Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021
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Lord Bethell
That the Grand Committee do consider the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021.
Relevant document: 43rd Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, at the outset, I thank the massive cross-government and civic movement that has mobilised to fight the disease. It is not possible to name-check everyone, but I single out for thanks all those in the NHS, social care, volunteers, returned healthcare staff and the Army involved in the deployment of the vaccine. I thank scientists at universities and pharmaceutical companies and those running clinical trials for developing new vaccines, antivirals and all manner of therapies to combat the threat of mutant viruses. I thank all those in the Border Force, test and trace, the hospitality industry, Project Eagle and local authorities who have worked so hard in the last week to stand up new mechanisms for protecting the vaccine from variants of concern. Lastly, of course, I thank the general public for continuing to follow the lockdown rules. The attitude of the public remains resolute. I know there are exceptions, and I appreciate that there are huge sacrifices everywhere, but the actions everyone is taking now are doing a huge amount to protect your family and loved ones as well as the family and loved ones of others.
Our focus remains on the rollout of the vaccine, the development of a sure-fire system to battle any mutations, and an exit strategy from this awful pandemic. In the meantime, social restrictions are necessary while this occurs, so it is important that we bring forward this SI.
This SI makes a number of minor technical amendments to the all tiers regulations, which is necessary for legal coherency. It removes the provision for a linked Christmas household—the “Christmas bubble”—to prevent any scope for misinterpretation. It adds the Marriage (Same Sex Couples) Act 2013 to the list of Acts governing permitted marriages, civil partnerships and conversions, so that we treat everyone equally under these restrictions no matter their sexual orientation. It allows cafés and canteens in all post-16 education and training settings to remain open. It inserts an exemption from the closure of sports facilities in tier 3 to allow for elite sports competition, which essentially ensures that elite sports competitions such as the Premier League are permitted. It clarifies that the exception to leave home to collect goods from businesses operating click and collect also applies to libraries. We know that libraries have been a lifeline for many during the pandemic, providing educational and IT support to those who need it, and this amendment will ensure that this keeps happening.
These regulations came into force on 20 January 2021, and we regret that we are only now debating them. However, they were simply technical amendments to existing law. They do not change policy which noble Lords have previously approved.
I thought it would be helpful to provide a short update of the situation we are currently in and our understanding of its impact. The general public recognise the importance of following social distancing rules to control the virus and protect the NHS, which is why the vast majority of people continue to follow the rules. An example of this is limiting social contact. The most recent ONS survey shows that only one in seven respondents reported meeting with someone that they do not live with or are not in a support bubble with outdoors. Some of these people will have met one other person for the purpose of exercise, which is allowed by the regulations. For those people who do not comply, we have a strategy. Police officers will engage, explain and encourage, and for those people who simply refuse to comply, we do enforce. We continue to review the tools available to police to take action and have introduced a new penalty for attending a gathering of more than 15 people in a private dwelling or educational premises, or as a rave.
I am cautiously delighted to be able to inform noble Lords that, as a result of the restrictions put in place and the efforts of the nation to follow the rules, we are now seeing the first signs of improvement. There has been a positive impact in reducing transmission of the virus, and as the Chief Medical Officer stated last week, we have passed the peak of the second wave. I said I was only cautiously delighted because, despite this being a very positive development, we still have more to do. The virus is still prevalent, with approximately 21,000 people testing positive for Covid across the UK each day last week and significant pressure still placed on the NHS.
We also still have approximately 29,000 Covid patients in UK hospitals as of 4 February. That number has been decreasing since the peak on 18 January 2021, when there were more than 39,000 Covid patients in hospitals. That said, the number is still far too high, much higher than the previous peak of just under 22,000, and this sustained pressure is coinciding with the period of greatest seasonal pressure on the NHS. As we know, any new measures take some time to take effect on our hospital numbers, so it is right that we remain cautious and continue, for now, with the restrictions.
This is clearly a challenging and worrying time for everyone. However, there is more good news. There is early evidence that the number of people testing positive has started to fall across England. As reported in the minutes from the SAGE meeting on 14 January 2021, we have indications that new infections are declining in those areas which have been in tier 4 for the longest. This indicates that it is likely that R can be brought down significantly during the lockdown, even with the presence of the new variant. It shows that our approach is working and that we are taking the necessary action to keep us all safe.
We intend to publish our plan for taking the country out of lockdown on 22 February. That plan will, of course, depend on the continued success of our vaccination programme and on deaths falling at the pace we would expect, as more people are inoculated. Our aim will be to set out a gradual and phased approach, easing restrictions in a sustainable way and beginning with the most important principle of all: that reopening schools must be our national priority. If we continue to make the progress that we want to see, and believe we can see, we hope to be able to begin to return to face-to-face education on 8 March. We will set out more detail in due course and will ensure that we give at least two weeks’ notice to allow students, staff and parents to prepare.
I again pay tribute to the wonderful staff of our NHS and social care sector, who are working tirelessly to protect the vulnerable and save lives. I commend these regulations to the Committee.
Lord Bethell (Con)
My Lords, I want to say a massive thank you to all noble Lords for their questions and, in particular, for the extremely kind and generous comments about the NHS, healthcare workers and all those who have contributed to our pandemic response. It is very rewarding to hear those remarks and I am sure that everyone involved is extremely grateful.
I will try to answer as many questions as I can. If I cannot answer now, I will endeavour to write to noble Lords. The noble Lord, Lord Winston, was right at the beginning of this debate to point out that pandemics last for a long time. We are profoundly conscious of that from the Black Death, Justinian’s plague, the Chinese plague and 1665. We are in it for the long haul and we hope that the remedies and protections we are putting in place today will help protect society for years to come. The noble Lord is entirely right that those worst affected disproportionately come from areas of deprivation, the elderly and the poor. That is very much on our mind.
The noble Lord, Lord Winston, asked about children. The green book is very clear about what vaccines are appropriate for children. We have endorsed the provision of vaccines for CEV children and are doing tests and clinical trials to see if the vaccine can be extended to children because, while not likely to be hospitalised, they are a source of transmission. He rightly raised antivirals. He and I have had correspondence on that subject. He also alluded to a key challenge in the administration of antivirals, which is portability. Access is a profound challenge in primary care for the delivery of antivirals, and that is one of the issues we have to resolve.
The noble Baroness, Lady Barker, asked about first aid training. If first aiders are unable to access annual refresher training face to face during coronavirus, HSE supports the use of online refresher training to keep skills up to date. If the noble Baroness has more questions about this important issue, I will be glad to answer them by correspondence. I reassure her, though, that when we publish the vaccination figures they are not vaccinations offered; they are vaccinations delivered. Some 549,078 were delivered on Saturday.
The noble Lord, Lord Blencathra, rightly raised the massive liberal dilemma of refuseniks. He alluded to the massive public health truism that my health affects not only me but the people I meet. I confirm that surgeons currently have validation for their vaccinations. A surgeon cannot perform surgery if he or she does not have, for instance, a hepatitis vaccination. That is, indeed, food for thought.
The noble Baroness, Lady Massey, asked about police data. We are looking forward to debating that issue on 1 March. On the very challenging question of social care, she asked quite reasonably about when we will be able to change the extremely distressing current regime for meeting those in social care. At the moment, meetings do happen outdoors and with protective measures, such as screens, but close contact is not allowed. This is not just to protect those involved but also to prevent the virus entering care homes, where it runs rife. We are seeking data on asymptomatic infection, transmission and the other relevant details from post-vaccination clinical trials. We will publish updated guidance after this period of national lockdown. More than anyone, I hope that this uncomfortable and challenging regime can be changed.
I completely hear the comments from the noble Baroness, Lady Thornton, on sport. She asked some very specific questions and I will be glad to write to her. In reply to my noble friend Lord Moynihan, I pay tribute to those in elite sports for raising our spirits. The Six Nations this weekend was great entertainment, even if the result was rather disappointing for England supporters. We are engaged with elite sport on the border issues, as he knows. We completely hear his arguments and we are trying our hardest to meet the hopes of elite sport. However, I say to him that we are in the hands of the variant and these matters are not completely in our control.
I reassure the noble Lord, Lord Scriven, that Parliament has a voice and that these debates on regulations do have an impact on the way that they are delivered. We are working within the framework of the laws we have and are doing our best to respect the influence of Parliament. He makes important points about the use of emergency legislation and I suggest that he addresses these comments to the Constitution Committee, which is doing a report on emergency legislation at the moment and would, I am sure, take his comments into account.
To my noble friend Lord Naseby, I am very glad, as I am sure we all are, to hear to hear of both his recovery and, in particular, that of Lady Naseby. I share his tribute to the NHS staff who have been delivering the vaccine. However, I well remember my noble friend’s comments. On six occasions last year, he made comments about cricket. I also remember, on 3 September, his profound scepticism about my comments that a second wave was on its way, so I gently and kindly remind him that we are not through this pandemic yet and I just cannot give him the reassurances on the reopening of cricket that I know he is looking for.
I completely share the frustration of the noble Lord, Lord Clark, and I agree wholeheartedly with his appeal for consistency. The bottom line is that the current guidance is that there should be no travel beyond the most local area—full stop. I completely understand his frustration about those travelling to his area.
My noble friend Lady Warsi’s comments are best directed to MHCLG, which provides guidance on wedding issues. The PM has made it clear that he will be issuing new guidance on 22 February, and the matters she asked about will be addressed in that. Although I hear the concerns of the wedding venue industry, I cannot make any promises on this today. The close proximity that weddings inevitably create does not suit pandemic management.
The noble Baroness, Lady Walmsley, is entirely right on Israel. Vaccinations are not a panacea. Social distancing remains essential, transmissibility after the vaccine is not clear cut, and therefore our message to the British public is to be patient and maintain the face, space and distance rules. She also asked about new genome sequencing. I reassure her that we are increasing our capacity for turnaround times and the amount of analysis that we provide. She is entirely right that about 5% of the positive PCR tests done today are genomically sequenced, so if a couple of cases of the South African variant are found today, you can expect there to be more tomorrow. But she is not right that central testing is more expensive than local testing; it is in fact much, much cheaper. Nor are we standing down resources: 783,851 tests were done yesterday—a phenomenal number. We continue to invest in local outbreak management: £925 million has been put in the contained outbreak management fund, supporting local testing.
I reassure the noble Baroness, Lady Tyler, that the CMO’s very strong view is that 12 weeks is a safe interval for the second dose of the Pfizer vaccine, and that an antibody test is therefore not needed.
I thank the noble Lord, Lord Mann, and the noble Baroness, Lady Thornton, who echoed his remarks, very much for his sincere comments on certification, which he made extremely persuasively. I reassure him that we are at a very early stage of the vaccine rollout at the moment. There are questions of fairness and justice when only a small proportion of the population have had access to the vaccine at all, but I take his points very much on board and will take them back to the department.
I reassure the noble Baroness, Lady Brinton, that the Project Eagle detective work and fire-blanket scheme is proceeding extremely well. It is too early to be able to give her categoric evidence of success, but the implementation is promising so far. She mentioned messaging and payment, and we have addressed those matters before. We have published an assessment of the tiering system, and I would be glad to email her a link to it. On her comments on test and trace, it would be generous and warm-hearted to say at least one word of praise to the management and the tens of thousands of people who work in test and trace for their phenomenal achievement over the past few months, turning around a massive enterprise that is having a huge impact on the virus.
In conclusion, I reiterate the sentiments of the noble Baroness, Lady Thornton, on the NHS. She is entirely right that this shows the NHS at its very best. The vaccination programme has been a phenomenal achievement, and I look forward very much to its successful deployment.