Covid-19 Update

Wednesday 14th October 2020 Lords Chamber

Statement

The following Statement was made in the House of Commons on Monday 12 October.

“With permission, Mr Speaker, I will make a Statement on our continuing fight against coronavirus and how we intend to fulfil our simultaneous objectives of saving lives and protecting the NHS while keeping our children in school and our economy running, thus protecting jobs and livelihoods.

This morning, the Deputy Chief Medical Officer set out the stark reality of the second wave of the virus. The number of cases has quadrupled in the last three weeks. There are now more people in hospital with Covid than when we went into lockdown on 23 March, and deaths are already rising. Of course, there are those who say that on that logic, we should go back into a full national lockdown of indefinite duration, closing schools and businesses, telling people again to stay at home as we did in March, and once again shattering our lives and our society. I do not believe that would be the right course. We would not only deprive our children of their education but we would do such damage to our economy as to erode our long-time ability to fund the NHS and other crucial public services.

On the other side of the argument, there are those who think that the patience of the public is now exhausted, that we should abandon the fight against Covid, stand aside, let nature take her course and call a halt to these repressions of liberty. Of course, I understand those emotions. I understand the frustration of those who have been chafing under the restrictions and the sacrifices they have made. But if we were to follow that course and let the virus rip, the bleak mathematics dictate that we would suffer not only an intolerable death toll but put such a huge strain on our NHS, with an uncontrolled second spike, that our doctors and nurses would be simply unable to devote themselves to other treatments for cancer, heart disease and hundreds more illnesses that have already been delayed and would be delayed again, with serious long-term damage to the health of the nation.

I am afraid that it is no answer to say that we could let the virus take hold among the young and fit while shielding the elderly and vulnerable, because the virus would then spread with such velocity in the general population that there would be no way of stopping it spreading among the elderly. Even if the virus is less lethal for the under-60s, there will still be many younger people for whom, alas, it remains lethal.

We do not want to go back to another national lockdown; we cannot let the virus rip, so since June, we have followed a balanced approach, with the support of many Members across the House, to keep the R rate down while keeping schools and the economy going, and controlling the virus by changing our behaviour to restrict its spread. That is why we have the rule of six and restrictions such as the 10 pm closing time on our hospitality sector.

I take no pleasure whatever in imposing restrictions on those businesses, many of which have gone to great lengths to reopen as safely as possible. Nor do I want to stop people enjoying themselves. But we must act to save lives and the evidence shows that in changing our behaviour to restrict transmission between us, our actions are saving lives. Left unchecked, each person with the virus will infect an average of between 2.7 and three others, but the Scientific Advisory Group for Emergencies assesses that the current R nationally is between 1.2 and 1.5. So we are already suppressing that R to well below its natural level, which is why the virus is not spreading as quickly as it did in March, but we need to go further. In recent months we have worked with local leaders to counter local spikes with targeted restrictions. This local approach has inevitably produced different sets of rules in different parts of the country, which are now complex to understand and to enforce. So just as we simplified our national rules with the rule of six, we will now simplify and standardise our local rules by introducing a three-tiered system of local Covid alert levels in England, set at medium, high and very high.

The medium alert level, which will cover most of the country, will consist of the current national measures. This includes the rule of six and the closure of hospitality at 10 pm.

The high alert level reflects the interventions in many local areas at the moment. This primarily aims to reduce household-to-household transmission, by preventing all mixing between different households or support bubbles indoors. In these areas, the rule of six will continue to apply outdoors, where it is harder for the virus to spread, in public spaces as well as private gardens. Most areas which are already subject to local restrictions will automatically move into the high alert level. As a result of rising infection rates, Nottinghamshire, east and west Cheshire and a small area of High Peak will also move into the high alert level.

The very high alert level will apply where transmission rates are rising most rapidly and where the NHS could soon be under unbearable pressure without further restrictions. In these areas the Government will set a baseline of prohibiting social mixing indoors and in private gardens, and, I am sorry to say, closing pubs and bars. We want to create the maximum possible local consensus behind this more severe local action, so in each area we will work with local government leaders on the additional measures which should be taken. This could lead to further restrictions on the hospitality, leisure, entertainment or personal care sectors, but retail, schools and universities will remain open.

As my right honourable friend the Chancellor has set out, the Government will expand their unprecedented economic support to assist those affected by these decisions, extending our Job Support Scheme to cover two-thirds of the wages of those in any business that is required to close, and providing those businesses with a cash grant of up to £3,000 a month, instead of £1,500 every three weeks. We will also provide local authorities across England with around £1 billion of new financial support, on top of our £3.6 billion towns fund. And for ‘very high’ areas, we will give further financial support for local test and trace and local enforcement, and assistance from the Armed Forces—not for enforcement, but rather to support local services, if desired in the local area.

I can report that we have been able to reach agreement with leaders in Merseyside. Local authorities in the Liverpool city region will move into the very high alert level from Wednesday. In addition to the baseline I have outlined—this is as well as pubs and bars—in Merseyside gyms and leisure centres, betting shops, adult gaming centres and casinos will also close. I would like to put on record my thanks to Steve Rotheram and his colleagues for their co-operation in very difficult circumstances.

Engagement with other leaders in the north-west, the north-east and Yorkshire and the Humber is continuing. I know how difficult this is—they, like us, like everyone in this House, are grappling with very real dilemmas—but we cannot let the NHS fall over when lives are at stake. Let me repeat the offer that we are making to those local authorities: work with us on these difficult but necessary measures in the areas that are rated very high, in return for more support for local test and trace, more funding for local enforcement, the offer of help from the armed services, and the Job Support Scheme, as announced by the Chancellor.

I believe not to act would be unforgivable, so I hope that rapid progress can be made in the coming days. Regulations for all three Covid local alert levels are being laid today. They will be debated and voted on tomorrow, before coming into force on Wednesday.

We will also keep these measures under constant review, including a four-week sunset clause for interventions in very high areas. A postcode search on GOV.UK, as well as the NHS Covid-19 app, will show which local alert level applies in each area. We are also publishing updated guidance to explain what the Covid alert levels mean for those who are clinically extremely vulnerable. While these levels specifically apply to England, we continue to work closely with the devolved Administrations to tackle this virus across the whole United Kingdom.

This is not how we want to live our lives, but this is the narrow path we have to tread between the social and economic trauma of a full lockdown and the massive human and, indeed, economic cost of an uncontained epidemic. With local, regional and national government coming together in a shared responsibility and a shared effort to deliver ever-better testing and tracing and ever-more efficient enforcement of rules; with ever-improving therapies and the mountains of personal protective equipment and the ventilators that we have stockpiled; and with all the lessons we have learned in the last few months, we are becoming better and better at fighting this virus.

Though I must warn the House again that the weeks and months ahead will continue to be difficult and will test the mettle of this country, I have no doubt at all that, together, we will succeed, and I commend this Statement to the House.”

13:05

[Baroness Smith of Basildon (Lab)]

My Lords, I doubt that the Prime Minister, Boris Johnson, shares my admiration for Harold Wilson, but even he will recognise that his oft-quoted comment that a week is a long time in politics is very relevant today. With the pace of events over the last couple of days they must have felt like at least a week. I expect that the noble Baroness the Lord Privy Seal might be relieved not to be repeating the Statement made by the Prime Minister in the Chamber today.

The Statement on Monday, announcing a three-tier system of restrictions, is already wilting under close examination and the publication of the scientific advice received by the Prime Minister. In the Statement, the Prime Minister said that we needed to “go further” than the existing restrictions. He is right to consider and announce further actions, but the scale and rate of infections is increasing. There are now more people in hospital, including ICU, than there were in March when we went into lockdown. On the positive side, our knowledge and ability to treat have improved, but we have a clearer understanding of how devastating this illness is for so many.

The Prime Minister referenced the Government’s advisory body SAGE in his announcement, but if you go back and read it again there is a very serious omission. This was clearly no accident; it was calculated and deliberate. Unlike earlier Statements from the Prime Minister and members of his Government, this one makes no reference to following the scientific evidence or to evidence-based policy-making. We now know why. The minutes of the SAGE meeting of 21 September, published after the Prime Minister’s Statement on Monday, are very clear about the scale of the challenge and the action needed—not suggested—to tackle it. Its warnings are stark:

“not acting now … will result in … catastrophic consequences in terms of direct COVID related deaths and the ability of the health service to meet needs.”

The report then lists a range of short-term measures to be considered for “immediate introduction”. That was on 21 September, three weeks ago, and it said “immediate”: not next week or next month.

Since then, the Prime Minister has made two announcements of new restrictions but has failed to act on, or share with Parliament or the public, the advice that his Government have received. Let us be clear: any restrictions are difficult; none is pain free. But surely the worst kind of restrictive measures are those that are piecemeal. They fall short of what is required and, therefore, go on longer without the level of impact that is needed. The Prime Minister has, therefore, twice announced measures knowing that they fall short of what the scientific advice says is essential.

The seriousness of this cannot be overestimated. He knows that his measures are inadequate, as evidenced in an article in today’s Telegraph that says that the Government are now considering the circuit break that was recommended by SAGE three weeks ago and called for by my colleague and Leader of the Opposition yesterday. At the same time, the world-beating test, trace and isolate system that the nation was promised has failed to materialise. After the Government have spent £12 billion, SAGE has concluded that that is having “marginal impact”.

For those who are suffering lockdowns, desperately missing and worrying about loved ones, worried about their own and their families’ health; for the self-employed, the now unemployed and struggling businesses, to go through that pain without the gain, with the Government ignoring the scientific advice, is deeply shocking and unacceptable.

It has to change. The stop-start approach has failed; we have to break that cycle. It is so much harder to deal with the economic consequences unless there is public confidence in the Government’s ability to protect the nation’s health. I get upset and quite angry when it is suggested that this is a binary choice between our health and the economy. That is plain wrong. It is so evident that they are two sides of the same coin and totally interlinked.

Last night, having considered the scientific evidence and consulted widely, Keir Starmer called on the Government to reset their approach—to introduce that circuit breaker alongside the other measures deemed necessary by the scientific experts, along with the essential economic support, and to get a grip of the test, trace and isolate system. That is not a single measure; it is a complete package of health protection, economic support and future planning.

I have a couple of questions for the noble Baroness, who is a member of the Cabinet and of Cabinet committees. I appreciate that the details of Cabinet discussions are not published, but can she confirm that members of the Cabinet were informed of the SAGE advice of 21 September? Following that, can she explain the rationale, which must surely have been discussed in Cabinet, in ignoring that advice?

Too often, the Government’s approach has been very centralised, and effectiveness has been lost through a failure to properly engage, consult and support local authorities. What action is being taken now to ensure local capacity, knowledge and experience is being effectively utilised, particularly in test, trace and isolate, with the necessary resources being provided for that? I refer to all local authorities, not just those in tiers 2 and 3, because this has to be a nationwide engagement.

The costs of tackling the crisis and preparing for the post-Covid future are huge. Obviously, we need to ensure such large amounts of money are used to the greatest effect. Many in your Lordships’ House have been in government or in positions of authority where difficult decisions have to be taken. No one is pretending this is easy, but it is even harder when members of your own party are pulling in different directions. There is only one thing to do in those circumstances; it is not possible to steer a middle course and try to placate different views. You just have to do what is right, because that is what true leadership is really about.

[Lord Newby (LD)]

My Lords, I thank the noble Baroness the Leader of the House for responding to questions on the Prime Minister’s Statement. Although we are discussing a Statement barely 48 hours after it was made, things on the ground, as the noble Baroness, Lady Smith, has said, have moved on apace since Monday. Infections have risen, deaths have risen rapidly, and people have become more confused and more worried.

In the Statement, the Prime Minister said the Government are seeking to balance the

“objectives of saving lives and protecting the NHS while keeping our children in school and … protecting jobs and livelihoods.”—[Official Report, Commons, 12/10/20; col. 23.]

What he did not do was level with the British people about what his scientific advisers have been proposing. We now know that last month, SAGE urged an immediate circuit breaker of more restrictive measures, because, as the noble Baroness said, and in its words,

“not acting now … will result in a very large epidemic with catastrophic consequences.”

That was several weeks ago. No action was taken, and we do now have a “very large epidemic” on our hands. That is why my colleagues in the other place and those on these Benches support the leader of the Opposition’s proposal for a short circuit breaker, to give time to get firmly in place some measures to get the virus under control, in the hope that we might have some relaxation—albeit possibly temporarily—at Christmas. I have never seen the Prime Minister as one of nature’s Roundheads but as things stand, he looks set to succeed and follow Oliver Cromwell by cancelling Christmas as we know it.

The one welcome change in the Government’s position over recent days is that they have been willing, for the first time since March, to have a serious dialogue with civic leaders in those areas most heavily affected by the virus. This is extremely welcome but long overdue. However, it needs to go much further. The national test, track and trace system is failing, and failing badly. A large proportion of people who have been in contact with someone who has tested positive are still not being contacted. Some 27% of those asked to isolate do not do so. Will the Government now effect a step change in the role they give to all local directors of public health to implement the track, trace and isolate system in their areas? Will they do so across the country and not only, as currently envisaged, in very high-alert areas; and will they give them the resources they need to do the job properly? If they do not, I fear we are simply going to see a large increase in the number of areas requiring the highest level of restrictions.

The Prime Minister’s Statement seems to bring clarity to an extremely confused picture, but it simply does not. It is completely unclear, for example, on the criteria the Government will use to decide which areas fall into the “very high”, “high” and “medium” categories. Can the noble Baroness tell the House what those criteria are?

The Prime Minister said the measures announced on Monday could lead to additional measures if local government leaders agreed. What measures do the Government have in mind? What happens if the Government think additional measures are needed and local leaders do not? Equally, if local authority leaders think that more restrictive measures should be imposed in advance of any government initiative—as is now the case with Essex County Council, and which is, I believe, the policy of the Mayor London—what will the Government’s response be?

The Government have briefed that they are preparing to open some of the Nightingale hospitals. It is widely believed in Yorkshire that, as far as the Nightingale hospital in Harrogate is concerned, this will not happen, because the hospital simply does not have the staff available to allow it to operate safely. Can the noble Baroness assure the House that this is not the case?

The country is now at a very dangerous point. The Government are at odds with their own scientific advisers, many council leaders and many of their own Back-Benchers. Their rules are complex and, in some cases, perverse. Track and trace is a shambles: it has lost the confidence of the majority of the population. It is time for a reset.

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

I thank the noble Baroness and the noble Lord for their comments and questions. First, they are right to point out some of the statistics to highlight the situation we are in. As the noble Baroness rightly said, there are now more people in hospital with Covid than when we went into lockdown on 23 March, and the number of people testing positive for Covid has quadrupled in the last three weeks, so we are very cognisant, as I know we all are in this House, of the issues that face us.

The noble Lord and the noble Baroness referenced the need for action in September. We did take robust and proportionate action when introducing measures in England, including the rule of six and the 10 pm curfew, which we discussed in this House, as well as advising people to work from home when they can. Each of those was carefully judged to protect lives and reduce transmission, while minimising the impact on people’s livelihoods.

So, we did take robust action, but with the step change in cases, more action is needed, which is why we made the decision to move to the tiered approach. The reason we have gone for the tiered approach rather than the circuit breaker is that, as the Prime Minister said to the leader of the Opposition at Prime Minister’s Question Time today, the disease is appearing more strongly in some areas and regions than others, which is a different situation from March. That is why we are introducing this approach, which can be tailored more effectively to local situations. However, having said that, we regularly, and will regularly, keep measures under review to ensure that we are always taking the best action we can.

The noble Lord and the noble Baroness mentioned evidence. Evidence is considered by SAGE and its advice is published regularly online when it is no longer under live consideration for policy decisions. That is exactly what happened in this case. I hope I can reassure noble Lords that we will continue to take advice from a wide range of scientific and medical experts, as we have done throughout the pandemic, to inform our decisions. We are, as the noble Baroness rightly said, constantly having to evaluate the balance between protecting the NHS, saving lives, keeping our economy moving and keeping our children in school. These are very difficult issues to balance and I think the tone of the noble Lord’s and the noble Baroness’s questions, which I very much welcome, expresses the gravity of the situation and the difficult decisions that are being made.

I can assure the noble Baroness that as a member of Cabinet I have regular briefings, along with my Cabinet colleagues, from the Chief Medical Officer and the Chief Scientific Adviser about the latest data. As I have said, the Prime Minister and the Cabinet have to take decisions based on the best available science, along with considerations of the economic, operational, social and policy implications that follow, and that is what we do.

The noble Lord and the noble Baroness both reiterated criticisms of the test and trace system. I remind noble Lords that our daily capacity for testing is now around 340,000, with the aim of reaching more than 500,000 by the end of October. We increased capacity by around 30% in September alone. We are testing at a higher rate than other European countries and we have assembled the largest testing network in our history, including 96 NHS labs, 151 walk-in sites, 258 mobile testing sites and 77 regional sites. We are also looking to combine, as effectively as possible, the national framework and local expertise, which is why, since August, NHS test and trace has provided local authorities with dedicated teams of contact tracers to work alongside local public health officials to provide a more specialist service. We have provided more than £300 million to local authorities to help with this and, across the country now, we have 95 local authority contact tracing teams that are live, and more are coming online in the coming weeks. We have been very cognisant of some of the criticisms and are improving the situation on the ground. More than 700,000 people have been contacted and advised to isolate through the system and the latest figures show that more than 82% of contacts were reached and asked to self-isolate where contact details were provided.

The noble Lord, Lord Newby, asked about moving between tiers. Decisions on which areas are in which tier are made on a number of factors, including the rate of transmission, how quickly it is increasing and the effectiveness of current interventions, as well as hospitalisations and hospital capacity. Of course, all is also done in line with work and conversations with local leaders to discuss all their evidence and what they are seeing on the ground. It is a collaborative effort, but a range of factors is taken into account.

The noble Lord also asked about the Harrogate Nightingale Hospital. I am not sure whether he is aware, but it is currently being used. CT scanners have been made available to provide people with safer and faster access for a range of conditions, including cancer. As he will be aware, there are two hospitals providing that kind of support, Harrogate and Exeter, and another three Nightingale hospitals in some of the areas with the highest rates have been put on standby in order that they can play their part, along with the rest of our fantastic NHS, as we deal with this crisis.

[The Lord Speaker (Lord Fowler)]

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.

13:23

[Baroness Newlove (Con) [V]]

My Lords, I welcome the Statement made on Monday in the other place by the Prime Minister. However, I have received lots of correspondence from people who are confused, very angry and very concerned. This means that their mental health is actually off the scale. My concern, therefore, is that the area that I live in, in Liverpool, is in a high tier and everything has been shut down. One place that a lot of people like to go to is gyms, and while they appreciate that there has been recent overcrowding, these businesses have invested a lot of money to be Covid-friendly. This morning, the Northern Ireland Assembly has said that from Friday they will be in a four-week lockdown, but gyms are allowed to be open on a one-to-one basis. What conversations has the Prime Minister had with the mayors of Liverpool to discuss how we can keep certain businesses open, so that people have safe spaces for their anxiety and their mental health?

[Baroness Evans of Bowes Park (Con)]

I thank my noble friend. Certainly, the Prime Minister, the Secretary of State for Health and Social Care and the Communities Minister have all had regular dialogues with the leaders of the Liverpool City Region over the last few days. She is absolutely right that within the very high tier there are certain baseline restrictions and then others that can be decided at a local level. She is right that in Liverpool, decisions have been made to close casinos, betting shops, indoor gyms, fitness and dance studios and sports facilities, although there are going to be exemptions for organised indoor team sports for disabled people and activities for under-18s, understanding some of the issues she raised. Obviously, she is absolutely right about mental health, which is why we have provided £9.2 million of additional funding for mental health charities.

[Lord Patel (CB) [V]]

My Lords, it is generally accepted that the test, track and isolation policy is important for suppression of the virus. Despite the large volume of tests that we carry out, as the noble Baroness stated, plus the increase in capacity, we have not seen any significant effect in suppression of the virus through this policy, so what more needs to be done to make our test, track and isolation policy more effective? Furthermore, does the Minister agree that any policy, suggested by some, of abandoning suppression of the virus and adopting a policy of herd immunity is morally, ethically and scientifically flawed?

[Baroness Evans of Bowes Park (Con)]

On test and trace, I hope I outlined in my earlier answers the work that is going on to further improve national and local link-up. As I said, across the country there are now 95 local authority contact tracing teams—21 local teams in the east of England, for instance, 23 in the east Midlands and 21 in the north-west. Combined with the national system, they are helping to ensure that we have good data on the ground so that we are able more effectively to track what is happening and then, with the tiered approach, make sure that the interventions work on a regional or even more local level.

[The Lord Bishop of Durham [V]]

In welcoming the fact that places of worship have been allowed to continue to open—that is partly a recognition of their important place in the life of the nation—I note that the Prime Minister spoke still in the binaries of economic health and medical health that we have heard throughout the course of the pandemic. However, the nation’s health is more than this binary. The Government must surely no longer overlook the need to protect the nation’s social and spiritual health too. The Christian faith is clear that well-being is far more than being medically healthy or simply alive; rather, it involves social engagement, emotional nourishment, spiritual rest and love from good community. Will the Government acknowledge the nation’s need for social and spiritual health by including experts on social well-being in all future conversations around lockdown measures?

[Baroness Evans of Bowes Park (Con)]

I agree with the right reverend Prelate that that is the dilemma being faced. As he rightly says, harm to health is harm to the economy and harm to the economy is harm to health: these things are all interlinked, which is why this is a very difficult situation and why difficult decisions are having to be made about how to balance them. I can assure him that that is at the forefront of our thoughts. As part of the ongoing discussions around decisions being made about national and local levels, I know that Cabinet colleagues and the Prime Minister are talking to a huge range of people with different backgrounds to make sure that we get that right and get the country moving in the right direction.

[Baroness Clark of Kilwinning (Lab)]

Now that the Government are finally consulting metro mayors and local authorities, will they consider calling a jobs summit to discuss what can be done in the here and now to protect jobs, given the further restrictions that are coming in, and to create the kind of green future that we talk about so often?

[Baroness Evans of Bowes Park (Con)]

I can certainly assure the noble Baroness that discussions are ongoing across government, including through the Treasury and the Business Secretary, with local leaders, local business leaders, unions and workers’ representatives. Of course, she will be aware that, as part of the announcements we have made, we have extended the job support scheme. She will also be aware that, since the beginning of the crisis, we have provided more than £200 billion of support to business. We completely understand, and by using these figures I am not trying to diminish the issues that people are facing in their daily lives, but I can reassure her that this is top of our agenda. I hope she will recognise that the Chancellor has been working fleet of foot so that he is able to bring forward support packages to help individuals and businesses through this difficult time.

[Lord Greaves (LD)]

My Lords, I spent quite a lot of time yesterday afternoon looking at the detailed infection figures for Covid for each Lancashire district on a daily basis over the last 10 weeks. It is absolutely clear that the first main surge of infections occurred during September, particularly around the middle of September. On 1 September the schools went back, and this seems to be the topic that we are not allowed to talk about. The Government have said they are not going to close schools under any circumstances. I am not saying that the statistical correlation—which is clearly there—is a causal one; I am saying it needs to be looked at hard and investigated. I notice that Northern Ireland is closing its schools for a fortnight. Will the Minister forecast how long it will be before schools in the most affected areas in England are closed?

[Baroness Evans of Bowes Park (Con)]

Within the very high tier—the top level of the new interventions—non-essential retail, schools and universities will remain open. They remain open at all levels. As the noble Lord rightly said, we have prioritised keeping schools open as one of the key things we wish to do because, as we have heard in previous debates in your Lordships’ House, the disadvantage to young people when schools close is something that we really do not want to repeat, having seen what happened earlier in the year. I am afraid I will not make any apology for the fact that we have put that at the top of our priority list.

[Lord Naseby (Con)]

If saving lives is a key criteria, will my noble friend commit Her Majesty’s Government to ensuring that no hospital patients will be discharged to care and nursing homes unless they have had a negative Covid test? Furthermore, will she commit that no persons may enter those homes, including inspectors, unless they have had a recent Covid test? Finally, if any of these homes should be in considerable financial difficulty, will she commit that Her Majesty’s Treasury will support them until the pandemic is over?

[Baroness Evans of Bowes Park (Con)]

My noble friend is absolutely right to talk about care homes, and I can certainly reassure him that no care homes should be forced to admit residents they do not feel they can provide appropriate care for. Also, all individuals must be tested before discharge from hospital into a care home. I hope I can reassure him by letting him know that we have provided over 208 million items of PPE and are giving every care home free PPE until at least the end of March. We are also piloting weekly testing for professionals who visit care homes regularly and come within one metre of residents when carrying out their roles, so that we can do everything we can to ensure that infection rates do not rise exponentially within that sector.

[Lord Kakkar (CB)]

My Lords, I draw attention to my registered interests. The noble Baroness the Leader of the House made reference to Nightingale hospitals. Is she in a position to advise your Lordships on what measures were taken and how the Nightingale hospitals have been prepared during the summer months, with specific reference to the provision of protective equipment, clinical equipment, advanced therapeutics and, most importantly, human resource staff, so that they are now immediately able to make a contribution to the management of this second wave of Covid-19? In particular, I ask if, and how, a clinical protocol has been established to ensure that the Nightingale hospitals can be deployed for the management of not only Covid-19 but other diseases, in such a way that the NHS can continue to deliver?

[Baroness Evans of Bowes Park (Con)]

As I mentioned in reference to a comment by the noble Lord, Lord Newby, CT scanners have been made available—for instance, in Harrogate and Exeter—to provide safer, faster access for people with a range of conditions, including cancer, so that we can continue to try to ensure that routine appointments and operations can still take place. As I also mentioned, three other hospitals are now on alert in areas of high prevalence in order that they can come on stream. Obviously work is going on between the Department of Health and NHS England, but they will be staffed from the local area. We will of course keep all of this under review because we know that capacity is important, and the Nightingale hospitals will, I am sure, once again play an important part in our response as we go forward.

[Baroness Blackstone (Ind Lab)]

My Lords, given the threat to jobs from measures set out in the Statement, can the Leader of the House say what the Government intend to do to prevent higher levels of unemployment? In replying, can she tell the House what proportion of jobs will be supported by the Job Support Scheme, and who will still miss out in the extension of the Self-employment Income Support Scheme?

[Baroness Evans of Bowes Park (Con)]

First of all, our Job Support Scheme is in line with those of other major European countries, including France, Germany, Ireland and Italy, in its proportion of wage support. We very much believe that this scheme can help the lowest paid in particular, who can benefit from the responsiveness of our welfare system. The dovetailing of those two things should actually mean that some of the poorest workers—or those on the lowest pay, I should say—could end up on around 88% of their original income, and so more than the two-thirds on which the scheme itself is based. Obviously, businesses are able to top up the two-thirds as they wish, as they did for the furlough scheme.

However, I think the Chancellor has been quite clear: unfortunately, we are not going to be able to save every job. We will do all we can to support businesses and individuals. That is why we are trying to look to the future with, for instance, the £2 billion Kickstart scheme, which will create thousands of subsidised jobs for young people; paying employers to hire apprentices; and doubling the number of work coaches. We are very cognisant of the issues in this area, and have a range of things—both trying to protect jobs at the moment and looking to the future—to make sure that everyone has an opportunity for employment going forward.

[Baroness Neville-Rolfe (Con)]

My Lords, it is now clear that lockdowns do not solve the problems posed by the virus. They merely delay them, at enormous cost in money, running into tens of billions; unhappiness, brought on by loneliness; and, indeed, lives lost, due to the consequent neglect of other medical conditions. We need to avoid another national lockdown at all costs. Instead, we need to deal with the virus regionally, as the Government are now doing. Will the Government ensure that any local controls are adapted very quickly to take account of developments? Speed is of the essence—I think everyone agrees about that—and we are not yet as quick as we need to be.

[Baroness Evans of Bowes Park (Con)]

I entirely agree with my noble friend. That is the basis of the thinking behind the very high tier in particular, where restrictions can be dovetailed to the specific circumstances of the individual region. I can assure her that PHE, the Joint Biosecurity Centre and NHS Test and Trace are constantly monitoring levels of infection and data across different areas of the country, so we can do exactly as she suggests.

[Lord Bilimoria (CB) [V]]

My Lords, a second national lockdown would be devastating for our economy, so it is right to prioritise bringing infections under control. As president of the CBI, I know that business supports the simplification of the Covid rules with three tiers of restrictions. But does the noble Baroness the Leader of the House agree that the Government must show more of their evidence base for the new restrictions? This includes the 10 pm closing for restaurants, bars and pubs, where, I am led to believe, less than 5% of new infections come from. Why do we still need the 10 pm rule? Will they also keep financial support under review, in lock-step with the severity of the restrictions? The noble Baroness the Leader of the House mentioned testing. It is admirable that the testing has gone up from 2,000 to 350,000, and soon to 500,000, but she has not mentioned mass testing. Could she talk about mass testing—

[Lord Ashton of Hyde (Con)]

My Lords, could the noble Lord put his question please?

[Lord Bilimoria (CB) [V]]

I have asked two questions.

[Baroness Evans of Bowes Park (Con)]

Very quickly, analysis from PHE and NHS Test and Trace suggests that pubs, bars, restaurants and cafes account for the highest rates of common exposure for Covid, especially in those under-30. We will of course continue to keep an eye on financial support, which we have continued to do. I am afraid I did not hear the third part of the question.

[Baroness Symons of Vernham Dean (Lab)]

My Lords, the House will have noted that the Leader of the House, in answering the questions put by my noble friend Lady Smith, did not answer the specific question of whether or not the Cabinet was aware of, or saw, the SAGE advice for 21 September before the decision was taken to have a lockdown. Perhaps the noble Baroness could answer that now. Perhaps she could also say why the Prime Minister, having relied so heavily on scientific advice, chose on this occasion to ignore it and to ignore the warnings about the catastrophic position if it were ignored.

[Baroness Evans of Bowes Park (Con)]

I have never and will never comment on Cabinet meetings, so I have said as much as I can in answer to the noble Baroness. I also said, with regard to the decisions being made, that we will continue to take advice from a wide range of scientific and medical experts, but we will also have to look at the wide economic policy implications of decisions. That is why we believe that the tiered approach, which comes into effect only today, is correct at this time.

[Viscount Trenchard (Con)]

My Lords, the Prime Minister is right to have resisted the call by some for a return to a full lockdown, and I congratulate him on insisting on retaining a balanced approach. However, it is important to note that the death toll, while rising, is nowhere near the same percentage of known infections that it was in late March. That suggests that the mortality rate attributable to Covid alone is lower than we thought at that time. If the mortality rate remains at a relatively low level compared to infections, can my noble friend confirm that the Government will take early steps to lift restrictions on the hospitality and other affected sectors, providing a platform for economic recovery?

[Baroness Evans of Bowes Park (Con)]

I can certainly assure my noble friend that our priority is to ensure that we bear down on this. As I said, the number of people testing positive for Covid has quadrupled in the last three weeks, there are more people in hospital with Covid now than there were when we went into lockdown and, worryingly, infections among older people are rising. However, of course, part of this tiered approach is very much also to ensure that businesses such as hospitality can function in areas where the disease is perhaps not as prevalent in the community.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, the Government’s overriding objective must be to reduce both the direct threat to life from Covid-19 and the indirect threat of an overwhelmed health service being unable to help those with other serious conditions. It is an affront to many that the risk to life and the hardship caused by pubs closing at 10 pm is talked about in the same breath. A short, sharp shock approach is clearly needed to reduce a rapidly rising reinfection rate to less than R1. Will the Government now urgently consider something like a two-week national lockdown to coincide with the half-term break?

[Baroness Evans of Bowes Park (Con)]

The noble Lord will be aware that these new measures came into effect only today, and we believe that they will have an impact. As I said in my initial answer to the noble Baroness, Lady Smith, we have taken this approach because the disease is appearing at the moment more strongly in some areas and regions than others, which is a different situation from that we were in in March. That is why we have introduced this regional, tiered approach.

[Baroness Andrews (Lab) [V]]

My Lords, the noble Baroness in her responses has not addressed the fact that, as SAGE put it so starkly, the centralised track and trace system is bringing only marginal benefit in stemming the pandemic in the regions. Despite all the statistics she has offered, is it not absolutely clear that local leaders are still therefore not getting what they have been asking for for months: full access, full support and all the resources they need to put them in the driving seat? When will that happen?

[Baroness Evans of Bowes Park (Con)]

I am afraid that I do not agree with that assessment from the noble Baroness. As I said, local and national government are working together with resources and expertise, and 95 local authority contact tracing teams are now live, with more to come, and we will continue to increase that capacity. However, we are working together, because the only way we can combat this is by national and local government and local leaders working together.

[Viscount Ridley (Con) [V]]

Does my noble friend accept that conceding that a vaccine is a long way off changes the calculation? Mathematically, treating old and young by the same rules ensures that they have an equal probability of catching the disease, other things being equal, whereas a policy of voluntary focused protection would ensure that the elderly and vulnerable are less likely to catch it. Given that young people are very unlikely to die from this virus, does she agree that focused protection may now be the safest route to slowing the spread the virus through community immunity while not destroying young people’s livelihoods and mental health?

[Baroness Evans of Bowes Park (Con)]

Unfortunately, as we have seen in the UK and other populations, a high infection rate among the young population is almost always followed by delayed infection rates in the older and vulnerable population, leading to more deaths. That is why we are not pursuing that approach.

[Lord Wigley (PC) [V]]

My Lords, is the noble Baroness aware that in Wales large areas are closed down for all but essential travel, so that, for example, people along the north Wales coast between Wrexham, Rhyl and Bangor are banned from travelling to Anglesey for recreational purposes? Yet people from the areas of highest Covid incidence in England, such as Liverpool and Manchester, can travel with impunity to Anglesey as tourists. When will the UK Government start working in co-operation with the Welsh Government in this regard, instead of systematically undermining them?

[Baroness Evans of Bowes Park (Con)]

Obviously, it is for each devolved Administration to make its decisions, although I know there has been a lot of discussion in this area. However, I reassure the noble Lord that, among the restrictions in areas of high incidence, it is very clear that people should avoid travelling in and out of such areas apart from for work, education, youth services and caring responsibilities, and that overnight stays in other areas of the UK as a whole should be avoided. That is quite clear guidance.

[Lord Cormack (Con)]

My Lords, I have lost count of the number of taxi drivers who have told me that the 10 pm curfew produces too many people on the streets at the same time. Could that be looked at? Will my noble friend also bear in mind that political acrimony does not help to create national unity? Would it not be a good idea if Sir Keir Starmer were invited to No. 10 to sit down with the Prime Minister and discuss all these complex matters?

[Baroness Evans of Bowes Park (Con)]

I agree that we all want to work together to fight this terrible disease. Your Lordships’ House provides a very good model for how constructive discussions can happen. On my noble friend’s point about the 10 pm curfew, public health directors have reported that compliance with social distancing and enforcement of regulations becomes more challenging later in the evening, after people have been drinking. That is part of the reasoning behind the 10 pm curfew, so that drinking does not continue through the evening.

[Viscount Waverley (CB) [V]]

My Lords, the complexities of getting the balance right are immense. While I sympathise with a circuit-breaker strategy that pulls the nation together in regional endeavour and would resolve confusion, why not thereafter reduce risk by restricting or shutting down hospitality but funding it, keeping manufacturing and construction running as normal, and encouraging or even insisting on working from home?

[Baroness Evans of Bowes Park (Con)]

Each tier—medium, high and very high—has a range of restrictions around all the things the noble Viscount rightly says.

[Baroness Donaghy (Lab)]

My Lords, we have the highest rate of deaths in Europe and the third-highest in the world. The Government did not take the risks to people in care homes seriously until it was almost too late; they dithered for a couple of months about wearing masks. My question is on test and trace. There are too many examples of delays in getting test results and failure to collect samples from care homes until those samples have to be destroyed. The noble Baroness said that the largest number of people are now being tested. Can she say something about the poor quality control?

[Baroness Evans of Bowes Park (Con)]

I can say to the noble Baroness that, in total, one in eight people in England have now been tested at least once. The average distance travelled for in-person tests is now 3.7 miles, and we continue to return the majority of in-person tests the following day.

[Baroness Noakes (Con)]

My Lords, government Ministers, including the Prime Minister, like to characterise alternatives to their liberty and economy-destroying actions as “letting the virus rip”. Will my noble friend the Leader accept that that is a mischaracterisation of a sincerely held belief that there is a different way to arrive at a difficult balance between dealing with the virus while minimising the wider health, societal and economic impacts? That way has worked in Sweden without any letting rip. Why do the Government refuse to contemplate changing course?

[Baroness Evans of Bowes Park (Con)]

I am happy to acknowledge that there are differing views on how to approach this issue. In fact, today’s discussion has shown that. I believe that everyone is taking their position for the right reasons and because they truly think that that is the best way. As I have said to all noble Lords, we are looking at the advice and are having to make very difficult judgments. The Prime Minister has that weight on his shoulders and it is a very difficult situation to have to manage.

[Lord Berkeley of Knighton (CB) [V]]

My Lords, the Government have, quite rightly, encouraged the uptake of the flu jab to help to minimise the severity of Covid, but in this area—and in many others—it is impossible to get a flu jab. I realise that she may need to write to me but can the Leader tell me how the sourcing of flu jabs is going, because it is almost impossible to get one in many areas?

[Baroness Evans of Bowes Park (Con)]

The issue is that the flu jab is released in batches so certain amounts are available per month. It is more about flow-through than the availability of the flu jab; that is because it is delivered in batches up to and past December.

[Lord Dubs (Lab) [V]]

My Lords, does the Leader agree that it is important to keep public opinion onside and that, if the public have lost faith in the Government’s policies, they will not respond in the way we want them to? Specifically, why has local government been virtually ignored over the whole period of the pandemic, as have the Governments of Northern Ireland, Scotland and Wales? Surely we must ensure that all local bodies, Governments and Administrations pull together so that the people of this country can have confidence that the Government are doing the right thing.

[Baroness Evans of Bowes Park (Con)]

I assure the noble Lord that dialogue with local leaders at the local government level and between the devolved Administrations is ongoing. There is a lot of working together. Obviously, it is for the devolved Administrations to make judgments on their areas. The Chief Medical Officers also talk regularly, so we are working together closely.

I can also assure the noble Lord that there will be a significant communications campaign about the new tiers. Actually, if noble Lords go on to GOV.UK, there is a postcode checker and some very good, accessible information; we need to make sure that that is getting out to everyone because we need people to follow the rules so that we can hope to turn the tide on the virus.

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

The noble Baroness, Lady Gardner of Parkes, has withdrawn so I call the noble Lord, Lord Hunt of Kings Heath.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, this was the most telling comment from the SAGE meeting on 21 September:

“The more rapidly interventions are put in place, and the more stringent they are, the faster the reduction in incidence and prevalence, and the greater the reduction in COVID-related deaths”.


Do the Government not owe it to the public to spell out for them the consequences for health and deaths of the decision to reject the advice from SAGE?

[Baroness Evans of Bowes Park (Con)]

As I have already said, we took a robust and proportionate approach in September, introducing the rule of six and the curfew. We have done the same again. As I said, our new tiered approach came into effect only today. We believe that it will be effective and we look forward to working with leaders across local government and the devolved Administrations to make sure that we get a grip on the virus and bring it down and ensure that we all follow the rules so that we go into winter in the best possible situation.