Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020
(Limited Text - Ministerial Extracts only)
Read Full debate20:12 - Division conducted remotely on Baroness Neville-Rolfe’s amendment to the Motion. - Ayes: 64 / Noes: 246 - Baroness Neville-Rolfe’s amendment to the Motion disagreed.
Lord Bethell
That the Regulations laid before the House on 30 November be approved. Instrument not yet reported by the Joint Committee on Statutory Instruments.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we know this virus well enough now to know that it is not an inconsequential enemy. It has taken loved ones from us, including my godfather, Alan Williams, who some in this House may know. It has separated us from our friends and families and has left people suffering from its ill effects months after first falling ill. This country has made a great collective sacrifice throughout this year, but it has been integral to combating the virus. Regretfully, much as we would wish it were true, this virus cannot be ignored. It has not mutated into a gentler version of itself or blown itself out in the wind. Instead, it remains on the rampage, highly contagious, malicious and mortal, with the old and vulnerable square in its sights, and anyone potentially affected.
While I know that these measures have been hard, this is the reason why we have taken this course. They have always been proportionate to the threat that we face. However, I reassure noble Lords who might be in any doubt that we do not want to leave them in place for one day longer than we have to. We now judge this to be the right time to come out of the national lockdown and revert to a localised approach to managing the virus. Why is that? It is because coronavirus cases are down by 19% in England and hospital admissions have fallen by 7% compared to a week ago. The data tells us that, after many false peaks, the virus curve is finally flattening. The latest assessment from SAGE is that, having reached the summit, we are now walking down the other side, with the R for the UK between 0.9 and 1. Indeed, in its most recent survey, Imperial College London placed its estimate for England at an impressive 0.88.
This is a monumental achievement. After more than three months of growth, this is the first time the R has been estimated at or below 1 for the United Kingdom since mid-August, so at last we can be confident that the virus is coming into check. Only at that point is the danger of our hospitals being overrun starting to pass.
While this drop in the infection rate is encouraging, and confirmation that our national sacrifice has proved successful over the last few weeks, the picture remains varied across the country. That is why we are introducing a framework of regional tiers so that interventions are suited to the situation in any given area. There will be three tiers that apply to the whole country—but, before I go on to them in more detail, I want to spend a moment on the principles that underpin all three.
First, I reassure noble Lords that schools will remain open to protect children’s education and development. Secondly, we will seek to keep as many businesses open and trading as is reasonably possible, to support the people who work within them and the wider economy.
Beyond these core principles, as the winter plan sets out, there are the five key factors in determining the tier of any region: case rates in all age groups, cases among the over-60s in particular, the rate at which cases are rising or falling, the positivity rate and the pressure on the local NHS. When setting boundaries for these tiers, we have looked not only at the human and physical geographies that determine how the virus spreads but at travel patterns and the epidemiological situation in neighbouring areas. We have listened to the public voice, and noble Lords in this Chamber, to fine-tune the system. As a result, people can practise their faith in places of worship, gyms will remain open, outdoor leisure will be permitted and we are doing everything reasonable to allow businesses to remain open.
I turn to the details of each tier. The aim of tier 3 is simple: to bring down the rate of infection when rates are rising too fast. That requires considerable collective effort. Tier 3 will be used only when necessary, in order to protect the NHS and save lives where the virus is threatening to get out of control. Tier 2 is intended rigorously to manage the spread of the virus, restricting indoor mixing outside your household or bubble, although the rule of six will apply outdoors. Hospitality will be open but with restrictions on opening hours and serving alcohol. We want to help all local authorities to move down to tier 1, the least restrictive tier. It has been designed to contain the virus and limit new potential outbreaks. It will apply in areas where efforts to suppress the infection have been successful, and represents a relative return to normality, including for the hospitality sector, although the rule of six for social contact must be maintained.
I reassure noble Lords that the decision to put areas in these tiers was made according to the best possible data and clinical advice. This system offers a sustainable and enduring framework for controlling the virus, as well as offering consistency, stability and clarity on the steps people should take to control the virus. On the effects of these measures, I draw noble Lords’ attention to the evidence paper on the health, economic and social effects of our approach that was published by the Government yesterday. This analysis recognised that:
“The impacts of COVID-19 to date have been significant on health, the economy and society.”
However, it makes clear that:
“Allowing the virus to grow exponentially would lead to”
worse
“impacts, in terms of loss of life and ill health”
and the economy, and
“that would be considered intolerable for society.”
The analysis provided in our paper has been informed by evidence from SAGE and its sub-groups, the ONS, forecasts from the OBR and data on the epidemiology of the virus. As the paper sets out, the balance of evidence supports the need for our tiered approach.
However, the tiers are not the only weapon in our arsenal. We are launching a major community testing programme targeted on the tier 3 areas with the greatest rate of infection. Test and trace will work with local authorities on a plan to get tests to where they are needed most, using military support where helpful and designing their own incentives to attract the right groups. The tier regulations are supported by an increased focus on enforcement and compliance, which is what the local authority enforcement powers regulations are all about.
Throughout, we have listened to and engaged with local authorities to understand how we can support our partners in local government and make sure that they have the right tools in place to ensure that rules are being followed. We know that these are the right tools because our partners in local government helped us to design and build them. The coronavirus improvement notices allow businesses to be given a clear and consistent notice, outlining what changes must be made to meet specific requirements set out in named regulations.
Local authorities will be able to use the notices as an effective tool to communicate with businesses before a fixed penalty notice is issued. These regulations reflect feedback from business and others, who are doing their utmost to support NHS Test and Trace. The changes will support businesses to comply with the legislation while ensuring that NHS Test and Trace has the information it needs to contact people who may have been exposed to the virus.
Finally, by keeping the virus under control through December, the Government can enable everyone to see more of their family and friends over the upcoming festive season. These regulations make provision for extended Christmas bubbles that will allow three households to mix between 23 and 27 December. When following these new rules, it is vital that we continue to take personal responsibility to limit the spread of the virus and protect loved ones, particularly if they are vulnerable. The year 2020 has proved to be an extraordinary one that has brought a lot of hardship and heartache for everyone. With the winter bank holidays on the horizon, we believe it is important that people are able to see some of their family and friends during this time. We have been living with this virus for too long.
As we go into winter, our emphasis is on reducing the pressure on the NHS at a time when hospital admissions are already considerable. Our approach is guided by the need to mitigate the virus as much as possible. We have considered the needs of the British people and are seeking approval here to implement a system that remains uniform and clear, wherever in England you might be. It also provides a proportionate and measured response to the continuing threat of the virus. The tier system is not just a government policy; it is a national endeavour that we must all continue to be active players in, because this virus threatens us all, so we must all play our part in keeping it under control.
I know that these are tough sacrifices at the end of a year of sacrifices but, to continue to be able to protect education and the economy, we must continue to limit our social contact with other people where possible. I commend the hard work and dedication shown by the British public through these trying times. Hope is on the horizon, with new scientific advances being made every day, but we still have further to go. Until science can make us safe, we must put in place these new rules, which will help us to keep the virus under control. I commend these regulations to the House.
Amendment to the Motion
Lord Bethell (Con)
My Lords, it has not been the most comfortable two and a half hours of my life, but I have profound sympathy for a huge amount of what has been said in this debate; I really do. I completely understand where the Opposition Benches are coming from on some of the major themes raised. I will go through some of those in detail, but I will summarise briefly before moving on.
On test and trace, I understand the frustration that those on the Opposition Benches have voiced, but I would like to reassure them that the numbers have come up dramatically, that Thursday’s numbers were incredibly impressive and that this Thursday’s will be even more impressive. A massive amount has been done to address the concerns they have quite reasonably voiced in the past.
Huge strides have been made on collaboration with local authorities in the last few weeks. The publication yesterday of the community testing document and the process around that is proof that those commitments are sincere. I have been held to task on the clarity of government communications many times over the last seven months. The way in which even these restrictions have been communicated has had a lot of thought and has landed very clearly indeed.
On my own Benches, there have been extremely clear messages that I personally agree with wholeheartedly on a sentimental basis. Who would want to stand at the Dispatch Box today putting a restraint on the liberty of the British public of the kind we are looking at in these statutory instruments? This is a joy to absolutely no one, and it is done with a huge number of reservations, with concern and with a full understanding of the implications.
On the economic case, I do not need to be told by anybody about the implications of these restrictions on our economy. I know from my own life, my friends and those I love what they mean to our economy. I feel that very harshly indeed and assure noble Lords that those matters are taken fully into account when we put these statutory instruments before the House.
On the complexity of some of these statutory instruments, we are dealing with a difficult and complex situation. Noble Lords have rightly ridiculed the language used, and I have greatly enjoyed some of the language used in tearing into these statutory instruments, but I cannot hide from noble Lords the fact that to be effective they have to be legal. Legal language is sometimes funny but always necessary. We need to do things in a thorough, thoughtful way.
I have sat in more meetings with experts in the last eight months than anyone else in this House, and they drive me nuts, but we appreciate and value the scientific dialectic. We have approached it with an enormous amount of transparency, and there is no point in scapegoating those who posit the best ideas they can. It is up to us as the decision-makers to make our choices, not to blame the experts for the advice they give us.
Lastly, on the democratic element, I have stood here and apologised for the late arrival of statutory instruments and the retrospective nature of some of these debates. But I remind everyone that I am standing here ahead of the application of these statutory instruments and, as the noble Baroness, Lady Thornton, just reminded us, next door—in the other place—they have been approved by a vote of 291 to 78, which is an emphatic win for the Government.
Before I move on, let me tackle a couple of the key questions; I cannot possibly address all the issues that have been raised today. My noble friend Lord Robathan covered an enormous number of points, and I very much value the challenge he brings to the Government in these matters. I remind him that we are all sobered by the statistics that he cited on suicides and cancer, and, of course, those numbers are far too high. I cannot help thinking that, at the end of all of this, we are going to rethink the value of life and think about how much more we can do to address questions like suicide and cancer. But no one is suggesting that we are facing a tsunami of either cancer or suicides that threatens hundreds of thousands of lives in the next few months, or that it might overwhelm the NHS. Therefore, the parity he suggests is not right.
I completely sympathise with the points that my noble friend Lady Neville-Rolfe made so eloquently and thoughtfully on the impact of regulations such as these on the economy and, in particular, on the hospitality sector. I reassure her and all other noble Lords who have raised, quite reasonably, the impact on the economy of these regulations that we absolutely think about education, business and the secondary health impacts of these regulations on the country.
However, when asked about the impact assessment, I remind noble Lords of the very important work done by the ONS, the Home Office, the Department of Health and Social Care and the Government Actuary called Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity. That is a detailed analysis of the various impacts of a strategy of letting the disease take its course, and if anyone wants any guide to what the alternative looks like, that report spells it out extremely clearly indeed. I am extremely disappointed whenever people raise the question of cost-benefit analysis and government analysis that this report is not cited more, because it is an excellent piece of work, and I highly recommend it.
My noble friend Lord Lilley speaks of an institutional bias and groupthink. I respect his challenge enormously. He is entirely right to warn any organisation, particularly one in the grip of a serious pandemic, about falling into the trap of any kind of groupthink. But I remind him that there have been moments when the groupthink went the other way. I remember very well at the beginning of this pandemic, when people told us that Covid was going to be like flu—and then many millions have died around the world. I remember when people said that it would never come to Britain and that it would stay in China where it started, but then the cruise ships showed that the disease did travel, and when it started travelling, it would not stop.
There were those who initially denied that the lockdown in March was necessary, but I think there are few people who would make that case right now. There were people who said that antibodies and T cells would somehow mean that large sections of the population would be resistant to the disease. That has been seen not to be true and, in fact, antibodies in the UK—now that we have tested hundreds of thousands, or millions, of people—are rarely more than 10%, and show every sign of fading away in some people. There were those who thought that the disease might just blow itself out and mutate into something that was harmless, and that the second lockdown was unnecessary. Professor Spiegelhalter has predicted 20,000 deaths before Christmas, and I am afraid that the second lockdown absolutely has been necessary.
I completely understand my noble friend Lord Howard of Rising’s aspiration of somehow segmenting demographics. He makes it sound easy, as if we could somehow split older people off from the rest of society. However, it is not only the view of SPI-M that this is impossible but the view of every single country in the world. Not one country has managed to do what he suggests. It is simply not possible. He may not like this answer and feel that I have not answered him completely but, as on the 180 times I have stood at this Dispatch Box in the last eight months and in the 1,000 letters I have replied to, I am afraid that this is one of those cases where I have sought to answer his question, even if he does not like the answer.
I completely agree with my noble friend Lord Ridley that persuasion is of course better than compulsion. That is exactly the approach we have taken. We have tried to use consent wherever possible. If you speak to the police force or any of the agencies of the state, you will find that that is absolutely the principle we have taken. I also completely agree that the authoritarian approach of China, Korea or Taiwan may suit those cultures and political systems, but they are not for us. However, he is completely wrong to think the public are not with us on our approach. In September, 62% of the public supported our rules; in October, it was 72%; and in November, it was 73%. Some 89% support the wearing of masks and 77%, even now, support the rule of seven. And 76% support the closing of bars and restaurants where necessary. I fear that, sometimes, noble Lords in this Chamber are out of step with the heart of public opinion. While I agree ideologically with the points they make, it is wrong to suggest that they are speaking on behalf of the public in these matters.
I am extremely glad that my noble friend Lady Meyer and the noble Lord, Lord Birt, mentioned the vaccine, because that is very much the focus of our efforts. These restrictions are merely a bridge to get there. No one wants to live under the terms of these statutory instruments. I can report that progress on the vaccine is extremely encouraging; I am grateful to the scientists designing it and those involved in its deployment.
The noble Baroness, Lady Barker, speaks with so much truth and wisdom in her interventions, but I push back slightly on her remarks on the shielding letters. I know my noble friend Lord Cormack thought that they were wise. The shielding letters are extremely clear because people asked for them to be clear. We work very closely with stakeholders to make sure that they are right, and they are passed to stakeholders for their consent before they go out. The 76-page documents are very long because people want to know the answers to detailed questions. When we ask them what kind of detail they want, this is exactly it. The extract the noble Baroness read out seemed to me a model of clarity and exemplary in the wisdom of its advice.
I am afraid to tell the noble Baroness, Lady Hayman, that, if you are going to have boundaries, they must lie somewhere. Regions need boundaries. When you live on the side of one, that is always uncomfortable, but I know no other way of dividing the country.
Where I completely agree with the noble Baroness, Lady Hayman, is on her reference to Dame Sally Davies, who has a point when she says that social deprivation, bad diet and bad living habits have undoubtedly contributed and hit the country hard in this epidemic. Sally Davies is completely right that there is a social justice issue here. Levelling up, which I campaigned on in the last election and which the Prime Minister has evangelical support for, means health outcome equality, if it means anything at all. I completely share the aspiration that a benign outcome of this awful disease would be a national commitment to this agenda, not only for the principles of social justice but, pragmatically, for national resilience.
I will say a few words about trust and authoritarian measures to my noble friend Lord Cormack, who had extremely harsh words about the Government’s motives and their actions. I respectfully remind my noble friend that the Government are not conspiring to separate families, isolate the vulnerable or close businesses but this awful virus. That is what is causing the trouble, and it is our commitment to protect the vulnerable, businesses, the health service and, thereby, to protect the economy and the very fabric of society that leads us to this point. I completely sympathise with his frustration and I take his concerns about liberty seriously, but he is aiming at the wrong target.
The noble Lord, Lord Scriven, asked about the accuracy of lateral flow tests, and I would be happy to enter into correspondence with him on this. It is a short measure. I reassure him that these are an extremely effective screen. We have been using millions of them up and down the country and have become extremely experienced with them. They are not the tests we would use if you were going to go into an operating theatre, but they are the tests we would use if you were going to see Granny.
The noble Lord, Lord Scriven and my noble friend Lord Cormack asked about public understanding of government measures, which is a relevant, pertinent question. I reassure them both that the Centre for the Mathematical Modelling of Infectious Diseases has found that mean contacts—the number of contacts each original case study had—increased gradually from early April to July, which is exactly what we learned during the summer, when contacts began to grow. Since then, contacts peaked in mid-September and have come down, which is an indication that people are taking more seriously the strictures of the Government to socially distance and reduce social contact.
The noble Lord, Lord Greaves, spoke with great humanity about the plight of those in Pendle and the north. I reassure him that we do not think that it was only community testing that led to the decline in Liverpool but the commitment of the political leadership and a terrific civil effort on the part of the whole city. However, community testing did help. It not only helped break the chain of transmission but helped focus minds on the disciplines of epidemic control. He is right that the Army cannot do everything and that the priority is to test people who are most likely to have the disease. On the £500, it has undoubtedly been a struggle for both councils and individuals to claim the money, but we have, as of yesterday, made it accessible through the app, which I hope will change matters considerably.
The noble Baroness, Lady Thornton, and others asked about support; we have provided unprecedented levels of support to businesses and individuals. That includes helping to pay the wages of people in 9.6 million jobs across the country through the Coronavirus Job Retention Scheme, protecting jobs that might otherwise have been lost, and supporting the livelihoods of 2.7 million self-employed workers. Businesses have received billions in loans and tax deferrals.
By way of summary, the noble Lord, Lord Birt, made this central public health insight that we have all learned throughout this pandemic. My health is no longer a private matter. What I have realised is that I might have Covid, therefore, I might infect my neighbour. If I get ill, I will take up a bed in a hospital, and that bed will not be available for you. In other words, this is a classic liberal dilemma, which a number of noble Lords referred to. Of course, we respect everybody’s freedom and liberty but at this stage, with this horrible contagious disease spreading around the country, I am afraid we are all dangerous to others, and that is why we have to bring in statutory instruments such as the one we are looking at today.
Around 633,000 people in Britain have Covid today. We are doing our best. Some 246,298 were isolated by track and trace between 22 and 28 November, but we are going into the winter with far too many people walking the streets, schools and hospitals with a highly contagious and dangerous disease. That is why we have the restrictions we are looking at today, why I stand by them and hope your Lordships will support them, why I hope my noble friend and others will withdraw their amendments, and why I commend these regulations to the House.