Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020
(Limited Text - Ministerial Extracts only)
Read Full debate
Lord Bethell
That the Regulations laid before the House on 17 December 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, despite all the pressure we are under, I would like to take a moment to celebrate some good news. The Government have today accepted the recommendation from the Medicines and Healthcare products Regulatory Agency to authorise Oxford University/AstraZeneca’s Covid-19 vaccine for use. This follows rigorous clinical trials and a thorough analysis of the data by experts at the MHRA, which has concluded that the vaccine has met its strict standards of safety, quality and effectiveness. We have hundreds of thousands of doses ready to go and 100 million on order—enough for everyone.
On 4 January, the NHS will start administering doses to a revised list that reflects many of the interventions by noble Lords in this Chamber in recent debates. While the vaccine project is an international collaboration, we should take a moment to recognise the contribution of the British life sciences sector and reflect that this easy-to-administer, affordable and mass-produced vaccine offers Britain a way out of this disease, and will make a huge impact on the global response.
But, in the meantime, news from the front line remains grim. While the November national restrictions drove cases down in most areas, it is now clear that cases are rising again at a worrying rate. Across the whole country, cases have risen 57% in the last week, driven by the highly transmissible new variant. The number of people testing positive for Covid-19 has increased rapidly and a growing proportion have the new variant. Data from 29 December showed that there were an enormous 53,135 new Covid cases across the UK—half with the new variant—an increase of 272,551 over seven days. NERVTAG has concluded that the new variant demonstrates a substantial increase in transmissibility, of around 70%, and the R value appears significantly higher, with initial estimates at 0.39 and 0.93 higher—a massive margin in epidemiological terms.
In September, we introduced the tiering framework, which we built upon and refined in December. This is designed to provide a flexible and responsive system, which allows areas to move up and down the tiers as case rates change. It proved effective, with many areas containing transmission. Despite our efforts, the new variant has changed things. It forced us to establish the new tier 4 and to move regions, such as London and the majority of the south-east, into this higher tier.
The good news is that there is no evidence, at this stage, to suggest that the new variant of the virus is likely to cause more serious disease, that our current testing regimes will not detect it or that a vaccine will not respond effectively to it. For this, we give thanks. But the bad news is that there is no data showing that it causes less disease. The new variant accounts for 60% of cases in London and is growing around the country. As always, we see that increased infections lead to increased hospital admissions and loss of life. I need hardly remind noble Lords that this is a time when the NHS faces enormous challenges from winter pressures, its commitment to elective procedures and now the new variant. That is why we introduced the tier 4 stay-at-home measures we are debating today.
As in the November lockdown, people in tier 4 areas must stay at home and not travel out of tier 4. They may leave only for a limited number of reasons, such as work, education or caring purposes. People elsewhere are advised to avoid travelling into tier 4 areas. In tier 4, support and childcare bubbles are the same as in all other tiers. However, all non-essential retail and indoor entertainment will close. International travel is restricted to business trips. The clinically extremely vulnerable in tier 4 areas should do as they did in November and stay at home as much as possible, except to go outdoors for exercise or to attend health appointments.
However, we have listened to noble Lords in this Chamber and the public about what is important for the way people go about their daily lives. Unlike under the November restrictions, communal worship and a wide range of outdoor recreation are permitted. The restrictions imposed in tier 4 areas are hard, but necessarily so. They are designed to reduce transmission of this new variant, so that the NHS is not overwhelmed and we can return to normal as quickly as possible. These stricter rules are in line with other major European countries.
In addition to Greater London, other areas have now moved into tier 4, including Cambridgeshire, the rest of Essex, Norfolk, Suffolk, West Sussex, Hampshire, Southampton, Oxfordshire and Waverley. These changes took place on Boxing Day. We have balanced the economic impact of greater restrictions on business with measures to protect public health. These restrictions impact business in the short term, which is hugely regretful, but we should be clear that they will be economically beneficial in the long term, because we will get back to normal quicker. We are also mitigating the short-term impact through financial support schemes.
On 19 December, we had to take the horribly difficult decision to reduce the Christmas bubble exemption. I know that this meant that the majority of us could not celebrate in the way we would choose. However, given the increase in transmission rates, it would have been irresponsible and reckless to provide too great a window for increased social mixing and the inevitable increase in transmission that that brings.
Therefore, the Government had to ask people across the country to make further restrictions to their Christmas plans. Although this period has been difficult, we now have clear hope. With the rollout of the vaccine under way, we can start to plot our path out of the pandemic with greater certainty, but it is precisely because of this hope that we cannot give up now. That is why my right honourable friend the Secretary of State for Health and Social Care will make a Statement in the House of Commons later this afternoon, addressing future tiering arrangements in response to the new variant. My right honourable friend the Secretary of State for Education will make a Statement in the other place on the return of schools and universities. The sacrifices we make now are crucial to getting back to normal and ensuring that, next year, Christmas will be much more normal for every family in the country.
I commend the hard work of the NHS teams on the front line, including our Chief Medical Officer, scientists developing vaccines and other therapeutics, and those in the life sciences industry seeking to mitigate the impact of this epidemic. I also express the sympathy of us all to those feeling under pressure of any kind—financial hardship, domestic strife, health concerns, educational worries, mental health pressure or just the worry for loved ones and an uncertain future. To all those, I say that there is light at the end of the tunnel. With new scientific advances being made every day, we are taking concrete steps but, in the meantime, we must dig deep. The end is in sight and, until science can make us safe, it is our duty to put in place these new rules, which will help us to keep this virus under control. I commend these regulations to the House.
Lord Bethell (Con)
My Lords, I am enormously grateful to noble Lords for an informed, thoughtful and passionate debate. These regulations are incredibly important, but they are clearly not enough to battle the growth of Covid in recent weeks, and the noble Lord, Lord Harris, was entirely right to spotlight the situation in London, which is particularly acute. In Havering, there is a prevalence of 1,500 per 100,000. I remember being surprised when somewhere hit 200, and we used to be happy with 400—1,500 is an astonishing number. I fear that that is what we are looking at, at the moment, and that is the seriousness of the situation we have to face up to.
Some noble Lords have suggested that we are not doing enough, and I will answer a few questions in that area. As noble Lords who have frequently attended these debates will know, we could not have been more committed to our testing regime. In the last reported week, from 10 to 16 December, 92.6% of contacts were reached, 93.9% of pillar 1 tests were within 24 hours and 91.1% of care home tests were within three days. Some 2,293,012 tests were done in that week. That is a colossal number, which reflects an enormous commitment.
The noble Lord, Lord Berkeley, is quite wrong when he describes the project in the Channel Tunnel as chaotic. It was a remarkable achievement, and I do not think that any other country could have pulled it off: 30,000 tests were brought together incredibly quickly on the roadside, with a multinational team of hauliers, under the most difficult circumstances. This helped to get trade moving, and I personally pay tribute to colleagues from the DfT, the military, local police, the test and trace programme and all those who made that possible. I also pay tribute to those who are pulling together tracing partnerships and the community testing regimes over the Christmas period; they have made enormous progress.
A number of noble Lords have quite rightly asked about volunteers and whether we could or should be using them more. I reassure noble Lords in the Chamber that we are absolutely working our hardest to make use of volunteers where we can. A number of noble Lords have asked about administrative problems, and I reassure noble Lords that NHS Resolution has put in place clinical negligence schemes for coronavirus under the terms of the Coronavirus Act, which we debated here at the beginning of the year, and Covid-19 has been added to the Vaccine Damage Payments Act.
NHS volunteer responders have delivered 1 million tasks to 123,455 unique clients; that is the work of 360,000 NHS responders. The St John Ambulance, which has had an absolutely massive impact, has delivered 200,000 hours of support and has very helpfully been involved in training 30,000 people for the administration of the vaccine. It is very much our intention to make use of that valuable resource. Of the 45,000 on the Bringing Back Staff team at the NHS, 2,700 have already been used, and many more will be deployed right now.
In relation to the vaccination, I reassure noble Lords that the authorisation today is a complete game-changer in relation to the scale and speed of the deployment. Not only is the vaccine massively easier to take to care homes, in particular, and GP surgeries, but the change in the dosage pattern means that we can not only deliver every single dose as it arrives in the warehouse but we do not necessarily have to book someone in for an immediate second dose. That gives our deployment programme an enormous amount of flexibility, and will lead to a great increase in our turnover: we will literally be delivering them as quickly as they can be manufactured.
Others are concerned that we are doing too much, and I will address that very quickly. In relation to projections, I have stood at this Dispatch Box and had the projections of the Government, SAGE and PHE derided by noble Lords as fearmongering. Who could possibly have believed that we would have 53,000 new infections? It is a little bit rich of noble Lords to question the work of scientists and our modelling teams in relation to their projections on today of all days. We accept advice from a very wide range of scientists; no voice is excluded. It is the role of government to synthesise advice into policy, and we do not need to smear or deride the scientists who supply that advice.
I have been through the statistics on public support on numerous occasions; I do not think I need to go through that again. There is massive public support for the measures that we have implemented. As for ignoring the Government, adherence rates are remarkably high, and I pay tribute to the public, which, although there are exceptions, by and large are incredibly committed to the regulations that are in place.
Lastly, as I have said before, it is not the Government’s policy to use two-week lockdowns as an emergency brake. These were used in Wales but not nationally, and that will not be our policy.
I agree with the sentiments of the noble Baroness, Lady Watkins—at heart, I also celebrate British liberties, but it is the virus that is not respecting liberty, not government, and we have no option but to bring in these kinds of measures to battle the virus, save lives and protect future generations.
A number of noble Lords mentioned schools, which are, without doubt, the most difficult subject at the moment. Of course it is right that we should do absolutely everything we can to keep schools open. Noble Lords who made that point enjoy my complete and utter support, but the epidemiology is very challenging. Schools have undoubtedly been the source of an enormous amount of transmission. Some of that is asymptomatic, but it is deadly nevertheless. The opening of schools has contributed to the high rate of transmission, particularly in London. It will be up to the Secretary of State for Education in the other place to make the announcement on schools, but the Government are entirely committed to trying to keep schools open for exactly the reasons cited in this Chamber, not least because it is those who come from the poorest backgrounds who undoubtedly suffer most from their closure. However, in order to make an effective regime to battle this virus we may need to make some tough decisions.
The noble Baroness, Lady Thornton, asked whether this is going to be enough. That is not for me to answer; my right honourable friend the Secretary of State for Health will be making a Statement in the other place shortly and he will address the question of any future restrictions or regulations. However, the noble Baroness is entirely right; the challenge we face this week is completely different to the one we had when we went into recess before Christmas. This new variant is of a different order; we may as well be battling a different disease. We will have to step up to that challenge in order to see ourselves through to the spring, when the vaccine will have been delivered to sufficient numbers to make a real difference. I regret that that may strike a chilling note at the end of this debate, but we have to face up to it.