MUSLIM COUNCIL OF BRITAIN−WRITTEN EVIDENCE (PSR0108) In its explanatory notes, the House of Lords Select Committee on Public Services stated its desire to gather experiences of the Public Services during the Covid-19 crisis, particularly from those working in frontline services. The Committee also noted its intention “to take evidence from hard-to-reach groups and individuals with experience of accessing services during the Covid-19 outbreak.” The Muslim Council of Britain (MCB) is grateful to the Select Committee for its extension of the deadline for submissions to 27th July 2020. The scope is taken as covering publicly funded bodies, delivering a public or government service (central and local, and including public corporations under their control) but not as a ministerial department. Background Muslims in Britain form the second largest faith community, numbering 2.7 million, or 5% of the population (2011 Census). The majority (76%) live in the inner-city conurbations of Greater London, West Midlands, North West and Yorkshire and the Humber. The MCB is a national umbrella body with over 500 mosques, educational, charitable associations and professional networks affiliated to it. It includes national, regional, local, and specialist Muslim organisations and institutions from different backgrounds within British Muslim civil society, reflecting its diversity of ethnicity, language, culture and schools of thought. Introductory comments Britain’s faith institutions – that include about 1,200 mosques - have fulfilled a crucial role in safeguarding communities during this crisis and have emerged as an essential partner of public service delivery bodies at national and local level. For example, UK Government called for the closure of all places of worship and imposed lockdown measures across the UK on 23 March 2020. However, the MCB had taken steps earlier, on 16 March, to strongly recommend to its network of affiliated mosques the temporary suspension of all congregational activities. This was widely taken up and has since been followed up by the MCB and its affiliate, the British Islamic Medical Association (BIMA), in numerous and on-going regional and national online briefings. The faith sector can reach out to the population promptly and effectively because it is a trusted voice with established lines of communication and networks that have grown in an organic way over the decades. Given the day-to-day evolving picture on what is known of Covid-19 and its societal impact, this submission should not be seen as offering any definitive answers to the questions posed by the Committee, but a snapshot of ‘voices from the grassroots’. Moreover, the MCB is still in the process of collating data on the various efforts of its affiliates in providing services of public benefit, either to complement the public services, or to step in where there have been shortcomings or shortfalls in delivery. With these provisos, this submission provides responses to a subset of the questions posed by the Select Committee from: I. Carers and Care organisations II. Professionals in public health, and primary and secondary care services III. Policy Analyst in the MCB IV. Voluntary Sector Muslim civil society organisations – ten case studies of public benefit work Some of the responses obtained overlap in content, offering different perspectives. Concluding observations and reflections are provided at the end. I. Carers and Care organisations What have been the main areas of public service success and failure during the Covid-19 outbreak? [HoL Committee Q. 1] How have public attitudes to public services changed as a result of the Covid-19 outbreak? [HoL Committee Q. 1] Source Response Unpaid carer In May 2020, my local Council phoned me to ask me how I was coping with providing care. This was a good step and helped my morale. I was asked whether I needed face masks. A delivery was promised. It is now two months, and this has not come. Housing consultant & board What is clear is that community based member of housing organisations like some of the ones I associations with care home work, represent and am engaged with services (Manningham Housing Association, Unity Home & Enterprise, The Popda Society, Mount Cricket Club), are vital to ensure that there is two way communication as we have earned the trust of the communities and reassure them at a time of national crisis and therefore an essential partner to government and its agencies. The government has just adopted to date a one size fit approach which is not having the right impact amongst certain BAME communities. Perhaps the biggest contribution we can make is speak up and communicate on behalf of our communities and raise the concerns and deficits in provision, PPE etc [that occurred in May 2020]. This is where we need to pull our effort to get the message back to government and its various agencies and partners. Given the number of cases of Covid-19 and fatalities in the social care and independent living sector for older people, I am concerned that after all this is over or at least under control, that the perception and reaction from the BAME communities towards older person specific accommodation with care and support and provision might be viewed negatively given the high number of Covid-19 related deaths, yet it’s essential given the MCB research to reduce loneliness, isolation and economic hardship, that these perceptions are corrected. GP with special interest in Excess burden of illness in the Muslim elderly and palliative care and community and restrictions on hospital chair of community-led visitation policies resulted in ill patients organisation not wanting to go into hospital. They wanted to be cared for at home. This placed increased pressure on family members. There is stigma around care homes in the Muslim community, and this has not been helped by data which shows that despite making up 3% of the population of care homes, BAME care home residents made up approximately half of all care home deaths II. Professionals in public health, and primary and secondary care services From a Public Health Response delivery perspective What have been the main Successes: areas of public service London was the epicentre of early success and failure during stages of the pandemic in the UK. the Covid-19 outbreak? Excess deaths and provision of allied services was well co-ordinated [HoL Committee Q. 1] (Logistics Cell) which involved participation of multidisciplinary Did resource problems or stakeholder groups that included capacity issues limit the coronial services, Metropolitan Police, ability of public services to funeral directors, cemetery operators, respond to the crisis? Are community and faith representatives. there lessons to be learnt The multidisciplinary stakeholder group from the pandemic on how worked collaboratively to address resources can be better issues such as storage, transport, PPE, allocated and public service infection control, real time sharing of resilience improved? resources and experience. The National Burial Council played a significant role [HoL Committee Q. 3] in representing the Muslim community. Failures: Confusion about testing: An emergency national Public Health Laboratory Service, created in 1940 as a response to threat of bacteriological warfare, was converted to a Public Health Laboratory Service (PHLS) by an Act of Parliament 1946. The 50+ laboratories that were co-located and integrated with local NHS hospitals across the country provided a public health focus, well placed to participate in local and national public health response. Since the replacement of the PHLS by the Health Protection Agency (HPA) in 2003 and later by the PHE (2013), this important public health response capacity has been lost. The PHLS existed to provide the essential service to respond to outbreaks like Covic-19. It is hoped the Select Committee will consider recommending the reintroduction of dedicated public health microbiological services at local/regional level. Pandemic preparedness: Following experience with the H1N1 influenza pandemic of 2009, UK developed its Influenza Pandemic Preparedness strategy (2011), the PHE Pandemic Influenza Strategic Framework (2014) was established. There is a need to assess to whether the strategy was implemented appropriately or was it not fit for purpose. Is an “Implementation Strategy” needed? Infection control advice: Making people follow advice requires behavioural changes. Its dissemination and effective implementation require clear, precise and authoritative public messaging. Unfortunately, this has not been the case in the two important areas: wearing of masks and testing for the virus. There has been an appreciable dent in confidence. Messaging: This could have been better and better directed for the communities (socially, culturally). Messages were often confusing – civil society devised innovative methods – need to acknowledge their role and work more closely with them, co- production, cobranding approaches Lockdown: No strategy/criteria for easing lockdown. Access to services: Accessing non- Covid related health services was difficult – need to assess to what extent this contributed to spread of infection in the community (e.g. care homes/carers; increase in pool of vulnerable in lockdown situation). It was difficult for some to get through the over-stretched 111 NHS line. There was confusion about who to contact- GP, 111 or 999. There have been delays with patients seeking advice on cancer and cardiovascular conditions/symptoms