those who are particularly vulnerable to the virus could be advised to remain shielded for up to 18 months, or until a vaccine has been developed. Can the Minister confirm whether these reports are true? Secondly, the Government have recruited 700,000 NHS volunteers to support those who are vulnerable or shielded. Most of them seem to have been processed but many have been given nothing to do as yet, when there clearly is need. Will the Minister tell me how quickly that issue will be resolved?

The noble Baroness is entirely right. The prospect of long-term shielding for those most vulnerable is of deep concern. That is why we are pressing so hard on the disease, through the lockdown, to try to get R as low as possible. We will be putting in track-and-tracing measures to ensure that R can be held down and those in lockdown can be freed from their confinement. In terms of volunteers, the response has been incredible. It takes time to turn around all the offers of help that we have, but we are moving extremely quickly to do that.

My Lords, is there not a danger that extending the lockdown for only certain groups might unintentionally discriminate against elderly and vulnerable people? Might a better way forward be mass testing, tracking and tracing, as the Minister mentioned, plus the rapid development of a vaccine? If the Government are going to continue to isolate vulnerable people, will the Minister agree that this should be subject to a view by an individual’s GP?

The noble Lord makes a reasonable point, but I confirm that it is the virus that makes this discrimination, not the Government. Certain demographics are even more vulnerable than others. It is an unfortunate fact that those who are medically vulnerable are singled out by the virus. We have to put in place measures to protect and safeguard their lives.

Following up on the questions from the noble Lord, Lord Truscott, and the noble Baroness, Lady Thornton, when we eventually get to the stage of lifting restrictions I urge the Government not to discriminate against the elderly on the grounds of vulnerability and not to treat them as a single category. Many of the elderly—over half a million—continue to work. They feel acutely the separation from loved ones. They are conscious of their own vulnerability, are perfectly sensible and do not need the threat of law to protect them. Will the Minister remind his colleagues when decisions come to be made about lifting restrictions that the decision is not just for scientists? It is a political question as well. Policy that might be acceptable in China might not be acceptable here.

My noble friend is entirely right that the political context in Britain is based on rule by consent. We are not an authoritarian state. However, I cannot hide from my noble friend the point that I made to the noble Lord, Lord Truscott: it is the virus that is a discriminator, not the Government. The clinical assessment of risk for many older people, particularly those with medical conditions, is very high. The Government will be guided by clinical advice in their advice and recommendations to all groups, although the effect of safeguarding and lockdown on the elderly is fully understood. We will put in as many mitigation measures as we can to prevent any long-term harm.

My Lords, on 16 March the noble Lord, Lord Bethell, told the House that anyone with an underlying health condition will be contacted by their local GP to clarify what kind of risks they face. A very large number of people still have not had their letter or text from the Government saying that they should be shielding, let alone conversations with GPs. I am in the shielding group and my consultant has told me that I should prepare to be shielding for 18 months. Can the Minister confirm that everyone who should be shielding has now been notified by the Government and their GP that this is the case?

The noble Baroness is entirely right. Letters should have been sent to all those who should be shielding. I am aware, as she rightly points out, that this process happened extremely quickly and there was a very fast turnaround. I have accounts of people who were sent a letter who should not have had one and I have accounts of people who should have had a letter who did not get one. We are working hard to fill the gap, but 1.3 million letters were sent out and, on the whole, I believe that this exercise has delivered clear recommendations to those involved.

To follow on from my noble friend Lord Lamont’s question, can we please ensure that vulnerable people have agency, that those who want to act as the unvulnerable are allowed to, that grandparents who wish to see their children are allowed to, and, at the same time, that those who are young and vulnerable are protected in their decision to continue to isolate and are not discriminated against because of it?

My noble friend Lord Lucas makes a completely reasonable plea. On a personal level I completely understand where he is coming from. I have elderly relations who I would like to see, hold, touch and socialise with. But, as I said, I cannot hide from the House that this virus is an extremely predatory killer that has in its sights particular demographic groups, including the elderly and in particular those with conditions. It would be wrong of me to mislead the House by pretending that there was an easy way out of this epidemic for those who the disease seeks to attack.

My Lords, given that some very healthy older people have mistakenly received 12-week lockdown letters, including inaccurate and anxiety-causing assertions that they have underlying medical conditions, will the Government permit an arrangement whereby the relevant GP practice can confirm or refute the issue of the letter and certify to that effect?

The noble Lord makes a very reasonable request. I have sought clarification from the department on this point, because his suggestion seems eminently reasonable, and as soon as I have a reply I will write to him and share the contents with the Library.

My Lords, I regret that the time allowed for this Question has elapsed. I apologise to the few people at the end of the list who have not managed to get in. We will seek to deal with that in the allocation for future Questions.