Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020
(Limited Text - Ministerial Extracts only)
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Lord Bethell
That the Regulations laid before the House on 28 September be approved.
Relevant document: Special attention drawn to the instrument by the Secondary Legislation Scrutiny Committee, 29th Report.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, this instrument sets out the regulations on the legal duty to stay at home and self-isolate for people who test positive for Covid-19 and their contacts who are told to self-isolate by NHS Test and Trace, which came into force on 28 September. The principle of self-isolation is a key component of our strategy to break the chain of transmission, which in turn stops the spread of the virus, protects individuals and local communities and avoids further societal and economic restrictions. The legal requirement in this statutory instrument is to make it crystal clear to the public—more than any marketing, published guidelines or televised Downing Street presentation possibly could—that people who are infectious or potentially so should stay at home and self-isolate. Providing this clarity about the right thing to do is an essential step to securing a more normal way of life and supporting the economy.
On the scientific substantiation for this strategy, perhaps I may reassure noble Lords that SAGE has advised that ensuring that infected individuals and their close contacts isolate is a vital tool in controlling transmission. Faced with the current rising incidence levels, it is the right time to provide this clarity. Positive cases have increased sharply, with seven times as many cases compared with the end of August. Since it was launched on 28 May, 290,034 people have tested positive and have had their cases transferred to NHS Test and Trace. Some 1,198,151 contacts have been identified and 82% of those for whom contacts have been given have been reached and told to self-isolate. These are astonishing figures. The most recent weekly statistics for 8 to 14 October show that 101,494 people tested positive during that week at least once, an increase of 12% compared with the previous week. I cannot emphasise enough how important it is that those people should self-isolate when instructed.
We are naturally concerned about compliance levels. We cannot knock on 1 million doors every day for 10 days for each person when they are isolated, so we cannot be certain about compliance levels. However, there is enough evidence to suggest that it is not good enough and we have a programme in place of measures to improve it. The first is to increase public understanding of the importance of self-isolation in stopping the spread of the virus. We have put in place a comprehensive media campaign to explain what test and trace is, why it is important and what the public need to do when they are told to self-isolate.
I thank the Secondary Legislation Scrutiny Committee for its important review of this SI and its impact on the public’s understanding, and I acknowledge the committee’s comments on the importance of that. However, I point out that the SI is part of a broad effort to simplify and clarify the rules, which includes the introduction of local alert levels in England and the rule of six.
Secondly, we are supporting people to self-isolate by providing assistance to those who may have practical difficulties in self-isolating. NHS Test and Trace will check with individuals who test positive and their contacts to reinforce the importance of self-isolation. They will ensure that they have access to any support needed. Since 28 September, contact tracers have made around 35,000 to 50,000 calls a day to people who are self-isolating.
The £500 test and trace support payment has been introduced to ensure that people on low incomes self-isolate when they test positive or are identified as a contact, and to encourage more people to get tested. Eligible individuals receive an up-front, one-off payment of £500. This is on top of any benefits and statutory sick pay that they may currently receive. The Government set a deadline of 12 October for local authorities to be ready to administer the test and trace support payment scheme.
Local authorities are now making payments to people on low incomes to support them to self-isolate. We are monitoring the situation to ensure that national coverage is in place. I acknowledge that a small number of local authorities are experiencing technical difficulties in administering the scheme, as we would expect with a programme set up so quickly. We are supporting them to resolve these issues as soon as possible. In addition to the support payment, local authorities will focus on the principle of encouraging, educating and supporting self-compliance.
Thirdly, we are introducing fixed penalty notices for those who do not follow the rules to send a clear message about the seriousness of not self-isolating. Penalties and offences were designed in conjunction with legal colleagues, consulting previous precedents. During this process, the Department of Health and Social Care worked closely with the Home Office, the National Police Chiefs’ Council and the Government Legal Department to agree the memorandum of understanding. The Information Commissioner’s Office has also advised on the process of information sharing involved to ensure data is shared appropriately and proportionately. BEIS and MHCLG also supported the decision-making around enforcement methods and processes. Fines start at £1,000 and may increase up to £10,000 for repeat offenders. For more serious breaches, fines start at £4,000, increasing up to £10,000.
We have needed to use emergency powers to introduce these regulations so that we can respond quickly to the increased threat posed by Covid. The urgency in this case arises from the increasing rate of diagnosed positive cases at the time of making the instrument. The Secretary of State for Health and Social Care keeps the necessity of regulations under consideration between formal review points. We are committed to ensuring that these measures are in place only for as long as necessary.
The requirement on people who are notified to self-isolate plays a key role in slowing or preventing the spread of the virus. The regulations will protect individuals and their loved ones. They will help to ensure that we keep the virus under control. For that reason, I beg to move.
Lord Touhig (Lab) [V]
My Lords, I thank the Minister for introducing this instrument, although I must put on record my concern that we are only now able to debate these regulations, almost four weeks after they came into effect. Moreover, it is simply unacceptable that this instrument came into force a mere seven hours after it was laid on a Sunday evening. Given that it contains significant requirements and penalties for individuals and employers, a lead time would have been reasonable to communicate these changes to the public and encourage compliance.
The Government say that these regulations are necessary precisely because there have been low levels of compliance. A study commissioned by the Government found that just 18% of people who had symptoms went into isolation. Why was this evidence not included in the Explanatory Memorandum? Is it because the Government are embarrassed by their record? The low levels of compliance must be viewed in the context of the failure of the Government’s test and trace system. The most recent weekly statistics show that only two-thirds of people who tested positive were transferred to the contact tracing system. How can we possibly expect people to self-isolate if they are not contacted?
It beggars belief that what was called Britain’s world-beating app, costing tens of millions of pounds, was finally rolled out months later than promised and is unable to operate on phones more than five years old. This world-beating app cannot accept all coronavirus test codes; it struggles to calculate distances and does not require people to self-isolate. Can the Minister explain why the app, a vital tool in the fight to contain coronavirus, is not part of these regulations?
While I understand the data and privacy concerns, the Government appear to have no qualms about sharing information obtained through the contact-tracing programme with the police—a point made by a number of colleagues. The Secondary Legislation Scrutiny Committee pointed out that those informed by the app could avoid being fined for failing to self-isolate if they do not follow up the notification by applying for a test. Who would know? A number of colleagues today have also made that point. Does the Minister accept that excluding app users is ineffective and discriminatory? It is discriminatory because those who do not have access to the app are more likely to be identified by track and trace, and to be fined.
The Government have said that people on low incomes who cannot work from home and have lost income will be eligible for a new £500 test and trace support payment. With around 4 million people in receipt of benefits in England expected to be eligible for this payment, we welcome this support, however belated its introduction was. However, the Health Minister, Helen Whately, said that only 60 people had received a £500 payment as of last week—60 out of a potential 4 million people. How many people have applied and how many are awaiting a decision for this compensation and support? This is important because these regulations require our fellow citizens to act and do the right thing. The effective delivery of financial support where it is needed is therefore vital to ensure that no one is pushed into poverty for doing the right thing.
Lord Bethell (Con)
My Lords, I am enormously grateful for a debate that shed a huge amount of light on an issue which acutely illustrates the delicate task that we and a lot of liberal democracies face in fighting Covid: on the one hand, balancing the preservation of life and the difficult public health measures necessary to protect it with, on the other, our liberty and freedoms, the livelihoods we need and the love of family and friends that we enjoy. I believe that these measures do strike the right balance, but this debate has rightly raised important questions about whether we have hit exactly the right point. I will address a few of those.
I reassure all noble Lords that these measures in no way seek to instigate some kind of mass fining or punishment regime. They are about supporting the principle of isolation, to ensure that there is absolute clarity about its meaning and the requirements expected of people, and to give the authorities the powers to enforce these—if absolutely necessary and only in the most extreme circumstances—when they have been most overtly breached.
We recognise that the people who are breaching isolation have not respected a clear and simple public health message in the first place. It is, therefore, not our policy to believe that they would necessarily be motivated by the threat of a fine. Instead, we seek to support people in a number of important ways and to educate them on the importance of isolation. We remain committed to the principle of consent, wherever possible, and we believe in the good nature and good intentions of the British public. That support has been enhanced by a payment of £500. The noble Lord, Lord Touhig, asked about the number of payments. Those payments are being made by local authorities and we are putting in place the measures necessary to count the number being made.
A number of noble Lords asked about the precise nature of isolation: how long should you isolate for; what is isolation; what are the requirements of those who have been asked to isolate? In the last five months, we have taken a large number of genuinely complex measures through the Chamber. This is not one of them. The protocols around isolation are clearly spelled out. If anyone needs to, they can look at GOV.UK/coronavirus or google “Do I need to isolate?” They will see, spelled out in very clear terms, the timing of the isolation, what is required when you isolate and the support you get when you do. I take with a large pinch of salt the suggestion that this is not clear.
What is definitely true is that isolation is a big challenge. For those in casual work, it may have a massive impact on their income. For those with families to support, it hits their ability to look after them. I do not doubt that it is an onerous obligation, but it is a necessary one, because there is no other way of breaking the chain of transmission. If those with the disease travel in our community and share the virus with those they love or pass by, we will never contain it. If people adhere to isolation, the regime of local lockdowns and of hands, face, space, stands a chance of being effective. We believe that it is effective on the great majority of occasions and we applaud the British public for their adherence.
We have sought not to make these measures draconian. There are exemptions for travelling for food and medical emergencies and for other reasons. As I said, there is support from NHS volunteers, statutory sick pay and discretionary payments from local authorities.
A number of noble Lords raised the impact on the elderly, and I hear their concerns loud and clear. It is without doubt that the Covid regime puts a huge emphasis on digital communication, whether that is getting information from websites or the app itself, which is available on 89% of phones. The elderly undoubtedly have a larger proportion of the older phones or have not updated their technology recently. However, the lack of the app does not necessarily mean that you are somehow excluded from the isolation protocols. The 111 telephone facility is enormously helpful and has proved hugely successful. We have given local authorities special support to reach out to the elderly to ensure that they have both the necessary support under isolation and the information to understand the protocols.
A number of noble Lords mentioned the impact on children. The impact on their mental health is enormous, which is why we are supporting local authorities and charities with funds. The noble Baroness, Lady Meacher, asked about testing in schools. I reassure her that we have, today, started a large set of pilots, first in Stoke and then in a number of schools up and down the country, to try to use testing in a much smarter way in order to keep schools open.
The noble Baroness, Lady Altmann, mentioned the pressure on families and the discipline needed in schools. She made her point very well: it is my personal lived experience and I have no doubts about that pressure. However, I cannot avoid the fact that containing this virus does require us to stop the chain of transmission, in children as well as everyone else.
The noble Lord, Lord Adonis, asked a number of pertinent, thoughtful and detailed questions. I will be happy to write to him with answers to some of them. I reassure him that, although the Welsh may have closed secondary schools, it is very much our intention to keep the schools in England open. On inspecting online learning, on 6 October Ofsted published the first of a new series of briefings looking at how schools are managing pupils’ return, including online learning. The Department for Education has made available an initial 250,000 additional laptops and tablets for children who need them. On wi-fi, the department has delivered over 50,000 4G wireless routers to support disadvantaged children in accessing remote education and vital support services.
There were a number of other detailed questions that I will be glad to write to noble Lords about. The noble Lord, Lord Hain, made a number of points, not all of which I completely agree with, but he is absolutely right that there is a balance to strike between speed and quantity. We have massively increased quantity and will continue to do so, but we have a case to answer on the turnaround time of our tests. The noble Lord is right that turnaround time is very important.
In conclusion, the noble Baroness, Lady Jones, set me a challenge about what we can do to “build back better”. Those were not her words but the Prime Minister’s, but they capture rather well her intention regarding the investment needed to address the levelling-up agenda and the damage done by Covid. I am afraid that I do not run the Treasury, so I cannot necessarily meet with her economists.
However, there are a number of resonant themes in the healthcare sector regarding the way in which Covid will actually lead to improvements in our healthcare system if we take the right measures now to capture that progress. I get reports from the front line about an enormous culture of collaboration between different parts of the healthcare system, which is refreshing and impressive. That is exemplified by the sharing of data. Although we have not changed the guidelines or rules on data sharing, we have hugely encouraged it, which has helped with treatment and therapeutics. The renaissance in the diagnostics and pathology professions, and the investment in a large amount of diagnostic kit, is going to have a huge impact on early interventions in disease. The investment and progress we have made in vaccines and therapeutics demonstrates Britain’s leadership role in and the value of science, and illustrates the huge return on the British taxpayer’s investment in science. It is a sign of how we should take things from here.