Baroness Brinton (LD) [V]
I thank the noble Lord, Lord Bethell, and the noble Baroness, Lady Penn, their officials and all staff in the Lords, the Whips’ Office and the health team, as well as Members, for their extraordinary work this year on Covid-related business—mostly emergency Statements and statutory instruments. From these Benches, we particularly wish the noble Baroness, Lady Penn, a safe delivery and a happy maternity leave.
The Statement talks about enjoying “new experiences” following the lifting of lockdown and safely slowing the spread of this deadly virus, but 48 hours is a long time in politics, as evidenced by the difficulties of taking this Statement two days after it was delivered. So much has happened, much of it demonstrating that this Government are still struggling to get a grip on keeping people safe from this deadly virus.
The phrase in the Statement:
“We are cautiously easing restrictions”
is the most extraordinary thing to say, given all the rhetoric about freedom day—and it is wrong. All restrictions have been lifted—no mandatory face masks—and young people have understandably taken their lead from Ministers. There are videos of young people deservedly enjoying themselves in nightclubs in the knowledge that the Prime Minister has declared it safe to do so, yet hidden in this Statement is the bizarre announcement that in two months’ time only those who are double-jabbed will be able to go to such crowded venues, thus delivering Covid ID cards by the back door. Once again our young people, who have had to bear much of the brunt of lockdown life, are the ones targeted by this Government.
That little phrase caused chaos on Tuesday morning. Paul Scully was not clear about which other large venues might be included—for example, pubs with performance dance venues, large or small. He thought so. Two hours later, No. 10 contradicted that: no pubs. Can the Minister tell me what is the difference between a pub with a large dance venue of, say, 500, and a nightclub that can have up to 400 people and why one will require everyone to be double-jabbed but the other will not? I am really struggling to understand the difference. Perhaps the Minister can point your Lordships’ House at a safety document that sets out what the risks are for these different venues and why it is appropriate to ignore lateral flow tests and only go on double vaccination when we know that people can still get Covid after they have been double-jabbed.
The Statement is right to praise the progress of the vaccination scheme, although there is some considerable way to go, including awaiting the data on whether the booster jab can be given at the same time as the flu jab in the autumn. What plans are in place to provide support for GPs if the jabs cannot be given at the same time? We all know that the annual flu vaccine date requires a very large amount of administration by medical and admin staff alike.
The Statement says that JCVI has decided not to vaccinate all 12 to 17 year-olds yet but is keeping it under review. I too refer to today’s ONS data that was referred to by the noble Baroness, Lady Thornton, demonstrating underlying illnesses and a greater prevalence of long Covid among the young than among older people. I thank the Minister for the helpful briefing on Monday, but I remain concerned that with up to 1 million children out of school now it has been clear that the alternative to vaccinating secondary-age pupils appears to be allowing Covid to rip through our schools. We all want our children back in school in the autumn, so what are the Government going to do about that? It is good that the Government are finally allowing the children most vulnerable to Covid to receive the vaccine because they deserve protection and that those children with an immunocompromised or immunosuppressed adult in their home will also finally be able to be vaccinated. That is good.
This Statement also refers to the regulations debated in your Lordships’ House last night, and I hope the Minister has taken away the many concerns expressed by all sides of the House. The Statement refers to tradespeople, such as plumbers and hairdressers, who will also have to be doubled-jabbed to gain entry into a care home. I have two questions about these non-staff members. I am happy to receive a reply by correspondence if the Minister does not have immediate answers. First, if the registered person is not on the premises when an outside worker comes in, can another member of staff admit them and make the decision about their vaccination status? What does that do to the registered person’s responsibilities? If a plumber comes out of office hours to, say, mend a burst pipe and the registered person is not there, must they be turned away? Secondly, care homes are already reporting that some contractors are heavily ramping up the rates for care homes for their staff who have been double-jabbed. Did the hurried and inadequate impact statement published on Monday include the cost to homes of this outrageous practice, and will the Government issue guidance that it should be stopped immediately? Can the Minister say when the detail of how this is all going to work in practice will be published?
The Statement refers to the fact that we must be pragmatic about how we manage the risks we face, yet the past two days have been full of contradictions from the Prime Minister and other Ministers about the need to self-isolate when people are pinged. It has taken journalists to reveal that the only legal responsibility to self-isolate is when called by track and trace, but after the embarrassing U-turns on Sunday morning of the Prime Minister and the Chancellor about not self-isolating, the PM is confidently saying “You must self-isolate once pinged”. Apart from the irony of that statement, given his behaviour, once again we have Ministers not seeming to understand the difference between advice to people—moral guidance, perhaps— versus the reality of a chaotic series of SIs that confuse not just the police, the public and Parliament but the very Ministers responsible for them.
With a further 44,000 new cases today, making us world-beating in one league table no one wants to head, a further 73 deaths and millions of people being pinged and everything in chaos, I fear we are in for a long and difficult summer.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]
My Lords, I am enormously grateful for the thoughtful and challenging questions from the noble Baronesses, Lady Thornton and Lady Brinton. I will start by using a couple of their specific questions to illustrate, as clearly as I can, the strategy behind our approach and the challenges and limitations in what government can and cannot do.
When it comes to the app, this situation illustrates the difficulties of leaving an epidemic. I remember well the CMO talking about what happens to a country when it enters an epidemic; at the beginning of last year, he gave us an introduction and said how difficult it was when you are trying to make that transition. The challenge is of having a partially vaccinated population that has huge pressures to get on with life, while at the same this infection leaves many largely untouched by the virus—in fact, the largest proportion of people. That is exactly the kind of dilemma we are wrestling with.
With the app and the Government’s position on whether you have to isolate when you get pinged, isolation remains the most important action that people can take to stop the spread of the virus. It breaks the chain of transmission. There is no single better measure for breaking the spread of the virus than isolation, so it is argued that it is crucial for people to isolate when told to do so, either by test and trace or by the app. I can confirm that the Government’s advice is to isolate if you are pinged by the app although, as I have said previously, this is not captured in law.
Both noble Baronesses asked about policy on schools and why we emphasise Covid vaccination over LFDs for entry into venues. Those questions give me an opportunity, I hope, to be really clear about the strategy. It is to vaccinate a sufficient proportion of the country that the virus cannot spread so easily, and that R is brought below 1. When we have that moment, we can be more confident that the impact of the virus on hospitalisations, severe illness and worse will be brought under control. At the rates at which we are vaccinating, we are hopeful that we can reach that stage relatively soon.
There is no other plan; there is no way of beating the virus other than ensuring that the vaccination deployment is as effective as possible. That is why we are looking at ways to bring young people and those who are reluctant onside, by engaging them in dialogue, answering their questions and emphasising through our measures the critical importance of vaccination, particularly when sharing space with others in your community.
On vaccinating children, healthy children are at a very low risk from Covid-19, with their risk of death being around one in 2.5 million. No previously healthy child in the UK under the age of 15 has died from the pandemic in the UK, and admissions to hospitals or intensive care are very rare. That is why we are taking a cautious approach in this area. The JCVI will keep this advice under review as more safety and effectiveness information becomes available on the use of vaccines in children; for example, regarding reports of myocarditis as an adverse event following vaccination with Pfizer. However, we will be extremely energetic in looking at all avenues in this area.
We are also looking at booster shots. Following the publication of interim advice by the JCVI, the Government are preparing for a potential booster vaccination programme from September. The noble Baroness, Lady Brinton, asked what the state of the country will be in the autumn. That will in large part depend on the flu vaccine and on the Covid vaccine, which can be taken at the same time. We are working closely with GPs to ensure that that rollout is as effective as possible, because the resilience of the NHS depends enormously on the success of our dual vaccine rollout.
Lastly, the noble Baroness, Lady Thornton, spoke about the importance of keeping life moving. I do not know that phrase but I know that there is a huge backlog in the NHS. There are other profound impacts of our social restrictions and our lockdown measures on the health of the nation, the economy and our society. We cannot continue in this way for ever. There is value in trying to open up our economy and giving individuals the information to be able to make decisions for themselves. That is the inflection point we are at now. I have enormous sympathy for those looking for information on the best approach but I hope the direction of travel is crystal clear.
Lord McNicol of West Kilbride (Lab)
My Lords, we now come to the 30 minutes allocated for Back-Bench questions.
Baroness Wheatcroft (CB)
My Lords, I too send my best wishes to the noble Baroness, Lady Penn. I echo the concerns of the noble Baronesses, Lady Thornton and Lady Brinton, over the contradictions over nightclubs and pubs and when we are going to insist on double vaccinations. Why not now? Why wait until September?
It is the contradictions in government policy that continue to cause concern. It is good to know that we are going to insist on vaccination for those working in care homes but why not across the NHS? Surely there is good sense in doing that.
We have lessons to learn from the treatment of Covid. We need to learn them as quickly as possible before the next emergency strikes. Sir Jeremy Farrar, the chief executive of Wellcome and a very eminent member of SAGE, has been coruscating about the failure to launch an inquiry now and to wait until March. Can the Minister explain why, when different people would be involved in conducting an inquiry, it cannot get under way immediately and report back as quickly as possible?
Lord Bethell (Con) [V]
My Lords, I have complete sympathy with the noble Baroness about the fast-changing nature of our response to this pandemic. However, as I have said from these Benches before, it is the virus that chops and changes and delivers us surprises. Who would have expected two or three months ago that the delta variant would have hit us as hard as it did?
We are trying to be agile and to adapt to changing circumstances. The guidelines on nightclubs and pubs will be published and when they are published, they will, I hope, be clear. The arrangements for September are being arranged right now. On mandatory vaccination in the NHS—which I think is what the noble Baroness inquired about—we have signalled our intention to consult on mandatory vaccination across the healthcare service. I hope that I will be able to share further details on that with the House at a future date.
In terms of an inquiry, of course I hear Sir Jeremy Farrar. However, I and many others are already working all the hours that God gives us on responding to this pandemic. There is no extra bandwidth for dealing with an inquiry. We are doing our best and we will look back and learn the lessons when the moment is right.
Lord Herbert of South Downs (Con) [V]
My Lords, given the growing number of people now being pinged and required to isolate, would it not make sense now to extend the sensible and welcome provision for critical workers so that those who have been doubled jabbed and then taken negative PCR tests need not isolate? I appreciate my noble friend’s point about breaking the chain of transmission but there is a danger that people will quite reasonably not see isolation as a proportionate requirement when they have been double vaccinated and tested. As well as the growing impact on businesses and public sector organisations of losing staff for up to 10 days, is there not also a need to maintain public confidence in the NHS Covid app? That is clearly now a serious concern.
Lord Bethell (Con) [V]
I hear loud and clear the concerns that members of industry and critical services have about isolation of the workforce and the impact that is having on supply chains and the provision of services. However, I cannot hide from my noble friend that the infection rates are higher. It is important that people who have been close to someone who is infected isolate themselves. If they do not, infection rates will go higher still, and if we have sufficiently high numbers of infections, although the vaccines are incredibly effective, that will roll into hospitalisations, severe disease and worse. This is a moment for holding steady and keeping the line. I am hopeful that this moment of acute discomfort for industry and services will pass soon.
Baroness Donaghy (Lab) [V]
My Lords, as the noble Baroness, Lady Wheatcroft, said, every contradiction by a Minister not only confuses but encourages opt-out. If even those of us who follow these issues closely are totally confused by what is happening and what the Government’s intentions are, it is hardly surprising that people are going to sit down and make their own decisions, rightly or wrongly.
My noble friend Lady Thornton asked what happens if the rates of vaccination fall. Are there any figures to support that and are there any plans to increase the urgency of vaccines? What is the situation for those involved in social care who are not in care homes but who go visiting from home to home? Will they be made to have double vaccines? Who will be the monitor? Will it be local authorities?
Finally, on the booster jab and the combination with the flu jab, the Minister was fairly definite about this and said that they can be done at the same time. Will they be done at the same time? Also, is a programme of vaccinations for flu and Covid combined already set out, or is that part of a future plan?
Lord Bethell (Con) [V]
My Lords, the take-up of vaccine will at some point begin to tail off among some demographics. We are redoubling our efforts with our marketing and the availability of the vaccine, particularly among younger groups. The introduction of domestic certification for major events and pubs and clubs, if that is brought about, will create a strong incentive. These are the kinds of measures that we are putting in place to see through the strategy which, as I said at the beginning, is to get the vaccination levels to such a rate that R is below 1.
In terms of social care, as I mentioned earlier, we are looking to consult on domiciliary care and other forms of the healthcare system. On booster jabs, the noble Baroness makes me want to check my notes. In my briefing it says emphatically that flu and Covid jabs can be taken together, but I will take the opportunity of her additional question to offer to write confirming that point in case I have got it wrong.
Baroness Barker (LD)
My Lords, throughout the pandemic, epidemiologists have been clearly telling us that when restrictions are eased, there will inevitably be further outbreaks, some of them localised. For the past 15 months, test, trace and isolate has been a shambles. Can the Minister explain what will be done over the summer to improve test, trace and isolate and improve the information going, in real time, to local authorities and to other parts of the NHS, in order that we can move swiftly, as necessary, to very localised lockdowns when that proves necessary for public health?
Lord Bethell (Con) [V]
I completely agree that the post-lockdown wave is a well-known phenomenon, and we are living through the pain of it right now. I do not agree that test, trace and isolate is a shambles, and if the noble Baroness really still feels that way, I would be glad to arrange a briefing for her. As for what more we can do, we are investing heavily in the system and we will continue to improve things, as we have done already.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, on 28 June, the Secretary of State said that the lifting of restrictions in July would be “irreversible”, but the Minister will know that the SAGE meeting of 7 July said that all modelled scenarios show a period of extremely high prevalence of infection, lasting at least until the end of August. It identified four risks associated with high infection, including an increase in hospitalisations and deaths. If there is a risk of the NHS being overwhelmed, surely the Government will have to consider some more lockdown restrictions.
Lord Bethell (Con) [V]
My Lords, the noble Lord, who is so wise in these matters, has answered his own question. If necessary, we will do what it takes, but the aspiration is clear: we are seeking to get the vaccination level to such a high rate that R is below 1 and no further lockdowns are necessary. That is an honourable, reasonable and epidemiologically sound objective.
Lord Scriven (LD)
My Lords, the Secretary of State for Health and Social Care is living proof that, despite having two jabs, 20% of individuals can catch and be spreaders of coronavirus. If this is the case, why are the Government, as a matter of policy, going to use internal Covid passports as a public health measure to deal with the virus in large venues? At best, they will give individuals and venues a false sense of security. At worst, for those who are double jabbed, infected but asymptomatic, they will be useless in the fight against the spread of this disease.
Lord Bethell (Con) [V]
My Lords, this is the clinical advice given to us by clinicians. I cannot answer the whole question in the round in this brief session, but a number of considerations include not only that vaccines offer a significantly reduced rate of infection but that the level of infection is much lower, the viral load is much lower, and therefore the infectiousness is much lower. The aggregate effect is that a group of people who have been vaccinated, with a few who have the disease, is less infectious than a group of people who have been tested, however good the test.
Baroness Altmann (Con)
My Lords, I echo the words of appreciation for my noble friends Lady Penn and Lord Bethell and congratulate them on all the work they have been doing. I also want wholeheartedly to support the aims of the policy that we have now, with so-called freedom. Indeed, I encourage the Government to consider going even further. This is about managing risk, not just of Covid but of all other illnesses, so I have to ask, having listened to this debate, when will be the right time? If all the most vulnerable and two-thirds of all adults are vaccinated, and if the mass numbers of infections do not lead to mass hospitalisations and deaths, and if zero Covid is unachievable, when will we learn to live with the virus and stop government interference with individual citizens’ lives in the way that has been, in my view, so frightening over the last period?
Lord Bethell (Con) [V]
I am grateful for my noble friend’s kind remarks. Her question is extremely complex, and difficult to answer briefly but I will rest on one particular answer. As I said before, this is a question of getting the disease transmission to a point where R is below one. If that can be done on a national basis, we have contained the disease. We can then turn to local outbreak management. That is when test and trace resources will come into their own and local deployment will make a big difference. That is when we can consider the virus to have been beaten. We are not quite there yet, but vaccination rates are incredibly impressive and I am hopeful that we are near to that point.
Baroness Bennett of Manor Castle (GP) [V]
My Lords, the Statement given in the other place said that
“our wall of protection must be more than just vaccines alone”.—[Official Report, Commons, 19/7/21; col. 688.]
Yet it made no mention of ventilation despite its obvious importance, given that I am hearing, as I am sure many others are, about double-vaccinated people becoming infected every day, and about the widespread transmission of Covid-19 in schools among children of all ages. The noble Baroness, Lady Thornton, asked, without answer, whether air filtration was being installed over the holidays in every school. I add—this could be done rather more cheaply—can schools be given help over the summer to do a ventilation plan for every classroom? Strategic placement of fans, and the choice and manner of window-opening, could be crucial. I see from media reports that the Government plan to replace the “hands, face, space” slogan with the slogan “keep life moving”. If it is not too late, may I suggest that “keep air moving” would be far more useful?
Lord Bethell (Con) [V]
I am grateful to the noble Baroness for giving me an opportunity to address this issue, and I hope the noble Baroness, Lady Thornton, will forgive me for overlooking it in my opening answers. The noble Baroness, Lady Bennett, is entirely right: ventilation is critical—but it is also challenging. On air filters, we have to understand better the science of whether filtration really makes an impact on the spread of the virus. I would not want investment in a large amount of ventilation infrastructure that did not actually have an impact. I agree that we have a lot to learn from the Victorians, who understood these matters very well. We must understand how modern buildings, which are often airtight to achieve environmental qualifications, may need to be adapted to get fresh air within them. We may also need to change our lifestyles, so that more socialising, eating and drinking is done outside—something that I, as an outdoorsy person, would very much welcome.
Lord Taylor of Goss Moor (LD) [V]
I am sure that the Minister is alive to the fact that the beta variant is less susceptible to the AstraZeneca vaccine in particular, with effectiveness as low as 10%. Perhaps, therefore, he found it understandable that the Government put further restrictions on travel from France. However, could he explain why we are not doing it with Greece, where the levels of that variant are higher than in France, or Spain, where they are much higher than in France?
Lord Bethell (Con) [V]
The noble Lord makes an important and serious point—but could I just address one matter first? The AstraZeneca vaccine has very low efficacy on a single dose against beta—around 14% or 15%—but on two doses its effectiveness is significantly higher. None the less, his broad point is right. As we vaccinate the nation, the variants that escape the vaccine will gain a natural advantage, and those will be the ones that begin to outperform the highly infectious variants such as delta that work so well among the unvaccinated. When it comes to travel, the analysis is complex. We have taken a precautionary approach with France, which I think is right, because there is a large amount of beta in France, but we are looking at all countries all the time, and we will take whatever steps are necessary to protect these shores.
Baroness Fox of Buckley (Non-Afl)
Following on from the noble Lord, Lord Scriven, I want to ask specifically about the surprise in the Statement: the need for vaccination passports in nightclubs and other venues with large crowds gathering. It was a surprise because last year the Prime Minister called vaccine passports unnecessary and intrusive. More recently, the Vaccines Minister called them “discriminatory” and Matt Hancock, when in office, declared that they were a step too far and said that
“we’re not a papers-carrying country”.
It seems as though we are, because this is about making young people’s engagement in public life contingent on papers. Would the Minister comment on whether this rowing back on previous statements will fuel cynicism among the young and the conspiratorial thinking that, “You said you wouldn’t do it and now you’ve done it”? Some Conservatives told me that I am not to worry, that it will not happen and that it is just a plan to threaten the young into compliance. Can the Minister clarify that?
If nightclubs, football grounds, pubs and so on require vaccine passports, does that mean that bar staff, cleaners, bouncers, groundsmen et cetera will need proof of vaccination to keep their jobs? I am worried about another group of workers having vaccines mandated, this time in the hospitality industry.
Finally, does
“other venues where large crowds gather”
include political conferences? I am asking for a friend or two.
Lord Bethell (Con) [V]
My Lords, I make no apology for changing my mind during the pandemic. I will admit readily to the House that I have changed my mind and rowed back on all sorts of things that I thought I was certain about. It has been a learning experience, to put it politely, for all of us, and we have all had to adjust our thinking on lots of matters as the evidence and the impact of the virus have affected us greatly. So, no, I do not believe in conspiracy theories, as the noble Baroness specifically asked me.
We all have to be responsible for the fact that our health touches on those we sit next to and share air with. This is a public health truism that is self-evident and has become highly apparent. There is no way out of this pandemic other than through the vaccine; there is no other silver bullet. Therefore, we all have a personal responsibility to ensure that we are as safe as possible when we share space with other people. That is the principle with which we go into this and which we are applying when it comes to domestic certification. The guidelines and precise details have not been hammered out yet, but we will do it in a way that seeks to be as inclusive as possible and is considerate to many of the concerns that the noble Baroness quite rightly articulated.
The Deputy Speaker (Lord McNicol of West Kilbride) (Lab)
That brings us to the end of the Oral Statement. All questions have been asked.