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.
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