Public Health

(Limited Text - Ministerial Extracts only)

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Wednesday 4th November 2020

(4 years ago)

Commons Chamber
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Boris Johnson Portrait The Prime Minister (Boris Johnson)
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I beg to move,

That the Health Protection (Coronavirus, Restrictions) (England) (No. 4) Regulations 2020 (S.I., 2020, No. 1200), dated 3 November 2020, a copy of which was laid before this House on 3 November, be approved.

We come together today to implement time-limited restrictions across England from midnight, so that we can contain the autumn surge of the virus, protect our NHS and save many lives. Of course, this is not something that any of us wanted to do. None of us came into politics to tell people once again to shutter their shops, furlough their staff or stay away from their friends and family. In common with all Members, I feel the pain and anxiety that we will all share in the month ahead. But as Prime Minister, when I am confronted with data which projects that our NHS could even collapse, with deaths in the second wave potentially exceeding those of the first, and when I look at what is happening among some of our continental friends and see doctors who have tested positive being ordered to work on covid wards and patients airlifted to hospitals in some other countries simply to make space, I can reach only one conclusion: I am not prepared to take the risk with the lives of the British people.

I know it might be tempting to think that, because some progress has been made, we just need to stay the course and see through our locally led approach. It is true that the extraordinary efforts of millions across the country—especially those in high and very high alert level areas—have made a difference, suppressing the reproduction rate of the virus below where it would otherwise have been. I want to record again my thanks to the millions who have put up with local restrictions. I want to thank the local leaders who have understood the gravity of the position.

But I am sorry to say that the number of covid patients in some hospitals is already higher than at the peak of the first wave. Even in the south-west, which has so far had lower case rates than most of the rest of the country, hospital admissions are over halfway to their first-wave peak. The latest analysis from the Scientific Advisory Group for Emergencies, published on Friday, suggests that the R remains above 1 in every part of England, which means that the virus is continuing to grow among the population. Every day that the number is above 1 is another day that the number of cases will rise, locking in more hospital admissions and, alas, more fatalities, pushing the NHS ever closer to the moment when it cannot cope.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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Every one of us in this House has received numerous emails and telephone calls about the closure of church services. I understand that, and I am making a plea to the Prime Minister for that to be reviewed. For many people, it is the only outing they have in the week and the only opportunity to have any contact with people for prayer and contemplation. In Northern Ireland, churches have been able to remain open through the use of masks and hands, face, space. Could that be looked at? I believe that people across the United Kingdom of Great Britain and Northern Ireland would appreciate that, especially in England.

Boris Johnson Portrait The Prime Minister
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I know the hon. Gentleman speaks for many people in this House in raising that concern, and I feel it very deeply. It is an awful thing to restrict people’s ability to worship in a communal way. Obviously, as he knows, we are allowing private worship, but for many people that will not be enough. The best I can say is that in all reality, if we approve this package of measures tonight, we have a very good prospect of allowing everybody to return to communal worship in time for Christmas and other celebrations in December.

The course we have before us is to prevent R from remaining above 1 and to get it down, otherwise we face a bleak and uncertain future of steadily rising infections and admissions until, as I say, the capacity of the NHS is breached. I know there has been some debate about the projections of some of these models.

Neil Gray Portrait Neil Gray (Airdrie and Shotts) (SNP)
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On uncertainty, we have had a week of uncertainty from the Prime Minister and his Cabinet on whether the extension of furlough will apply to Scotland if it chooses to go into lockdown, if it needs to go into lockdown, beyond 2 December. That comes after the Prime Minister’s Government refused the request of the Scottish, Welsh and Northern Irish Governments for furlough support at the end of September.

Can the Prime Minister finally provide us with a clear, unambiguous answer as to whether, if Scotland, Wales or Northern Ireland requests 80% furlough after 2 December, it will be granted?

Boris Johnson Portrait The Prime Minister
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The hon. Gentleman cannot take yes for an answer. Not only will I come to that point later, but my right hon. Friend the Chancellor will be saying more about the matter tomorrow, and the hon. Gentleman can interrogate him.

What I will say, on the point of uncertainty, is that I know there has been a debate about the statistics on how big the loss of life might be and on the precise point at which the NHS might be overwhelmed, but all the scientific experts I have talked to are unanimous on one point. As the chief medical officer has said, if we do not act now, the chances of the NHS being in extraordinary trouble in December would be very high.

Be in no doubt about what that means for our country and for our society. It means that the precious principle of care for everyone who needs it, whoever they are and whenever they need it, could be shattered for the first time in our experience. It means that those who are sick, suffering and in need of help could be turned away because there is no room in our hospitals—even in East Sussex.

Huw Merriman Portrait Huw Merriman (Bexhill and Battle) (Con)
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All of us in this place will be concerned about saving lives. What evidence has my right hon. Friend received that we will save more lives by the lockdown he proposes than we will lose from public health, from a lack of jobs and from a mental health crisis? That is the evidence I seek from the Prime Minister today in order to cast my vote his way.

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Boris Johnson Portrait The Prime Minister
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My hon. Friend raises a very important point, and it is the crux of the debate. Alas, as leaders and as politicians, we have to look at the immediate peril we face. I do not in any way minimise the risks to mental health and physical health that come from the measures we have to apply. That is, of course, why we debate and insist that we explore every other avenue before we go down that route, but we have to look at the real risk of mortality, and mortality on what I think would be a grievous scale, that would stem from doing nothing.

To give my hon. Friend a picture of what it would mean, those who are sick, suffering or in need of help could be turned away because there is no room in our hospitals.

None Portrait Several hon. Members rose—
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Boris Johnson Portrait The Prime Minister
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I will give way in a moment.

Doctors and nurses could be forced to make impossible choices about which patients would live and which would die, who would get oxygen and who could not. I know that some Members, like my hon. Friend the Member for Bexhill and Battle (Huw Merriman), are hearing from their local hospitals that the pressure is not that great yet, but the whole point about a national health service is that when hospitals in one part of the country are overrun, sick patients are transferred to another, until the whole system falls over. Let me be clear that this existential threat to our NHS comes not from focusing too much on coronavirus, as is sometimes asserted, but from not focusing enough, because if we fail to get coronavirus under control, the sheer weight of demand from covid patients would not only lead to the covid casualties that I have described, but deprive other patients of the care they need. We simply cannot reach the point where our national health service is no longer there for everyone.

This fate is not inevitable. We are moving to these national measures here when the rate both of deaths and infections is lower than they were, for instance, in France, when President Macron took similar steps. If we act now, and act decisively, we can stem the rising waters before our defences are breached.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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I accept the Prime Minister’s logic and think it is far more dangerous to do nothing than to do what he proposes, but does he accept that we need to learn some serious lessons from the first lockdown, particularly about the impact on cancer patients? There was a 100,000 backlog when it came to treatment and diagnosis at one point. Cancer Research UK estimates that 35,000 people might unnecessarily lose their lives to cancer because of wrong decisions. Will he accept that, while there are many hospitals that are, shall I say, clean sites, where covid is not being treated or is not present, there is an opportunity to use those sites to treat cancer patients, catch up with cancer, save those lives and not make the same mistakes as we did first time?

Boris Johnson Portrait The Prime Minister
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The hon. Gentleman is exactly right and has encapsulated the argument that we make. My right hon. Friend the Health Secretary and I have talked repeatedly to Simon Stevens of the NHS and his teams about making sure that throughout this period, we continue to look after cancer patients—those who need the decisive care that the NHS can provide. I do believe that this approach—these regulations—are the way that we can do that.

I know there are many in this House who are concerned about how long these measures might last and that, if people vote for these regulations today, they could suddenly find that we are trapped with these national measures for months on end. So let me level with the House: of course, I cannot say exactly where the epidemiology will be by 2 December, but what I can say is that the national measures that I hope the House will vote for tonight are time-limited. It is not that we choose to stop them. They legally expire, so whatever we do from 2 December will require a fresh mandate and a fresh vote from this House. As I have made clear, it is my express intent that we should return to a tiered system on a local and regional basis according to the latest data and trends.

Mark Harper Portrait Mr Mark Harper (Forest of Dean) (Con)
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Will my right hon. Friend give way?

Boris Johnson Portrait The Prime Minister
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The whole House will share my sorrow and regret at the necessity of these measures, which I know is a perspective shared by my right hon. Friend—I am happy to give way to him.

Mark Harper Portrait Mr Harper
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I have listened carefully to the argument and looked at the data very carefully. What I am troubled by—when I have looked at the basis on which the modelling has been done, both in terms of SAGE and the NHS—is that the modelling does not take into account the effect of the introduction of the tier system and any of the effects of it. I think, therefore, that we have acted too soon, because we are starting now to see the tier system working. The data from Liverpool yesterday, published by Steve Rotheram, is very encouraging and shows that the tier system is working, but the modelling that the NHS is using for its capacity usage does not take into account that introduction at all.

Boris Johnson Portrait The Prime Minister
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My right hon. Friend makes a very important point. He is expressing a point of view that is shared by many people, but, alas, I believe that he is wrong. The facts do not support his view. I looked at the data and, unfortunately, this is what we have: hospitalisations mounting very, very steadily, which, as he knows, are leading indicators of fatalities. We have 2,000 more people on covid wards than this time last week and 25% more people today than there were last week and, alas, 397 deaths tragically announced yesterday —more than we have had for many months. The curve is already unmistakable and, alas, incontestable.

Neil O'Brien Portrait Neil O’Brien (Harborough) (Con)
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In the past two weeks, we have gone from seeing cases mainly among young people to them being mainly among older people. We have seen it going from a problem in a few cities to a problem across the country. Does my right hon. Friend agree that we do not need a fancy model to see the numbers piling up in hospitals and to see what has happened in France—because it has not taken action as quickly as we have—to know that the thing to do is to take action now, not just to save lives, but to save the economy as well?

Boris Johnson Portrait The Prime Minister
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The economic dimension of what we are doing is absolutely right and the argument, as my hon. Friend rightly says, works both ways. I know how difficult it is, particularly for businesses that have just got back on their feet, that have done their level best to make themselves covid-secure, installing hand- washing stations, plexiglass screens and one-way systems, and, as the Chancellor has set out, we will do whatever it takes to support them. We have protected almost 10 million jobs with furlough and we are now extending the scheme throughout November. We have already paid out £13 billion to help support the self-employed, and we are now doubling our support from 40% to 80% of trading profits for the self-employed for this month. We are providing cash grants of up to £3,000 per month for businesses that are closed, which is worth more than £1 billion a month and benefits more than 600,000 business premises. We are giving funding of £1.1 billion to local authorities in England further to support businesses in their local economy in the winter months.

Drew Hendry Portrait Drew Hendry (Inverness, Nairn, Badenoch and Strathspey) (SNP)
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The Prime Minister accused us earlier of not being able to take yes for an answer on differentiated furlough for the other nations of the UK. The problem is that we have not heard a clear, unequivocal yes to the question, so can he sort that out now? If Scotland, Wales or Northern Ireland need to introduce lockdown measures at different times than England, will the Chancellor be there to support us with furlough?

Boris Johnson Portrait The Prime Minister
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Yes. I really do not know how to exhaust my affirmative vocabulary any further—they won’t take yes for an answer, Mr Speaker. All of this comes on top, as the hon. Gentleman knows—

None Portrait Several hon. Members rose—
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Boris Johnson Portrait The Prime Minister
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With great respect, Mr Speaker, I think that I have answered the question and I think that my friends opposite are going to oppose.

This comes on top of the more than £200 billion that we provided since March. We will also ensure that, throughout this period, our schools stay open. We will not allow this virus to do any further damage to the future of our children. I said in the summer that we had a moral duty to reopen our schools as soon as it was safe to do so, and that they would be the last element of our society to close down again. We have stuck to that pledge. Our schools will remain open, as will colleges, universities, childcare and early years settings.

The measures before the House are designed to arrest the virus, to drive it down and to get on top of it once and for all. If we are able to test on a big enough scale to identify the people who are infected, often without symptoms and who unwittingly and asymptomatically pass the virus to others, those people will be helped immediately—this is the key thing—to self-isolate and to break the chains of transmission, reducing the spread of the virus, reducing the numbers of people in hospital, and reducing the numbers of people dying. I think that if we all play our part in this system it could be a hugely valuable weapon in our fight against covid in the short, medium and long term, and an alternative to the blanket restrictions that have been imposed in so many parts of the world.

This week we are piloting a mass test in Liverpool, where an immense effort benefiting from the logistical skill of the armed services will offer everyone a test, and our aim is to make mass repeated testing available for everyone across the country. Thanks to the pioneering work of British scientists, we already have a life-saving treatment for covid and the genuine possibility of a safe and effective vaccine next year. Taken together, these achievements provide every reason for confidence that our country can and will pull through this crisis, and that our ingenuity will prove equal to the challenge.

Clive Efford Portrait Clive Efford (Eltham) (Lab)
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Will the Prime Minister give way?

Boris Johnson Portrait The Prime Minister
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No, I will not—I am finishing up.

This year, I and the whole of Government have asked much of the British people: more than any Prime Minister, I believe, has asked of the British people in peacetime. I have to say that the public have responded magnificently and selflessly, putting their lives on hold, bearing any burden, overcoming every obstacle, and tolerating every disruption and inconvenience, no matter how large or small—or inconsistent—so that they could do the right thing by their fellow citizens. I wish that it had been enough to defeat this autumn surge. But while I am more optimistic now about the medium and long-term future than I have been for many months, there can be no doubt that the situation before us today is grave and the need for action acute.

It is absolutely right for this House to have doubts—

Lindsay Hoyle Portrait Mr Speaker
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Order. I am sorry, Prime Minister, but Mr Murrison, you cannot read newspapers in the Chamber.

Boris Johnson Portrait The Prime Minister
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It is absolutely right for hon. Members to consult relevant documents that may contain information to the advantage and betterment of the House.

Lindsay Hoyle Portrait Mr Speaker
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He could have been reading his horoscope —come on!

Boris Johnson Portrait The Prime Minister
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I can assure my right hon. Friend the Member for South West Wiltshire (Dr Murrison) that his future is rosy.

It is right for Members on all sides of this House to have the doubts that have been expressed, to seek answers from me, and to provide scrutiny. That is the purpose and duty of the House of Commons. But while it pains me to call for such restrictions on lives, liberty and business, I have no doubt that these restrictions represent the best and safest path for our country, our people and our economy. So now is the time for us to put our differences aside and focus on the next four weeks in getting this virus back in its box. I know that once again our amazing country will respond to adversity by doing what is right—staying at home, protecting the NHS and saving lives. In that spirit, I commend these regulations to the House.

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Matt Hancock Portrait The Secretary of State for Health and Social Care (Matt Hancock)
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The measures that we have just debated are indeed extraordinary; they are in response to an extraordinary threat to our nation’s health and prosperity. Taking these measures does not come easily to me or my right hon. Friend the Prime Minister, nor should it to the House. Our historical liberties are hard-won and precious, and should not be infringed save in the gravest of times, but these are grave times indeed, and if we do not act now, the NHS will not be able to cope. No Member of this House wants to see the scenes that we have witnessed elsewhere in the world of hospitals overrun, or of doctors forced to choose who to treat and who to turn away.

We must drive this virus down together and take these tough yet time-limited measures, making sacrifices now for the safety of all. It will not be easy—I know that—but in a pandemic there are no easy choices. As my hon. Friend the Member for Eddisbury (Edward Timpson) put it, we face an invidious choice. We are called to make fundamental changes to how we live, work and socialise, but it is in pursuit of a common cause. We must and will use this time to drive forward innovations that will help ensure, if at all possible, that this lockdown is the last: the mass testing mentioned by so many, which we began to roll out this week and are driving forward night and day; the vaccine mentioned by my right hon. Friend the Member for South West Wiltshire (Dr Murrison) and others, which, while not yet assured, we will be ready to roll out as soon as we safely can; and the treatments that this country has pioneered.

There have been some excellent speeches, all made with a heavy heart and with regard to the seriousness of the situation. My right hon. Friend the Member for Maidenhead (Mrs May) spoke of the need to assess the impact on not only health but the economy. We know that the economic impact of the measures will be significant, but we also know that if the virus continues to rise—to double—the economic impact will be still more serious.

Many Members raised the issue of the impact on mental health. I take that very seriously. Before supporting this decision, I consulted with the Royal College of Psychologists, which has said that stricter measures to control the virus are needed, because the virus itself has a negative impact on people’s mental health.

There is a wider point on mental health services and health services more broadly: the NHS is open. We are determined to ensure that it stays open as much as is possible for non-covid treatments. My hon. Friend the Member for Bexhill and Battle (Huw Merriman), for whom I have a huge amount of respect, argued passionately about the impact of the first lockdown on the health services available. I say to him with all sincerity that it is by tackling the rise in the virus that we will keep the NHS open, rather than by allowing the virus to grow. In his constituency, the number of cases has almost doubled in the last two weeks; I looked that up as he was speaking. I urge him and others who support the NHS so strongly to support these measures, in order to allow the NHS to continue to do its job.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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The Prime Minister very honestly said to me on Monday that one of the lessons from the end of the first lockdown was that we did not insist enough on people isolating when they were contacted by Test and Trace. Going forward, at the end of lockdown 2.0, how will we improve on that?

Matt Hancock Portrait Matt Hancock
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We have to constantly improve on that. First, the number of people being contacted and who are isolating has risen sharply. Secondly, while of course there is always a need for more, the proportion has started to rise recently, and the amount of resources and support that we are giving to the Test and Trace service continues to grow. I absolutely support my hon. Friend’s point that we must use this month to ensure that that service is there and ready. Those who have said that it does not have any impact are wrong. It is having a significant impact on bringing the R down from its natural elevated rate of around 2.5 to where it is today, but with the R above 1, the virus continues to grow, and we must bring it down.

A number of colleagues in all parts of the House raised the issue of communal worship, including my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) and my hon. Friend the Member for Gloucester (Richard Graham). I can tell the House that Ministers are talking to faith leaders to do everything we can to reach an accommodation as soon as possible. I understand the impact of this infringement on liberties, which many colleagues mentioned.

We saw support for the measures from across the House. The hon. Member for Aberavon (Stephen Kinnock) talked about how furlough must be fair for all, and we have extended the furlough system. My hon. Friend the Member for Wimbledon (Stephen Hammond) talked about the overwhelming weight of scientific evidence. While science of course consists of men and women with different views, I truly believe that the overwhelming weight of scientific evidence is in favour of suppressing the virus. We heard from my hon. Friends the Members for Wealden (Ms Ghani) and for Loughborough (Jane Hunt) about how, with heavy hearts, they are supporting these measures. My right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright) talked about taking damaging decisions to prevent a disastrous outcome later, and I think that was about right.

The hon. Members for Reading East (Matt Rodda) and for Blackburn (Kate Hollern) expressed their support, even though they also wished that this had come in earlier. My right hon. Friend the Member for East Hampshire (Damian Hinds) and my hon. Friends the Members for Bosworth (Dr Evans) and for South West Bedfordshire (Andrew Selous) spoke so eloquently of what the promise that the NHS is always there for you means. It is something that binds us together as a country and something that we must protect and cherish. The issue of care homes was raised, including by the hon. Member for Leicester South (Jonathan Ashworth). The updated visitor guidance was published this morning. I agree with him about seeking further expansion of testing in care homes, including for visitors.

There was a widespread debate about the need for more data publication. All I can say is that we are constantly expanding the data that is being published. There is more and more data from the NHS on hospitalisations, more and more data on cases and where they are, and more and more contact tracing data. I am absolutely enthusiastic about publishing more and more data. Indeed, we have been commended, as a country, for the open approach that we are taking to the amount of data that is published.

Ultimately, this comes down to a very significant judgment about how we best lead a nation through an incredibly difficult period with a virus that exists only to multiply, and lives and breathes off the essence of what it is to be human. My hon. Friend the Member for Broxbourne (Sir Charles Walker) spoke of a passion for freedom and I, too, am a lover of freedom, but I also care about protection, and it is the combination of the two that we must balance and address.

In ordinary times, these measures would be unimaginable, but these are not ordinary times. The virus in circulation feeds off the human contact that makes life worth living, and we must act to thwart its deadly march to protect our NHS and to save countless lives while supporting every person with everything that we have, and supporting the science that, with increasing confidence each day, I know will help us to find a better way through. I commend these regulations to the House.

Baroness Laing of Elderslie Portrait Madam Deputy Speaker (Dame Eleanor Laing)
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Order. Hon. Members, apart from those on the Front Bench, should leave the Chamber by the doors behind me. We must try to keep social distancing going.

Question put.

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15:59

Division 160

Ayes: 516


Conservative: 308
Labour: 190
Liberal Democrat: 11
Independent: 2
Alliance: 1
Green Party: 1

Noes: 38


Conservative: 33
Democratic Unionist Party: 4
Independent: 1

Resolved,