Lord Newby (LD)
My Lords, I begin by expressing my support for the extraordinary work being done by NHS staff and all those—including pharmacies and volunteers—who are helping to make the booster programme such a success.
The decision to scrap the requirement for a PCR test following a positive lateral flow test clearly makes sense, given the delays which are regularly occurring both in sending out the PCR test and then in receiving the results of it. I know of cases where these waits have been of a week or longer, which has meant that they have not arrived until far too late to be of any use to the individuals concerned.
The new relaxed rules for travellers entering or re-entering the UK apply to those who are fully vaccinated, but this definition does not require people to have had the booster jab. Have the Government any plans to require a booster jab, not least to incentivise travellers to get the booster before they travel?
Despite the scale of the testing programme, there have been and remain serious delays in getting test kits to local pharmacies, schools and individuals. I repeat the question from the noble Baroness, Lady Smith, about the Government’s current assessment of the ability of the supply chain to deliver the number of tests to fulfil the Government’s own targets.
Despite the Government’s support for Operation Moonshot—do people remember that?—to create a domestic production capacity, only one British manufacturer is making kits which meet UK standards. Others, as the noble Baroness said, are making kits which pass EU standards but not our own, and as a result they are exporting all their kits. What plans do the Government have to expedite approval of further UK manufacturers and reduce our dependency on kits made almost exclusively in China?
Can the Leader assure us that the Prime Minister, in his efforts to remove as many restrictions as possible, is not considering following the strategy of the United States by reducing isolation to five days without two negative lateral flow tests? There is considerable evidence that many people shed significant amounts of virus on days six and seven and later, making them still contagious and a threat to public health, so making any reduction would be dangerous.
It is clear that hospitals and ambulance services are struggling at the moment, with 24 critical incidents already declared and people with a possible heart attack being advised to get a taxi or a lift to hospital. The NHS was clearly underresourced to cope with a pandemic such as this, not least due to its having lost thousands of beds over the past decade. Can the Leader say what assessment is being made of the resilience and ability of our health services to deal with future pandemics?
It is clear that there will be further disruption for many school pupils who have yet to catch up on their studies following the closures over the last 18 months. Will the Government therefore expedite the catch-up programme and start by providing every parent with a £30 catch-up voucher for every day their child misses school?
The Prime Minister repeated the government injunction yesterday for people to
“carry on working from home whenever they can”.
I fear that the Government are not supporting their own policy when it comes to your Lordships’ House. I accept that we can legislate really effectively only when we are here in person, but we know that we can vote effectively from home. Next week, we are asking people to take journeys on public transport of up to five hours and more to sit in an office, often not even in the Palace itself, simply to vote. This poses a potential threat to them and their families. It has been argued that reverting to virtual voting would pose a reputational risk to the House. I believe the opposite, and anecdotal evidence supports that view. I hope that the commission will look at this again as a matter of urgency and that the noble Baroness the Leader will now support this sensible change.
The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)
I thank the noble Lord and the noble Baroness for their comments. First, touching on the questions of the noble Baroness, Lady Smith, about our international efforts, she may well be aware that last week, we pledged a further £105 million of UK emergency aid to help vulnerable countries tackle the omicron variant by scaling up testing capacity, improving access to oxygen supplies and providing communities with hygiene advice and products. That builds on the £1.3 billion of UK aid already committed to the international health response, supporting vaccines, health systems and economic recovery in developing countries. I am delighted to say that we met our 2020-21 target of delivering more than 30 million vaccines to more than 30 countries as part of our pledge to donate 100 million doses to the world. This year, we will be donating millions more vaccines, including 20 million AstraZeneca doses and 20 million Janssen doses.
The noble Lord and noble Baroness both rightly asked about education, and of course there will be more detail in the further Statement later today, but we have delivered almost 3 million doses to children aged between 12 and 17 in England. We continue to work on increasing uptake, including through repeat offers, ensuring parental consent forms are translated into appropriate languages and collaborating with leading social media platforms to direct people to trusted sources of information. Obviously, we must make sure that where people can get vaccinated is clearly evidenced, and we are working with the education sector on that.
In relation to catch-up, the noble Lord is absolutely right. It is a priority, and always has been, to try to keep schools open, which is why we have been putting so much effort into that, and we are incredibly grateful to all the teachers and other staff in schools who have been helping to make that happen. We already announced £5 billion for education recovery, including £1.5 billion for tutoring, to provide up to 100 million tutoring hours for five to 19 year-olds by 2024, more than £800 million to fund 40 additional hours per student in 16 to 19 education and more than £950 million in flexible funding for schools to use how they see best. We are very cognisant of the need to ensure that young people do not suffer yet more during the pandemic, and we have a lot of work in place to do that.
The noble Baroness asked about antivirals, and I am pleased to say that we are leading in the number of antivirals bought per head of population in Europe. We are currently rolling out neutralising monoclonal antibodies and antiviral treatments for patients at highest risk of severe disease and hospitalisation, and up to 1.3 million patients could benefit if they are clinically eligible. We have a plan to personally communicate with those patients and make sure that they receive prioritised PCR test kits to ensure early access to treatment if they become ill. Antivirals are and will be playing an increasing role for us in coming to live with this virus, so I can certainly assure the noble Baroness that we are in the forefront of making sure we have access to the drugs, which are developing constantly, to help tackle Covid.
The noble Baroness asked about lateral flow tests for the 100,000 critical care workers. These kits will be sent directly to organisations, including those who work in critical national infrastructure, national security, transport and food distribution and processing. These are separate and in addition to the tests already allocated to our public services, and we will be working with those sectors on distribution; but, as I said, tests will be sent directly to those sectors.
Both the noble Lord and the noble Baroness asked about testing capacity. We are now delivering record numbers of lateral flow tests to pharmacies across England, with almost 8 million tests being made available this week alone. I can reassure the noble Lord and noble Baroness that we are tripling our supply of lateral flow tests in January and February from our pre-omicron plan of 100 million to 300 million a month. Of course, we will continue to review and work with the sector on where we can source tests to ensure we can meet the demand, which they rightly say is unprecedented. But this shows how conscientious the public are being in protecting themselves and their loved ones by testing regularly, and we are very grateful to everyone for everything they are doing to keep each other safe.
The noble Baroness asked about statutory sick pay. We have extended it to those who are self-isolating and made Covid-related SSP payable from day one, meaning that it could be up to 75% more generous for full-time employees who need to self-isolate. Statutory sick pay is £96.35 a week, and that remains the statutory minimum, but more than half of employees receive contractual sick pay from their employer. It should not be looked at in isolation. We have taken other measures through universal credit and employment support allowance, so we have been focused on and cognisant of the need to provide support for people. We have also provided the £500 test and trace support payment, which we have extended until the end of March. We have already committed more than £340 million to ensure that there are no financial barriers for those isolating in England, and we have made nearly 400,000 of those payments.
On the NHS’s preparedness, the noble Lord and noble Baroness will be well aware that we have provided record investment to tackle the backlog, with £2 billion this year and £8 billion over the next three years to deliver an extra 9 million checks, scans and operations. We have provided an extra £5.4 billion for the NHS to respond to Covid up to April, including £2.8 billion for costs including infection control measures, £600 million for day-to-day costs, £478 million for enhanced hospital discharge and £1.5 billion for elective recovery, together with capital funding. I hope that they will agree that we are supporting our NHS with further investment to help it get through this incredibly difficult time.
Both the noble Lord and the noble Baroness asked about critical incidents, which, as they will know, are determined and activated locally. Of course it is serious when that happens, but noble Lords will be aware that the NHS also takes this approach during non-Covid winters, because it is a way of ensuring that the local NHS can continue to best serve patients and protect staff, as it is an operational escalation mechanism. Ministers are working very closely with NHS England to get the assurance that proper support is being delivered.
The noble Baroness rightly asked about mental health. Noble Lords will know that at the heart of the NHS long-term plan is an expansion of mental health services. Mental health will receive at least a further £2.3 billion a year of extra investment to support 380,000 more adults and 345,000 more children.
I was grateful to hear the noble Lord mention the changes to the travel rules. The one thing I would say is that there have been no changes for unvaccinated adults: the changes that have been made are for those who have been vaccinated, and we are keeping the definition of fully vaccinated under review. If it changes to include boosters, plenty of time and notice will of course be given to make sure that people understand and are aware of that.
The noble Lord asked about reducing isolation times. Our current assessment is that shortening the period would be counterproductive. In some settings, such as hospitals, it could actually worsen staff shortages if it led to more people being infected.
In relation to your Lordships’ House, as the noble Lord said, legislating, of which I believe voting is a key part, is the central element of what we do. I disagree with him: I believe it should be done in person. We are working to make sure that it is as safe for everyone as possible. I am afraid that I disagree with him on that point.
The Deputy Speaker (Baroness Pitkeathley) (Lab)
The noble Baroness, Lady Harris, is contributing virtually, so I call her as the first Back-Bench speaker.
Baroness Harris of Richmond (LD) [V]
My Lords, the noble Baroness the Leader of the House just said that she disagrees with my noble friend—my leader—but clearly, the House of Lords must be described as a high-risk area; otherwise, why must Peers take a lateral flow test every day before attending? Why, then, are we not at least implementing remote voting? Surely, we have a duty of care to Members and staff.
Baroness Evans of Bowes Park (Con)
I completely agree that we have a duty of care, which is why we have implemented a whole range of measures to which noble Lords were alerted earlier this week. It would be a great disservice to the whole commission to suggest that that is not at the front and centre of what we are doing, but we are trying to balance that with being able to work in an effective manner—noble Lords made it clear that they did not believe that hybrid working was as effective as being here—and we are meeting regularly to assess the situation as things happen. We are asking millions of people to go to work in such circumstances. I think we should show by example, but I also genuinely believe that we are providing a safe working environment here for both Peers and staff.
Lord Reid of Cardowan (Lab)
My Lords, given the chronic shortage of lateral flow tests, can the noble Baroness confirm press reports over the Christmas and new year period that no sooner had one of the major distributors received 2.5 million lateral flow tests then it went on holiday for a week? Has there been any follow-up on that to discover whether that was an isolated incident, or has it been a recurrent pattern?
Baroness Evans of Bowes Park (Con)
The noble Lord is right: there was a reduction in capacity over Christmas. I am sure that conversations are being had, but I go back to the point that I made earlier: in the next couple of months, we are tripling the supply of lateral flow tests from 100 million under our pre-omicron plan to 300 million a month to ensure that we have the testing capacity that we need.
The Lord Bishop of Leeds
I am intrigued by the statement about Nightingale hospitals. What is meant by a virtual bed and how does that increase actual capacity, especially in the light of the staffing pressures in the NHS already? If these Nightingale hospitals are to be populated and used, how will they be staffed?
Baroness Evans of Bowes Park (Con)
The virtual wards are different from the Nightingale surge hubs. The hubs will create up to 4,000 beds if needed, and will be facilities that take patients who, although not fit for discharge, need minimal support and monitoring while they recover. The virtual wards involve people who are able to return home to have treatment through virtual interaction with medical professionals. They are different things done in different ways for different patients in different situations so that they can be properly treated in an appropriate manner.
Baroness Finlay of Llandaff (CB)
Can the noble Baroness explain to the House how the messaging is being reviewed, given that we have some areas of great resistance to vaccination? There is extensive anti-vax propaganda going out through the internet, which picks up the transmission of one internet message such that once one logs into that one gets bombarded with messages? Is there a way of intercepting those and countering them through the same route? There are patients in their 40s whom I have heard of almost at first hand who have been desperately sick and said that they were too frightened to be vaccinated because of that type of messaging.
There is also false reassurance now that omicron is mild. It is a mild disease most of the time in those who have been vaccinated and boosted, but in the unvaccinated what appears to be a simple cold might be a killer disease. That message does not seem to be getting out to the public. Nor is the message about the symptomatology presenting differently, so that if people have not lost taste they think that they do not have Covid.
Baroness Evans of Bowes Park (Con)
The noble Baroness of course makes incredibly important points. We already know that about 60% of those in intensive care have not been vaccinated. We know that unvaccinated people are up to eight times more likely to be hospitalised. The noble Baroness is absolutely right about the importance of this, which is why we are pushing the constant message about getting boosted. She will, I hope, be pleased to know—I am not saying that this solves the problem by any stretch—that we have seen more people coming forward to have their first jabs. There was an increase of 44% in the seven days to 22 December, compared to the previous seven days, which is a move in the right direction. However, the noble Baroness is absolutely right: we need to work with social media companies and are continuing to do so to identify and remove dangerous disinformation about vaccines, and make sure that we are getting our positive messages out.
We have allocated £22.5 million to help areas with low vaccine take-up. We recruited vaccine ambassadors, who speak 33 languages between them, to promote take-up across the country. We have a community vaccine scheme to target the 60 local authorities with the lowest uptake and use local networks to promote accurate health information. So we are trying to use a range of sources in order to try and either address the disinformation or the nervousness that is preventing people from coming forward.
Lord Forsyth of Drumlean (Con)
My Lords, should we not congratulate the Prime Minister on having made the right judgment call about the arrangements between Christmas and new year and on deciding to prevent us from having to have a PCR test on returning from abroad? I declare an interest, having been to the United States over Christmas and new year to see my grandchildren and paying an exorbitant amount in costs for testing. Is it not obvious that profiteering is going on, both in the supply of tests and in the costs that people are being asked to pay in order to be able to go abroad or continue to work? Will the Government ask the Competition and Markets Authority or some other body to look at this and end this absolute rip-off?
Baroness Evans of Bowes Park (Con)
My noble friend is right. It is something that I know noble Lords and our colleagues in the other place have raised. Work is going on to try to take action in this area. When the omicron variant was first identified we introduced the travel restrictions to try to slow its arrival, but now that it is so prevalent these measures are having a limited impact but are obviously having a significant impact on the travel industry. I think these are welcome measures that will, I hope, be welcomed by the public. However, there are no changes for unvaccinated adults.
Baroness Blackstone (Ind Lab)
My Lords, in the period before Christmas, the Government gave a high priority to keeping schools open, which was welcome. However, does the Minister agree that it is not just a matter of keeping schools open but a matter of encouraging all parents to send their children to school? With that in mind, will the Government consider making exclusion zones around schools to prevent anti-vaxxers providing parents, pupils and teachers with a lot of misinformation about vaccination? Does she also agree that it is extremely important that parents do not think that their children are going to have to sit in classrooms in the kind of weather that we are having now with windows open because adequate funds have not been provided for proper ventilation schemes for schools?
Baroness Evans of Bowes Park (Con)
I certainly agree with the noble Baroness about the appalling behaviour of some people around schools, and we have provided guidance to all schools on how to manage vaccination-related protests in liaison with the police, the NHS and the local authorities. Should a protest contravene the law, the police have comprehensive powers to deal with activities that spread hate or deliberately raise tensions. But she is right: it is an unsatisfactory situation and we are working with schools to try to help and support them in any way we can.
On the noble Baroness’s second point, more than 350,000 CO2 monitors have been rolled out to schools across the country and 8,000 air purifiers are being distributed to schools with particular ventilation difficulties. However, in the areas where CO2 monitors have been rolled out to schools to identify poorly ventilated areas, feedback shows that in most of those settings existing ventilation measures are sufficient. So a lot of work is being done, but we have added 7,000 to the 1,000 purifiers that we were planning for SEN and alternative provision settings to add to the broader school estate.
Lord Bilimoria (CB)
My Lords, I returned from South Africa where I spoke to Dr Abdool Karim, one of the leading epidemiologists there. He said on Monday —after I landed on Tuesday I saw the message—that they are coming to the end of their fourth wave. Are we learning the lessons from South Africa, where there are three-day hospital stays for omicron versus stays of between seven and eight days for beta and delta? There is far less use of ventilators and ICUs. Are the Government aware of the report of Professor Ravi Gupta of Cambridge, as well as a report from Hong Kong, showing that omicron is not as severe because it does not affect the lungs as much? If that is the case, can we try to reduce the isolation period as much as possible using testing? Can testing be made free, right up to spring? Finally, given the good news about the MHRA approving the Pfizer antiviral, which in trials has shown an 89% reduction in hospitalisation and deaths, how soon can we get 2.5 million treatments? That will be a game-changer. Will it be before March?
Baroness Evans of Bowes Park (Con)
As I mentioned in response to an earlier question from the noble Lord, Lord Newby, our current assessment is that we are not planning to shorten the isolation period, for the reasons I gave. We are certainly working with international partners to learn the lessons of omicron and we obviously have increasing data on what is happening here across the country. We are monitoring data daily. We have tried to have a proportionate approach to ensuring that people’s health, safety and well-being are at the top of our priorities while understanding that lockdowns have a severe cost in many other ways. Balancing that has been incredibly difficult, but we are looking at data daily to try to make sure that we get that balance right in order to keep the economy open and keep people safe.
Lord Grocott (Lab)
My Lords, 60% of the people in intensive care have received no vaccination whatever. Can the Minister tell us more about the people who have not been vaccinated? In particular, what proportion of them are unvaccinated because of medical reasons? What proportion of them are unvaccinated because they have not received the information that they need to know where to go and the importance of this? What proportion of them are simply, for whatever reason, ideologically opposed and refuseniks as far as vaccination is concerned, which of course brings great problems to the rest of us who are vaccinated?
Baroness Evans of Bowes Park (Con)
I am afraid that we do not have that kind of granularity of data but, as I explained in my response to the noble Baroness, Lady Finlay, we are trying to use a whole array of different means to target people who, for instance, are unvaccinated because they are nervous and need more information. Obviously there are issues around different communities in the country. Then, I am afraid, there are people who believe the disinformation that they read on the internet or elsewhere; we are trying to tackle that. We are trying to have a holistic approach where we tackle the differing reasons why people do not want to be vaccinated. Most importantly, we need to keep highlighting some of the numbers that the noble Lord rightly mentioned, as well as highlighting to people the absolute importance of getting their booster.
Lord Scriven (LD)
My Lords, when it comes to lateral flow tests, test and trace has become more like “trace a test”. The Statement says clearly:
“From next Tuesday in England, if someone tests positive on a lateral flow device, they should just record that result on GOV.UK and begin self-isolating.”
As supply is not keeping up with demand, rather than giving generic numbers, can the Minister say on what date in January the supply of lateral flow tests will meet demand so that people who are worried can take a test and carry out the Statement’s instruction?
Baroness Evans of Bowes Park (Con)
As I have already said in answer to previous questions, almost 8 million tests are being made available to pharmacies in this week alone, and we are increasing our supply of lateral flow tests from 100 million to 300 million over January and February.
Baroness Fox of Buckley (Non-Afl)
My Lords, there is a slight panic in the House about the non-affiliated. I am glad to hear a new emphasis that lockdown is not cost-free, but that devastating toll is present with these restrictions too. Can the Minister comment on whether there is an impact assessment on, for example, working from home guidance and effectively closing down city and town centres and the impact that this has on jobs and livelihoods for the people who work there? On the pressures on the NHS, is there more detailed evidence of how many people are actively being hospitalised by this new variant of Covid rather than being in hospital already and testing positive for it? That is not at all clear in the Statement but it makes a difference as to how frightened people might be of it.
Baroness Evans of Bowes Park (Con)
Of course we understand that the rise of omicron has been very challenging, particularly for certain sectors and businesses, which is why we have announced a £1 billion support package to help those affected. We have provided £683 million for targeted grants of up to £6,000 per premises for hospitality and leisure businesses, and provided an additional £30 million for the Culture Recovery Fund. We have also given a £100-million boost to the additional restrictions fund for local authorities in England. We are well aware of the issues, and obviously that is within the context of the huge economic support that we have provided throughout the pandemic. The pressures on the NHS are indeed considerable but we need to remember that we are in a much better position this year, not least because of the 133 million vaccine doses, including 34 million boosters, that have been administered. We need to keep that going forward in the right direction so that we can try to relieve the pressure on the NHS as much as we can.
Lord West of Spithead (Lab)
My Lords, has any work been done on the necessity or value of a second booster after a three-month period, bearing in mind that a whole raft of people who have had their first booster and are in vulnerable categories are coming to the end of it just as we are hitting the peak of omicron?
Baroness Evans of Bowes Park (Con)
My understanding is that discussions are taking place in the JCVI and among scientific advisers but, in terms of things that have come politically, the answer is: not as far as I am aware. It is being looked at. The one thing that is happening is that those people who have specific immunity issues are being offered a further, fourth, jab after 12 weeks but, to be honest, that generally does not have a clear-cut science to it at the moment, if the noble Lord sees what I mean. It is being looked at but I am afraid that I cannot set out a position for him today.
Lord Walney (CB)
My Lords, do the Government recognise that the scale of the NHS backlog means that what is required is not only a great deal of extra investment but a focus on NHS reform beyond the ambition of the current Health and Care Bill—indeed, on a scale last seen under the leadership and Government of the newly knighted Sir Tony Blair?
Baroness Evans of Bowes Park (Con)
The noble Lord is absolutely right, which is why a huge amount of work around NHS reform is going on in government. The integrated care White Paper and other things will be coming down the line.
Baroness Bennett of Manor Castle (GP)
My Lords, the Minister addressed ventilation and air filtration in schools but the noble Baroness, Lady Smith of Basildon, asked about stepping the issue up more broadly. In her response, the Minister said that antiviral drugs were the key to the next stage of dealing with the pandemic, but surely we need to get beyond treating infected people. As a ballpark figure, air sanitation provides a 70% reduction in the transmission of disease. This is a long-term, systematic solution that should be implemented not just in schools but everywhere, particularly in public buildings. Should we not be getting ahead of the viruses rather than continually chasing after them?
Baroness Evans of Bowes Park (Con)
I agree with the noble Baroness’s last point but I think that she miscategorised me slightly. I did not say that antivirals were the only answer; I said that they are one part of a suite of things that we need to be doing, from ventilation through to hygiene and cleanliness. There is a whole range of things that we will need to do, but she is absolutely right: we need to understand how we can live with Covid and not continually chase our tails, because we can see the damage that it causes.
Lord Purvis of Tweed (LD)
My Lords, I received my two vaccines in Scotland but my booster jab in England. I have been informed by NHS England and NHS Scotland that there is still no way of having that booster jab recognised under the Scottish system. Likewise, after so many months of this pandemic, why have both Governments not worked this out together? When will this be resolved?
Baroness Evans of Bowes Park (Con)
I completely understand the noble Lord’s frustration. My niece is at university in Cardiff and is in exactly the same position; she has had to go back to Wales over the holiday to get her jabs. I will certainly take his request to bang heads together back to the department.
Baroness Donaghy (Lab)
My Lords, I am appalled by the level of complacency about the availability of lateral flow tests—