Written evidence from Lord Alton of Liverpool (COV0095)


I welcome this important inquiry into HMG’s response to one of the most significant challenges faced by this country since World War II. My submission focuses on the situation in care homes.

  1. Introduction

On 30 April 2020, the Telegraph reported that Care home deaths could be four times worse than official figures suggest, with new analysis showing that more than 17,000 deaths in homes across the UK are linked to coronavirus.[1] The phenomenal loss of life in our care homes is an issue about which I spoke in a House of Lords debate last week – and about which I have tabled questions and sent emails.[2] I have also argued that it is urgent to decentralise more direct control of testing and local management of the arrangements for containing the wildfire raging through our care homes.[3] I am very fearful that care homes will be the arterial road down which the virus will travel to create a second wave of the pandemic – and about which the Prime Minister rightly expressed his grave concern yesterday. But to understand the enormity of this challenge we need much more finely tuned data. This submission challenges the data published by HMG and emphasises the lack of transparency in how HMG is responding to the deteriorating situation.

  1. The Severity of the Issue 

In late April 2020, HMG released backdated information about Covid19 related death in care homes (and places other than hospitals). Despite this being an important step, the presented data differs significantly from some of the recently published assessments. For example, the National Care Forum estimates that more than 4,000 elderly and disabled people have died across all residential and nursing homes in the UK, deaths that are reportedly related to Covid19.[4] Another assessment by Care England suggests that in the last two weeks there have been 7,500 more deaths in care homes, from all causes, than would be expected at this time of year. Candesic, a health consultancy, estimated that the number of deaths due to Covid19 in the UK care homes at over 6,000.[5] These figures (and those published in Telegraph on 30 April 2020) are extremely disturbing, especially, as they constitute a significant proportion of the care home population (currently assessed at approximately 400,000), and present a much higher Covid19 related mortality rate than that of the general public. My concern is that the situation will simply deteriorate further. 

  1. HMG’s Response to the Issue  

It is unclear what HMG is doing to ensure that the presented data is coherent, as accurate as possible, and reflects the severity of the challenge.

It is crucial that elderly members of our society are provided with adequate medical assistance during this pandemic; assistance that is human rights compliant and affirms their human dignity. No human life is expendable in this pandemic. The very moment we start choosing which life is worthy of protection and which is not, we are losing the ultimate fight against Covid19, we lose our very humanity.

It is also unclear how HMG is responding to the issue. Because of reports of inadequate responses to the Covid19-reated challenges faced by elderly people, in May 2020, the UN published a Policy Brief: The Impact of COVID-19 on older persons, to guide States through the human rights complaint responses.

The UN Policy Briefing calls upon States to: 

 Ensure that all older persons at risk of acquiring COVID-19 - especially those with underlying health conditions and those living alone - are identified and attended to as early as possible.

 Ensure that medical decisions are based on individualized clinical assessments, medical need, ethical criteria and on the best available scientific evidence. 

 Take urgent action to prioritize testing of vulnerable populations in closed settings, including older adults living in long-term care facilities, in areas of sustained community transmission.

 Ensure continuity of adequate care services for older persons such as mental health services, palliative and geriatric care, including through support for unpaid caregivers in homes and communities, and for paid care workers who provide home-based care or care in institutional settings. 

 Ensure that COVID-19 cases or deaths occurring in care facilities are reported and improve monitoring of the situation in residential care facilities.

• Strengthen services to prevent and protect older persons, particularly older women, from any form of violence and abuse, such as domestic violence and neglect. 

 Ensure that visitor policies in residential care facilities, hospitals and hospices balance the protection of others with their need for family and connection. 

 Ensure that contingency plans and strategies address the high risks faced by older refugees, migrants and displaced persons and provide access to health treatment and care.

In parliamentary questions I have asked how HMG is acting on these recommendations and, where necessary, how HMG will change the current practices and implement the above recommendations. I have current questions on the Order Paper about this.

  1. Recommendations

I am grateful that the Joint Committee on Human Rights has decided to give careful attention to this issue. During its deliberations I hope that it will carefully appraise the way in which the Government and public bodies have responded to the situation in care homes; what lessons we learnt from the experiences of Italy and Spain; and, specifically, how the Government has implemented the UN recommendations and with what result.


[1] https://www.telegraph.co.uk/news/2020/04/30/exclusive-care-home-coronavirus-deaths-could-four-times-higher/

[2] https://davidalton.net/2020/04/23/house-of-lords-virtual-debate-on-covid-19-and-the-impact-on-care-homes-april-23rd-2019-when-will-care-homes-be-provided-with-adequate-supplies-of-ppe-and-their-staff-routinely-and-regularly-tested/

[3] https://davidalton.net/2020/04/30/parliament-urged-to-decentralise-powers-to-successfully-fight-covid-19-contract-tracing-and-detailed-on-the-ground-management-should-not-be-done-by-whitehall-disraeli-and-churchill-were-right-that/

[4] https://www.theguardian.com/society/2020/apr/19/care-homes-body-says-4000-residents-may-died-have-from-coronavirus

[5] Ibid.