Health Protection (Coronavirus, Restrictions) (Steps etc.) (England) (Revocation and Amendment) Regulations 2021

Tuesday 14th September 2021 Grand Committee

Considered in Grand Committee

16:11

Moved by

[Lord Bethell]

That the Grand Committee do consider the Health Protection (Coronavirus, Restrictions) (Steps etc.) (England) (Revocation and Amendment) Regulations 2021

Relevant document: 11th Report from the Secondary Legislation Scrutiny Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, these regulations are an important milestone on our journey through the pandemic—and, I hope, beyond. On their introduction, most coronavirus restrictions in England were lifted, so on 19 July we moved to step 4 of the Government’s road map—the final step of our cautious journey out of lockdown.

I do not need to detain your Lordships for very long setting out the content of these regulations. Almost all legal restrictions have been lifted. Businesses across all sectors are able to open again. We can now attend weddings, birthdays and festivals and spend time with our families, friends and loved ones without legal restrictions on social contact. The balance has truly shifted, with most restrictions enforced in law now replaced with guidance.

I am pleased to see that our theatres and the wider entertainment sector are blossoming once again. I know that many of us have enthusiastically welcomed the return of singing in churches and amateur choirs. In the broadest sense, community life has returned, and I do not think we realised quite how much we missed it.

I know that many people may feel nervous, particularly those who are immunocompromised or immunosuppressed. We must all continue to act carefully, respond to the latest guidance and remain cautious to protect ourselves and those around us. That means continuing to follow the Government’s advice on protecting ourselves and others: for example, by getting the vaccine, letting fresh air in if meeting indoors, and getting tested when symptomatic and isolating when necessary.

The pandemic is not over. The virus will remain part of our lives. We are undoubtedly in a better place now than when we embarked on the road map out of lockdown in February this year. This is a testament to the expertise and dedication of all those involved in building our defences against the virus.

We have a toolkit in place for tackling the virus in the months ahead. The Government have set out our plan for managing the virus over these difficult months, and the Secretary of State has recently finished making his Statement in the other place. Our plan A is to continue to build on the progress we have made and manage the virus without the need for restrictions that impact on the lives and livelihoods of citizens.

We are implementing the biggest and most successful vaccination programme the country has ever seen, with more than 48 million people having now received their first vaccine dose. Data shows that the vaccination reduces overall symptomatic disease by 80% to 90%, hospitalisations by more and deaths by around 95%. The vaccination programme has substantially weakened the link between infections and serious illness or disease.

We will continue to bolster the wall of defence provided by vaccines by encouraging take-up and through booster jabs. Extensive planning for a booster vaccination programme is well under way, and the NHS is preparing to start booster doses from next week. Details have emerged during the course of today. This will protect the most vulnerable throughout the winter months and strengthen our wall of defence even further.

Vaccines are now being offered to 16 and 17 year-olds, and the Government have accepted the advice of the four Chief Medical Officers to offer vaccination to all healthy 12 to 15 year-olds. Invitations for vaccinations will begin shortly.

Our test, trace and self-isolate system is another of the key defences in our armour against the virus. We have established the largest network of diagnostic testing facilities in British history. The UK has conducted 274 million Covid tests and reached 15.9 million people who have either tested positive or been in contact with someone who has. I look forward to updating noble Lords further on the test, trace and self-isolate systems when we debate important changes to the self-isolation regs later this afternoon.

16:15

We are supporting the NHS and social care. Last week, we announced a £5.4 billion cash injection for the NHS to support the Covid-19 response over the next six months, including £1 billion to tackle the elective backlog. Our world-leading scientific expertise has created significant breakthroughs in the treatment of Covid-19. Robust clinical analysis has enabled us to take decisions based on evidence and rigorous science to improve patient care. We continue to manage risks at the border and support a global response to reduce the risk of variants emerging globally and entering the UK. The safety of the public will always come first.

This comprehensive toolkit will stand us in good stead over the coming winter. As far as possible, we will avoid reimposing social and economic restrictions. The progress made so far is built on the perseverance and resolve of us all. If we are to safeguard the return of familiar freedoms, everyone needs to continue to follow behaviours and actions set out in the guidance on how to limit the spread of Covid-19.

I am sure your Lordships will join me in extending heartfelt thanks to all those in the NHS, the social care sector and wider support services, including the many volunteers, who have helped make this progress possible. Indeed, I particularly thank every person and every organisation that has contributed to this achievement and made sacrifices to protect themselves and others during this difficult time. Thanks to them all, we can look forward with optimism and a sense of resolve as we learn to live with the virus.

I sincerely regret that we are debating the regulations only now. We have always been clear that restrictions would be in place for only as long as they were needed. It was therefore essential to bring these regulations quickly once the four tests had been met, allowing us to move to step 4. The content of each step of the road map has Parliament’s prior approval, and we debated the Oral Statements setting out the shape of step 4 and announcing the move to step 4 prior to these regulations being laid. As ever, I welcome the scrutiny of Parliament and noble Lords’ valuable contributions to this. I commend these regulations to the Grand Committee.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very glad to follow the noble Lord and to speak to these regulations. They were laid two months ago and, once again, we are debating regulations that in a sense have been superseded by the various announcements made over the last 24 hours. I realise that this week we will probably debate at least two of the Statements, as well as looking forward to a lot of activity when we return.

I will focus on the instruments. At the time they were brought into force, the Government stated:

“The vaccine deployment programme continues successfully … Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated”


and that confidence in vaccine effectiveness against the delta variant has increased significantly. I hope the Minister can update us on that.

Can he confirm the number of adults who have not yet been vaccinated? I think there are figures in the winter plan that I have just seen. Does he agree that, while one should applaud all the efforts of those who have made the vaccination programme possible, it is still striking that so many adults have irresponsibly decided not to vaccinate? I know we will debate the issue of children aged 12 to 15 later this week, but I for one feel very uncomfortable that, even with just one jab, there will be a small risk to those taking it— particularly some boys—partly because of the selfishness of adults in not taking the vaccine. I personally think there are some ethical issues and am not surprised that the JCVI found this a very difficult decision. What else does the Minister think can be done to encourage adults to take up the vaccine?

Could the Minister also say a little about the unknown risks of vaccine effectiveness in high-prevalence environments where transmission pressures are high? I will also ask about the relationship between the booster jabs, which I think the Chief Medical Officer recently announced are to happen, and the flu vaccine programme. I understand that there is concern that immunity to the virus is low, leading to fear that flu, together with other winter viruses, could put the NHS under extreme pressure. Could he also comment on the likely effectiveness of the flu vaccine, which I gather is pretty low?

May I also ask about face coverings? These regulations remove the requirement for people to wear face coverings when using public transport services and in relevant indoor settings. The rationale for that was that the success of the vaccination programme meant we could move away from strict legal restrictions towards personal responsibility and informed judgment. Last week we debated this to an extent and the Minister pointed to data that his department had showing that this had not had much impact on people’s behaviour. From talking to noble Lords, I note that there is some surprise about this, because to the visible eye mask-wearing has dropped off considerably, particularly among men. I wonder about the extent to which this is being monitored and whether we need to step up some programmes about why it is still to be encouraged.

Finally, I will ask about local authority powers. These regulations enable local authorities to take action where an outbreak or risk of outbreak is linked to premises or an event, with local authorities retaining powers to respond to local serious and imminent public health threats. That is a very sensible provision. The Government then describe those regulations as continuing

“to act as an important public health tool for local authorities”.

Could he update me on the use of these regulations since they were passed?

[Baroness Barker (LD)]

My Lords, I am speaking in this debate because my noble friend Lady Brinton cannot be in her place to take part. We have the technology to enable remote participation in debates in the Moses Room, but the House authorities have not yet permitted that for contributions in Grand Committee, so virtual participation in these proceedings is unfortunately not possible, even though we have seen in this last week that the very few participants who need to take part remotely can be managed very effectively without recourse to extensive speakers’ lists.

It is also a loss to the Committee, because my noble friend Lady Brinton cannot take part for one very important reason, about which she has been quite public: she is clinically vulnerable, and one thing she cannot do is travel on public transport, which she cannot do because people are not wearing masks. Of all people, she should have been able to be here to make that point.

Yet again, these SIs were tabled very late. They came in just before the recess in late July, so yet again we are back to debating things that are long in the past. We have repeatedly asked the Government to respect the House and timetable SIs when they are not genuinely urgent. However, these are, as the noble Lord, Lord Hunt of Kings Heath, said, quite pertinent in view of the Statements being made this week.

This statutory instrument mostly deals with the revocation of statutory instruments on 21 July, which confirmed a number of the changes in the Prime Minister’s so-called freedom day. However, there is one extension, in Regulation 4, to the expiry date of the Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations, which are now to end on 27 September. The Explanatory Memorandum says that this

“will ensure that local authorities retain powers to respond to local serious and imminent public health threats as a result of the spread of coronavirus. The No. 3 Regulations will continue to act as an important public health tool for local authorities in their local coronavirus outbreak management, compliance and enforcement activities. This is particularly important in light of the revocation of the other restrictions mentioned above”.

As we have said all the way through this pandemic, it is important that local authorities have the power to manage local outbreaks. Simply extending that power in law, but not making sure that they have the resources, will not work. As epidemiologists have said to us in terms, there will inevitably be points when it is important to close all the pubs in a certain area, simply because an outbreak has to be contained. While we welcome that, it behoves the Minister to say something about local authorities such as Croydon, which is insolvent, and how it will have the resources to manage this significant and enduring public health problem.

We regret the removal of face coverings on public transport and other crowded venues. I can say, as somebody who travels on the London Underground every working day, that fewer and fewer people are wearing masks and, as more and more people are on the Tube, I am certain we will see a spike in infections as a result. I also point out to noble Lords that the bad messaging on this does not help. There is genuine confusion. One of my colleagues was on a train to Scotland in the summer and, when it got to the border, there was an announcement that the law now required everybody on that train to wear a mask, and they did, as they should have done all the way.

It is now clear that the Government, and in particular the Prime Minister, have been so desperate to place emphasis on the vaccination programme as our primary defence that they have forgotten to look at the role of other mitigations against the disease. Although we support the passing of these regulations, we need to make the messaging clearer as a matter of urgency, so we can avoid the confusion that is now prevalent among people in England.

[Baroness McIntosh of Pickering (Con)]

My Lords, I welcome the regulations and congratulate my noble friend on bringing them before us. To a certain extent, my comments echo those that have already been made by previous speakers. I was fortunate enough to visit my family in Denmark and Scotland this summer, and the guidance in each place was much clearer. Speaking as an older person, I prefer to keep my mask on, on all forms of public transport. I am sure my noble friend will recognise that one of the reasons why there was not a high incidence of flu last year was, in large measure, because we followed the example of the Asians after the SARS epidemic in the late 2000s of masking up. Even the common cold was kept under control.

I understand the Department of Health and Social Care’s concern about a high incidence of flu this year, but I am sure we can encourage people to mask up, particularly in areas of close proximity. The noble Baroness, Lady Barker, mentioned the Tube. I am still reluctant to go on the Tube at busy times, but even the trains on the east coast main line are incredibly busy now, and you can find yourself next to someone who you are not normally accustomed to seeing.

To me, wearing a mask is not an infringement of my liberty; it is my passport to health and keeping safe. I hope that it will keep others safe as well. Does my noble friend imagine that the guidance will be revisited? It is in stark contrast to what has applied in Denmark and in Scotland.

16:30

Having visited Scotland, I was alarmed to see that, just 10 days after the schools returned, the incidence of Covid in general circulation was so high and increasing. The Government there have said in no uncertain terms that they will bring back restrictions, as have our Government in England. That is welcome. To what does my noble friend attribute the high incidence of circulation among the general community in Scotland, which we have not seen in England? I take great comfort from that, but is there a concern that, after the schools have been back for three weeks in England, we might see a similar rise here?

I applaud the pace and efficiency of the vaccine programme and I congratulate all those who were involved in rolling it out, from the department down to the general practices, as well as all those in the big vaccination venues. It was absolutely amazing. One of the positives to come out of Covid was seeing the vaccine not only created, approved and produced but then rolled out so efficiently.

My particular concern is the vaccines for those aged 12 and upwards. I would like to press my noble friend on the medical evidence. If I was a 12 year-old female or male, I would be concerned about what exactly the evidence is. I understand that a young boy might be vulnerable to this infection around the heart. Are these young people more at risk of being sick by being vaccinated or are they more at risk of being hospitalised or seriously ill from contracting Covid? Are we asking them to be vaccinated for the health of the general population? It would be helpful to know that from the point of view of the parent and the individual.

I looked at the regulations closely and I may have missed it, so I end with one question about PCR tests. I had to have various PCR tests in my visit to Denmark. I was disappointed that, because we were saying how high the infection level was in July, the Danish Government immediately whacked us into the red zone and I had to quarantine for four days, although it was not unpleasant and I passed the time as best I could. I should add that the PCR tests were completely free in Denmark. They were paid for by the Danish Government, for which I am grateful. I do not contribute to the Danish economy other than when I am there, but the fact that the Danish Government took that approach has helped the tourism trade and the travel industry hugely, so my noble friend may like to revisit that with the Department for Transport here.

My understanding was that the reason why all of us were paying these high levels for PCR tests going out and slightly less for the two-day test on our return was that they would all be investigated to see whether we had contracted Covid—thankfully in my case, I had not, but I was grateful for the opportunity to test myself out of self-isolation. Being a Scot and living in North Yorkshire, I was prudent and shopped around, but I paid about £130 as an individual, which is a substantial amount of money. I understood that, where there were positive tests, they would be investigated to see if there was a particular variant—the delta variant or a new variant. Can my noble friend confirm that that is the case? He may not have the figures at his disposal, but he could perhaps write to me and give a copy of the letter to the Library in the usual way. I am alarmed that these high rates have been allowed with no follow-up on those who have contracted Covid as evidenced by these PCR tests. The term “rip-off” comes to mind. Many of these companies seem to have taken advantage of the British public and others visiting the UK. If that is the case, it is deeply regrettable.

With those few remarks, obviously I welcome where we are today. In particular, as chairman of the proof of age PASS board, it is welcome that those in casinos and other nightlife who rely on PASS cards will be able to open up in the same way as other establishments such as coffee bars and restaurants have done. That is particularly welcome, and I welcome the broad thrust of the regulations this afternoon.

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for introducing this late regulation. As I said to him last week, there is a sort of “Groundhog Day” tendency in having to deal with these things. I would also like to register with the noble Baroness, Lady Barker, that the House needs to address the issue of the noble Baroness, Lady Brinton, being able to access these sessions in the same way that she can access the Chamber. I would even go so far as to say that it is discriminatory that she cannot. As well as that, we are missing her wisdom, words and her representation of her points of view.

The noble Baroness, Lady Barker, and my noble friend Lord Hunt have covered many of the points and have asked many of the questions that need to be asked on this regulation. As noble Lords have said, it triggers the end of most of the lockdown restrictions in England by revoking regulations and amending regulations listed in the schedule from 19 July. I echo what other noble Lords have said. Does the Minister believe that it was premature to remove face mask regulations? I have not yet read the 30-odd page toolkit document in full, so I do not know whether the option is there to reintroduce them as part of the autumn-winter Covid plans. Would that be mandatory?

At the time of lifting the restrictions, from these Benches we opposed and still oppose the decision to remove the requirement to wear a face covering indoors and on public transport. The risk of transmission inside a crowded bus or train will be high. If it is true, as the scientists say, that one in 70 of us in England has Covid, and the capacity of a double decker bus is about 70 and a full Tube train or regular train carriage can carry up to 140 passengers, that would mean that on average one person on a crowded bus and two people on a crowded Tube train will be contagious. They will have Covid, and with little ventilation and no legal requirement to wear a mask.

I travel on public transport all the time—it is how I get to your Lordships’ House and go home—and it is certainly noticeable that mask-wearing, particularly among young men, has fallen. It is true that on the Tube there are marginally more people wearing masks than on the Overground, but the number has fallen. It is very concerning and worrying, and I have got to the point where I have stopped being a mask monitor and offering people masks if they have not got one on, because there are too many of them on the Tube and on trains without masks on.

We supported the removal of restrictions on gatherings, but we thought the Government were going too far and too fast at the time. We were also concerned that the lifting of all the restrictions was confusing to businesses. Has the Minister had feedback about how effective the lifting of those restrictions was? This instrument extended the expiry date of the Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations to the end of September to ensure that local authorities retain the power to respond to local serious and imminent public health threats as a result of the spread of coronavirus. Can the Minister confirm whether the Government intend to further extend these provisions? If it is in the winter plan I apologise, but I think we will be discussing that tomorrow or Thursday.

I suspect that the winter plan contains which bits of the Coronavirus Act are being retained and which will be got rid of. However, what worries me is whether in three or four weeks’ time, if infection rates have increased enormously as a result of the schools going back, there will be sufficient powers to deal with that, and sufficient powers if we need to go into further restrictions. The Minister must explain what will happen if the worst happens. The byword throughout the whole pandemic has been “Let’s plan for the worst and hope that we don’t have to use those powers.” If all those powers are being rescinded now, what will we do if there is a new variant further into the winter or we see a spike in the next three or four weeks? We need to know that.

In terms of mask wearing, I went on holiday to Scotland by train and it is true that as we neared the border, there was an announcement that everybody had to wear a mask, and everybody put a mask on. It was not an issue. Like the noble Baroness, Lady McIntosh, I do not regard mask-wearing as an encroachment on my civil liberties. I regard it as something that protects me and with which I protect others. We seem to have lost that message in the wearing of masks. Are the Government going to do anything about that?

[Lord Bethell (Con)]

My Lords, I thank noble Lords very much for an extremely helpful debate, and I very much welcome this return to the Moses Room. It is very nice to be back in the intimate and more conversational style of Committee.

The Secretary of State has been on his feet this afternoon to talk about the toolkit. My understanding is that there will be some kind of Statement repeat, and I look forward very much to going through the toolkit during that. I apologise in advance if I cannot answer every question on that right now, but I would like to tackle a couple of points that were raised. Before I do, I will say a word of appreciation for the contributions of the noble Baroness, Lady Brinton—her presence is highly valued—and for those who organised the virtual House and our current arrangements. It is all a massive compromise and uncomfortable, but I am extremely grateful for the work that has been done to make this return possible. I am hopeful that even more can be done in October.

A number of noble Lords, particularly the noble Lord, Lord Hunt, asked about the booster. The NHS will be rolling out a booster programme to protect those who are most vulnerable to Covid, as we announced previously. It will now be extended to individuals who received vaccination in phase 1 of the programme: that is, JCVI groups 1 to 9. That includes those living in residential care, all adults over 50, front-line health and social care workers, and all those aged between 16 and 40 who have underlying health conditions that put them at a higher risk of severe Covid.

This is very good news. There is very strong evidence that a booster programme such as this can have a very big impact, particularly on those who are immunosuppressed or who live with the immunosuppressed. The JCVI has advised that the booster vaccine programme is offered no earlier than six months after completion of the primary vaccine course, and that will of course affect many people. The vaccination programme has been planning booster vaccinations for some time, which means that the NHS is now in a position to offer booster doses from next week. As most younger adults will have received only their second Covid vaccine dose in late summer, the benefits of booster vaccination in this group will be considered at a later date. I think noble Lords would agree that this is a reasonable and proportionate approach to this complex issue.

16:45

Following the advice from the JCVI, the four CMOs and the NHS, working with the school immunisation teams, will offer a first dose of vaccine to 12 to 15 year-olds from next week. That is incredibly good news and sees through the immense amount of work that has gone into assessment. A decision will be made in consultation with a GP. If there is a dispute with parents, there will be a four-stage process for determining whether a young person has capacity to consent to a vaccination, as is the case with all vaccinations of children, as I am sure noble Lords know.

On the subject of face coverings, this came up last week and after the debate I looked into the figures on the wearing of them. The noble Lord, Lord Hunt, is right that there has been a change in the wearing—or the perceived wearing—of face coverings. The reassurance that I had seen in previous figures changed after the 19 July step 4 change, as many noble Lords noted.

We believe that the measures we have put in place are proportionate. It is our view that you cannot put something as intimate and detailed as face covering into law for very long periods. We have to trust the people themselves. That is why in step 4 the Government removed the legal requirement to wear face coverings. The success of the vaccine programme is not the only thing we are relying on, but it puts us in a position to relax some restrictions. Face coverings remain an incredibly important way to reduce the spread of the virus and that is why the Government expect and recommend that they continue to be used in indoor spaces where you come into contact with people you do not normally meet, particularly where there is a risk of greater transmission, such as the Tube, whether overland or underground. The government guidance on face covering enables people to make informed decisions about how to manage the risk to themselves and others. It is our hope that people will continue to respect that guidance and to be considerate to others.

The regulations provided local authorities with powers to enable local authority enforcement officers to issue improvement and restriction notices to persons not meeting Covid-secure business obligations, as the noble Lord, Lord Hunt, and the noble Baroness, Lady Barker, rightly noted. These regulations were revoked as part as the move to step 4 of the road map. We believe that the tests set out in the number 3 regs, including engagement with DPHs to ensure that they are proportionate, will mean that DPHs are left in a position to conduct whatever interventions they feel they need to. There is an appeal mechanism, and they can rely on that, if necessary.

In answer to the question from the noble Lord, Lord Hunt, about how often number 3 regulations have been used by the authorities, I can share with him that they have been used 330 times since the regulations were laid.

I have some sympathy for all those who travel from England to Scotland and have noted the differences in messaging. I think many noble Lords have made that journey and noted the same thing. However, there have been benefits from the four-nations approach. It is important that the leaders of each country take their country with them. It increases compliance if communities feel connected to the leaders who are trying to inspire and guide them. However, after so many months of the pandemic I think noble Lords are right that more alignment would be convenient and more impactful. We are certainly working hard at a ministerial and a CMO level to try to get more alignment in our policy-making, which then flows through to our message-making.

However, it is not right that, as I think the noble Baroness, Lady Thornton, suggested, we are relying simply on vaccinations. Other important mitigations are in place. Testing, borders and the investment in therapeutics and clinical innovations in the treatment of Covid have all meant that we have massively strengthened our response to the pandemic.

We believe that the spike in infections in Scotland is due in part to the return of schools, which, as noble Lords know, happens earlier in Scotland. We think it is also because the loosening of some regulations in Scotland coincided with the return of schools. We in England loosened a lot of our regulations with the step 4 regulations we have before us, so we hope that there will not be the same spike here.

My noble friend Lady McIntosh asked about tests for travel. Travel is essentially a voluntary business, done by a very tiny proportion of the country. It is therefore our view that it is not reasonable for the broad taxpayer, the vast majority of whom are not travelling, to pay for the tests of those who have the opportunity to travel. However, we are leaning into the test arrangements around foreign travel, and I am aware of the complaints of noble Lords and the public. Since 15 December, when we brought in the day two and day eight testing regime, private industry has come an enormous way to stand up a massive system of testing. It is not perfect but we are leaning in very heavily to make sure that there are improvements. There are currently 500 providers, many of whom deliver an absolutely first-class service, but we have got tough on providers who do not. We are enforcing minimum standards and making daily checks on the pricing arrangements that providers are promising on GOV.UK but not always standing by. For these reasons, we hope that there will be a significant improvement and that travellers will be able to rely on that service for months to come. I commend the regulations to the Committee.

Motion agreed.