Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020
(Limited Text - Ministerial Extracts only)
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Lord Bethell
That the Regulations laid before the House on 14 September be approved.
Relevant document: 27th Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I will start by summarising the changes to the regulations. These regulations, which were made on 13 September and came into force on 14 September, amend the Health Protection (Coronavirus Restrictions) (No. 2) (England) Regulations 2020. They mean that people may not participate in social gatherings, in any place, inside or out, in groups of more than six. The exceptions are members of the same household, two linked households, or exceptions that apply such as for work and schools. This is the measure we call the rule of six; its sole purpose is to halt the spread of the virus by breaking the chain of transmission.
Our message is clear. Those who flout the rules cannot do so with impunity. However, for those who follow the rules, we will provide support and encouragement. That is why the regulations gave police powers to enforce these legal limits, including issuing fines to a maximum of £3,200. It is also why we have introduced financial support for those in isolation.
After a period in the summer of reduction, or stabilisation, in the transmission of the virus, the headline numbers were clear: by mid-September we were seeing daily case numbers rise rapidly in most parts of the country. For example, on 14 August 2020, 1,168 confirmed cases were announced; whereas a month later, on 11 September, 3,286 confirmed cases were announced. That is why the Government, the Chief Medical Officer and the Chief Scientific Advisor jointly agreed the changes we announced.
We know that an increase in infections leads to increases in hospitalisations and deaths, and early indications were of hospital admissions increasing. For example, on 14 August, 99 patients were admitted to hospital; whereas on 11 September, 219 patients were admitted to hospital. We also looked at international data on the feedback on the transmission of the virus in large groups from contact tracing and the advice of infection control teams on the local front line who said the old rules were clearly being flouted. That is why we took the decision to act promptly to introduce these changes.
Regulations such as these are meaningful only if people comply with them. We recognise that in the last eight months the sum of all our regulations had become confusing for many people. Anecdotally, local leaders told us that the term “households” was not well understood—and could be misunderstood as including people’s extended family, whether or not you lived with them—and that a numerical limit was likely to be better understood. Our instincts and these anecdotes were supported by evidence from the Health Protection Research Unit at King’s College London, to which we owe thanks. That is why we have moved to the rule of six: one number; in all settings; inside and out; at home or in the pub. Clear, easily understood guidance, based on clear principles—that is what we have sought to do.
To be clear, in this instance, the buy-in of the public and adherence of the majority are more important than the epidemiological transmission analysis and fine-tuning points of the committees of experts. Breaking the chain of transmission is all that matters. We tightened the regulations so they exactly reflected the guidance, rather than there being one set of numbers in guidance and another set in the legal framework.
I accept that there are seemingly many inconsistencies, injustices and perceived unfairnesses in rules such as these. I have heard many of them already. Probably everyone in this Chamber has an instance where the rules do not seem to make sense. We cannot legislate for every scenario. The virus does not respect special circumstances, however moving. However, there is wisdom in simplicity and there is effectiveness in being easily understood. That is why the rules were simplified and strengthened: so that they were easier to understand, people knew where they stood, the police can act without hesitation and we can get the virus under control. If we achieve that, it is our sincere hope and expectation that the measures will be effective, and we can potentially lift the restrictions.
Let me say a few words about the impact of the measures—I note of course that they have been in place for only three weeks. We have seen the proportion of people who have socialised with six or more people from outside their household at the same time reduce by over a third to 7% last week, compared to 12% in recent weeks.
Let me say a few words about the impact of the measures by giving some examples of where local lockdowns have worked. In Northampton, the weekly incidence rate on 21 August was 116 per 100,000, mainly because of an outbreak in the Greencore factory. We brought in measures and the prevalence rate was brought down to 25.8 per 100,000. Swindon was put on the watchlist, the rise there being linked to a large-scale workplace outbreak and car-sharing issues. These were addressed and the prevalence was brought down to 15. I could go on. I accept that the picture for local lockdowns is complicated, and there are places where the numbers have gone up and have come down, but where measures have been supported by communities, we have broken the chain of transmission.
I want briefly to say something about the way these measures were introduced. Our natural inclination is to lift restrictions wherever and whenever we can. In the summer, we were hopeful that the country had got the message, that our exhortations on hands, face and space had got through and that, except for some local outbreaks, we had basically got a lid on it. However, the numbers told another story. It was therefore essential that the Government moved quickly. As in the past, we used the powers under the public health Act. Our lawyers diligently crossed every “t” and dotted every “i”, so the paperwork was not laid until hours before the measures became law.
None of this is ideal. The Government accept that parliamentary scrutiny has an important role to challenge the detail and to build support. That is why the Secretary of State for Health and Social Care told the other place last week that, for significant national measures with effect in the whole of England, the Government would consult the House of Commons wherever possible and hold votes before the regulations came into force.
I reassure noble Lords that the Government have heard the message on this point and that we are building on the success of these regulations to take them forward. For that reason, I beg to move.
Lord Bethell (Con)
My Lords, I am extremely grateful for this debate, not because it was particularly enjoyable for any Minister to be described in the terms that I was—although I am grateful for some of the kind words—but because it was an important one. What I heard, loud and clear, was huge frustration: it was like listening to an elastic band being stretched to breaking point—not a pleasant sound. However, it was an important moment when we heard quite clearly the deep and heartfelt concerns of noble Lords about the key issues around this statutory instrument. I will address those concerns in turn.
Fundamental is the science, and I will talk a little about the background to this statutory instrument because there is clearly enormous concern about that—about the Government’s strategy and its complexity, and about the sheer volume, sophistication and confusion of the guidelines and the requests that are being made to the public, and the process by which these instruments are being put together. It is a lot to bite off, but I will cover it as well as I can.
I want to convey to noble Lords that in the past six months our understanding of the virus has changed dramatically. From receiving telephone calls from the front line of the health system we now have a massive information system plugged into the Joint Biosecurity Centre, which was designed by the best minds that the Government have from the intelligence services, the data services and the Cabinet Office. That gives us a very clear picture of what is going on on the ground. Some of that information is data flows from the health system, hospital logs and test and trace, while some is local intelligence from infection control teams on the ground, local resilience forums and local councils. Some of it is then filtered by analysts with epidemiological training, who plug into the proper scientists—the white-coated scientists—who provide their own analysis.
I do not offer this Chamber a volume and say, “This is the science”. Rather, I offer a huge amount of technical insight that is pored over every day, is delivered in extremely sophisticated dashboards, is interrogated by inquiring minds and is challenged by sceptics. We now have a much clearer day-to-day picture of what is going on, in the country as a whole and in different parts of it. When we drafted these regulations, we considered all that information.
The story being told in mid-September was that the public had miscued: that they had, during the summer, massively relaxed their behaviour. The key form of transmission—the trigger to a huge amount of infection —was families taking an extremely lax interpretation of what social mixing they could do. The insight that came from the ground—not from the top—was that we needed to give a much clearer, more easily understood and more enforceable story, or instruction, to the public in order to separate people.
For all that has been said in the Chamber, it is clear to all of us how this disease is spread. It is spread in the aerosol from our breath and by our touching and feeling things. At the end of the day, what we are talking about here is something deeply uncomfortable. We can rightly challenge the regulations for being too complex, and I have enjoyed the speeches that poked fun at some of the difficult and potentially ludicrous parts of sophisticated and complicated guidelines. I can hear the frustration in that kind of challenge, but the bottom line is that social distancing means putting space between ourselves and the people we love. There is no avoiding that bottom line.
You can try to blame the laws, if you like, and blame the regulations for being at fault—“We’ve drafted bad regulations”. But it is not the regulations; it is the space. We all want to spend a lot more time with the people we worry about and care about. We want to enjoy the conviviality of groups we know and trust. We want to plug into the networks of spiritual connection, interest, power and familial connection. These regulations emphatically break those connections. Where there was love, they put in space. I cannot apologise for that. I cannot change it or find some form of words that transforms that simple fact, or in any way changes the grim realities of how we have to limit the transmission of this disease.
I completely hear the ridicule. I feel the frustration and I do not doubt that things could have been done better. Some of these regulations could have been written better. My noble friend Lord Lamont has rightly queried the differences between weddings and funerals. There is an explanation for why they are treated differently, but it would be churlish of me to stand here and plod through it in a bureaucratic and, frankly, frustrating manner. However, I would be glad to write to my noble friend with that explanation. The honest truth is that they are hurtful, they do damage the way in which we show our love, and they will leave a lasting effect on the psychological health of the country and on the economy. I would like quickly to address those two points.
I have been questioned on the strategy many times but, as most noble Lords know, the strategy is clear. The Prime Minister was clear about it last Thursday, as was the Chancellor this morning. We will suppress the virus, while supporting education and the economy, until we eliminate it by vaccine, therapeutics and mass testing. This is a middle way. It emphatically is not a national measure to lock down the country—we tried that and it was horrible, although successful and made a big difference—nor is it running hot. It is the middle way. Therefore, we have to accommodate. We have complexity. We are using local lockdowns and we are trying to instruct by consent, rather than by force. We are trying to be flexible with those who have special needs. Most importantly, we are letting those trying to defend their jobs and education pursue those interests. Those are our two major priorities.
Time is tight, so I will address just a couple of points. As a father of four children, three under 12, I completely hear the point on children. There are many parents and grandparents here who feel it harshly, but the research from the front line was crystal clear: people were using children’s birthdays, drop-offs and congregations around children to flout the rules and create events where infection was happening. Clarity and preventing those nodes of transmission became a priority, which is why we have pursued the route we have.
In reply to my noble friend Lord Dobbs, I can be crystal clear: the Vaccine Taskforce has done brilliantly in researching, identifying and buying vaccines. Advice on how they will be distributed will be given by the JCVI. Our policy on vaccine distribution will be to listen to the JCVI, which has yet to pronounce on it.
My noble friend Lord Robathan is right that some of long Covid is post-viral fatigue, but there is more to it than that. Neurological, cardiac and renal failure are being seen in many people, which is extremely alarming.
I have to draw stumps there. I reassure the House that we have learned the lesson about parliamentary scrutiny, which builds support and brings the light of scrutiny to these measures. We would not have had this debate today, with all the pain and frustration that has been present, if we had had more debates like it previously. My right honourable friend has given a commitment in the other place to bring measures to the House more promptly. In response to the noble Baroness, Lady Thornton, it will be up to the usual channels and the Joint Committee on Statutory Instruments to bring these instruments to the Chamber for debates more promptly, as has rightly been suggested today.