My Lords, it is a sad fact that this horrible virus targets over-75s more than any other group. We should all be proud of the country’s determination to protect the lives of the elderly and the infirm and give thanks for the vaccines that save so many lives. I assure my noble friend that the NHS has remained open to all and will catch up on the backlog for all those who need medical intervention, irrespective of age.
My Lords, we all recognise that the pandemic has had a particularly devastating impact on the elderly, with them not being able to see loved ones, isolation increasing dementia and high death rates in care homes. While I congratulate the Government on vaccinating all those in care homes, can the Minister kindly tell us when those housebound and receiving care will all be vaccinated? Will the Government consider adopting the successful Tubbe system being used in many Belgian care homes, whereby management and residents cojoin in decision-making, thus giving the residents more control of their daily lives and helping them to cope?
My Lords, we have now reached more than 80% of over-80 year-olds. Local vaccination services, of which there are more than 1,000 in England, co-ordinate the delivery of vaccinations to people who are unable to attend a vaccination site, including visiting homes, the personal homes of housebound individuals and other settings such as residential facilities for those with learning difficulties. The rollout of the vaccine to those at home is progressing at great pace and we are getting great feedback from the front line.
Is the Minister aware that many people over 75, notwithstanding their age, are providing care for family members—a spouse or an adult child with special needs, for example? Research by Carers UK shows that two-thirds of these older carers are providing more than 90 hours’ care a week, having had to take on more duties during the pandemic. One-third of them say that they are reaching breaking point and that their own health, physical and mental, has been severely affected. How will the Government ensure that sufficient support is available to these older carers, on whom so many depend?
My Lords, I pay tribute to all those elderly carers, who, as the noble Baroness quite rightly points out, provide a huge service to society, to their loved ones and to the community. We have put in place a tremendous amount of support for carers, including PPE support. We have changed the arrangements for domiciliary care so that we can restrict the spread of the virus, and we have changed the way in which domiciliary care is paid for. The noble Baroness is entirely right: we should not forget the considerable contribution made by a large number of unpaid carers, many of whom are themselves elderly.
My Lords, as well as the direct health impacts that the pandemic has brought on older people, there are the indirect effects of increasing loneliness and isolation, which can have a devastating impact too. As the country emerges from lockdown, will my noble friend ensure that the right support for mental health and other support is in place for this group, including better access to their families and loved ones through more flexibility in the use of support bubbles?
My Lords, my noble friend is entirely right about the massive mental health challenge and, if not the challenge to mental health, that of the isolation and loneliness felt by many who are shielding or isolated. Seven hundred and eighty thousand individuals over 70 are considered clinically extremely vulnerable. We have changed the terms of the shielding arrangements to give them more flexibility, and we have published the well-being and mental health support plan relating to Covid-19, which sets out steps to strengthen the support available for those who are struggling. But my noble friend is entirely right: we must do more to support and help voluntary organisations, which play a critical role, as do local authorities.
Another wave of Covid is hitting care homes at the moment. Therefore, there is an urgent need for hand-held rapid testing kits that deliver accurate and swift results. What investment is being made in biotech companies and care staff to develop a rapid testing system that works at scale?
My Lords, the innovation and partnerships team at NHS Test and Trace has an enormous programme on this. The lateral flow devices are a huge development but, as the noble Baroness undoubtedly knows, the sensitivity of a lateral flow device means that it is not necessarily appropriate for the user case that she described. We have invested in DnaNudge and other small point-of-care devices, but having a fast-turnaround device that can be rolled out in mass numbers is a challenge, and we continue to search for the ideal format.
My Lords, with the opening up of appointment slots for the fourth cohort, as announced by the Secretary of State last night, can the Minister assure all those in earlier cohorts that their second dose of the vaccine will be given in a timely manner within the 12-week timeframe, and how will this be managed?
I completely recognise the concern of my noble friend and of many in the Chamber on this point, so I shall provide concrete reassurance. Everyone will receive their second dose within 12 weeks of the first one. All those booked in at vaccination centres will have an appointment, made at the same time, to receive their second dose, and those who do not have a date today will receive one from their GP.
My Lords, the Minister will know that six out of 10 people with dementia live in their own home, so they depend on a range of care workers coming into their home—sad to say, often without PPE and some even without face masks. In contrast, those living in residential care have now gone almost a year without being allowed a visit from a loved one—they are not able even to hold their hand. Does the Minister agree that now is the time to set up a formal review in order for us to learn the lessons of the impact of Covid-19 on the over-75s suffering from dementia?
The noble Lord explains the situation of those who have been in care homes and separated from their loved ones extremely well. We all feel extremely heartbroken by the stories of people who have been separated from their loved ones, but we need to put the saving of life as the first priority. Visits have been allowed outdoors, behind screens and in safe environments. I appreciate that that is not the same as an intimate face-to-face meeting but, where we can, we have put in place guidelines to ensure that people are protected. A review of the guidelines will happen on 22 February, and that seems the right moment to review these procedures.
My Lords, the priority list from the JCVI indicates that all residents in care homes, older adults and those over 80 will be first. But, with the current state of the rollout, all those over 65 should have been offered a vaccine, and I encourage them all to step up and respond to the letter when they receive it.
I would like to ask the noble Lord about domestic abuse. Next year, ONS data collection will, for the first time, include those aged over 75 who suffer from domestic abuse. That is an important step forward. However, the pandemic has meant that many older people at risk of domestic abuse are indeed isolated and at risk. So what steps are the Government taking to collect data on the impact of domestic abuse on over-75s during the pandemic and to ensure that appropriate support is in place for older victims and survivors?
My Lords, the noble Baroness makes the point extremely powerfully. Of course, our prevailing feeling is of admiration for all those who have, through love and companionship, cared for those who are shielding or at home. But of course, as the noble Baroness alludes to, there are instances when, through either domestic tension or simple abuse, there is violence, and we cannot hide from that fact. I am not aware of a current trial or piece of research on this matter but I will take it back to the department and undertake to write to the noble Baroness with an update.
I declare a personal interest in this question. One thing that has really helped to keep elderly people informed has been broadcasts, which they have accessed through the free TV licence. I hope that the Minister will make sure that the free licence continues long after the pandemic is over.