Covid-19 (Public Services Committee Report) — House of Lords, 2021-07-22
Topic: Health
Nicholas Bourne (Conservative, Centre-right): My Lords, it is a great pleasure to follow the noble Lord, Lord Bilimoria, who spoke compellingly about collaboration. It has been a pleasure and an honour to be a member of the Public Services Committee, which has behaved throughout in a collegiate and constructive way, and I thank my committee colleagues. Like others, I would like to thank our excellent chair, the noble Baroness, Lady Armstrong of Hilltop, who has demonstrated throughout hard work, dedication and great good humour. Thanks also go to our secretariat—the team of Tristan Stubbs, Claire Coast-Smith and Mark Hudson —for their utter professionalism Our first report, as has been stated, commenced physically in February last year, before the first lockdown, but we quickly moved to working virtually. Work was carried out remarkably smoothly on our report A Critical Juncture for Public Services: Lessons from COVID-19, which was published in November last year. I thank officials, broadcasters and all who made this possible. I will focus on three areas in particular, although, as has been demonstrated by those serving on the committee, our report was wide-ranging. I would like to look at prevention and early intervention, then at local delivery, and then at the importance of voluntary organisations. On prevention and early intervention, a key area, the evidence that we saw was clear. People who are obese, who smoke, who are diabetic and who live in unhealthy social, economic and physical environments are at a far higher risk of dying from Covid-19. That seems now almost beyond challenge. The Prime Minister himself nailed the danger of obesity when he spoke of Covid-19. Yet the Government in their response to the report did not recognise these factors explicitly, rather surprisingly, saying that further analysis of the evidence will inform our learning. I hope that the Government accept the very clear evidence, and it will be good to hear from the Minister on this Our inquiry heard from Sir Michael Marmot about the underfunding of prevention services, and we heard that obesity rates were highest in deprived areas. It is laudable that the Conservative manifesto of 2019 commits to extension of healthy life expectancy by five years by 2035. A litmus test of the Government’s approach will be the attitude to the recently published national food strategy, the Dimbleby report, the last part of which was published last week. That report is clear on action at producer level to reduce salt and sugar in foods, just as we have done successfully under a Conservative Government for soft drinks. That action would produce results. I hope that the murmurings of some on the libertarian extremes, who suggest that exhortation is sufficient, are ignored, given that they are the voices of a few people who have not been following the evidence of the pandemic, and who are committed to an imagined libertarian Valhalla. Not only will positive action help hundreds of thousands, if not millions, of our fellow country men and women, it will also of course ease pressures on the NHS and, indeed, on the economy from the impact of ill health. The details of how the Government are to carry out future arrangements are awaited with interest The importance of preventive services in the Ministry of Justice and the Home Office is also highlighted in our report. The Government’s response does not pick up on how there will be investment here in preventive services for those who have been impacted by addiction, homelessness and poor mental health—evidence that we received on this from Revolving Doors. By the same token, early intervention on education, particularly as disadvantaged children have fallen further behind, is crucial. Beyond the existing pupil premium, we need to pick up the proposals on catch-up that Sir Kevan Collins put forward On localisation, in the memorable phrase spoken earlier by the noble Lord, Lord Shipley, running England out of London is not on. I agree with that, as does the report. Local provision, whether through the public sector or voluntary organisations, is vital; it is familial, trusted, responsive and fleet-footed, and it is more likely to be flexible. We need to recognise that through public health teams and more local funding, not just because of a democratic deficit but because of lack of local provision, certainly contributing to the disease and to death. I welcome the progress that has been made on metro mayors, and I anticipate more—but much more than that is needed for the localisation that is necessary. The third area of our report that I wanted to cover related to the importance of voluntary organisations. As I have indicated, they are trusted and familial. Their reach is extraordinary, as I found during our inquiry. For example, Ian Jones, the chief executive of Volunteer Cornwall, told us of 4,500 Cornish charities. Many local councils pick up and work with the voluntary sector. Camden Council, for example, relies on Hampstead Volunteer Corps to help with food distribution, and we welcome the development of the new outsourcing playbook by the Cabinet Office. It is welcome, but we need to see it being followed by ensuring that public service commissioners prioritise social value when contracting services. We look forward to that In short, there is a lot to do, and I look forward to hearing from the Minister on taking things forward—in all our interests, but particularly in the interests of those most disadvantaged, which, as we have heard, includes the BAME community, as well as the Gypsy, Roma and Traveller communities. Generally, those at the bottom of the pile have been hardest hit, and the Government must do more to help them.