Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Wednesday 15th December 2021

(5 months, 1 week ago)

Lords Chamber
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Motion to Approve
11:07
Moved by
Lord Kamall Portrait Lord Kamall
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That the Regulations laid before the House on 13 December be approved.

Relevant document: Instrument not yet reported by the Joint Committee on Statutory Instruments

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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My Lords, I beg to move that the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021 be approved and shall also be moving the Health Protection (Coronavirus, Wearing of Face Coverings) (England) (Amendment) Regulations 2021 and the Health Protection (Coronavirus, Restrictions) (Entry to Venues and Events) (England) Regulations 2021.

Despite our progress so far and our investment in treatments, the omicron variant has been designated a variant of concern and so we must act now, as quickly as possible, to slow its spread. The UK Health Security Agency predicts that omicron will become the dominant strain within one to two weeks across the whole country. In response, the UK’s four Chief Medical Officers have raised the Covid alert level to 4, its second-highest level.

Although we do not yet have a complete picture of omicron’s severity, it has become increasingly clear that omicron is growing much faster than the previous delta variant and is spreading rapidly all around the world, so its higher transmissibility means it still threatens to overwhelm the NHS. We are seeing increased transmission rates reflected currently in case rates, and the current doubling time for omicron cases is now between two and three days. We need to act now to help slow the spread of the variant and reduce the chances of the NHS coming under unsustainable pressure, while buying time to deliver more boosters.

On 8 December, the Government announced that it was now necessary to implement plan B measures in England in response to the risks of the omicron variant. This includes: extending regulations on face coverings to make them mandatory in most indoor public settings from 10 December; asking those who can work from home to do so from 13 December; and making vaccine or test certification mandatory for entry to certain venues and events from this morning.

Today, we are debating the regulations that bring about the legal requirements for face coverings and certification. These regulations are sunsetted or due to expire on 26 January 2022, but they will be reviewed by the Government in early January. We are also debating regulations that bring important changes to self-isolation requirements to enable fully vaccinated contacts to take part in daily contact testing.

From 10 December, face coverings have been mandatory in most indoor public spaces in England. However, they are not required in hospitality settings such as cafés, restaurants and pubs, or in nightclubs. Exemptions apply—including for children aged under 11 and for those unable to wear a face covering for health or disability reasons. Evidence from the UK Health Security Agency respiratory evidence panel suggests that all types of face covering are, to some extent, effective in reducing transmission.

From today, showing the NHS Covid pass is mandatory as a condition of entry to certain settings in England. This is not a vaccination passport, and people will have different ways to show that they are eligible. Negative test results provide some assurance that an individual is not infectious when the test is taken and for a short time afterwards.

There is evidence to suggest that vaccination reduces the likelihood of infection or transmission to a small degree with delta, which continues to circulate. Early evidence suggests that vaccine effectiveness against symptomatic infection after two doses is significantly lower against omicron than against delta. Nevertheless, a moderate to high vaccine effectiveness is seen in the early period after a booster dose. Vaccine effectiveness is also likely to be higher in preventing severe, rather than mild, disease, and it continues to be vital in response to the high levels of delta cases that continue to circulate.

Covid status can also be shown through proof of a negative test taken in the previous 48 hours, which demonstrates that you are less likely to be infectious, as well as proof of medical exemption or evidence of participation in a clinical trial.

Certification will apply in a limited number of settings, including venues acting like nightclubs; indoor events with 500 or more attendees likely to stand and move around; outdoor events with 4,000 or more attendees likely to stand and move around; and all events with more than 10,000 attendees. Vaccine or test certification will not eliminate the possibility of infectious people attending or transmitting the virus in these settings, but it will help to reduce the risks.

The test, trace and self-isolate system continues to be one of the key ways to control the virus and to protect our nation. Yesterday, the Government introduced a policy of daily testing for all fully vaccinated contacts of people who have tested positive for Covid-19. This will identify—or help to identify—the virus quickly and help to break chains of transmission without requiring large numbers of people to self-isolate. To support this, we have removed the requirement in the self-isolation regulations for all close contacts of suspected or confirmed omicron cases to self-isolate, regardless of their age or vaccination status. This was introduced as a temporary measure on 30 November. Unvaccinated adult contacts will continue to be legally required to self-isolate, unless they are participating in an approved workplace daily contact testing scheme. We will constantly monitor and review the data.

Lastly, let us all urge everyone who can have the vaccine to get boosted now. More than 24 million booster or third doses have already been administered across the UK. Our target is to offer this to every eligible adult in England by the end of December.

I thank everyone involved in the vaccination programme for their continued efforts to maintain this tremendous progress over the important weeks ahead. I understand that there are concerns among noble Lords across the House about these regulations. It is always a difficult balance and we hope we have got the balance right. I look forward to continued scrutiny by noble Lords and to their valuable contributions to this debate.

Lord Robathan Portrait Lord Robathan (Con)
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My Lords, I will start with a quote:

“It always suits Governments … to scarify the population.”


This was specifically about the ID cards Bill in 2005, when

“only a handful of principled Tories stuck up for liberty, and they were duly overwhelmed by the Government.”

The same person promised to “eat” his ID card if asked to show it to an official—so I expect that noble Lords will recognise the author of the quotes, who was then the Member of Parliament for Henley and editor of the Spectator.

Roosevelt famously said in his 1933 inaugural speech during the Depression—others had said it before—that

“the only thing we have to fear is fear itself”.

So what is going on? Why are the Government scarifying the population and stoking fear?

11:15
We know that omicron has caused far fewer deaths in South Africa than delta—in a country with only approximately 29% of its population vaccinated and a much less good health system than ours. On Monday, apparently, there were 11 Covid deaths in South Africa, down from a weekly average of 578 at the height of the delta variant infections.
Dr Coetzee, who identified the variant last month, said in a newspaper article yesterday that she was
“astonished by the extraordinary worldwide reaction in the days that followed, with Britain and some other European nations imposing heavy travel restrictions on flights from across southern Africa, as well as imposing tighter rules at home on mask-wearing, fines and extended quarantines.”
So could my noble friend tell the House, and indeed publish, what evidence the Government have that has led to these restrictions? For instance, how many deaths has omicron caused in this country? Yesterday we were told it was one, so could the Minister also tell us the age of that unfortunate, tragic patient, and whether they had underlying health conditions? Could he tell us how many people have been hospitalised and are in ICUs because of omicron? We were told—yesterday again—that there were 10 extra patients in hospital with the variant.
This appears to be—although God knows, I do not pretend to be an authority—a less dangerous variant: I have been told that viruses will mutate in this manner. So, as omicron replaces delta, surely that is a good thing. So why are we now restricting freedoms in this way?
The impact of these restrictions includes, first, the immense damage to the economy, especially hospitality, the airline and travel industries and retail. The restrictions have led to the imposition of the highest tax burden for 70 years, and a debt burden that our children and grandchildren will spend decades paying off.
The second impact has been on our children’s and grandchildren’s education, from reception, delaying development and social skills, all the way to universities. Schools are already restricting children: I am told they are closing early for the holidays.
The third impact is isolation and loneliness. The latter particularly affects the elderly living alone, but the former is ghastly for children out of school. Yesterday another child murderer was convicted of killing her partner’s two year-old daughter. As in the case of that poor child, six year-old Arthur, it happened because of evil people—but social services have not been able to do their job properly because of lockdowns. Isolating children is madness.
The fourth impact is the consequences for mental health and the fifth is the impact on normal NHS work, with rocketing waiting lists and thousands of cancer referrals being delayed or missed. Some 5.8 million people were waiting for hospital care in September, which is the last month for which figures are available. The number of those waiting over a year for treatment has increased 237-fold in the last two years. Since April last year there have been more than 4 million fewer elective procedures. That sounds rather bland, but anyone who has been in agony waiting for a new hip will understand that it is not bland at all.
So could my noble friend tell the House what estimate the Government have made of the damage to the economy? Some reports suggest it may be between £2 billion and £4 billion per day. Is that true? How many schools have closed because of this new variant? How many children are now out of education? What estimate has Her Majesty’s Government made of the number of excess deaths because of untreated conditions since March last year?
The Prime Minister is apparently talking about another mandatory lockdown, yet we were repeatedly told that the excellent vaccine programme—for which I pay tribute to Kate Bingham and Nadhim Zahawi—would protect the nation and take us out of this nightmare. Of the two SIs against which I have put down amendments, one is about mandatory face masks and the other about Covid passports. I have asked before for a peer-reviewed, conclusive study or evidence that these flimsy face masks limit infection. Last year we were told by government advisers that they were pointless—by Patrick Vallance, Jenny Harris and Professor Van-Tam. The last said that there was
“no evidence that general wearing of face masks by the public who are well, affects the spread of the disease in our society.”
We were even warned that masks might “trap the virus” and cause people to breathe it in, so were not a good idea. Views have changed since then, but I would like to see the evidence that changed them. I say to my noble friend that, if shown reasonable proof, I will not press my amendment.
Many Ministers have spoken against Covid passports in the past. For instance, Nadhim Zahawi, when he was Vaccine Minister in September, said that they go
“against everything I believe in”.
That is a different matter. I ask, “Why?” To the lawyers I say, “Cui bono?” Yesterday, Chris Whitty said that vaccination does not prevent infection, so those with this passport can still spread the virus. What does it achieve, except to create a sense of crisis?
I can see from the SI that
“Plan B includes measures aimed at helping control transmission”,
but, according to the Chief Medical Officer, this will not, so will the Prime Minister eat his Covid passport, as he promised to eat his ID card? What exactly is the point of them, apart from further scaring people?
I suspect that isolating people through lockdown did slow down the spread of the virus, but it certainly has not contained it. According to official statistics, there have been some 10 million cases in the UK. My view is that there have probably been two or three times more, but we can certainly conclude that the virus has defeated the restrictions. Overseas, it is the same story. So, I ask my noble friend: do lockdowns work? The idea, of course, was borrowed from China. Has hand-sanitising worked? It has now largely been discredited. Has social distancing helped? The Government are being entirely illogical in their advice and policy. For instance, could my noble friend explain the logic of encouraging people to work from home, but saying that Christmas parties are fine?
The Opposition, from whom we will hear shortly, will say that we must go further. I am afraid that it is a trait of authoritarian parties and regimes, from both the left and the right, to want to cow and scare their populations and make them more compliant and manageable. I fear the Labour Party always wants more laws to tell people what to do, although some of us believe we should be free to make our own decisions. One might have thought that the Liberal Democrats would be more freedom-loving and liberal, but they disappoint, showing that the name really is an oxymoron. The Conservative Government should be worried when their opponents support them but their own parliamentarians do not. I fear that my long-standing scepticism has now been replaced by cynicism.
I started with the Prime Minister. Let me close with the Health Secretary, who said, not six months ago on his appointment in June, that we must
“restore our freedoms—freedoms that … no Government should ever wish to curtail”,
and that
“restrictions on our freedoms must come to an end.”—[Official Report, Commons, 28/6/21; cols. 45-46.]
On 3 July, he spoke of two challenges:
“The first is how we restore our freedoms and learn to live with coronavirus… The second is to tackle the NHS backlog—something that we know is going to get far worse before it gets better…
The economic arguments for opening up are well known, but for me, the health arguments are equally compelling. The pandemic has hit some groups disproportionately hard. Rules that we have had to put in place have caused a shocking rise in domestic violence and a terrible impact on so many people’s mental health.”
I agree.
Lord Cormack Portrait Lord Cormack (Con)
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If nobody else is going to get up, I will. My Lords, some of the things my noble friend said, I entirely agree with. There has been a very real degree of confusion. It is inexplicable to have a situation in which you are told not to go to your place of work, but do go to the office party. This confusion spreads like a cancer through a community—but we are here to debate something slightly different.

Yesterday in the other place, there was a massive majority in favour of the propositions before us. There is a very important constitutional issue here. This House is not the elected House. I believe fervently in it and have made that plain on innumerable occasions, and I believe that we have a real job to do, but when the elected House has given, by a massive majority, approval to certain orders dealing with the most important issue of the day, it would be ill advised for us to vote in a contrary direction.

While I admire my noble friend’s persistence—he certainly has not come new to this subject—I urge him, as the debate takes its course, to consider very carefully before he divides the House. There is clearly no doubt that there is a very real division in the Conservative Party, with the so-called libertarian wing. However, all these things have been oversimplified; the keynote of the debates has been hyperbole, which is not really very good for sensible parliamentary debating and democracy.

The fact that the Conservative Party is divided is common knowledge. I urge those who have not done so yet to read the main leader in today’s Times and a very penetrating article by our colleague, my noble friend Lord Finkelstein, also in the Times. I ask noble Lords please to read those articles and consider carefully what they say. We are at crisis point in this country when a large number, more than a hundred—99 voted and many abstained—of the governing party refuse to support the Government. That is a very serious matter.

However, an MP is an MP, no matter what constituency he or she sits for. Each Member of Parliament has a vote of equal value. Yesterday, as I said at the beginning, a massive majority of Members of the other place decided to support what the Government are proposing—a divided Government, yes, and the division in the Government is not caused, let us be honest, just by this subject. The appalling way in which the Owen Paterson affair was handled is indicative of a Government which have lost their grip.

My noble friend the former Chief Whip—he is an old friend—may be waving his hands at me; Chief Whips are important, but parliamentary democracy is even more important. I believe, as I said, that it would be ill advised for us to vote today against what the Government have proposed. We should not seek to contradict the other place but, with a degree of sadness perhaps, we should endorse it and certainly not divide the House.

Baroness Walmsley Portrait Baroness Walmsley (LD)
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My Lords, the Prime Minister has correctly pointed out that a “tidal wave” of the omicron Covid-19 virus is upon us. Yet the noble Lord, Lord Robathan, wants to do nothing. I do not agree with him. He wants to learn to live with the virus; most people do not want to have to learn to die with it.

There are three sets of regulations before us today. I will first deal with extending the mandatory wearing of face masks. We support it because face masks work. But who is monitoring or enforcing it? To give the Minister one example out of hundreds of thousands, on Monday one of my colleagues was travelling on an LNER train for two hours to come to your Lordships’ House—I must ask why we are here in person today—and only about 60% of the passengers were wearing masks and somebody behind her was coughing and spluttering for the whole two-hour journey. Nobody checked. This must be enforced.

The second set of regulations are on changing isolation rules for contacts of people testing positive. We support them but I have concerns about reported supply issues in self-administered lateral flow tests. People are just “strongly advised” to take tests for seven days after they have had contact. Will there be enough and will there be regular public information to remind people how important it is to take them? Will anyone check that they have done so?

11:30
Finally, on the regulations on restrictions on entry to crowded venues, something has to be done if people insist on entering crowded spaces for non-essential services at this dangerous time. However, this regulation is not good enough for preventing widespread transmission. Here is why: the purpose of these measures is to reduce transmission of the very contagious new omicron variant and avoid further pressure on the NHS if it produces serious disease, which we do not know yet. Measures should be based on the science. So what do we know? We are told that, to get into those venues, you can have had either two doses of the vaccine at some time or a lateral flow test within the previous 48 hours. Let us look at what those do.
When the vaccines were first administered, they gave good protection from disease within a few weeks, especially serious disease, and in some cases up to 90%. As the immunity waned over time, the boosters were developed, which now give around 75% protection to those who have them, and the NHS is doing a magnificent job getting them into people’s arms. But let us note that the regulations do not require a booster. However, a vaccinated person without a booster may now have immunity as low as 40%. Add to that the fact that we know they can still pick up the virus and pass it on to others even if they have no symptoms. Also add the fact that the scientists suspect the omicron variant might be able to avoid the vaccines most widely used in the UK, although, as I said, the booster gives good protection. However, they are not asking for proof of a booster.
On the other hand, we also know that the lateral flow tests are at least 80% accurate in detecting someone with the virus, crucially at the point when they are most contagious, and that includes the omicron variant. Let us remember that the regulation says that you can present proof either of two vaccinations, which could have been months ago, or of a lateral flow test within the previous 48 hours. I know which I would go for.
If the Government want proof of the Covid status of a person unwise enough to want to go into a crowded venue in the middle of a pandemic, why do they not insist on the widely available and 80% accurate lateral flow test rather than giving people the option of showing proof of a vaccine which may now be only 40% effective against the disease? Such people may have the virus and do not know about it, and they may pass it on to others in a crowd, whereas the person who shows a recent negative lateral flow test is highly likely not to be infected and can therefore not pass on the virus.
It’s a no-brainer. It has to be a negative lateral flow test only if we really want to reduce transmission among those who go to crowded events. I hope to persuade the Government this morning to do better. In my opinion, this regulation will not achieve its objective.
Lord Fowler Portrait Lord Fowler (CB)
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My Lords, perhaps I may intervene briefly as the last Secretary of State who had responsibility for a major epidemic, that of AIDS.

It is in no way exceptional that there should be profound differences in view among politicians and others of the way in which an epidemic or pandemic should be handled. In my day, we had chief constables openly attacking the patients and the Government. We had religious leaders, I regret to say, arguing that it was not a public health issue at all, but one of morality. We had Ministers, particularly Scottish Ministers, arguing that giving free needles to drug addicts was condoning crime, although there was absolutely no evidence that crime increased, and the example of our Government was followed worldwide. We had a Treasury which refused to provide extra resources for the pandemic.

Debate, controversy and difficulties on the way forward are absolutely nothing new in debates of this kind. The crucial question is: what advice do we follow? My view now, as then, is that we should follow the advice of the public health experts inside the Department of Health who work on these issues year after year, in particular the Chief Medical Officer. I pay particular tribute to my old CMO, Donald Acheson, and the new CMO, Chris Whitty. Chris Whitty and the Chief Scientific Adviser have done a remarkable job for this country over the last months and deserve full credit for that.

It is said that this is a question of freedom; obviously, I do not discount that argument, but surely the exercise of that freedom should not put others at risk. That seems to be a matter of common sense. It should not lead to infection being spread or hospitals having to prioritise which patients they treat because some have decided to remain unvaccinated and then become dangerously ill.

As is evident, after my spell on the Woolsack, I am now a Cross-Bencher, so I am not an automatic or whipped supporter of the Government—I am not whipped at all. My days as Conservative Party chairman are behind me—noble Lords might be very grateful for that—and no more than noble Lords in the Labour Party do I automatically follow the lead of the Government Front Bench. However, I must say that I think their case is totally overwhelming. The success of the national vaccination programme has moved us ahead in the race to get people vaccinated in this country and worldwide but, with the new omicron variant, we have to work even harder to stay ahead. That is the lesson of the whole thing.

Last week, we learned two things about this variant. The first is that no variant of Covid-19 has spread this fast—if you want a definition of an emergency or a need for action, surely that is not a bad one. We expect the numbers to increase dramatically in the days and weeks ahead. I do not think that is seriously disputed by anybody so, again, this is an argument for action. As the Prime Minister said—for once, his language is not over the top—

“there is a tidal wave of omicron coming”.

That seems to be the view of the public health experts as well. We know that a third or booster dose provides strong protection, with analysis from the UK Health Security Agency showing that a third dose is 70% effective at preventing symptomatic infection. We expect the booster to take effect more quickly than the second dose. Again, I would have thought that this should provide an incentive to us to do what is not just the best thing in terms of public health but the right thing, as I would term it—and action is the right thing.

What I really wished to say to this House in the few minutes that I have spoken is that we should do our utmost as a House and a Parliament to appear united. It seems it is not the best day to make that case or plea, after the rather dismal vote in the House of Commons yesterday, but I hope that the House of Lords will give support to this struggle. Parliament consists of two Houses—a fact that seems to be conveniently forgotten by much of the media and the press—and this House can give a real lead as far as the handling of this pandemic is concerned.

Like the noble Lord, Lord Cormack, whose speech I enjoyed, I hope that the noble Lord who has proposed a series of amendments will not persist with them. The Government have far more support than I think they realise. Far more people outside this confined area of Parliament are signing up to the case that they are putting. Ministers should persist in their case and fight for it as strongly as they can.

Lord Rooker Portrait Lord Rooker (Lab)
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My Lords, I make two preliminary points before my main point. First, it would be quite contrary to the way in which this House works and to the conventions under which we operate to throw out secondary legislation. This is just not on. We do not do it, and it would be quite wrong to attempt to do so. Secondly, I follow up on what the noble Baroness, Lady Walmsley, who spoke for the Liberal Democrats said. As many other people have done, I tried to order lateral flow tests this morning. They are not available; you cannot order them. Every week for the past two months, I have succeeded in ordering them and the pack has arrived within a couple of days. The Minister must have an answer to this fundamental issue. Now, you cannot just walk into the chemist and collect them, or order them via a QR code, as you could do months ago—at 8.30 am today, it was not possible.

The Minister said that we are doing all this to protect people—which is true—and also to protect the NHS. I make no apology for asking why is it that we need to protect the NHS? It seems self-evident: we need to protect the NHS because it is incredibly vulnerable compared with how it was. In recent years, we have lost 17,000 beds, systematically and deliberately. Why?

I cite two or three examples from the recent NAO report on NHS backlogs pre pandemic. The OECD is the rich countries—or rather, the richer countries— of the world. In the context of the health systems within the OECD, the UK has fewer resources than many of the other rich countries. The UK has 2.4 hospital beds per 1,000 of the population. France has 5.8 and Belgium 5.5—and they are not the highest. Sweden has 2.1, which is less than the UK but, at 2.4, we are way down the list. With 8.5 nurses per 1,000 of the population, the UK is 11th on that list, whichever way you look at it. Ireland has 12.9; Germany 14; and France 11.1. This is all before the pandemic. The UK has three doctors per 1,000 of the population. Sweden has 4.3 and Spain has 4.4. They are not the highest; the highest is much greater. Finally, in 2019, we did 175 CT, MRI and PET examinations per 1,000 of the population. France did 332; Austria 349, and Belgium 313. In other words, the NHS has been deliberately run down since 2010. The other thing that has happened since 2010 is that life expectancy has stalled—read the Marmot reports. Why has life expectancy stalled since 2010? More people are dying earlier as a result of life expectancy stalling. There is something systematically wrong.

Of course, we need to carry these orders for public health reasons. I have no problem with that. I am 100% with the noble Lord, Lord Fowler. When it comes to protecting the NHS, we have to ask ourselves why it is so vulnerable. It is because we have lost out on doctors and nurses and because of the other issues that I have raised. It has been done systematically. I do not know why—a national policy has never been announced on that. We always talk about protecting the NHS. We need to ask why.

I hope that the noble Lord will not push this to a vote. He would be breaching the conventions of the way in which this House is run. I presume he is only pushing for a vote because he wants to win—you do not push for a vote if you do not want to win. Throwing out the regulations would breach the conventions and the elected House would be after us pretty damn quick—and rightly so.

11:45
Lord Hannan of Kingsclere Portrait Lord Hannan of Kingsclere (Con)
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My Lords, I envy the moral certainty of some of the loudest voices on both sides of this debate. As the noble Lord, Lord Fowler, just explained, it is bound to be an issue on which there is a range of strong opinions. The only opinion that I really discount is glibness, in particular a facile imputation of base motives to the other side. It is absurd to argue either that the proponents of these measures are engaged in some plot to create an authoritarian panopticon state or that their opponents are all lunatic conspiracy theorists. We are debating the most basic question of politics, going back to Aristotelian theory: how do people live together while preserving the freedom of the individual?

The answer must hinge on whether these measures are proportionate. I say that very seriously. My noble friend the Minister makes a good argument to the effect that these measures were judiciously chosen to disrupt as little as possible, in the face of an identified threat. It would be silly to dismiss the claim that we try to slow things up while increasing the opportunity for people to get a booster jab. But I keep coming back to one question: why would that logic not now apply to every future variant or, indeed, to every disease as yet unencountered by our doctors? Are we in danger of permanently tilting the balance, so that we have pre-emptive stay-at-home orders or other restrictions, on the off-chance, every time there is something that may or may not turn out to be a severe public health risk?

It is here that we have to make our stand. Over the last 18 months, what has most alarmed me is a reversal in the burden of proof. When proposing to take away people’s elemental freedoms, the onus must be on the proponents of change to prove their case. It is not for defenders of the status quo ante, defenders of our traditional freedoms, to show why restrictions are not necessary. I am not sure that has happened in this case. Even if it has, how are we not opening the door to the same reasoning in future, so that we have a see-saw of constant lockdowns or other bans and restrictions, every time something happens, just to be on the safe side? That would be a fundamental alteration in the relationship between state and citizen.

As my noble friend Lord Cormack said, this was largely a Conservative Party debate in the other place. I tuned in and watched it: I saw 17 successive Conservative speakers, and that was not for a want of people from the other side or a bias in the Chair. The debate was largely confined to the government Benches and I do not see that as a bad thing. I am proud to be a member of a party that takes questions of personal freedom seriously. That is why I finish by saying that, on this or other issues, we must not reverse the way in which we normally determine guilt or innocence. We usually have a very high burden of proof before we confine people to house arrest and we should not lower that, either in this or in more general cases. Freedom should always be our default.

Baroness Hayman Portrait Baroness Hayman (CB)
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My Lords, I was interested in the comments we have just heard from the noble Lord, Lord Hannan of Kingsclere, and slightly surprised at how much of his speech I agreed with—in the sense that there is a danger from a constant stream of new variants, each provoking tactical responses in our own country. Therefore, I repeat the point I made yesterday at Question Time: it is in our national self-interest to ensure not only that people in this country are protected by vaccination but that people across the world are protected, because that will protect us in the future. It will stop us having these debates every two months, six months or year, ad infinitum.

The other point I will make in response to what the noble Lord said is that he is correct that we should not make this a debate between extreme positions, where you are either 100% right or 100% wrong. I am not 100% in favour of the detail of everything that is in these three SIs—but I am 100% sure that I am going to vote for them if the noble Lord, Lord Robathan, decides to divide the House.

There is a process by which we reach compromises and balances: between the threat to health from the virus and that of not having an NHS functioning as it normally does; or between the threats to mental health from the fear of contracting the virus and those from isolation—not being able to participate and work, and all those things. How we draw those balances is a very delicate exercise and it starts, as others have said, with medical and scientific advice. That must be the rock and the foundation, but of course there is a political dimension—a value weighing-up and a judgment to be made about the comparative harms and how we get our best way through.

I will make one last point about the dangers of an extremist position—and I think that the noble Lord, Lord Robathan, actually takes an extremist position. The danger comes when, after the advice, the Government’s view and their proposals, and then parliamentary scrutiny and challenge, to get it as right as we can on balance, there is a sense in the public that the political is playing too large a part; and that a Government—this Government—will actually be deterred from taking the action that they need, and are advised, to take, and which we need them to take to protect ourselves.

Other noble Lords will have seen the streams of responses to the email of the noble Lord, Lord Robathan, from people saying, “I’m sorry I can’t be there but I’m in bed with Covid”. On public confidence, let us face it: the current public adherence, on which we all depend, to the regulations before us will be damaged by the fear that they are not based fundamentally on the science but on fears of losing political support in the very narrow environment in which we operate. That would undermine public confidence. As others have said, it is absolutely vital that we go through this process with scientific advice, government recommendations and parliamentary scrutiny, and do the best that we can in those circumstances.

Lord Trefgarne Portrait Lord Trefgarne (Con)
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My Lords, I have had the privilege of being a Member of your Lordships’ House for a very long time. I was sitting on the Benches opposite back in 1977, when my late noble friend Lord Carrington, then Leader of the Opposition, and the late Earl Jellicoe moved the cancellation of sanctions on Rhodesia. That was a mistake, and it would be a mistake to vote down the regulations today.

Baroness Foster of Oxton Portrait Baroness Foster of Oxton (Con)
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My Lords, I saw a notice recently outside a restaurant. It read: “If you’d like to know how it feels to be in the hospitality sector during this Covid pandemic, just remember the ‘Titanic’ when it was sinking and the band played on.” Well, we are the band. Here we are, 21 months on, and it feels like we are going backwards.

Let us take a short trip down memory lane. Covid arrives, and it is March 2020. The Chinese authorities already knew that there was a problem several months before but did not decide to tell the WHO until the December—but there we are. So we go into lockdown. There are daily press conferences. There is new language: “Protect the NHS”, “Hands, face, space”, “Stay at home”, “We need to flatten the curve”. We needed to do that, but it would be for only a few weeks and it was for the greater good—quite right. “Go out once a day, but only for essential goods.” Spend hours queuing in Sainsbury’s car park, two metres apart, in the rain. “Close your businesses, do not travel, do not visit your neighbour, but it’s just for a short time.” “Don’t see your boyfriend—it’s for the greater good.” “We need to close all the schools.” “Teach your children from home.” “You won’t be able to see your loved ones in a care home, but that’s also for the greater good.” And we went with that, because it was for the greater good. But we are where we are now. Finally, it was: “You can’t see your GP if you’re ill. It is too dangerous.”

So what do we do next? We tried to comply. Of those who did not comply, some were arrested. They were arrested for sitting on a bench, having a cup of coffee. Perhaps they had already been out that day. But that was not the answer. Nevertheless, we looked ahead. I am nothing if not optimistic. There was a temporary release over summer, and, by autumn, it had started again. “But it’s okay; it’ll be fine for Christmas. The vaccines are coming, so please bear with us. It’s for the greater good.” And we did, and I am a huge supporter of the vaccine programme.

But families were still separated. Millions were home alone. Meanwhile, the economy went into freefall. Mental health issues have been raised. The number of suicides increased, and NHS waiting lists have grown and grown, with people becoming more and more ill. Then it arrived; it was the silver bullet, and it was such a relief. This vaccine programme has been fantastic; I am a huge supporter.

When the vaccine arrived we were told that, once we had got the over-70s jabbed, we would start to get back to normal. But then it was the over-60s. Then we had to wait for the over-50s, the over-40s and the over-20s. Then it was the 12 to 15s.

So, 21 months on, we were looking forward to Christmas again, but then the omicron variant arrived—talk about bad timing. “But don’t worry,” said the chairman of the South African Medical Association, Dr Angelique Coetzee, “you’re the most vaccinated country on the planet, the symptoms are mild and not one practitioner has prescribed oxygen.” But here we are. We feel as though we have been marched up the hill, as though we have taken one step forward and two steps back.

The headlines roared. Mainstream media have gone into overdrive. We have 10 cases and one death, but, as my noble friend asked, what were the causes? Did that person die of it, tragic though it is, or with it? We would like that information. There are approximately 10 cases a day. But we have also had the modelling figures. By April next year, we could have between 25,000 and 75,000 deaths, and 200,000 cases a day. They are the modelling figures, which sum up where we are. It is a very difficult situation. The question is: where will it end?

We cannot keep people in perpetual fear and we cannot knee-jerk from one day to the next. The hysteria is flooding the airwaves, and the consequences on the public are horrific. With a heavy heart, I find it difficult to support the Motions today, but I urge the Government to seriously rethink how we take this forward. I ask my noble friend to do that because, finally, coercion can never be the answer. Persuasion is much better. If we can have a frank and open discussion and hear arguments from both sides, that is how we will move forward.

12:00
Lord Bilimoria Portrait Lord Bilimoria (CB)
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My Lords, with plan B, while we have measures to keep the economy open, we have messages that have ended up closing much of it. There is fear and there are confusing messages, including the advice to work from home—just look at trains, buses and restaurants, which have seen a collapse in demand. We have to consider how necessary all this is, with a major South African study of 78,000 omicron cases showing that symptoms are significantly less severe than with the delta variant and that the vaccines still afford protection. There are many fewer hospitalisations and admissions to ICUs.

As president of the CBI, in July we produced a document called Living with the Virus. We are now updating it to Living with the Variants, in which we say that, if we follow these steps, there should be no necessity for a plan B or a plan C. First, there should be forward guidance to support businesses and organisations to adapt. We should prioritise mass testing over mass isolation or working from home. We should utilise all Covid-secure tools available to build employee and customer confidence. We must maximise our world-leading vaccine programme, of which we are all so proud—hats off to Kate Bingham and what she did. We should also use our antiviral programme as much as possible. We should prioritise border control so that we keep our country and economy open and, if there are restrictions, government support must move in lock-step with them.

If we follow these steps, there should be no need for a plan B or plan C. I am very proud that I was one of the first people in this country to call in August last year for lateral flow tests to be widely available. I am so glad that the Government eventually listened; they are very effective, as the noble Baroness, Lady Walmsley, said. Will the Minister confirm that the supply of lateral flow tests will be there and that they will be freely available—at the moment they are not even available—to businesses and the public until at least March next year, if not longer, as necessary?

Will he also confirm that the Government will put effort and urgency into the approval of antivirals? The best example I have is the Pfizer antiviral—tablets given for five days—which has shown in trials that it reduces hospitalisations and deaths by 89%. Can the MHRA approve drugs such as that as soon as possible? Can they be widely available, so that every GP has them and anyone, if they test positive and has symptoms, can take these tablets, which will lead to an 89% reduction in hospitalisations and deaths? That in itself could be “game over” for this wretched virus.

Can he also confirm that we will do everything possible to make sure that schools, colleges and universities are never shut again? Use daily lateral flow tests; do not have a bubble system or a million children isolating. It is completely unnecessary. The Oxford trial that took place between April and June last year proved that using lateral flow tests is the way forward, so that staff and students do not miss a single day of school. Can the Minister please assure us of that? Our children and parents have suffered so much. We should not let our children suffer any more.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, first of all, you will have heard me coughing—but I have done PCR and lateral flow tests and it is a chest infection. But I have found that coughing quite a bit is a way to get a seat on a train at the moment.

I have not prepared a speech, because I wanted to listen to the debate and see what happened. The most powerful speech so far has been that of the noble Lord, Lord Fowler. Let us be clear: political philosophy is not a tool that you use to deal with a health crisis. You have to listen to public health advice and the people who collectively advise the Government on that public health advice. There will of course be outliers—that is the nature of science—but SAGE is the body which brings scientists together to have those discussions and come to the best collective view on what is in the best interests of keeping people safe. This is not a political discussion about freedom or trying to say that you are the purest freedom fighter of all. I have to say to the noble Lord, Lord Robathan, that political jibes about other parties’ philosophies are not what is required to bring about a safe and stable approach to keeping this country safe.

The clear issue in this is about test, trace and isolate. Those are the three pillars of public health policy, which will not end infection but will mitigate transmission by taking out as many chains of transmission as possible while people are infectious. The concept is as simple as that, but it is difficult in practice—and that is what government policy should be about.

This virus has shown itself to be complex. It mutates, which means that, at times, emergency legislation will be required—and because of this variant, emergency legislation is required. The Minister will know that I have been sceptical about some of the statutory instruments and whether they are an abuse of parliamentary procedure—I think some of them have been. However, these regulations are required in an emergency. We are talking about 2 million people potentially being affected by the end of next week, and it only takes a small proportion of those to be hospitalised to cause great damage to the NHS. The backlogs and the pressures on cancer treatment are because the health service cannot cope—not just with coronavirus but with the effects of the everyday procedures it needs to carry out.

I declare an interest: I am a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust. It would be interesting to know whether those who have talked about the pressures on the health service have actually been to talk to the staff who are dealing with this, who are psychologically, as well as physically, drained. They are drained from the wave of difficulty that they have had to deal with, not just with coronavirus but the pressures of having to deal with people with ongoing problems and acute procedures. This wave is coming and it will mean that, yet again, more people will end up in intensive care and more people will die.

What can we do to try to minimise that? We test, we trace and we isolate. I have heard arguments that this is about the economy or public health, but it is not that binary; they affect each other. If you have 5 million to 6 million people infected, it affects the economy and it affects the NHS’s ability to cope with this. We have to go back to what the experts are saying and to these regulations: test, trace and isolate.

There are a couple of issues that I want to raise with the Minister, because I am a bit perplexed. I have no view that he is deliberately trying not to introduce test, trace and isolate procedures, but some of the things are contradictory and do not lead up to that approach.

The issue of self-isolation is about taking out chains of transmission, so that people are not circulating when they are most infected. But on the reduction of self-isolation and the use of lateral flow tests, paragraph 7.6 of the Explanatory Memorandum states:

“Close contacts of positive cases will be advised (but not required by the regulations as amended) to take daily tests for up to 7 days”.


That means that people are not required to test and to isolate, and there will be no tracing. What is the effect of that? I ask the Minister why it is not mandatory to test and upload those results, so test, trace and isolate can kick in. It seems to be a fundamental flaw in these regulations that people who have been in contact with somebody with Covid, and in particular with this most virulent strain, are told not to isolate and also not to test. If the key to public health is to test, trace and isolate, and we are taking out isolation and testing, how do we trace, particularly as we are told that the R rate could potentially be 3—so every person who is infected could infect another three people? This is a fundamental flaw, so will the Government look at this as a matter of urgency? It is vital.

I continue on some of the issues raised by my noble friend Lady Walmsley about the effectiveness of Covid certification. This is a chocolate teapot approach; it is not going to work. The reason for that has been laid out. If I have not had the booster, I may still have my certification and will be able to show it—but it could have been 10 or 11 months since I was vaccinated if this continues until March. That will mean I am 40% protected going into a large venue where I may actually infect people. The way to do this is a lateral flow test at the point of entry. That would not be 100% effective—nothing is in this type of pandemic—but it would be a damn sight more effective than relying on certification that is out of date, does not require a third dose and actually means that you are putting more people at risk of getting and spreading this than you would be if there was a lateral flow test on entry. Again, I urge the Government to look at this.

Finally, on the wearing of face coverings, lots of studies can be quoted but most come down to this fact: the argument is not about whether they are effective, apart from certain outliers that have not been peer-reviewed, but the extent to which they actually reduce transmission. In this case, where we are talking about numbers doubling every two days and up to 1 million or 2 million people being infected a week, it is important to do everything possible to minimise transmission, as part of a systematic approach. That is why face coverings are important.

Just as important as wearing them is who will enforce the wearing of them. It is unfair to leave it solely to private enterprise to deal with, so what is the enforcement regime? My noble friend Lady Walmsley referred to our noble friend Lady Pinnock and, similarly, I came down on an East Midlands train on Monday. I had to ask six people to put on their face coverings. One was quite verbally violent towards me. I was not doing it to be difficult; I was trying to protect people in that carriage. The evidence is that we wear masks not to protect ourselves but to try to stop the spread of a disease that could kill somebody—and I do not know who it will kill. Who is going to enforce? So I will not be voting for the amendment tabled by the noble Lord, Lord Robathan, on face coverings.

I might vote for the noble Lord’s amendment on certification simply because, for me, it is not a political issue but a practical one about whether certificates will work, because I think lateral flow tests will. Generally, I want this debate not to be about who is the purest of all in upholding a political philosophy. I want it to be about listening to SAGE and the collective view of scientists, and about doing everything possible to follow the public health view of test, trace and isolate, and trying to keep as many people as safe as possible and reducing the risk of death and serious illness to people in this country.

12:15
Lord Sterling of Plaistow Portrait Lord Sterling of Plaistow (Con)
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My Lords, I suggest that, if it were not for omicron, we would not be sitting here today. It is only because of omicron that we are all debating this. I have to say this. Could the messages have been better? Yes. Could the NHS have been better prepared? Possibly. But that does not matter. I completely support what my dear noble friend Lord Fowler said.

Decisions have to be made and I will finish on this point. The sooner we are able to be free—truly free—I want the opportunity for us all to get everybody back to creating wealth in this country, because that will be the real challenge before us. Unless we manage to do it, the rest, sadly, will become unnecessary.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I commend the 126 MPs in the other place who voted on their principles and conscience, despite heavy whipping, in yesterday’s rebellion. They formed an ad hoc Official Opposition while the formal Official Opposition did their—what did Keir Starmer call it?—“patriotic duty” in not opposing but endorsing every single one of the Government’s proposals.

Despite having previously opposed vaccine passports, now renamed by Ministers—as though that were convincing—and despite all the talk of preventing the NHS toppling over and lauding NHS workers as heroes, Labour voted for discriminatory employment practices and the brute force of job losses to coerce NHS staff into complying with a medical intervention or getting sacked.

In every wing of the Conservative Party there was a significant minority of MPs who, despite personal appeals from the Prime Minister, defied the Whip—and that means something important that this House might note.

This legislation has already been passed, so detailed scrutiny of each aspect of it is largely formal, with little meaning, but there are broader issues worth raising. One is trust. I am concerned that the Government’s response to omicron is eating away at trust in political institutions, and objective statistics and data have been misused recently, with examples of regular contradictions and different figures coming from Ministers with quick contradictions afterwards. We worry about misinformation on the web, but there has been a fair amount of it from official sources.

Also, can we remind ourselves that the Prime Minister, Boris Johnson, declared an “irreversible” road map out of lockdown? But that irreversible moment has now screeched to a halt and is reversing at rapid speed. Then we get shrill warnings that the UK is facing a “tidal wave” of omicron. Is that a bit like “one minute to midnight”? I am worried that there is overhype and too much hyperbole.

This is all in the real context that 95% of the population have antibodies. There has been a phenomenally successful vaccine take-up and, in the real-world international evidence—not speculative modelling—we are thankfully shown that, while this variant is highly transmissible, it is not as yet seen as a widespread, lethal threat by medics and scientists. And hyping up the potential threat can do real damage in other ways. If everything is an emergency, nothing is an emergency, and there is always a danger in crying wolf.

The speed of omicron is not the only danger. More worrying is the dangerous speed with which the Government immediately have recourse to invasive restrictions. This is no longer a last resort. It is almost the first policy idea at which they grab. It is not based on weighing up the broad social pros and cons. We are not presented with a detailed cost-benefit analysis; it is deployed just in case there is a worst-case scenario. There is always a hint of worse to come. It might be vaccine passports now, but in the new year there will be three-dose vaccine passports.

The Prime Minister offered a rare opportunity for a national debate. I was quite excited. A national debate is sorely needed on the whole question of the balance of risk and the priorities which society wants to take. But, no, the Prime Minister’s offer of a national debate was to discuss mandatory vaccination, of all things.

This Government have made national sovereignty a byword and sovereignty something which people understand. I remind them that this direction of travel is in danger of trashing the Enlightenment ideals of individual sovereignty and bodily autonomy. John Locke’s A Letter Concerning Toleration says,

“no man can be forced to be … healthful”

Vaccine passes are not inconvenient or a bother. I have one in my bag in the unlikely event that I might go to a nightclub. What does it mean? Most people will say, “I do not know what the fuss is about”, but there are far greater implications. Everyone’s freedom is limited if the state determines that it is contingent on accepting a medical treatment or providing medical information, or on a submission to public health priorities above all else. It is limited if we need a licence to go about our lives freely.

The noble Lord, Lord Scriven, has asked us to put our political philosophies to one side, as though noble Lords are raising matters of principle as if we are in some sort of sixth-form debating chamber. I understand that this is a caricatured view. If society is to be completely reorganised around public health, and dangerous, illiberal principles are to be set, debate should at least be encouraged. I should have thought that liberals and democrats—as in Liberal Democrats—might be quite keen on that kind of a debate.

I quote from a new document which the Government has brought forward in the last few days. It is a modern Bill of Rights. In the foreword, we are told,

“The United Kingdom has a long, proud, and diverse history of freedom. This stretches from Magna Carta in 1215”.


It then details all the proud freedom movements. It continues,

“Our proposals, which form the basis of this consultation, reflect the Government’s enduring commitment to liberty under the rule of law.”


What is the point of having documents declaring a commitment to liberty under the rule of law if liberty can be so easily dispensed with in the name of public health?

State power works. Of course it does. You can scare and threaten people into changing their behaviour, but is that what we want in our society? Many of my extended family have disagreed with my more liberal views on this question, throughout this pandemic, and have been enthusiastic adherents of lockdown. At the moment, they are not so much scared of the virus as of the next government press conference. They have become cynical about a lot of what they are being told. They are fearful that their way of life is being disrupted, rather than being immediately frightened of death.

In a recent pamphlet, Toxic Sociality: Reflections on a Pandemic, Josie Appleton makes the point that every pandemic has a social dynamic, as well as an epidemiological cause which structures the way the disease is seen and responded to. In many ways, my extended family has noticed that there is more to life than epidemiology. There has been a period when they have been able to meet publicly and socially to discuss what kind of priorities they want. It is important not to dismiss that social side. It seems to me that one clear and present danger is that social cohesion is now threatened by the kind of messaging that we are getting around the virus. Human interaction is presented as a contagion. All the unregulated examples of free conviviality and spontaneous social gatherings, such as going to a nightclub without showing a pass, are presented as toxic. Free association is being replaced by state-authorised association.

We are encouraged to view the unvaccinated as “the other”, as lesser, to be excluded from aspects of society and employment and discriminated against—not there to be encouraged or persuaded into the vaccine, but threatened. This is not making a positive case for the wonders of the vaccine and it promises to backfire.

The noble Lord, Lord Fowler, made a point about what he considered to be the role of this House. I thought that its role was to scrutinise and be critical. I hope that in the new year this House gives a lead, not just by going along with whatever we are told but by asking questions and potentially prioritising the importance of a free society, without having to apologise for it.

Lord Thomas of Gresford Portrait Lord Thomas of Gresford (LD)
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My Lords, it is only about eight miles from Buckley to Gresford, but I must say that the distance between me and the noble Baroness, Lady Fox, is infinite given the views that she takes.

I want to put a personal note into this debate. Within the last two years, I have undergone a course of chemotherapy, which destroyed my immunity to disease, according to the experts. I was told a fortnight ago that I should have another booster in addition to the booster that I have already had—in other words, four jabs altogether for me. But I come here. I am sure that the noble Lord, Lord Robathan, will approve of my coming here in answer to the Writ of Summons to contribute, to try to play a part and go on as though nothing has happened. But I come here because I rely on the common sense and collegiate responsibility of my colleagues in this place, of the doorkeepers and of the staff, and of all the people here who are doing their best to protect us.

I can tell your Lordships that it is a matter of concern to me when I see, on the opposite Benches, people who are proud not to wear something but of not wearing a mask. That makes me feel unsafe. I am sure that I am not the only person here with a compromised immunity—there must be others—who come here to try to carry on, but this is only one workplace. There are workplaces throughout this country where people are trying to carry on. They need leadership; they need confidence that the advice they receive from this House, from the other place and from the Government is soundly based on the best medical science that can be brought to bear. That science tells us that we should protect ourselves and wear masks, not just for ourselves but for the people whom we move among when we travel here—referred to by my noble friend Lord Scriven —or are going about this place.

We are protecting not just ourselves by wearing a mask but everybody else, and I do not understand a philosophy which permits people to say, “I am above all this.” “Freedom!” is the great cry. That is rubbish. I shall oppose the noble Lord, Lord Robathan, if he puts his amendment to a vote, but I plead with him to think of people like me with a compromised immunity who are trying to carry on, and to withdraw that amendment.

12:30
Lord Dobbs Portrait Lord Dobbs (Con)
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My Lords, I shall try to be very brief. First, I want to thank my noble friend the Minister. He arrived in his job at a particularly difficult time. There has been turmoil, but he does his job with great sensitivity. I hope he will excuse me if I in any way ruffle his collar today. He said that we do not yet have a complete picture of the latest variant. That is absolutely the case and I want to press him on it a little. I find it difficult to simply accept that we must follow the science. What is the science? Science is not God and scientists are not messiahs. There are some pretty inadequate scientists, as well as some very gifted ones. Our job is to listen and learn, not simply follow blindly.

I have tried to listen carefully through this debate and many others, but I still do not understand the difference between a passport and a mandatory certificate—I hope the Minister will forgive me. I have been asking for a debate on passports. This is a very difficult issue which you can see from many different sides, but it is central to this policy. I have been asking for that debate ever since the start of the pandemic but we still have not had one. I still do not understand why all these new regulations have come in just days after we abandoned the red list on international travel, but there are many things that do not necessarily fit together easily in these difficult times.

There are many costs associated with any policy, no matter how well intentioned it might be. One cost I think we will be discussing for many years to come is the impact of these policies on the mental health of this nation, particularly the younger population. I wonder whether the Minister has looked at the increase in self- harm among young people or the number of attempted suicides. This is a real issue, yet we do not have impact assessments on any of these things—this is the debate we had yesterday. The Government are not doing enough to keep us informed or to allow us to debate the many issues associated with this pandemic.

I will ask the Minister three brief questions about the tidal wave that we are now experiencing. Of course, we want to be properly prepared for contingencies and cannot wait until we have answers to all the questions before we act. However, could we be told how many deaths have so far occurred from omicron in this country? I would have thought that an important, fundamental building block of any policy. Of those deaths, did the person die from omicron or simply with it? That is a very important distinction. Were those deaths of people who had been vaccinated or were they the unvaccinated? I do not know the answers to these questions and that certainly affects the way I would make up my mind about this policy. We need to know these basic figures.

As we have just heard, Covid has the capacity to ruin lives, but our reaction to it also has that capacity. We must seek a proper balance, rather than simply going blindly down the road of saying “This is the science; we must therefore do this without any debate at all”. I am grateful to my noble friend Lord Robathan for raising these issues today, because we need to debate them. If I were in his position, I suggest that I would not push this to a vote. However, he has done us a service in allowing us to discuss issues which would not otherwise have been properly discussed. We have been in pandemic circumstances for almost two years and too many outstanding questions have still not yet been answered. I hope that, through impact assessments and other means, the Government will make even more effort to answer the questions that we need to have answered.

Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP)
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My Lords, as an aside, I begin with a reflection on how this debate illustrates how outdated our political frames and the arrangement of our political furniture are, with the idea that we have two sides of politics. That clearly does not reflect the way our politics is operating now. I must respond to the noble Lord, Lord Dobbs, who asked how many deaths there have been from omicron; he appears to have learned nothing from the past two years about the exponential spread of viruses and the delay between infection, hospitalisation and death.

I caught the No. 29 bus down this morning. I saw, as I have seen pretty well throughout the last two years, the public in advance of where the Government thought they might be. The bus was largely empty. Everyone on it was wearing a mask properly. I was seeking to speak after the noble Lord, Lord Thomas of Gresford, because I wanted to say how honoured I would have been to do so and to express my respect for his presence and speech today. It is an utter rebuttal to the claim of the noble Lord, Lord Robathan, that we are all free to make our own decisions. None of us is free to choose whether or not to breathe. We all have to breathe the air in this Chamber and wherever we go.

That brings me to the first of my two points. We could be debating some very different SIs today, ones based on both the science and a response I had from the noble Lord, Lord Bethell, in July, when he was sitting where the Minister is now. The noble Lord said then that

“ventilation is critical—but it is also challenging.”—[Official Report, 21/7/21; col. 335.]

Instead of these SIs, we could be debating SIs that allowed for an emergency scheme for entertainment premises—concert halls and theatres—to have on the door, as restaurants do for food health, a rating for ventilation. People would be able to choose which venues they went into based on the real measure of risk that they presented. We could see another SI that would have an emergency programme, as the National Education Union has for many months been calling for, of installation in schools of not just carbon dioxide meters but ventilation and filtration systems. We are seeing isolated trials popping up, but not those things.

However, we cannot see emergency SIs such as those because such long-term schemes would take many months to implement. But they are long-term schemes that should have been implemented many months ago. I turn to a British Medical Journal editorial from July, which says that

“workplaces, healthcare facilities and education providers”

must

“pay greater attention to the cleanliness of the air”.

This editorial was written by world-leading microbiologists and engineers.

Over the past two years we have seen a public who have done amazing things, shown an amazing grasp of reality and adapted their behaviour accordingly. Sadly, we have seen a Government which have not lived up to their responsibilities and have been totally focused on one prong of defence—vaccination. I absolutely support and agree with the huge drive for vaccination, like many Members of your Lordships’ House; my booster is booked for next Monday. I am holding out for that and hoping to survive until that point.

I turn to the other SI, on vaccine passports. The noble Baroness, Lady Walmsley, and the noble Lord, Lord Scriven, made some very powerful points about the medical faults in this. I will pick up another concern, which I raised yesterday when we were talking about vaccination for deployment in health and care. If we send a message to people that vaccination is something that we have to force them to do, it risks building resistance and being counterproductive. We want to get to a situation where every person for whom it is medically possible is vaccinated, and has chosen to be. That requires a fairly large ask—trust in the Government—but above all it requires a programme of education and outreach, which we have clearly not seen nearly enough of.

In the other place, the Green MP Caroline Lucas, while expressing great reluctance, voted with those opposing the vaccine passport SI before us. I must admit I feel rather torn at the moment, because I think the SI is dangerous and counterproductive, but I feel extremely uncomfortable with people making different arguments grouped in the same space, so I have not quite decided what to do. But I want to see a Government allowing people to keep themselves safe by taking on what the noble Lord, Lord Bethell, accepted was crucial in July, which is ventilation.

I also pick up the point from the noble Baroness, Lady Hayman, on global scale. No one is safe until everyone is safe. The Government are not doing nearly enough to get vaccines around the world, so we will see more risks. In picking up on how people can keep themselves safe, whatever the Government pass, we will see people not going to entertainment venues and rearranging their lives. That means that people and businesses will need public support, on which I agree with the noble Lord, Lord Blencathra. We also need people to be able to keep other people safe, which means proper and full sickness payments when they have to self-isolate, as they should.

Lord Birt Portrait Lord Birt (CB)
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My Lords, this is overwhelmingly a public health issue and, at heart, not a complex one. We all agree that we should constrain our freedoms only for a good reason. Not drinking and driving at the same time would be a good reason. The good reason here is the overwhelming nature of the scientific advice. I have participated, as have many of your Lordships, in the briefings we have had from all the leading scientists who advise the Government. The airwaves are full of professors who know their stuff and who also advise, and there is a real scientific consensus about the problem we face.

It is simple at heart: this particular variant of the virus is much more transmissible than any variant we have seen before, and the scientists are clear that they do not yet know how severe its symptoms will be. We can all be hopeful; there is some evidence from South Africa that the symptoms are mild, but the scientists tell us not to jump to conclusions, because you cannot easily translate the South African experience to our own. Its population is far younger and has hitherto been much more infected by other forms of the virus. We cannot assume that what has happened in South Africa will happen here.

We have used the word “exponential”; it is a powerful word. It means, as the scientific modelling has demonstrated, that the numbers double every few days. You do not need more than O-level maths to know that, after not many days, you get to a very large number indeed. If the symptoms turn out to be severe, the combination of those large numbers and more severe symptoms would be devastating and the NHS would be overwhelmed. That is why this action is prudential. It is not definitive, but is prudential and entirely justified. I support the Government.

Lord Bishop of Leeds Portrait The Lord Bishop of Leeds
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My Lords, in one sense I hesitate to contribute to this debate, which has been very interesting for lots of reasons. We sit in a Chamber where we contribute to the making of law, which is precisely about the infringement of people’s freedoms—that is what law is—so I struggle with the arguments about freedom. Yesterday or the day before we talked about infringing people’s freedoms regarding the right to protest, for example. I hope to hear the same arguments about the importance of freedom when we get to some of those very restrictive debates.

12:45
There are two issues here that we must not confuse. One is the public health issue and the demands of that; I hear everything that has been said about good scientists and bad scientists, and I totally agree that science is not God and scientists are not messiahs—noble Lords would expect me to say that anyway—but our job is to interpret the science with a view to then taking responsible decisions on behalf of other people. Like the noble Lord, Lord Thomas of Gresford, and his immuno- compromised situation, my wife up in Leeds is immuno- compromised because of radical chemotherapy for cancer at the moment. I had to think very carefully about whether I should come down here, and I question how it will be when I go back.
There is the public health issue, but we have heard in the last couple of days, from all sides of the House, remonstrations about the culture in which we are now exercising our responsibilities, with language such as “government contempt” for parliamentary process and so on. I question why we are still hearing announcements on television, rather than announcements being made in Parliament, subject to scrutiny and debate, on matters of such public importance. However, this is not the first time, and to protest about it in this respect is to beg the question why we have not protested about it in respect of other legislation where the same criteria do not seem to apply. I agree with the noble Baroness, Lady Fox, about the erosion of trust, but this has not caused the erosion of trust. What we are dealing with now plays into a pool in which we swim, in which trust has been eroded over time by a scratching away of what we might consider the conventions and norms of our parliamentary democracy.
The question I want to put to the Minister comes back to something that—I apologise, I cannot remember who used the language earlier—was said about the difference between tactics and strategy. Strategy is the plumbing that gets us towards the end that we want to achieve. What we seem to be seeing at the moment are reactive tactical decisions, which are not subject to the normal scrutiny that we would expect in this place. What is the strategy in which the tactics make some coherent sense? That can be determined only when we articulate what the end is that the strategy is intended to achieve.
I fear that I have not added anything new to this debate, but I think that we need to be clear about some of the issues that I have raised.
Lord Davies of Brixton Portrait Lord Davies of Brixton (Lab)
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My Lords, I have three points. First, I was struck that the noble Lord, Lord Robathan, introduced his speech by referring to the scarifying effect of the debate in the Commons yesterday. Subsequently he went on—as have other speakers—to try to scare us about these regulations. It has been, to a large extent, a scare story about these proposed regulations. In truth, they are oh-so limited in their extent. It is quite possible that we might have to introduce stronger restrictions, so what we are being scared about is a slippery slope, that sooner or later these regulations will lead to an oppressive state. Well, they do not—they are just keeping us a little bit safer.

Secondly, on the idea that omicron is milder, we do not yet know that it is milder in the UK context. What we do know is that it is much more invasive. It will infect many more people. Even if it is milder—which we do not yet know—a milder effect on a much larger number may place a heavier burden on the health service. There is even the perverse, non-intuitive effect that a milder disease could place a heavier burden on the health service because, sad though it is to say, if people do not die so quickly of this disease, they will be in hospital for longer.

Thirdly, the debate on vaccine passports has been mentioned. I do not quite understand what people are saying, because I already have a vaccine passport—I guess that the great majority of people in this Chamber have one. I have used my vaccine passport. These regulations are saying that, in certain circumstances, that is one way of showing that there are good odds of you not being as infectious. I agree that there is a slippery slope here—I am totally against ID cards—but this information is already contained in the vaccine passports. The regulations are about how they should be used.

Baroness Garden of Frognal Portrait The Deputy Speaker (Baroness Garden of Frognal) (LD)
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My Lords, I am getting indications from the Chief Whip that we should move to the winding Front-Benchers. The noble Baroness, Lady Brinton, will be speaking remotely. I invite her to speak for the Liberal Democrats.

Baroness Brinton Portrait Baroness Brinton (LD) [V]
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My Lords, I declare my interest as a chair of the All-Party Group on Coronavirus. I thank the Minister for his speech on the three SIs before your Lordships’ House today.

Plan B was published four months ago. It was absolutely evident, first from the Secretary of State for Health’s announcement on Friday and then from the Prime Minister’s speech on Sunday, that no real planning has been going on behind the scenes in the department. Before we get into the practical consequences of these regulations, from these Benches we want once again to join in the strongest objection to the slack way in which the regulations and the Explanatory Memoranda are written.

The right reverend Prelate was right to say that we accept that late legislation may need to be written at pace, but this is communication at its worst and, of course, it cannot go through the usual scrutiny from the Secondary Legislation Scrutiny Committee and others. This goes hand in hand with Ministers’ messaging to the wider public, from the Prime Minister down. All because he is worried about certain parts of his party, he has once again announced mitigations too late, which inevitably result in further restrictions and in omicron being allowed to move really fast through our society.

The noble Lord, Lord Hannan, said that he worries this will be the case with every new variant we go through. That has not been the reality so far. What is different about omicron is how quickly transmission has doubled, which, by the way, without mitigations, will have an effect on the economy, because businesses are already seeing staff go off sick. If we have 2 million people with omicron by the end of the year, and that continues to increase at the same doubling rate every two days, we will find that the economy, schools, societies, our GP surgeries, ambulances and hospitals struggle even more than they are now. On Tuesday, at the All-Party Group on Coronavirus, one GP said to us that, on the previous day, every single doctor in her practice had tested positive. That meant that there were no doctors available to work, other than by Zoom.

We are learning about omicron because it is very new to us. The evidence of its exponential growth so far is concerning. The noble Baroness, Lady Foster, said that not one patient in South Africa has had oxygen. This is not true. It is true that there are fewer people in hospital, but some have severe disease. The number of omicron critical care beds is going up. At the end of November, 291 people in hospital were on oxygen. Two weeks later, it is nearly 900. The numbers in ICU have also doubled. These figures are from the Covid dashboard on the Spectator website.

From all Benches, we have heard agreement with the Prime Minister’s confused lines in the sand—for example, face masks must be worn in shops, but not in pubs and restaurants. Even if omicron is less dangerous—by which I think the noble Lord, Lord Robathan, means that there are fewer people with severe disease—its key elements are higher transmission and the doubling of cases. If there are fewer hospital admissions per 100,000, the already beleaguered NHS will have to find many more hospital beds than were needed in January 2021. This is what the doctors are advising us.

The noble Lord, Lord Robathan, constantly repeats his mantra that the only deaths from Covid are in the over-80s or among those with underlying conditions. In a recent debate, he asked if anyone knew anyone under the age of 80 who had died. Last week, a dear friend died of Covid after just four days in hospital. She was much younger than I am. Another friend in his 40s, who had a lung transplant earlier this year, is back in ICU with Covid. He does not know where he caught it because he has been very careful. Is the noble Lord really saying that there should be no mitigations to keep the vulnerable safe? This is the consequence of removing all these mitigations.

My noble friend Lord Thomas of Gresford spoke movingly about his compromised immune system. I too am in this position, though for a different reason. My medical advice is not to come out at the moment.

The 800,000 clinically extremely vulnerable have not had one word of guidance in the last week. It is not good enough to say that shielding ended in July. This group is at high risk and needs advice. When will this be evidenced? I think that even the noble Lord, Lord Robathan, would recognise that some people are at high risk. Shame on the Government for not getting in touch with them at all.

Other noble Lords have spoken about those with long Covid, including children. On schools, we have been asking since last year for air filtration units in classrooms. This has only just happened in the last week. Until now, the Government have been talking about CO2 monitors, but the public health need in our schools is for air filtration units.

The first regulation is about self-isolation and moving to a daily lateral flow test. If it is negative, you can leave your isolation. We say that test and trace must remain the key defence in fighting Covid—particularly omicron—not least because of the somewhat reduced vaccine efficacy with this variant. The level of transmission of omicron is so high that this is a public health precaution. We disagree, therefore, with the fatal amendment laid by the noble Lord, Lord Robathan, which would remove this vital, basic, public health rule of self-isolation and testing.

The second SI on entry to venues and events creates a broader Covid pass, vaccine or test result, than the previously proposed vaccine pass. We have consistently opposed vaccine passports—first, for public health reasons. Importantly, vaccine passes give people a false sense of security, especially as it is possible to catch Covid and pass it on, even if you are double-jabbed. People cannot tell if their vaccine immunity is waning. We just do not like the reliance on that. We also do not want vaccine passports creeping in by the back door, as the noble Baroness, Lady Bennett, outlined. Our principal concern with this SI is about public health. This hotch-potch Covid pass is a muddle.

We agree with the use of lateral flow tests. They are highly accurate. Researchers from University College London found that they are more than 80% effective at detecting any level of Covid-19 infection. They are likely to be more than 90% effective at detecting who is most infectious when they use the test. None of us wants lockdown, particularly the noble Lord, Lord Robathan, and his colleagues, but I struggle to understand why those who do not want lockdown will not accept lateral flow tests as a mechanism to help reduce transmission.

We cannot support the noble Lord’s fatal amendment on the issue of flow tests, but we are deeply unhappy that the Government are relying on the vaccine element of the Covid pass at a time when we need to reduce transmission by the tried and tested test, trace and isolate system. So, if a vote is called, we will not support the Government’s proposals for Covid passes—although for very different reasons from those of the noble Lord, Lord Robathan.

13:00
The third SI, on the wearing of face coverings, expands the legal requirement to wear face coverings when in shops, on public transport or in transport hubs, banks, places of worship, public areas in hotels, hospitals and museums. But it does not extend face masks to hospitality and some other venues. My noble friend Lord Scriven has spoken on the need for face masks. He is absolutely right.
Liberal Democrats have consistently argued for the regular use of face masks, and for hand washing and social distancing. The WHO and our doctors and scientists still say that those three basic elements, along with test, trace and isolate, are absolutely key. This is particularly important with omicron, given how fast the number of cases is growing. So, although we want the Government to go further, we will support this SI.
There are rumours that further restrictions may come in. Can I ask the Minister whether Parliament will be recalled if further restrictions are put in place during Recess?
To conclude, the noble Lord, Lord Robathan, has argued that there is absolutely no evidence that face masks work at all, and his fatal amendment would remove the requirement for any face masks. While we would like masks in more places, we cannot vote for the removal of the requirement to wear masks, so we would vote against his fatal amendment. We believe that the noble Lord is wrong to say that this is an issue of freedom. With freedom come responsibilities to minimise spread and to keep all people safe, especially the most vulnerable. It is shameful that parts of the Government’s SIs do not do this.
But above all, I echo the comments of many Peers from all sides of the House that these SIs are chaotic and confusing—but parts of them are absolutely vital in our public health fight against Covid. The noble Lord, Lord Cormack is right that this House should not use the fatal amendment procedure, but we will continue to hold this Government to account.
Baroness Thornton Portrait Baroness Thornton (Lab)
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My Lords, this has been a proper House of Lords debate and I thank the Minister for introducing the regulations with such clarity. I need to declare an interest as a non-executive director of an NHS hospital.

I would like to start my remarks by quoting my honourable friend Wes Streeting, the shadow Secretary of State for Health and Social Care, who said yesterday that

“it should not be for me, as shadow Secretary of State, to point out”

to some Conservative MPs, following remarks made in the media in recent days,

“that we are not living in the 1930s and that the Secretary of State and his team are not Nazis.”—[Official Report, Commons, 14/12/21; col 954.]

It is sad that my honourable friend felt that he needed to say that. Our history is peppered with examples of where we required citizens to act in a way that served both their own self-interest and the interests of others. That does not make us a totalitarian state. I believe that the public are less outraged by the fact that some obligations are being placed on them than by the antics of those who blatantly and arrogantly imagine that the obligations do not apply to them.

On these Benches we will be supporting the Government today, as we did yesterday, and we will vote with the Government if the noble Lord, Lord Robathan, chooses to test the opinion of the House on either of the fatal amendments before us. Actually, the noble Lord said that these Benches would go further than the Motions before us. That is not true—but what is certainly true is that we have tended to be two or three weeks ahead of the Government. We have said “We think you need to do this, that or the other”—and I can testify to this, having been here for nearly two years, saying this —and the Government have said “No, no, no”, and two or three weeks later that is exactly what happens.

We will act in the national interest, as we have done throughout the pandemic, putting public health before party politics, by supporting the Motions under consideration now. Our task today—as it has been throughout the pandemic—is to consider what is best for the health of our nation and how to discharge our responsibility to protect our NHS.

The noble Lord, Lord Fowler, absolutely nailed it when he said that we had to listen to the CMO, the CSO, the other scientists and the public health experts, and follow the course of action that they were recommending. This was echoed by the noble Baroness, Lady Hayman, who said that we should be listening to the advice we are given. My noble friend Lord Davies put these regulations into proportion in terms of what they are seeking to achieve. There is no doubt that sacrifices have impacted on lives, livelihoods and liberties; that is why noble Lords need to scrutinise and question how the Government are dealing with this issue, or indeed mishandling it. I say to the noble Lord, Lord Robathan, and other noble Lords that we would be having this debate today whether or not he had put down his amendments.

On Sunday the Prime Minister made a totally unnecessary broadcast which served to panic people and create worry and confusion. Presumably he was trying to re-establish leadership credibility for himself, which clearly did not work with his own Conservative Benches. The broadcast was irresponsible in its lack of preparedness and clarity. As well as displeasing Mr Speaker, as the Prime Minister tends to do, it held Parliament in contempt yet again.

The lack of clarity is clear, for example, as NHS England and the Prime Minister have made conflicting promises on the booster rollout, leaving plans to deal with the rapid spread of omicron mired in chaos and confusion. On Sunday evening, the Prime Minister said:

“Everyone eligible aged 18 and over in England will have the chance to get their booster before the New Year.”


However, the NHS has promised a different target, pledging to offer all adults the chance to book a booster rather than receive one. Pressed on the conflicting advice, NHS England said:

“The NHS vaccination programme will offer every adult the chance to book a COVID-19 booster vaccine by the end of the year”.


Perhaps the Minister could clarify for the House which it is. If the Prime Minister has promised 1 million vaccinations a day, how is that supposed to be achieved?

I think it was even worse for local government than for the NHS. A local council leader in London, with a London-wide strategic role, said that 72 hours’ notice would have been helpful. It is not the need to up the vax and testing capability but the lack of planning—hence no tests, no testing ability and vaccinations not available. There was not one mention of local government in the Statement we heard on Monday. Had the relevant Government departments talked to local government, and when did they do that? It begs the question: did the NHS even know about Sunday’s statement before it was made?

We cannot yet be sure about the severity of the omicron variant, but we can be certain, as many noble Lords have said, that it is spreading faster than any other variant. Even if a smaller proportion of omicron victims are hospitalised, the rapid advance of the virus through the population could see large numbers of people admitted to hospital during the months in which the NHS is already under the greatest pressure. The winter months present pressures on the NHS in any normal year, and we know that this is far from a normal year.

The NHS is contending with winter pressures, a serious backlog, the delta variant and now this variant. Many of the challenges are understandable, given the unprecedented challenge of the Covid-19 pandemic, but we have got to be honest and acknowledge that confronting them has been made much harder because the country went into the pandemic with waiting lists already at 4.5 million, 100,000 NHS staff vacancies and a shortage of 112,000 staff in social care. My noble friend Lord Rooker was quite correct on that. We support the NHS and care services in the task they have been set. Let me say from these Benches to every NHS worker, every GP, every pharmacist, every public health official in local government, every member of the Armed Forces and every volunteer stepping up to meet this enormous task that we are with them 100% and thank them again.

The measures put forward for consideration today are an attempt to slow the spread of the virus, while trying to protect Christmas so that people can enjoy the festive season. They are about limiting interactions in the workplace, wearing face coverings in settings where the virus finds it easiest to spread, testing before we attend large indoor gatherings, and getting behind the booster rollout to ensure that everyone who can be protected is protected.

The goal in the end must be to learn to live with the virus. That means effective vaccination, antiviral treatments and public health measures that have a minimal impact on our lives, jobs and businesses. No one enjoys wearing a mask, but it is nothing compared with the costs that more draconian restrictions have for our lives, livelihoods and liberties. Masks are simply a price worth paying for our freedom to go out and live our lives during this pandemic.

On the introduction of a Covid pass for large indoor gatherings, the Labour Party argued against vaccine passports without the option of showing a negative test. Further, we argued that such passes should not be required for access to essential services. On both counts, I am pleased to say that the Government listened and amended the proposals, so we will support this measure today. I regret that colleagues on the Liberal Democrat Benches do not feel able to do so, but let me be clear: we in the Labour Party support Covid passes because we support British businesses. We want to give people the confidence to go out and about—to go to venues and to the theatre—despite the presence of this virus.

With passes and lateral flow tests, venues can operate at 100% capacity. Look at Italy, France and Denmark—countries with strict Covid rules. All have seen their retail and recreation sectors fare far better than those in the UK. However, for the passes to work, people must be able to access tests readily and easily. We cannot continue in this situation where tests are out of stock, so I ask the Minister whether this has been resolved or when it will be.

For months, we have called for workers to be given the flexibility to work from home and we support the guidance to work from home where possible. However, how does the Minister explain the contradiction that many noble Lords have asked about, which is why, at the same time, the Government are allowing them to go to Christmas parties? By limiting the interactions people have at work and by lowering infections, we hope to preserve their ability to go ahead with social events anyway.

Noble Lords have talked about ventilation in schools. We know that young people have borne the brunt of this pandemic, and we owe it to them and their education to support them and staff to make sure our schools are properly ventilated. The Christmas holidays seem to us to be an ideal time to get young people vaccinated. When does the Minister expect to know about this matter and share it with the House?

I hope this is my last contribution on Covid this year. I therefore end by wishing all noble Lords a safe and happy Christmas.

Lord Kamall Portrait Lord Kamall (Con)
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I start by thanking noble Lords for their valuable contributions to this debate. They showed the very best of debate in this place, in the range of views covered—some political, some scientific and some challenging the Government on constitutional issues. This demonstrates the importance of these discussions and I welcome all contributions, whether or not I agree with them. That is the purpose of debate and discussion.

I remind some of my noble friends behind me and other noble Lords why we have acted now and gone to plan B. We want to slow the spread of the virus, after looking at the replication rate; we want to buy time for more people, especially the older and more vulnerable, to get their booster dose; and we want to give our experts crucial time to gather and understand the data about omicron.

Noble Lords, and indeed noble friends, look at the experience of South Africa. As the noble Lord, Lord Birt, and others have said, its experience is different. It has a younger population, with an average age of about 29, when our average age is in the mid to high 40s. Given our experience at the beginning of the Covid pandemic, when a disproportionate number of older people died, surely it is right that we collect data to make sure that the most vulnerable people are safe before we go forward.

I turn to some specific points raised by noble Lords. As I said, my noble friend Lord Robathan asked about the data from Africa, which we will continue to monitor. We will monitor whether it is different or milder here.

The noble Baroness, Lady Bennett, mentioned the risk of exponential growth and I thank her for making that point. We do not want to see waiting times and patient numbers starting to overwhelm hospitals. By the time we had waited for exact data, it might be too late. The noble Lord, Lord Davies, rightly spoke about the limited data available. I assure the House that we will continue to review the data as it comes in.

13:15
As we have looked at the response, we have always tried to strike the right balance and act in a proportionate way. We have looked at the scientific evidence, including evidence from different scientists—they have not always agreed. We have looked at the differences within the health profession and at the concerns about lockdown and the effect of some of the restrictions on the mental health of our nation. We have also looked at the unintended consequences, including all the operations and diagnoses that have been delayed. I admit that it has been a difficult balance and that, whatever we do and whichever way we come down, we will always have critics—rightly so—but we have tried to get the balance right.
My noble friends Lord Robathan and Lady Foster raised concerns about the restrictions on social services, elective care, hospitality and the wider economy. Elective care recovery remains a priority and I have previously announced increased investment in tackling the backlog and waiting lists. As I have said previously, between 70% and 80% of those on waiting lists are waiting for diagnoses, rather than surgery. Of those waiting for surgery, about 80% do not need to stay overnight as their surgery can be completed without an overnight stay.
We need to protect our health service from the pressures caused by the new variant of Covid-19 and prioritise vaccinations and urgent appointments. My noble friend Lord Robathan and the noble Baroness, Lady Fox, asked why we are taking action now. On Sunday, the UK’s Chief Medical Officer increased the UK alert level from 3 to 4 because of the rise in cases and because the doubling rate is every couple of days. That is why it is right to act now, while we collect more data.
My noble friend Lord Dobbs asked several questions about cases of the omicron variant in the UK. While the number of hospitalisations and deaths from omicron may not seem troubling to some now in comparison with previous waves, the measures we have implemented to stem hospitalisations and deaths have been introduced to make sure that we do not overwhelm our health service.
The noble Lord, Lord Scriven, asked about the value of vaccine or test certification in the light of omicron. This is why it is so important that everyone gets boosted now and why my right honourable friend the Secretary of State set out that boosters will be included in the definition of a full course of vaccination once all adults have had the opportunity to get the jab. For now, the definition remains at two doses, but once a sufficient proportion of the population has had the booster vaccine, it will move to three. Vaccine effectiveness is likely to be higher for preventing severe rather than mild disease and, of course, it continues to be vital in relation to the high levels of delta cases which continue to circulate.
I say to the noble Baroness, Lady Fox, that certification is not a vaccine passport. We believe it is important that everyone has the option to access settings and that is why, alongside vaccination, a recent test from within 48 hours and medical or clinical trial exemptions will also be accepted.
My noble friend Lord Robathan asked about evidence on the effectiveness of face coverings. Evidence from the UK Health Security Agency respiratory evidence panel suggests that all types of face coverings are, to some extent, effective in reducing transmission of Covid-19, through a combination of source control and protection for the wearer. According to SAGE, face coverings are likely to reduce transmission through all routes by partially reducing the emission of and/or exposure to the full range of aerosols and droplets that carry the virus, including those that remain airborne and those that deposit on surfaces.
The noble Baroness, Lady Walmsley, and the noble Lord, Lord Scriven, raised the issue of compliance with regulations concerning face coverings. When face coverings were previously mandatory, our assessment showed that compliance was high. We are grateful for the public’s willingness to comply with the rules, which help to keep everybody safe, and expect similarly high levels of compliance as the public get used to these new requirements. Turning to enforcement, the police can enforce the law and issue fixed penalty notices. This includes the British Transport Police, who work and operate on the railways.
The noble Baroness, Lady Walmsley, also queried the value of certification. Introducing vaccine or test certification will help reduce risks in associated settings when compared with no intervention. It has been correctly stated that a negative test result provides some assurance that the individual is not infectious when the test is taken and for a short time afterwards. However, vaccine effectiveness is likely to be higher for preventing severe rather than mild disease for omicron and of course continues to be vital in response to the high level of delta cases.
The noble Baroness, Lady Walmsley, asked about compliance and enforcement of daily testing. I hear her concerns. To implement daily testing for contacts as quickly as possible, we have taken a pragmatic approach. As in all these things, we have once again to address a balance, but we strongly advise that people follow the advice to take daily lateral flow tests. Noble Lords will agree that most people will want to do the right thing to protect their loved ones and communities, with peer pressure from friends and family to help manage the pandemic so we can all live as normal a life as possible.
The noble Lord, Lord Bilimoria, rightly noted the importance of lateral flow tests in our pandemic response and the latest evidence of the efficacy of oral antivirals. The UK was the first country in the world to approve a Covid-19 antiviral; we are now also the first to begin rolling out oral antivirals in the community. UK patients have been receiving molnupiravir through a new national study called PANORAMIC, which opened on 8 December. I strongly encourage all eligible patients to sign up for this national study, to help the UK once again gather more data on how antivirals work in a predominantly vaccinated population.
The noble Baroness, Lady Walmsley, and the noble Lord, Lord Rooker, raised concerns about testing capacity in the face of increased demand. I reassure the House that there is no shortage of lateral flow tests. The issue has been one of distribution. I was in a meeting earlier this week with my right honourable friend the Secretary of State; he said that we have the numbers and the orders, we just have to make sure that we get them out everywhere. Everyone who needs a lateral flow test will be able to collect them at a local pharmacy, at some community sites and at some schools and colleges. Tests should become available for delivery every few hours. We are issuing record numbers of rapid test kits to people in zones across the country and are urgently working to expand our delivery capacity and improve distribution to the right places.
The noble Lord, Lord Rooker, my noble friend Lord Robathan and the noble Baroness, Lady Fox, asked what the Government are doing to protect the health service, not only in the context of Covid. The Government are committed to giving the NHS what it needs. In previous pronouncements in this place, I have gone into details on some of the investment into the new UK-wide health and social care levy, which provides £23 billion for the NHS, so I will not go into further detail on it here.
I echo the thanks of the noble Baroness, Lady Bennett, to the noble Lord, Lord Thomas, for his moving words and the importance of these measures in protecting the most vulnerable in our society. The noble Lord, Lord Fowler, spoke eloquently about the expertise of scientific advisers and their invaluable input throughout the pandemic, based on his own experience of championing treatments for AIDS over many years. I completely agree with the noble Lord and thank him for his advice. If he is ever tempted to jump back on to our Benches, he would be more than welcome—I am not sure I have done him any favours there.
The noble Baroness, Lady Hayman, spoke about the importance of this legislation given the balance between the threat posed by the virus and the threat to disruption of NHS services. I agree that we must balance these things; each of us may see that balance differently, and we must make a decision based on the balance of different factors. We will not all come to the same conclusions, but I hope noble Lords will acknowledge that we try our best to get the balance right—we may not always get it right, but we try.
I also thank noble Lords for their incisive, impassioned contributions to this and previous debates on other Covid-19 legislation. It would be remiss of me not to reply to the noble Baroness, Lady Brinton, on the immunosuppressed and shielding. The decision to end shielding was based on there being far more available information on the virus and what makes individuals more or less vulnerable. I hope I can give her and some of the charities we are talking to more information at our meeting tomorrow. I am grateful to Jonathan Van-Tam for making himself available for that meeting to discuss these issues, and I will make sure that noble Lords are aware of it.
On ventilation, as raised by the noble Baronesses, Lady Bennett, Lady Brinton and Lady Thornton, we have provided CO2 monitors to state-funded education settings. We continue to look at ventilation in education, from not only air units but open windows. However, we also understand, as many noble Lords have said, the pressures of lockdown and restrictions on children. We have seen an increase in mental health issues among the very youngest, as among those of many other ages. We understand that that is all part of the decision when getting the balance right.
A number of noble Lords spoke about freedom, including my noble friend Lord Hannan and the noble Baronesses, Lady Fox and Lady Hayman. With freedom comes responsibility. I shall be honest and say that I am someone who has been described as a libertarian or a classical liberal, and I quite often use the word “freedom”—but I have to ask a question of my noble friends who think that these measures impinge on their freedom. I believe that we should be allowed to do what we want as long as we do not impinge on the freedom or the rights of others, and do not engage in or advocate violence against individuals, their family or their property—but I fail to see what liberty is impinged on by the requirement to wear a mask. Is it the liberty for me to breathe on other people, and is it really such a bad thing if we impinge on that liberty?
So let us get away from the textbooks and look at it pragmatically. Let us get the balance right. I understand that many noble Lords will see some of the measures as impinging on freedom, but let us put this in context. Many noble Lords have spoken about freedom, but it does not include the right to spread the virus if you have it, and I hope that we all understand that with freedom comes responsibility.
I thank noble Lords for demonstrating the wisdom that exists right across this House and I hope that, despite the many reservations that have rightly been raised, they can support these measures today. I commend the regulations to the House.
Motion agreed.