Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020
(4 years, 3 months ago)
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Lord Bethell
That the Regulations laid before the House on 3 July be approved.
Relevant document: 22nd Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, these regulations were made on 3 July and came into effect the following day. On 16 July, my right honourable friend the Secretary of State for Health and Social Care made a Statement in the House of Commons saying that the latest epidemiological data allowed for a relaxation of some of the measures in the protected area of Leicester. As of Saturday 18 July, local restrictions were lifted in other parts of the county that were initially in the protected area, namely Charnwood and Blaby. As of 24 July, a further amendment to the regulations meant that non-essential retail, out-of-school childcare and education establishments were allowed to reopen in Leicester. Bars, restaurants and hairdressers remain closed until at least the next review, which will be on 30 July.
The concern about the outbreak in Leicester has been significant, which is why we took it so seriously. Engagement has been extensive, repeated and productive, and is, I am pleased to say, yielding results. I would like to say a profound thank you to the local authorities and the local resilience forum, to national organisations including Public Health England and the Joint Biosecurity Centre, and to the local directors of public health, Ivan Browne of Leicester City and Mike Sandys of Leicestershire County Council.
The decision to act was not driven by any one number. It was a judgment about the overall situation. But when we imposed the local lockdown, one number did stand out: the seven-day infection rate. In Leicester, it was 135 cases per 100,000 people, which was at the time three times higher than the next highest area. On the clinical front, admissions to hospital were between six and 10 per day in Leicester, rather than one or two, as in other trusts. Action had already taken place to protect people in Leicester, including increases in testing and public health capacity. We hoped that these interventions and the work of local public health teams would get the infection rate down. However, by the end of June it was clear that the high rate of infection was continuing.
The cross-government Covid-19 operations committee, chaired by the Prime Minister, decided on 29 June to take further measures. The Secretary of State set out these measures in his Statement. Most of the measures taken did not require legislation. We increased testing capacity further, with eight mobile testing units deployed across the city and three local test sites. We also gave additional funding to the upper tier local authorities: Leicester City Council received about £2.5 million and Leicestershire County Council received approximately £2.3 million. This enabled them to enhance communications, including using locally relevant languages and channels such as community leaders and volunteers. We recommended against all but essential travel to and from Leicester. Shielding measures could not be relaxed, as they were in the rest of the country the following week. Schools in Leicester were closed, except to vulnerable children and children of critical workers.
Data is critical to the response, and gigabytes of data have been provided to directors of public health and local authorities to inform their local action plans. From 11 June, NHS Digital made available to directors of public health an operational data dashboard, including counts of local tests, local total positives and local total voids per local authority. Leicester had access to the dashboard from 19 June. The PHE field team provided support and analysis for the directors of public health prior to them gaining access to the dashboard. Local-level test-positive data, including postcodes, was provided to Leicester on 25 June, once it had signed a data-sharing agreement. As of 20 July, PHE has provided to directors of public health access to fully identifiable data via a secure platform to enable them more flexible access to positive-test case and contact-tracing data to support their outbreak management responsibilities. Data is currently updated daily.
Every day there are dozens of conversations between directors of public health, local authorities, the JBC and PHE. Data and analysis are shared on secure platforms and according to privacy laws. However, I remind noble Lords that data on its own does not beat the virus; local action beats the virus, and I commend the unsung local heroes—the infection-control professionals—who deal with many outbreaks and break the chain of transmission by implementing effective Covid action plans every day of the week.
Given the urgency of the situation in Leicester, we used the emergency procedure to make the present set of regulations as soon as we could. They require the closure of non-essential retail, limited overnight stays and restricted gatherings, and they enable households containing only one adult or one adult and one or more people under the age of 18 to link with one other household.
Regulation 2 requires the Secretary of State to continue to review the need for the restrictions. The first review was on 16 July; the next one will be on 30 July. Regulations 8 to 11 set out how the provisions will be enforced. We also published guidance in the relevant languages for people living in Leicester.
Since these measures were introduced, it is clear that our co-ordinated local and national effort, particularly by the people of Leicester, is working. The number of positive cases is down by 54%, with the seven-day total per 100,000 of population reducing from 140 to 64.
We always knew that the path out of the lockdown would be a marathon, not a sprint. The Leicester lockdown has demonstrated our willingness and ability to take action where we need to. We will learn from the experience of the lockdown in Leicester to develop our responses to further outbreaks. As I said earlier, one review of the regulations has been completed and another is due by 30 July.
I am grateful to all Members for their continued engagement in this challenging process. I profoundly thank the people of Leicestershire, who have responded so well to the measures in place. It is thanks to their continued efforts that we were able to reopen non-essential retail and childcare and education centres. I commend the regulations to the House.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, I thank the Minister and refer him to the report of Sir David King and colleagues in Independent SAGE, who concluded that:
“The situation in Leicester was both predictable and avoidable.”
This derived from the premature lifting of lockdown restrictions when the virus was still circulating widely in some areas, when there was no functional system of find, test, trace, isolate and support, and when the Prime Minister then sent an implied message that things were getting back to normal. Independent SAGE further stated:
“The current situation arose out of a failure to respond to the increase of infections in Leicester … at an early stage and before they reached crisis levels. This was a result of several factors”,
including
“excessive centralisation and unavailability of data”.
The Minister said just now that megabytes of data were given to local directors of public health, but why did it take so long for all the data to be given to Leicester’s director of public health?
On Monday in his Covid-19 Statement, and he repeated it today, the Minister was very clear that the Government were in constructive dialogue with dozens of directors of public health. If that is the case, can he explain why, on the test and trace system, directors of public health have expressed frustration that local expertise has been sidelined? Of course, he is right in saying that data alone will not deal with the virus and that what counts is local action. However, does he not agree that for local action to be effective, you have to trust people locally and give them the full facts?
Lord Scriven (LD) [V]
I refer to my interest as a vice-president of the Local Government Association. These regulations, made at speed, playing catch-up and at odds with government guidance, have caused confusion for local people—for example, being told not to leave the lockdown area when that is not in the regulations, and some police forces saying that they would turn back cars registered to a Leicester address. The Government believe that a top-down approach is best, and they are not listening.
Back in March, I moved an amendment to the Coronavirus Bill to give local authorities a power of general direction. It is a pity that the Government refused to accept it. A little more listening to some of us who have served in local government would have helped prevent some of the issues that have arisen. Will the Government now implement a power of general direction for local authorities over this issue? I am doubtful that this will happen, as the Government have not been in listening mode when it comes to regulations dealing with this public health crisis. Emergency, top-down and contradictory official guidance has become the norm, coming to this House many weeks after it has come into law.
That matters because emergency powers have unintended consequences which scrutiny by this House would have teased out. More temporary powers for local government will mean smarter and effective measures in dealing with the smaller outbreaks. Ministers really do need to listen more and trust local areas to deliver. This has to be built on a true partnership and not on “Whitehall knows best”. So far in regulations that have been implemented but not yet brought before this House, only low-level operational powers have been granted to local authorities.
Countries with the best record of dealing with the virus unlocked the potential of local government right from the start. Rather than ongoing knee-jerk, emergency regulations, the Government should now bring forward a Bill that gives local authorities a full set of powers and tools to manage ongoing local outbreaks effectively.
Lord Ribeiro (Con) [V]
My Lords, these regulations are proportionate and in the interests of the public’s health. They should be passed. Professor Michael Marmot, in his review of the social determinants of health inequality, noted in 2010 that the lower an individual’s social position, the poorer their health was likely to be. Ten years on, in some parts of the UK not much has changed. The outbreak of coronavirus in Leicester, Oadby and Wigston was not surprising, given the occupational factors, the evidence of multigenerational living and the exposure to Covid-19 of those of BAME backgrounds—something that I understand the Government are reviewing.
The news today that Oldham has recorded 119 cases in a week, up from 26 the previous week, is equally worrying. Criticism was made in the House of Commons of the lack of sharing of information on pillar 2 tests —that is, tests outside hospitals—with local authorities. Details including ethnicity and postcode data for pillar 2 testing were key to identifying where the outbreak was occurring but did not become available until 25 June—11 days after they were requested. As pointed out by the noble Lords, Lord Hunt of Kings Heath and Lord Scriven, this was too late. Can my noble friend the Minister say why this delay occurred, what lessons have been learned and what plans there are to let local authorities manage the situation with the support of Public Health England rather than the other way round?
Baroness Young of Old Scone (Lab) [V]
My Lords, in reality, it is only within the last seven days that local directors of public health, after many times of asking, were finally given access to address-level data, which is so needed for local contact tracing. This is very important to stem household transmission within vulnerable communities, particularly among those living in overcrowded housing. As yet, local public health officials and local authorities still do not routinely, in real time, get other data on those who have had negative tests; nor do they have workplace data to spot workplace clusters early and take effective action based on local knowledge. They do not have data by ethnicity, which is provided only sporadically at the time of testing and not regularly on death certificates.
Some local authorities are doing crazy things, such as scanning test results to spot likely ethnic names to help them understand the characteristics of a community spread. Information from the call centre process is not available to local authorities on who has been contact traced, where they live or whether they have undertaken to self-isolate. As well as inadequate real-time data, local authorities lack resources. The additional £300 million for Covid-19 action plans will not go far. Some local authorities have no paid or trained local contact tracers. Can the Minister clarify whether he sees local authorities, rather than the national process, as the leads in managing outbreaks; what he is doing to assure them of real-time comprehensive data of the kind that I have outlined; and how he plans to create a step change in local authority capacity? Yesterday, the noble Baroness, Lady Harding, said that local outbreaks are being managed by local authorities extremely well. This is not how local authorities feel.
Baroness Jolly (LD) [V]
My Lords, I thank the Minister for his update, but again we find ourselves agreeing to regulations after the enforcement date, which was over three weeks ago. They will be in place until January 2021, although today’s news from Hong Kong is a very timely reminder of the gravity of our situation. The Secretary of State must review them every fortnight. Given that 16 July has passed, can the Minister please let us know the outcomes of that first review? Has there been any significant change in the situation? How will this be conveyed to Parliament during the Recess?
We know that there has been a considerable amount of testing in Leicester and the surrounding area, and that there is still a push for more testing. How is this progressing? What proportion of the population has now been tested, and is the sample size large enough to make meaningful decisions on a way forward?
Why is sport singled out for preferential treatment in SIs? We are a nation that loves our sport, but why is a sportsperson deemed more worthy than, for example, a world-class organist? They cannot take their instrument home, but their form goes unless they continue to practise. What is the harm in them trying to maintain their standard, too, if they can practise in a distanced fashion?
Finally, one area of concern that came from press coverage of the Leicester outbreak was employee safety. Employers have a legal responsibility to protect their employees and other people on site, and most are diligent. On the news that evening, we saw garment trade workers in Dickensian conditions, neither wearing masks nor distancing from their colleagues. What penalties does an employer pay for this dereliction of duty? What confidence have the Government that this was the exception and not the rule?
Lord Garnier (Con) [V]
My Lords, in this short contribution I need to remind myself that, although I was the Member of Parliament for Harborough for 25 years, since 2017 that constituency has been ably and diligently represented by Neil O’Brien. His constituents are more than fortunate to have him as their MP, and I could not have wished for a better successor.
Part of the constituency, the borough of Oadby and Wigston, covered by the LE2 and LE18 postcodes, is still included in the area covered by these regulations. It is wholly within the Harborough constituency, but has a three or four-mile border with the city of Leicester to its south and east. While politically—and in many other ways—wholly distinct from the city of Leicester, thousands of residents in the borough work in or have connections with the city. Many Leicester families send their children to the excellent state and private schools in the borough and in rural Harborough. There is a huge amount of social and business travel between the city and the borough. Many of the textile businesses in the city are owned by residents of the borough and a great many students at Leicester and De Montfort Universities, both of which are within the city, live in halls of residence and other accommodation in the borough. The three NHS hospitals in the city—the Royal Infirmary, the General and the Glenfield—employ staff and treat patients resident in the borough.
Therefore, what happens in the city affects the borough, even though the borough is not the city and the city is not the borough. In his article in the New Statesman dated 24 July to 13 August, Professor Robert Colls of De Montfort University reports that in Leicester there were 141 cases per 100,000 people for the week ending 28 June and 119 new cases per 100,000 people on 16 July, compared to a UK average of 13.2. The Minister’s figures were slightly different, and he tells us that they are now down to 64 per 100,000. However, while the residents of the borough, and of Harborough more widely, appreciate the general dangers of a resurgence of Covid-19, they are also entitled to a clear explanation of why their community is being brought in or out of local lockdown measures. In the city, the highest infection rates are in the most deprived and overcrowded council wards. There are no such wards in Oadby, but—
Baroness Penn (Con)
My Lords, we are very tight for time. Can my noble and learned friend bring his remarks to a close?
Lord Garnier [V]
If the demographic information given by my noble friend Lord Ribeiro is correct, there needs to be some sort of framework, as there is in other countries, to explain to people why decisions taken 100 miles away in London are necessary. At the moment, for example, people have no idea of where rates of infection need to fall to for them to be released from lockdown.
Lord Harris of Haringey (Lab) [V]
My Lords, these regulations relate to Leicester, but they are a template for what will arise in other places; indeed, yesterday we had the news from Oldham. My first question to the Minister is: how would this work in a much bigger conurbation, such as London? There are 32 boroughs—33 if you count the area of the City of London Corporation—each distinct administratively, but the public do not take much notice of borough boundaries as they go about their daily lives. If restrictions had to be reimposed in Greater London, would they be applied in a one-size-fits-all manner across all the city, or more selectively? If pubs and bars are closed in Islington but not in Camden, how will that work in practice? If there is a problem in Newham, does that mean that the lockdown will apply in Ealing or Richmond? What, in practice, will the consultation arrangements with the relevant local authorities, the London Mayor and the individual borough leaders be?
Last Friday in your Lordships’ House, I raised the issue of self-administered tests for those unable to attend a test centre. My understanding is that the Government are phasing these out. Can the Minister confirm this? Such tests require the subject to insert a swab up the nose and into the back of the throat, obtain a suitable sample and return it by post for analysis. This requires precision and dexterity, as well as overcoming the gag reflex. The Minister told the House last week that self-testing was “popular”. Since then, I have heard more public reaction than ever before to something said in Your Lordships’ House, with dozens of people saying how difficult they found self-testing. Today the Minister provided a briefing note in response to my topical Written Question of 14 May. Although it does not answer any of the specific questions raised, it does say that more than 1 million home tests have been sent out, so I ask the Minister again: what proportion of these were returned and how many were unusable?
The note says that the tests are “very accurate” but goes on to say that a negative result may be because “the sampling of the individual was not undertaken appropriately”. What, therefore, is the Government’s working estimate of the proportion where the sampling was not done properly?
Baroness Walmsley (LD) [V]
My Lords, while I appreciate the need for rapid action to contain new outbreaks of Covid-19, I too am very concerned that these regulations have come to Parliament for approval so long after they have been put into action and amended. How often will such measures be reviewed and what arrangements will be made to obtain parliamentary approval of such measures if they occur when Parliament is not sitting? These regulations, for example, are due for review tomorrow.
What are the Government’s criteria for creating further local lockdowns, and what is the role of local decision-makers in such decisions? Will workplace information be collected by test and trace, so that local officials can identify outbreaks in workplaces? How many local lockdowns would need to be in place before the Government considered a national lockdown necessary? What special measures will be put in place in local lockdown areas to protect care homes? As the Minister knows, patients in care homes have been very badly affected in the first wave. What is being put in place to ensure that these most vulnerable people are not put at risk again?
Baroness Verma (Con) [V]
My Lords, I have been in Leicester since the country went into lockdown and have witnessed the huge pressures that the second lockdown has put on local people and businesses. So I have three comments, or suggestions, for my noble friend the Minister to take back to the department.
Given that the Government have provided local authorities with new powers in the event of increased spikes of coronavirus, does my noble friend agree with me that local authorities, now knowing where spikes have occurred, should engage regularly in multiple testing to ensure that ongoing, regular monitoring is taking place? This would enable them to close individual properties or ask individuals to self-isolate if necessary, so that the rest of the city can carry on as normally as possible.
Does my noble friend the Minister agree that the local public health director, Ivan Browne, should be proactively collecting local intelligence through the local authority, GPs and community leaders, and that government data is just one part of fighting the spread of the virus? Will my noble friend ensure that the collection of local intelligence is part of the ongoing monitoring?
There has been a lot of concern from people, and some have contacted people such as me in Leicester. Some GP surgeries are now not only not allowing in-person appointments but not having telephone consultations, instead directing people to 111. This will not reduce pressure on the NHS or enable local knowledge to be used to inform local decision-making.
This has been a hugely testing time for Leicester’s citizens. A failure to ensure that BME communities with poor English language skills received appropriate communications from the local council did not help reduce the spread of the virus. There were many areas where there was no social distancing, and in some densely populated areas parks were the only option for fresh air. Does my noble friend the Minister agree that after the pandemic there should be a lot of focus on the mental health and well-being of citizens who have been in these closed communities for a long time?
Baroness Jones of Moulsecoomb (GP) [V]
My Lords, I echo the words of the noble Baronesses, Lady Jolly and Lady Walmsley, that we are getting these regulations 25 days after they were first tabled. Why are the Government doing this? Why are they not bringing these regulations to the House before they impose them?
Your Lordships’ House has been sitting since 21 April: there is no excuse for delaying to this extent. So my first question is: why the delay? My second question is: are the Government going to continue to act in this anti-democratic, dictatorial way in the autumn, or can we expect more consideration for the upper House?
Lord Campbell-Savours (Lab) [V]
My Lords, I start by asking for a third time a question which Ministers have so far either refused or felt unable to answer: will they rule out the use of valve masks apart from in clinical settings? They protect only the wearer, and not potential recipients of aerosol contamination. Secondly, have they been able to follow up on my previous comments on positive pressure masking systems?
My noble friend Lord Bach, the PCC for Leicester, Leicestershire and Rutland, is unable to attend today. I now set out his comments, in his words, for inclusion in Hansard:
“Leicester is a great city. It shows the world how people of different faiths and backgrounds can live and work in harmony. The 4 July lockdown was necessary; the data proved it, although Her Majesty’s Government were responsible for an absurd delay in drafting this SI. At least the area to be protected was based solely on health grounds; the current lockdown is based on local authority boundaries. However ridiculous and unfair they are, it was clearly wrong to pretend that health and administrative areas were exactly the same. Parts of Leicester still needed protected status, but others did not; it is hard not to believe that party politics intervened.
Today the news is good, as the recent Leicester Mercury headline—‘Positive coronavirus tests plummet’—from 14% down to 1.9%, suggests. The seven-day infection rate has fallen dramatically, at a time when huge amounts of testing are taking place. It is time to release Leicester from its chains. People and businesses who have followed the lockdown to the letter are entitled to their freedom. It is now up to HMG to do the right thing by Leicester later this week.”
Baroness Barker (LD) [V]
My Lords, why did Public Health England take until 20 July to start supplying test data to local authorities on a daily, rather than weekly, basis? Why were local authorities told only then which households contained people who had tested positive?
On track and trace, when will the Government stop wasting resources on national call centres and—as we on the Liberal Democrat Benches have been advocating since March—put resources into local resilience forums working with directors of public health, health and safety officers and local police?
Matt Hancock stated in mid-May that he had
“tried to throw a protective ring around our care homes”
right from the start of the outbreak. Today, the Public Accounts Committee stated that discharging 25,000 patients in order to free up beds was an example of
“the Government’s slow, inconsistent and, at times, negligent approach”
to social care. The committee also said that advising hospitals to discharge thousands of patients into care homes without knowing if they had coronavirus was a “reckless” and “appalling” policy error. Will the Minister tell the House who was responsible for that decision?
There was no protection from central government. Will directors of social services now be empowered to challenge any similar decisions by NHS Providers and central government which jeopardise social care? Will local authorities currently in lockdown, such as Leicester, be resourced to share their experience and good practice with colleagues in areas at risk, such as Oldham? As the demographic profile of areas most likely to experience second waves becomes clearer, will local authorities be identified and given additional resources now to put prevention plans in place?
Lord Holmes of Richmond (Non-Afl) [V]
My Lords, I pay tribute to all those in Leicester who are working so hard to bring this local outbreak under control. They deserve all our support and thanks.
Does my noble friend the Minister agree that, in essence, there is no such thing as a pandemic, just a series of local outbreaks? To this end, will he comment on the approach that should be taken to effectively bring local outbreaks under control? Similarly, I ask my noble friend: how do you hide a factory—secrete a sweatshop? Will he confirm that the Health and Safety Executive, not just in Leicester but countrywide, dramatically scaled back its operations, as did other inspectorates, at the beginning of the Covid outbreak for—yes, you guessed it, my Lords—health and safety reasons? This decision meant that a situation such as the one in Leicester was surely inevitable. What is being done to address this situation?
Similarly, at the beginning of the Covid outbreak, not the recent resurgence in Leicester, what efforts were made to ensure that communications could be obtained in different formats: large print, on tape, email for blind people, different languages—particularly in areas such as Leicester where there were clear language needs? Can my noble friend the Minister confirm what efforts were made in that respect, both at the beginning of the outbreak and, indeed, with the recent resurgence in the city of Leicester?
Lord Robathan (Con) [V]
My Lords, like my noble and learned friend Lord Garnier, I used to represent large parts of the original lockdown area—Braunstone Town, Thorpe Astley, Glen Parva and others, all in Blaby district and now outside the area. However, where I sit, were it to be necessary, I would go to a hospital in Leicester, because those are my nearest hospitals. I was speaking to two health professionals at the University Hospitals of Leicester NHS Trust on Monday. They told me that at the beginning of the crisis in March, everyone was worried about the hospitals being swamped, as I think we all were. That did not happen. Now, the hospitals are still not particularly full; indeed, they are not that busy, according to these people.
As the Minister said, on 29 June, the rapid investigation team from PHE, I think, reported that there were six to 10 new CV admissions each day in Leicester, and on 22 July, the University Hospitals of Leicester Trust reported four deaths in the previous week—that is, the week before last. All were people over 50, like me. We know that the infection has spread largely in cramped sweatshops, as mentioned by my noble friend Lord Holmes. These stayed working illegally throughout the crisis, illegally paying workers much less than the minimum wage, and certainly with some illegal immigrants working there who did not speak English or know their rights. This has been going on for many years, a fact to which public authorities, including some MPs in Leicester, have turned a blind eye.
Presumably, these regulations are about protecting people from death and serious incapacity. I believe they are disproportionate, so will my noble friend tell the House how many deaths there have been from CV in Leicester, compared to the general population of the UK? Although he will not be responsible, will he say what action Her Majesty’s Government will be taking to pursue those who fail to pay workers in their sweatshops the minimum wage, and the rest? This is a scandal that needs addressing.
Baroness Massey of Darwen (Lab) [V]
My Lords, I have a son who lives in one of the most multi-ethnic areas of Leicester. People there are surprised that there has been no update on the Leicester situation on the Government webpage since 30 June. Will the Minister say why not? We have seen, during the Covid-19 crisis, government actions that have been late and unco-ordinated, or hasty and ill thought through, to the detriment of local populations.
Public health is essentially about prevention, consultation and co-ordination. In Leicester, the situation was ripe for a public health disaster in at least two areas, with overcrowded workplaces, criminal employment policies and limited housing. Consultation between the Government and the Leicester infrastructures seems to have been lacking. For example, the Government announced a map of the affected areas but did not immediately inform the police, who received the map the following day. The data on infection rates in Leicester were requested some time before they were actually provided. Little clarity on lockdown and what it meant was given. It is difficult for mayors and local councils to be helpful to populations when they have inadequate data and are receiving confused messages.
People in Leicester are asking why the Leicester infection figures were lower than that in Blackburn, yet Blackburn was not locked down. Would it not be better if the Government set an acceptable infection rate, as other countries have done, so that more than 100 infections per 100,000 people signals the need for a local lockdown? Perhaps it should be some other figure, but let it be consistent.
What lessons does the Minister think have been learned from the Leicester experience? Are the Government in constant touch with Leicester to ensure it does not feel like a forgotten city but is carefully monitored?
Lord Addington (LD)
My Lords, this document is arriving a little after it was hot news, so we are asking the Government what they have actually learned from it. As many noble Lords have asked, do we have a set of circumstances in which the local authority—it has to be the local authority—should be concerned because it is vulnerable? That is coming across. Was what happened in Leicester replicated in other parts of the country? The answer is yes. To what extent, and when should people be worried? What has actually worked well there?
It is quite clear that there have been problems where English has not been the first language. There are lots of ways of living with that if you use technology: has that been done? Are there ways of communicating what should happen to that population? If there is a social organisation where people’s housing makes them slightly more vulnerable, what do they need to do to minimise that risk? Is that being communicated? Unless we actually hear that something is being done on a consistent basis, we are left with the feeling that we will be back very quickly asking similar questions. Surely the delay in seeing these regulations means that we should have some answers now about what works and what is to be avoided.
Baroness McIntosh of Pickering (Con) [V]
My Lords, is my noble friend convinced that the guidance he has issued through the local councils is sufficiently clear? Is he convinced that the councils, particularly the public health officer and his department, have sufficient resources to instigate local lockdown measures, as in the case before us? How does he intend some of the minutiae involved in the regulations to work, such as overnight stays by people who live outside the protected area but wish to stay in the protected area? We saw previously how difficult they are to enforce. In areas such as Leicester, Oldham and other places where we are seeing a spike, is my noble friend aware that it could be young people, through their innocent behaviour, who are contributing to the spikes? If that is the case going forward, is it the Government’s intention to issue clear advice to young people in this regard?
Lord Truscott (Ind Lab) [V]
My Lords, while the local lockdown in Leicester was unfortunately necessary, I cannot escape the feeling that the Government are continually playing catch-up during this pandemic. How likely does the Minister see a second wave of the virus, and how prepared are Her Majesty’s Government for the resultant spikes in cases? Will Her Majesty’s Government be prepared to reintroduce a national lockdown if required, as was asked earlier? Will Her Majesty’s Government formally revise their guidance on the advisability of foreign holidays this summer? What plans do Her Majesty’s Government have to introduce mandatory testing for Covid-19 at our airports? Finally, when will Her Majesty’s Government confirm that they will hold an immediate, independent and, importantly, public inquiry into their disastrous handling of this pandemic, which has caused so many unnecessary deaths and brought suffering to so many people?
Lord Willis of Knaresborough (LD) [V]
My Lords, no doubt these regulations are technically competent, and no doubt they will be used as other communities—perhaps Oldham or Peterborough—become the latest virus hotspots. What they do not do is to put into legislation the tools that would give local health authorities and local councils the data to act more confidently and effectively to minimise disruption to lives, businesses and social structures in some of our poorest communities.
On 6 June, the Covid-19 Clinical Information Network recommended the co-ordination of all clinical and health records of patients admitted to hospital with suspected Covid. Has this happened in Leicester, and has it been published? Is this data available to those who require it, and why is there not a requirement to do so via this SI? On 22 June, the Scientific Pandemic Influenza Group on Modelling recommended linking health with clinical data and data from other systems, including employment and social security. Why has this recommendation not appeared in the SI? It would enable a much more vigorous examination of outbreaks, something Leicester has urgently needed, yet nothing has appeared in these regulations. Why is there no requirement for all healthcare workers, patients and care home residents in Leicester to be repeat-tested for Covid-19 during the lockdown? Why has universal serological testing not taken place to seek out antibody carriers in Leicester?
Research data will increasingly play a vital role in managing future outbreaks of Covid, and these regulations were an opportunity to grasp that. Sadly, we have missed that glorious opportunity.
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
The noble Lord, Lord Cormack, has withdrawn from this debate, so I call the noble Baroness, Lady Uddin.
Baroness Uddin (Non-Afl) [V]
My Lords, as we debate health protections in Leicester, other areas such as Oldham have emerged as candidates for a potential second lockdown. Echoing concerns raised by other noble Lords, I ask whether the Minister’s department has had the opportunity to consider what factors preceded the resurgence in specific areas with substantial minority populations. What assessment has been made of the economic impact of the first and second lockdowns on minority groups, including vulnerable women and children who may have been experiencing abuse or neglect? Given the recent news highlighting the disproportionate number of deaths among people with a learning disability during Covid, what specific safeguarding measures have been put in place to mitigate extraneous harm and distress?
Is the Minister satisfied with the clarity on thresholds for localised lockdowns, and are they being communicated thoroughly to all relevant parties—all local leaders, health institutions, businesses and, above all, the public? I was glad to hear the Minister say that public health information was relayed in relevant local languages, about which I have been shouting quite a lot lately. I assume that this will continue on social distancing and the use and availability of masks, and I agree that working together is the most effective way to reduce further danger.
These measures must continue to go hand in glove with continued financial support to those confined. I hope very much that the Government will do everything possible to reduce poverty and long-term poor health. I acknowledge the pressure that the Minister and his department have been under and I wish him well, and I wish all noble Lords a peaceful break.
Lord Liddle (Lab) [V]
My Lords, once again we are debating a measure long after the horse has bolted. We need a radical change in our procedures so that we do not face this situation of Executive diktat in the future.
I want to ask the Minister if we can have a mature reflection on the lessons learned in the Leicester lockdown. It is clear that we are making progress in terms of better information sharing between the national and local systems. This is very much to be welcomed. But there is still a fundamental confusion of responsibility. Who is taking the decisions? Is it the responsible local people or is it Ministers? The regulations divide responsibility between the two. Can we not get to a situation where Ministers trust local decision-makers and give them the power and resources to organise effective local action?
Finally, the noble Lord, Lord Robathan, made an excellent point about what is happening to tackle the problems of sweatshops and the social circumstances which propagate the disease. Is stronger action being taken by the inspectorates, and will the Minister let us know what that is?
Baroness Benjamin (LD) [V]
My Lords, the coronavirus pandemic has exposed deep inequalities in our society. It has caused so much pain, death and suffering in areas across the country. This is evident in Leicester, where many families are from minority communities with low-level incomes and are reportedly working in unacceptable sweatshop conditions. Many are also living in cramped housing conditions, which is having a huge impact on their children’s mental and physical well-being. The report from Public Health England in June stated that the Government must:
“Ensure that COVID-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long-term sustainable change. Fully funded, sustained and meaningful approaches to tackling ethnic inequalities must be prioritised.”
When Ministers placed new restrictions on Leicester a few weeks ago, it came after weeks of warning from local authorities of major gaps in the Government’s Covid-19 policy. One of the gaps was the pillar 2 testing system. The data from these tests was received very late by Leicester authorities. Local authorities and communities need much clearer information and answers, because by not knowing they cannot prepare.
Leicester has a high number of diverse communities, so why was more not done in anticipation of a second outbreak of Covid-19? Worryingly, that situation could be replicated in other areas and is a huge cause for concern. If long-term sustainable preventive measures are not put in place to avoid major problems in the future, further outbreaks are likely to occur in other parts of the country. So what long-term action do the Government propose to counteract these threats, ensuring that people are better paid, have improved working conditions and better access to housing and healthcare? What short-term measures are being used to communicate public health messages such as social distancing, in Leicester and other communities such as Oldham, to ensure that people are aware of the Covid regulations imposed? Prevention is better than cure, and never before has that been so important to deal with this pandemic.
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
I now call Baroness Gardner of Parkes. Is she there? No? Then I call Lord Bhatia.
Lord Bhatia (Non-Afl) [V]
My Lords, with the coronavirus in the UK and the world over, it is extremely important that the Government’s policy on how to deal with a pandemic must follow scientific advice. It is not a political issue. Worldwide, tens of thousands of people have perished. I therefore fully support the Government’s lockdown in Leicester, where there was a second spike and those members of the community who got the virus were beginning to go to NHS hospitals, putting pressure on NHS facilities. According to reports, there has been a spike in Oldham, which will require another lockdown.
In the past, I regularly visited Leicester and found the city thriving with businesses and social facilities, including those for early childhood education, high-class Indian restaurants and gyms and swimming pools. Leicester is one of the most multiracial cities in the UK. In the 1960s and 1970s, Asians from Uganda and other East African countries came to Leicester. They were followed by many others from the sub-continent. It is unfortunate that it has become a victim of Covid-19 and the Government had no choice but to lock down Leicester and surrounding areas.
My prayers are that the lockdown will reduce the spike by self-isolation, using masks, self-distancing and hand washing. It is good news that test sites have been set up in Leicester. The lockdown will cause considerable financial losses to businesses and the Government must bring in special financial support for businesses and individual families whose incomes will disappear very quickly.
Lord Clark of Windermere (Lab) [V]
My Lords, we have all watched the progress in Leicester with the lockdown and I very much agreed with the noble Lord, Lord Liddle, when he emphasised the point about learning lessons. I feel that we probably have, because I perceive an evolution of approach. We have seen a different approach in Bradford, and in Oldham, again, there is more finessing—and I learned only today that the next borough in the north-west likely to suffer these problems is Stockport.
This raises an issue, because these are local authorities in their own right. But what will the Government do with problems that run across local authority boundaries? I have bored the House ad nauseam by talking about the Lake District National Park, where 40,000 of us residents welcome 19 million visitors a year, which puts immense strain on our already poor local health service. But the three authorities covered by the Morecambe Bay health authority have among the highest rates of infection across the UK. If we have a gross influx of visitors from the affected areas, which now seem to be around Manchester, will the Government, if there is a spike, take urgent action to stop the staycation happening in the Lake District National Park?
Lord Rennard (LD) [V]
My Lords, I lived in the great city of Leicester for four years in the 1980s, and I am now seriously worried about the situation there, and how long these restrictions may apply without the serious risk of them being breached on a regular basis and even civil unrest breaking out. Can the Minister confirm that tomorrow’s review will provide hope and further reassurance to people there that these restrictions will not be applied for any longer than necessary?
Part of the reason why areas such as Leicester are disproportionately affected by Covid-19 is that they are areas with high BME populations and higher levels of diabetes. The issues are related. I have therefore asked a number of Written Questions today about support for people with diabetes; I will not repeat them here but I look forward to the Minister’s answers. The Prime Minister’s own Covid experience may have had a beneficial effect in persuading him of the need for proactive measures to support people struggling with obesity and those seeking to maintain good diabetic control. However, will the Minister tell us that decisions on issues such as calorie labelling will be evidence-based in the interests of public health, and not determined as a result of big business lobbying efforts?
Finally, if the lockdown continues, can I ask the Minister to help potential holidaymakers who are outside the lockdown area but have Leicester postcodes? The leader of Hinckley & Bosworth Council, Councillor Stuart Bray, tells me that some travel companies are cancelling people’s holidays because of their Leicester postcodes, even though they live outside the lockdown area. If necessary, can steps now be taken to properly advise travel companies as to exactly which postcodes are relevant for lockdown restrictions?
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
My Lords, the noble Lord, Lord Wei, has withdrawn so I call the noble Baroness, Lady Tyler of Enfield.
Baroness Tyler of Enfield (LD) [V]
My Lords, we are debating these regulations very late in the day and on the last day before Recess, although they were introduced on 4 July. We are doing this at a time of growing concern about a second wave of the pandemic, both at home and abroad, and when new measures have been introduced in Oldham, Rochdale, Blackburn and Pendle to address localised flare-ups.
The link between the prevalence of Covid infections and levels of deprivation is becoming ever clearer, as the noble Lord, Lord Ribeiro, explained so well. What systems have been put in place to ensure the sharing not just of data but of good practice, and the effectiveness or otherwise of localised measures both at national and local government level?
While I welcome today’s news that the Government will fund studies into why people from black and ethnic-minority backgrounds are more likely to die from Covid-19 than the white population—that is highly relevant to the diverse population of Leicester—why have we waited until now to do this, when the link has become increasingly clear since the early differential death rates first became apparent? I repeat my call for a full debate in this Chamber at the earliest opportunity on urgent action needed to tackle inequalities before a second wave, and before it is too late to act.
Relaxations had been made to these regulations, which came into force on 18 July—including to the areas covered—before they were even laid before Parliament. I join my noble friend Lady Jolly in asking the Minister to explain what process will be in place over the Recess to inform the House of the outcome of the review of regulations, which happens every 14 days, with the next one tomorrow.
Finally, looking ahead, what extra financial help will be given to people affected by local lockdowns such as in Leicester when the Government’s furlough scheme ends in October? Will the Government also think again about a temporary lifting of the benefit cap for the duration of the pandemic for those affected by local lockdowns or indeed any further national lockdown required?
Lord Roberts of Llandudno (LD) [V]
This morning I spoke to some of our local councillors, who all said that the areas worst affected by the virus outbreak are the poorest ones. I therefore suggest that our battle is not just against the virus but against poverty, and we must take that seriously. We must realise that even when this lockdown comes to an end and people go back to work, about 4 million are forecast not to have any work as their jobs will have come to an end, which will just add to the poverty. We must therefore now make sure that the benefits received and help given to those who are furloughed in various parts of the country continue, to stop the desperation that people must feel when their income more or less disappears and all the other help that they get has gone. We must somehow stop poverty itself, as it increases the harshness of the virus.
We could of course look at Brexit because, yesterday or the day before, the LSE forecast that the areas worst affected by the exit from Europe will be very hard-pressed, and said that they will have difficulties on top of the virus. I therefore ask the Government—I know it is late but it is possible—to cut that poverty at a stroke, and by so doing make it easier for us to recover from the virus epidemic.
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
I call the noble Baroness, Lady Gardner.
Baroness Gardner of Parkes (Con) [V]
Oh, my Lords, I had not expected to speak again but I am only too pleased to do so. I have sat here all day through this virtual proceeding, and many interesting things have been said.
I had word from family in Australia, and the family member living in Melbourne said that everything has been quite devastated by the second lockdown. However, his wife, who was flying home to him, has been held in Sydney for 14 days. That is the latest report from Australia.
I am sorry if this communication is not what your Lordships expected—it is certainly not what I expected, as I thought that earlier would be my only moment to say a word. I wish everyone a good Recess.
Baroness Brinton (LD) [V]
My Lords, as my noble friends Lord Scriven and Lady Jolly and other noble Lords have commented, these regulations came into force on 4 July, well over three weeks ago, and indeed other towns and areas have had partial lockdowns since. However, there is a real problem with the constant delaying of presenting these regulations to Parliament, which shows that the Government are really not taking seriously the job that we have to do, which is to scrutinise legislation. Can the Minister therefore assure us that when we return in September and virtual Grand Committee comes into operation, we will return to the pre-pandemic timetable of notification and presentation of SIs to your Lordships’ House?
A number of noble Lords who have local knowledge of Leicester and the surrounding areas, including my noble friend Lord Rennard, have explained well the problems with the speed—or lack of it—of the Government’s response to the Leicester lockdown, and I agree. Local lockdowns will work only when Ministers and the NHS silo work at speed and openly with affected local authorities. On Friday, I asked the Minister why the leader of Oadby and Wigston Council had not been involved in the decision about his borough remaining in lockdown, despite much better figures than Leicester City Council. I am sorry to say that Councillor John Boyce, the leader of Oadby and Wigston, has still not heard from Matt Hancock, despite the latter saying publicly that he had spoken to him. However, it is not just the leader of the council. Many local residents are extremely concerned, as are senior councillors and officials, about the possibility of unrest if they continue to be treated unfairly compared to their neighbouring councils.
More generally, directors of public health report that communications are improved, and I thank the Minister and his team for that. However, the data still does not always arrive consistently or when it is requested, which effectively ties the hands of the local directors of public health behind their back. They say that this flow needs to be urgent, reliable and consistent if they are able to knock the local spikes on the head.
I echo my noble friend Lady Barker’s questions about the slowness of getting data to the local authorities and my noble friend Lady Walmsley’s concerns about care homes. Today’s Public Accounts Committee report recognised that care homes were “thrown to the wolves”, so what are the Government doing to protect care homes from now on, given that the Prime Minister and others say that there is not a second wave and that we are already in it?
This Saturday sees the guidance to 2.2 million shielders change. I and other Members of your Lordships’ House are shielding. On 22 June Matt Hancock and Robert Jenrick wrote to us all to set out the changes for shielders that would take place on 6 July and this Saturday, 1 August. We are told that shielding “will be paused” on 1 August, but throughout the four-page letter shielders are warned that they must continue to adopt strict social distancing as they are
“still at risk of severe illness if you catch Coronavirus, so the advice is to stay at home where possible”.
As I said on Friday, this letter also warns shielders who live alone that their government and local government support—for example, food parcels and medicine deliveries—will cease. For those who work, if your workplace is Covid-safe the Government say you should return to work. Alongside this, furlough and other payments will cease, so even if you cannot get to work or work from home, you have to throw yourself on the mercy of your employer.
I am grateful to the Minister for writing to me overnight to set out the Government’s position. I have also seen the recently updated guidance on the department website, which reiterates the points I have just made.
If I thought that the 22 June letter was contradictory and confusing, I am now even more confused. Only yesterday the Prime Minister said:
“Let’s be absolutely clear about what’s happening in Europe, amongst some of our European friends, I’m afraid you are starting to see in some places the signs of a second wave of the pandemic.”
Overnight, Oldham has joined the list of towns with local constraints and lockdowns, and Stockport is on notice. The World Health Organization says countries that relax arrangements because they are waiting for the second wave need to realise that this is the second wave and cases are popping up all over Europe. We lifted our lockdown later than these countries and so are a few weeks behind them, but I am afraid the trajectory looks clear.
For shielders, the Government say in one breath that you must avoid contact and strictly socially distance at all times, but in the new advice the onus is put on the clinically most vulnerable to leave home and go to work, the pharmacy and the supermarket. They have to be ultra-cautious about seeing people and preferably not do it. Medical charities and NGOs are getting calls from concerned shielders to ask what on earth they should do with this contradictory information, so I ask the Minister the following questions: has he formally raised with the Chancellor of the Exchequer the extension of furlough and other payments to shielders who cannot work? Does he recognise that this small, vulnerable group are highly likely to lose their jobs without continuing support? Is it safe for people whom doctors believe to be at extreme clinical risk to go to supermarkets and pharmacies when these places have little power to enforce the wearing of face coverings by other people? Will shielders be notified as a matter of extreme urgency if there is a local or partial lockdown? Will the emergency support be immediately reinstated for them?
Baroness Thornton (Lab)
My Lords, I thank the Minister and other noble Lords for their remarks. Here we are again. I do not intend to rehearse the absurdity of this debate; we need to look on it as an opportunity that has been offered. I think the Minister has picked up, today and before, the dissatisfaction in the House and the statutory instruments committee with the current arrangements for scrutiny and accountability.
Leicester remains in lockdown, a situation that I believe is due to be reviewed tomorrow. Can the Minister explain what metrics will be used to decide what happens next in Leicester? I ask this because the people in Leicester seem to be asking exactly the same question, as my noble friends Lady Massey and Lord Clark said.
New measures to stop the spread of Covid-19 were introduced in Oldham yesterday. Can the Minister confirm whether the new rules in Oldham are guidance or a legal requirement? If the latter, how will it be enforced? How is the new local policy being communicated to residents in Oldham, which has a higher proportion of ethnic minorities among whom English may not be the first language? Oldham Council’s deputy leader, Arooj Shah, said the new measures are essential to prevent a strict local lockdown like in Leicester. Can the Minister confirm that national lockdown relaxations, including the reopening of gyms, cafés and pubs, remain applicable in Oldham? What advice have the Government received regarding the increased risk these relaxations pose in Oldham? Can he advise what the threshold of new cases is for introducing local lockdown regulations in Oldham? Can he confirm whether Oldham has been categorised as an area of intervention alongside Leicester and Blackburn and will receive increased national support, capacity and oversight accordingly?
This debate offers an opportunity for the Minister to update the House on how life in Leicester is and what lessons can be learned from this citywide lockdown. As my noble friends Lord Harris and Lord Liddle said, lessons need to be learned from this. In particular, as my noble friend Lord Harris asked, what happens in a large area such as a London borough? What is the impact of the extended lockdown on children who are missing out on school, local businesses and jobs, universities and voluntary groups and the mental and other long-term health consequences for the people of Leicester?
Have the Government learned the lessons about data? We know from the launch of the NHS Test and Trace system at the beginning of May that Leicester’s director of public health repeatedly asked Public Health England for the results of the data from the pillar 2 tests. Although the Minister has assured the House that all data is now being made available, there is a dissonance between what he and the noble Baroness, Lady Dido Harding, tell us and the anecdotal local-level evidence. For example, Katrina Stephens, director of public health for Oldham Council, said she was being given incomplete data about the occupation and recent location history of people who had tested positive. Can the Minister explain why this information was not available from the start?
As other noble Lords have said, many weeks ago the Leicester director of public health asked week after week for postcode-level details and was assured week after week by Public Health England and regional public health that there was nothing to worry about in Leicester. He was told that on 15 June. Three days later, the Secretary of State announced in a press conference that there was an outbreak in Leicester. In such an urgent situation, with a dangerous virus that spreads so quickly, you would think that data sharing would not be an issue. Is the director of public health in Leicester now receiving all the information he needs to do his job? Are they receiving the contact-tracing data? Is the data made available daily?
Let us look at communications. Over the weekend of 27 and 28 June it was briefed in the Sunday Times by the Home Secretary that Leicester was to be subjected to a lockdown, without warning or the involvement of the city council, local police or the NHS. I hope the lesson has been learned that this is completely unacceptable. We should record gratitude to the local MPs, the mayor, the city council, the Leicester police and local community groups for handling the situation with calm confidence, patience and skill. Does the Minister believe it acceptable that a local lockdown that affects hundreds of thousands of people should be announced in a national newspaper and in the national media? Have the Government learned that lesson? If so, what have they learned?
Finally, I ask about the extra costs that come with the lockdown. Can the Minister tell the House whether the Government will meet all these costs and in other areas where there is a spike? The Leicester MPs are saying that, frankly, the Prime Minister has failed businesses in Leicester and put local livelihoods and jobs at risk. I would be grateful if the Minister clarified what support local businesses are receiving. I am sure the Minister will agree that Covid challenges can be terribly difficult to deal with, but it is vital if the Government want to close down a city that they do it with respect and transparency for the local civic community.
Lord Bethell
My Lords, I shall try to answer as many questions as I can. There are more than 30 of them, however, and I therefore hope that noble Lords will forgive me if I am brief.
In answer to the noble Lord, Lord Hunt, we have shared data when we have had data, but I cannot hide from this Chamber that when we started this process, we did not have data. Now that we do, we are sharing it.
I commend the noble Lord, Lord Scriven, for his well-remembered comments on the emergency powers for councils. We have done exactly that when it was needed and when they were asked for.
In answer to my noble friend Lord Ribeiro, we have put in place a system of co-ordination with local authorities that is proving effective. It is largely endorsed by those local authorities.
In answer to the noble Baroness, Lady Young, workplace and ethnic data is shared when we have it. Many do not wish to share their ethnic and workplace data, and we would prefer people to step forward to have a test. But I completely agree that local authorities do not have large contact-tracing outfits; that is why we have a centralised system.
I completely share in the comments of the noble Baroness, Lady Jolly, on the responsibility of employers. I pay tribute to the great many employers who have followed guidelines. I condemn those who break them and call on all employers to consider enhancing measures to break the chain of transmission.
I bow to the greater expertise of my noble and learned friend Lord Garnier in the area of Leicester.
May I please confirm to the noble Lord, Lord Harris, that, as I have said before, we are not phasing out self-testing? It is accurate—as accurate as laboratory testing—and very popular, particularly among those who prefer to avoid hospital, such as those who are still shielding.
I confirm to the noble Baroness, Lady Walmsley, that the boundaries are drawn up by directors of public health, mayors, county councils and the boroughs.
I confirm to the noble Baroness, Lady Verma, that local intelligence collection is essential. I commend the work of Ivan Browne, whose local intelligence is profound and invaluable. I agree that it has a huge amount of value to add to centralised data.
In reply to the noble Baroness, Lady Jones, the decision on Spanish travel shows how quickly things have changed and why we need to approach regulations as we do.
I say to the noble Lord, Lord Campbell-Savours, that I recognise the progress made in Leicester. I completely reject the suggestion that party politics has taken a role in these decisions. The decision on the future of the Leicester lockdown will take place on 30 July.
I reassure the noble Baroness, Lady Barker, that we maintain a rolling watchlist of areas and that support is offered to those areas. That has been done in the past, it is happening today and it will continue in the future.
I reassure my noble friend Lord Holmes that local and accessible materials have been made available. I completely understand the importance of getting this right.
My noble friend Lord Robathan is correct that Covid shines a spotlight on uncomfortable places in our society. The use of exploited labour in sweatshops has contributed to this disease. It is not good enough and it needs to stop.
In answer to the noble Lord, Lord Addington, one major lesson from Leicester is that we have to redouble our efforts to communicate our messages to hard-to-reach communities, which have not always heard our messages on social distancing, hygiene and isolation. We are focused on that mission.
On the second wave, I say to the noble Lord, Lord Truscott, that we are hopeful but cautious. That is why we are investing in diagnostics, therapeutics and vaccines.
I reassure the noble Lord, Lord Willis, that data is shared as he describes and that we are investing heavily in serology testing.
I thank the noble Baroness, Lady Uddin, who has championed the use of all languages in local situations. It is a lesson that we have taken to heart and we are redoubling our efforts in this area.
The noble Lord, Lord Liddle, is right that trust between local and central government is key. Dozens of bilaterals happen every day, but life is not simple and complex collaboration is essential to fighting this disease.
I remind the noble Baroness, Lady Benjamin, and all those who have clear 20/20 rear vision that we have done a huge amount to prepare areas on our watchlist. However, outbreaks happen extremely quickly and are extremely difficult to predict.
In reply to the noble Lord, Lord Clark, the travel patterns of the population are complex, exactly as he describes. It is a challenge that defies simple solutions and analysis of travel patterns is an important part of our response.
The noble Lord, Lord Rennard, is quite right to emphasise the links between obesity, diabetes and the worst effects of Covid. I share his hopes for our obesity strategy and can confirm that corporate influence will not be brought to bear.
Regarding care home discharge, may I reassure the noble Baroness, Lady Barker, that all patients are required to be tested prior to discharge? No care home should be forced to admit an existing or new resident if they are unable to cope with the impact of that person having Covid-19.
To the noble Lord, Lord Bhatia, and the noble Baroness, Lady Uddin, who asked about the impact on business: we have introduced a generous and wide-ranging package of support to help as many people as possible whose incomes are affected. The Coronavirus Job Retention Scheme remains open, and over 9 million jobs have been supported nationally.
To the noble Baroness, Lady Massey: Blackburn with Darwen has taken a number of proactive measures; we are working the authority and will look at further measures if necessary. Case rates in Blackburn with Darwen have decreased slightly, but we are monitoring them very closely.
To the noble Lord, Lord Roberts of Llandudno: the economic and clinical effects of the disease are both horrible, as he described. To reassure him, however, we are working hard to get the balance right, and addressing those who are underprivileged is an important part of that.
The noble Baroness, Lady Gardner, is right to remind us of the challenge of the second wave by example of Melbourne, and she is right to remind us of the importance of having a really good holiday.
I say to the noble Baroness, Lady Brinton, that I completely recognise and sympathise with the concerns of the vulnerable and the clinically extremely vulnerable. I remind her that the clinically extremely vulnerable are able to access, where they are eligible, statutory sick pay, self-employment income and income support packages, and they are benefiting from the injection of a further £8 billion into the welfare system.
On communications, the information given to those shielding has been clear and consistent. Decisions have been guided by the latest scientific advice, which has evolved as we have learned more about the virus, and we have worked closely with patient groups and charities throughout the process to ensure that our communications are correct.
Turning to the metrics for Leicester, I can tell the noble Baroness, Lady Thornton, that our lodestar is to break the chain of transmission, and we will do whatever it takes to fulfil that commitment. As for guidance or legality, we lean in all matters towards guidance and try to avoid mandating wherever possible.
In Oldham, we are working hard to reach those communities termed “hard to reach”. Resources have been allocated generously to Oldham, and more will be made available when they are needed.