Public Health

(Limited Text - Ministerial Extracts only)

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Tuesday 30th November 2021

(2 years, 4 months ago)

Commons Chamber
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Maggie Throup Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)
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I beg to move,

That the Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021 (S.I., 2021, No. 1340), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

Lindsay Hoyle Portrait Mr Speaker
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With this we shall take the following motion:

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 4) Regulations 2021 (S.I., 2021, No. 1338), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

Maggie Throup Portrait Maggie Throup
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In September, the Government set out their autumn and winter plan for fighting the virus, which could be implemented to ensure that the NHS is not overwhelmed. Although we are not implementing the entirety of the plan now, we are taking steps to respond to a potentially potent mutation of the virus. We have taken great steps in our fight against the virus, having delivered nearly 115 million vaccine doses so far, and more every day, with almost 18 million people having also received their booster jab, including me.

Desmond Swayne Portrait Sir Desmond Swayne (New Forest West) (Con)
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Will the Minister deprecate those public appointees who, notwithstanding the clear proportionate advice of the chief scientific adviser, have been on the airwaves telling people that they should not socialise, to the huge detriment of people’s wellbeing and of an industry struggling to recover from earlier lockdowns?

Maggie Throup Portrait Maggie Throup
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I am sure the people my right hon. Friend is referring to will have heard him loud and clear. We all enjoy socialising but, as he will appreciate, we are in a difficult situation. However, we also have personal responsibility.

We are confronted with an emerging threat, which is familiar but not yet well known. The measures that we are putting in place are proportionate, precautionary and balanced, and are being made in response to the specific threat.

Late last week, the challenge arising from the latest covid-19 threat from the variant of concern known as omicron emerged. Public health officials in South Africa shared information on the omicron variant and it was identified as a coronavirus variant of concern. Thanks to our world-leading genomic sequencing experts at the UK Health Security Agency, we were able to identify that some cases of the new variant are present in this country. So far, we have identified 14 cases in the UK and, unfortunately, we expect to find more in the coming days.

Mark Harper Portrait Mr Mark Harper (Forest of Dean) (Con)
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The Minister mentioned the UK Health Security Agency, the head of which my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) was referring to. Dr Harries said two things this morning. First, she said that people should not socialise. Secondly, she also implied—only implied, to be fair—that people should work from home. When the Prime Minister was asked about that, he made it clear that that was not the Government’s position and that people should follow the advice. I listened carefully to the Minister’s answer and I do not think that is quite what she said. Could she be clear that Dr Harries was speaking only for herself, not for the Government?

Maggie Throup Portrait Maggie Throup
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As my right hon. Friend said, the Prime Minister said that we are putting these measures in place, about which I will speak more. I cannot speak for any other person who goes on the airwaves.

Rachael Maskell Portrait Rachael Maskell (York Central) (Lab/Co-op)
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Dr Harries is a public health professional who therefore understands what public health measures need to be taken to secure our wellbeing against the pandemic. Why are the Government not listening to what public health professionals are advising?

Maggie Throup Portrait Maggie Throup
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I reassure the hon. Lady that we listen to the advice of health professionals all the time, but today we are debating statutory instruments on face coverings and self-isolation following travel.

Steve Baker Portrait Mr Steve Baker (Wycombe) (Con)
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Is the Minister seriously saying that it is not for Ministers to have any particular view on officials employed in the Department going out and taking a position that is at odds with the Government’s public policy? If it is now the policy that even Department employees can take their own personal positions, we are facing chaos and the overturning of long-standing Government principles.

Maggie Throup Portrait Maggie Throup
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I reiterate that I cannot speak for other people. I am setting out the measures today that we implemented this morning in a timely fashion, and it is those measures that we are considering. From the Government’s point of view, that is the legislation that we are implementing.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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I support what the Minister is putting forward. What happens here will happen in Northern Ireland, as the Minister in Northern Ireland has said that he will follow the instructions and guidelines from Westminster. We are aware of the variant and we are aware at this stage that our vaccinations may be enough to combat it. If we hand wash, distance and wear a mark, surely we cannot do anything other than support the measure. Does she agree that other hon. Members should adopt the same attitude?

Maggie Throup Portrait Maggie Throup
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I speak for myself in saying that I have changed my habits with regard to hand washing since the pandemic began, much to the detriment of my skin. We can take simple measures that have been put in place that have no impact on other people but help to protect us and others indirectly.

Richard Drax Portrait Richard Drax (South Dorset) (Con)
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The Minister is being incredibly generous. Can I clear up something for the travel industry and the airline industry? There is an SI on travel restrictions, not least PCR tests on day two, as I understand it. They are not being debated today. Why not and when will they be?

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Maggie Throup Portrait Maggie Throup
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Today, we are debating some travel restrictions about self-isolation, but the other restrictions are covered by different legislation and therefore they are not relevant to this debate.

Andrew Murrison Portrait Dr Andrew Murrison (South West Wiltshire) (Con)
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The Minister mentioned hand hygiene. Is she aware of a study published in The BMJ on 20 November that showed that hand hygiene was as effective as mask wearing? Does she agree that anything we do here needs to be firmly evidence-based? Can she say why we have focused on mask wearing in the regulations and not, for example, if our aim is to improve public health, mandating for alcohol gels in hospitality venues?

Maggie Throup Portrait Maggie Throup
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My right hon. Friend, with his medical background, makes a good point that I will take away and look into further.

I will return to my speech. Accordingly, our scientists are investigating omicron to determine, among other things, how quickly it is likely to spread and what the impact may be on the immunity that many of us have acquired through vaccination.

Maggie Throup Portrait Maggie Throup
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I must make some progress.

Vicky Foxcroft Portrait Vicky Foxcroft
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It is on that point.

Maggie Throup Portrait Maggie Throup
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I give way to the hon. Lady.

Vicky Foxcroft Portrait Vicky Foxcroft
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I thank the Minister for giving way. On the point of immunity, many people who are immunosuppressed are extremely worried. I have asked the Secretary of State on several occasions whether he will consider doing antibody testing so that those people have some idea whether they have any protection or they need to adjust things in their working lives.

Maggie Throup Portrait Maggie Throup
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I have heard the hon. Lady talk about that before and I take the point seriously. It is partly about antibodies and partly about T cells; the science behind it is obviously quite complex. I will take that point away and get back to her.

William Wragg Portrait Mr Wragg
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I will give way once more and then I must make progress.

William Wragg Portrait Mr Wragg
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My hon. Friend is the kindest of Ministers. On the question of the new variant’s severity, I wonder if she has data to hand about whether any of the new cases of omicron in this country that she mentioned have been detected in patients hospitalised with covid.

Maggie Throup Portrait Maggie Throup
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I am not aware of that, and it may not be in the public domain due to confidentiality. I must make some progress.

Meanwhile, the Government have responded quickly to introduce a temporary and targeted package of precautionary measures to combat the risk of transmission. The aim of the package is to buy our scientists time to investigate and gather information on the omicron variant, and to continue to build the protection that vaccination provides.

The package comprises the requirement for people to wear face coverings in shops, shopping centres and transport hubs, and on public transport; the requirement for those returning from abroad to take a PCR test by day two and to quarantine until they receive a negative PCR test; the requirement for people to self-isolate if they are identified as a close contact of a confirmed or suspected case of the omicron variant; the addition of 10 countries to the red list; and the requirement that those arriving from those countries in Africa quarantine in a managed quarantine service for 10 days.

Across England, at 4 o’clock this morning, face coverings became mandatory in all shops and shopping centres, which includes supermarkets, banks and close-contact services such as hairdressers, and on public transport.

None Portrait Several hon. Members rose—
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Maggie Throup Portrait Maggie Throup
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I must continue.

They became mandatory in transport hubs, including taxis and private hire vehicles. From the same time, close contacts with confirmed or suspected cases of the covid-19 omicron variant will be legally required to self-isolate. These measures will remain in place until the end of the day on Monday 20 December. By this point, we will review the measures to see whether they remain necessary. We do not wish to keep any measures of this nature in place any longer than is absolutely necessary. However, these measures are an important step in the fight against the virus, particularly while we wait to discover the full implications of the threat from omicron.

Clive Betts Portrait Mr Clive Betts (Sheffield South East) (Lab)
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The word “mandatory” was used but is that not just a word in the statutory instrument? In practice is it not unenforceable? As Darren Pearce, the manager of Meadowhall shopping centre, said in evidence to the Housing, Communities and Local Government Committee, “The biggest problem we had last time was about trying to get face coverings to be worn. I saw a group of young people going to Meadowhall, saying very loudly, ‘If they ask you, just say you’ve got asthma.’ Then they say, ‘We’ve got asthma. We’re exempt’, and there is nothing anyone can do, is there?” That causes all sorts of tensions with the shop assistants and with other people wearing face masks, who feel that some people are getting away with it. What is the Minister going to do about that situation?

Maggie Throup Portrait Maggie Throup
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I find it quite intriguing that the Labour party has been calling for this measure for some time and, now we are introducing it, it is unhappy about it.

Daisy Cooper Portrait Daisy Cooper (St Albans) (LD)
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I must make some progress.

In July, when we lifted most of the remaining restrictions at step 4 across England, we made it clear that our response to the pandemic was not over. The vaccination programme continues to be a huge success and vaccines remain the most important weapon in our fight against the virus. However, as we enter this uncertain time, we must do more and we must do it quickly.

Mark Harper Portrait Mr Harper
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Will the Minister give way on the timing?

Maggie Throup Portrait Maggie Throup
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I know I keep saying I will take one last intervention, but I give way.

Mark Harper Portrait Mr Harper
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I am very grateful. I listened carefully to what the Minister said about the timing. The Government have said that they are going to review these measures after three weeks and she is right—on the face masks, the regulations expire on 20 December—but the self-isolation SI has no expiry date, which means it will run all the way until the main statutory instrument expires on 24 March 2022. Why is that?

Maggie Throup Portrait Maggie Throup
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My right hon. Friend makes a very good point. I would like to reassure him that we will continue to update the House over the next few weeks, that we will not continue to have these regulations in place for any longer than is necessary, and that—[Interruption.] If I may just finish. The type of regulations he is referring to are reviewed under legislation every four weeks and are more likely to be reviewed every three weeks. I understand his point and I do take it very seriously. I wish we were not in a situation where we have this conflict, but I reassure him that I take his point very seriously and these measures will not be in place for any longer than is absolutely necessary.

Maggie Throup Portrait Maggie Throup
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I give way to the hon. Lady, who has been trying to intervene.

Daisy Cooper Portrait Daisy Cooper
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I am grateful to the Minister for giving way. The hon. Member for Sheffield South East (Mr Betts) raised a question about the enforcement of mask wearing. One of the major problems being faced by GPs in my constituency of St Albans is that some people are refusing to wear masks because, “The Prime Minister didn’t have to when he went to a hospital”, so could I ask the Minister how she intends to lead by example when half of her own colleagues are still refusing to wear masks on the Benches opposite?

Maggie Throup Portrait Maggie Throup
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As I said earlier, we are mandating the use of face coverings. I think we are in a different situation now with regards to that.

Andrew Murrison Portrait Dr Murrison
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I will allow one more intervention and then I will move on.

Andrew Murrison Portrait Dr Murrison
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The Minister is really being most generous and I thank her very much indeed. Our right hon. Friend the Member for Forest of Dean (Mr Harper) is absolutely right and I fear that, inadvertently, she has not given the fullest answer that she might have done to this. The fact is that motion 3 on the Order Paper expires on 20 December, yet motion 4 expires on 24 March 2022. Can she explain the logicality of that? I also observe that, given the extraordinary restriction on liberty that this potentially offers, most Members of this House would be more than delighted to return after the House rises for the Christmas recess in order to reaffirm our support for the measures that she has put before the House today.

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Maggie Throup Portrait Maggie Throup
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I have listened to my right hon. Friend very carefully, as I did to my right hon. Friend the Member for Forest of Dean (Mr Harper), and I reiterate that we will not keep these measures in place for a day longer than we need to.

Karl McCartney Portrait Karl MᶜCartney (Lincoln) (Con)
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On that point, will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I must make progress.

Given the potential severity of the consequences of not responding swiftly to this new variant, the Government have taken decisive action to bring back compulsory face-covering wearing in an array of settings. Face coverings are again compulsory in shops and on public transport, unless an individual has a medical exemption or a reasonable excuse.

Rachael Maskell Portrait Rachael Maskell
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On that point—

Maggie Throup Portrait Maggie Throup
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I will continue.

The requirement to wear face coverings is not new. We have asked people to do their bit to stop the spread of the virus before, so we are again asking people to play their part, this time to help slow down any transmission of this new variant of concern.

Clive Betts Portrait Mr Betts
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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No, I must make progress. I have been very generous with my time up until now.

However, anyone who has an age, health or disability reason for not wearing a face covering need not wear one, and they need not provide proof of their exemption. The Scientific Advisory Group for Emergencies has found that face coverings are likely to reduce transmission through all routes by partially reducing the emissions of and exposure to the full range of aerosols and droplets that carry the virus. This includes those that remain airborne and those that deposit on surfaces.

None Portrait Several hon. Members rose—
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Maggie Throup Portrait Maggie Throup
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I must make progress.

Scientific evidence also shows that all types of face coverings are to some extent effective in reducing the transmission of covid-19 in all settings. This is through a combination of source control, which limits the spread of the virus from a person, and protection to the wearer. Laboratory data shows that even non-medical masks, such as cloth masks made of two or three layers, may have similar filtration efficiency to surgical masks. As ever, we are guided by the advice of our scientific and medical experts. We will keep these measures under review, and we will take further action if necessary.

Clive Betts Portrait Mr Betts
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Will the Minister give way on the point of exemptions?

Maggie Throup Portrait Maggie Throup
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No, I must make progress.

The self-isolation regulations were introduced to provide a legal requirement to self-isolate for individuals who have been notified that they have tested positive for covid-19 or that they are a close contact of a positive case. On 16 August, thanks to the success of the vaccine roll-out, we were able to introduce a number of exemptions to self-isolation for close contacts, including for those who are fully vaccinated or under the age of 18 years old. Given the greater threat that may be posed by the omicron variant, we have reviewed the application of these exemptions. This latest amendment to the self-isolation regulations is targeted at helping to slow its spread. From 4 am today, all individuals notified by NHS Test and Trace or a public health official that they are a close contact of a confirmed or suspected case of the covid-19 omicron variant are legally required to self-isolate for a period of 10 days, regardless of their age or vaccination status.

Mark Harper Portrait Mr Harper
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Will the Minister give way on that one point?

Maggie Throup Portrait Maggie Throup
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No; I have been very generous up until now.

Anyone who has been notified as testing positive for covid-19, regardless of the variant, will continue to be legally required to self-isolate. We appreciate that self-isolation is not easy and that it places a burden on people, but we also know that it is highly effective in limiting the spread of the virus. The Canna model estimated the impact of testing—

Mark Harper Portrait Mr Harper
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I really must make progress.

The model estimated the impact of testing and tracing and self-isolation on covid-19 transmission from June 2020 to April 2021. During the period of the study, the model found that testing, tracing and self-isolation had a critical impact on identifying cases of covid-19 and reducing onward transmission. The model found that between 1.2 million and 2 million infections have been directly prevented as a result. Additional assistance is available to those who are being required to self-isolate through the range of financial and practical support measures that the Government have put in place.

I am confident that these two sets of regulations represent proportionate precautionary and targeted action in the face of the new covid-19 variant, the risk of which we still do not yet fully understand. [Interruption.]

None Portrait Several hon. Members rose—
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Lindsay Hoyle Portrait Mr Speaker
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Order. In fairness, I think the Minister has been very generous with her time, and I would say that I am sure we have some capacity to get more speakers in if they so require.

Maggie Throup Portrait Maggie Throup
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Together, the impacts of these regulations should combine to help slow down the spread of the omicron variant and give us valuable time to assess how effective our vaccines are as a shield against this new variant. We are committed to reviewing these measures in three weeks’ time, when further scientific analysis should help us determine whether they are still needed, or whether they need to be extended or strengthened to support us in our wider fight against covid-19. I hope colleagues will join me in supporting these regulations, and I commend them to the House.

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Steve Brine Portrait Steve Brine
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I do accept that, and I also accept that the scientists who discovered the variant said on the media at the weekend that this was often a less serious disease than the delta variant. However, notwithstanding the point that I have just made about the people whom it has affected in South Africa—younger, unvaccinated people—given that numbers are so small in this country, I fail to see how we will be any the wiser in three weeks’ time. That may explain why the isolation regulations will apply until next March. Perhaps the Minister can enlighten me, through an intervention now or in winding up the debate.

Finally, let me return to the situation in my constituency. I have raised this matter twice in the House. This morning I spoke to the Winchester City primary care network, which is responsible for some 62,000 people who are on its roll. PCN patients will be contacted if they are in one of the Joint Committee on Vaccination and Immunisation’s groups 1 to 9, if they are clinically extremely vulnerable or if they are over 50, and will have been offered a booster. The PCN expects that process to be complete by 17 December, and by the middle of January it will start to offer the booster to others. From that date onwards the booster will be offered to those aged 18 and over, following the welcome announcement from the Secretary of State during his statement yesterday.

Many of my constituents do not live in the area covered by the Winchester City PCN, but have access to vaccinations at the Badger Farm community centre. If they consult the NHS website, they are offered the opportunity to go to Salisbury, Portsmouth or Southampton. That is not easy access to the booster. In my constituency there is no easy walk-in access to it, and I am inundated by questions from constituents about why they cannot have such easy access in Winchester today. The difference between what is being said on television and by Ministers from the Dispatch Box and the reality of the access available on the frontline is growing, and it is a problem.

Steve Brine Portrait Steve Brine
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I know that the Minister has been looking into the matter for me. We have not teed this up, Mr Deputy Speaker, but she is kindly going to intervene.

Maggie Throup Portrait Maggie Throup
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I want to reassure my hon. Friend. I heard what he said yesterday, and I have asked my office to look into it further. I will get back to him as soon as I can.

Steve Brine Portrait Steve Brine
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I greatly appreciate that. The Minister is a good friend, and I know she is sincere. This morning I sent her some correspondence between me and the head of the new integrated care system in Hampshire, where we are trying to make progress with this. If “boosterism” works—in the context of covid-19 and this variant, which is where it probably does work—that will be all to the good, but let us get those boosters, and let us make it easy for people to get them.

I will end by reiterating that I am ambivalent about the face coverings regulations, but the isolation regulations concern me greatly. I am concerned about the timing and the conclusion of their application, and about their chilling effect, and unless I hear a very good answer to my question about the definition of “suspected”, I will not support them today.

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Maggie Throup Portrait Maggie Throup
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I am pleased to bring this wide-ranging debate to a close. We are now almost two years on from when this virus first emerged in Wuhan. Since then, science and disease have been locked in a battle for ascendancy. For the last year, science has been on top as the global effort on vaccines has dramatically reduced the risk of hospitalisation and death for those who catch covid-19, but we know from the history of previous diseases that they mutate and change, so that vaccinations and treatments become less effective. That is why only one disease, smallpox, has been eradicated, although we are close to eliminating polio, too.

The virus is fighting back, and we must respond. To those who say that the regulations we have debated—the reintroduction of face coverings in some settings and self-isolation requirements for close contacts—are an imposition on our liberties, I agree, but they are a necessary imposition to slow the spread of a new variant and allow science to catch up. However, there is a balance to be struck. Too many restrictions have a crippling effect on social and economic life, as well as adding to the burden of mental illness. For those who say that the regulations we have debated are not enough, I say that they will buy us time to understand this new variant better. That is why they will be reviewed in three weeks’ time.

We will continue to closely monitor all the emerging data on the new variant. We have committed to review all of the measures in three weeks’ time, ahead of the face coverings regulations expiring. Restrictions will not be in place any longer than necessary. We do need to learn to live with this virus, but it is right, in the face of a potential threat, to take balanced and proportionate measures, and we will continue to closely monitor all the emerging data on the new variant. Overall, I would like to reiterate that this will be a moving picture over the coming weeks. We will get a better idea of its nature in the next couple of weeks. Its transmission advantage, vaccine escape and severity of infection are some of the things we are looking at as we observe how the variant develops in southern Africa and the rest of the world, too. Alongside that, the scientists will continue to study it in the lab, but it will be several weeks before we get a clear picture. The most important thing is that the world keeps sharing information and findings as new cases emerge. I thank my hon. Friend the Member for Christchurch (Sir Christopher Chope) for raising an inconsistency in our explanatory memorandum at paragraph 12.3. For clarity, I will read out the section as it was intended:

“Furthermore, the policy will be supported by a communications campaign that will make clear that some people are exempt from these regulations and people should not be challenged by members of the public for not wearing the face regulation.”

I trust that that reassures my hon. Friend on the matter and on the seriousness with which the Government take supporting those who are exempt from these requirements. I will be working with officials to rectify this.

With respect to omicron-positive cases, NHS Test and Trace will work with the positive case and/or their parent to identify close contacts. Contacts from a school setting will only be traced by NHS Test and Trace where the positive case and/or their parents specifically identify the individual as being a close contact. There is likely to be a small number of individuals who will be most at risk of contracting covid-19 due to the nature of the close contact. I reiterate that the direct contact will be by NHS Test and Trace, rather than via the covid app.

My hon. Friend the Member for Winchester (Steve Brine) and my right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about suspected cases. My right hon. Friend hit the nail on the head: many of the laboratories processing the PCR tests will be able to test for the S-gene dropout and that will give a very good indication of cases of the omicron variant. While it does not provide 100% confirmation, we can get that information very quickly and at the same time the test result is reported and that is ahead of any genomic sequencing.

Mark Harper Portrait Mr Harper
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I want to continue as many points have been raised and I was very generous in giving way when opening the debate.

A debate on this subject would not be complete without the Opposition spokesman asking about financial support for those in self-isolation. I reassure the Opposition spokesman that anyone who is legally required to self-isolate as a contact or positive case will be able to apply for a test and trace support payment or practical support such as the medicines delivery service if they meet the normal eligibility criteria. The latest figures show that almost 363,000 people have received a test and trace payment since the scheme began, and over £180 million has been paid out. The help is there.

We have set out proportionate and balanced measures which do not include limiting socialising. It is the Government who set policy and guidance, which is what the public should follow. The Secretary of State updated the House yesterday on the changes to the JCVI guidance for boosters and the NHS will be issuing instructions on how that guidance should be operationalised shortly.

These regulations are precautionary and proportionate, helping to safeguard the gains made by our fantastic vaccination programme, which has seen almost 18 million people across the UK get a booster jab already. The Government have acted rapidly and reasonably to ensure that science retains the upper hand in the struggle with the virus and I commend these SIs to the House.

Question put.

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15:48

Division 123

Ayes: 434


Conservative: 268
Labour: 156
Liberal Democrat: 6
Democratic Unionist Party: 2
Green Party: 1

Noes: 23


Conservative: 19
Democratic Unionist Party: 3

Resolved,
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16:04

Division 124

Ayes: 431


Conservative: 259
Labour: 160
Liberal Democrat: 6
Green Party: 1
Democratic Unionist Party: 1

Noes: 36


Conservative: 32
Democratic Unionist Party: 3