Lord Newby (LD)
My Lords, I begin where the Prime Minister concludes his Statement:
“We do not need laws”,
he says,
“to compel people to be considerate of others. We can rely on that sense of responsibility towards one another”.—[Official Report, Commons, 21/2/22; col. 45.]
If this were the case, many laws would not be on the statute book and, indeed, many aspects of the regulations that we have had in place over the last two years would not have been necessary. For this Prime Minister to claim that we can rely on the sense of responsibility towards one another shows a remarkable lack of self-awareness. He did not behave responsibly even when there were laws in place, so to remove all legal restraints at one fell swoop seems to me, at best, an extremely risky option. Doing so makes sense only if we are confident that the costs involved are manageable.
It is obviously a great relief that numbers are falling and that serious illness is on the wane, but the death only last week of one of my colleagues, having been in ICU with Covid, is a timely warning to us all that this disease is far from done. While everybody agrees that we have to learn to live with Covid, that is not the same as getting rid of every precautionary measure. We need to ensure that cases continue to diminish, the vulnerable are protected and pressure on the NHS is bearable.
The Prime Minister repeatedly said yesterday that taking personal responsibility requires people to test themselves and to self-isolate if they think they have the disease, but, for those on limited income, including the millions who are not eligible for sick pay, the cancellation of self-isolation support payments will make that an impossible choice. If faced with heating or eating, or paying for a coronavirus test, it is pretty obvious which will be the lowest priority. So, we have real concerns about getting rid of free testing, especially for those who are either vulnerable or have family members who are vulnerable.
The latest testing figures show that, every week, nearly 4 million people are taking regular Covid tests—on average, two a week. This includes people who take tests to protect their elderly relatives and friends, as well as vulnerable workers in people-facing industries such as hospitality who are concerned about their health. If people have to pay for this, we estimate that it could amount to an annual testing cost to an individual of up to £500. Does the Minister agree that this is simply unfeasible for many people and is also, in effect, a tax on caring? While the Prime Minister said that half a million people who are the most severely immunocompromised will get free tests, their carers and families will not.
There is also a more important principle at stake here. The Government have consistently said that the NHS is safe in our hands because it is free at the point of need. However, Covid-19 is a notifiable, highly infectious disease under the Public Health (Control of Disease) Act 1984 and the Health Protection (Notification) Regulations 2010, which say that medical practitioners must test potential cases under the NHS so that infections can be managed and monitored. Currently, all notifiable disease tests are free of charge but, from 1 April, that will no longer be the case. So, how can the Government claim that the NHS will continue to be free at the point of need? In this case, it clearly will not.
The Statement refers to SAGE’s concern about the future path of the pandemic, which underlines the importance of the survey work carried out by the ONS and Imperial College. Can the Leader confirm that these surveillance operations at ONS and Imperial will continue on a substantial scale, and can she say how quickly full, free testing and tracing can be restarted in the not unlikely event of another variant emerging?
While vaccination remains a vital tool in learning to live with Covid, some people’s immune systems wane quickly after their booster jabs. The Statement says that these people will have access to antivirals and other treatments, but the antivirals must be administered within 48 hours of symptoms starting. Can the Government confirm that such people will get access to rapid testing, to be able to start these vital treatments within the first 48 hours?
Finally, the Statement mentions the UK’s G7 plan for future pandemics. How do the Government respond to comments from the WHO that countries such as the UK are dismantling the precautions needed to ensure a safe reduction in Covid? We will learn to live with Covid, but the Government have a lot more work to do to ensure that we do it with minimal risk.
The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)
My Lords, I thank the noble Baroness and the noble Lord for their comments. On behalf of the whole House, I send condolences to colleagues on the Liberal Democrat Benches on the loss of one of their dear colleagues, and to Lord Chidgey’s family. He is in our thoughts.
The noble Baroness and the noble Lord asked about SAGE advice. We have continued to take and publish the best advice and analysis from scientific groups such as SAGE and its subgroups, which has been used in decisions taken by Ministers, alongside economic and social considerations. The latest SAGE advice was referenced within the strategy that was published on 10 February. We will continue to publish SAGE advice as and when we have it.
The noble Lord rightly pointed out that the proportion of infections from the current omicron variant resulting in hospitalisations is significantly lower than in previous waves, with less than one per 100 infections, compared with over four per 100 infections during the alpha peak. Although there is a delay, we are also seeing a welcome fall in deaths, which we expect to continue.
The noble Lord and the noble Baroness both referred to the changes in the self-isolation regime and the legal requirement finishing on 24 February. We will be replacing that with guidance in the short term, still advising people with Covid to stay at home and avoid contact with others. From 1 April, we will be issuing new guidance setting out the ongoing steps that people with Covid should take to minimise contact with other people. There will be specific guidance for staff in particularly vulnerable services, such as adult social care, healthcare, and prisons and places of detention. Health and social care workers will continue to be asked to stay at home following the lifting of the legal requirements to self-isolate. We will review over the coming weeks the long-term approach to managing Covid in health and social care settings and will publish adult social care guidance, again by 1 April.
The noble Lord and the noble Baroness asked about testing. Free symptomatic testing will remain available to those at highest risk of Covid and to social care staff. Again, details will follow ahead of 31 March. We will also set out in due course further details on which high-risk groups and settings will be eligible for continued free testing. The noble Lord and the noble Baroness also asked about the costs of tests. We will be working with retailers to establish and develop a private market for lateral flow tests. There have been private markets operating in the US and many European countries for some time now. Retailers will be setting the price, but we will be ensuring that the private testing market is properly regulated, including monitoring prices charged, and we will continue to work with UK companies in developing lateral flow tests, which the noble Baroness referred to.
The noble Baroness asked about the value of test and trace and its cost. Of course, we are all aware that we began the pandemic with no diagnostics industry and yet have conducted the most tests in Europe. We have conducted more than 460 million tests, and over 36.3 million positive cases and their contacts have been reached who could have spread the virus. We have built a testing network from scratch that can process millions of tests per day—more than any other European country—and over two billion lateral flow tests have been distributed across the UK since the start of the pandemic. That is a pretty impressive record.
The noble Baroness mentioned, rightly, that we have accepted JCVI advice for a new spring booster, to be offered to those over 75, older care home residents and those over 12 who are immunosuppressed. Those doses will be given six months after their most recent booster dose. We have also procured five million patient courses of antivirals, more than anywhere else in Europe, which is a significant supply and will provide a crucial layer of protection going forward. We are rolling out neutralising monoclonal antibodies and antiviral treatments for patients at highest risk. Up to 1.3 million patients could benefit if they are clinically eligible, and we have a plan to personally communicate with these relevant patients so that they can take advantage of the treatments that we have invested in.
Both the noble Lord and the noble Baroness talked, quite rightly, about future surveillance and what we would be doing about it. UKHSA will continue to sequence infections and monitor a range of data, including infections, hospital admissions, patients in hospital and deaths with Covid. It will maintain critical surveillance capacity, including the Covid infection survey, genomic sequencing and additional data, and this will be augmented by continuing the SIREN and Vivaldi studies.
As the noble Lord and noble Baroness pointed out, we will have to keep a very close eye on the emergence of new variants, so we will retain the core capabilities and infrastructure required to scale up a proportionate response in the event of a resurgence or a new variant. Obviously, this will involve the continued use of pharmaceuticals as the first line of defence, along with continuing to develop capacity to respond in the health system. We will retain laboratory networks and diagnostic capabilities so that PCR testing can be stood back up in the event of a resurgence, and we will retain the ability to stand up the national trace response if it is needed. Local health teams will continue to use contact tracing and provide context-specific advice, where they assess that to be necessary, as part of their role in managing local outbreaks, as they do with other infectious diseases. We will also maintain the ability to increase asymptomatic testing in the NHS and care homes.
UKHSA continues to have good stocks of lateral flow tests and will manage them to enable the Government to establish an adequate stockpile that could be rapidly deployed in future outbreaks. We will also continue to run public health campaigns such as we have seen in the past to encourage people to think about their behaviour and to ensure the continuation of the good work that we have done to understand how to deal with Covid.
Finally, the noble Lord asked about the global scene. He is probably aware that in March we are hosting the Global Pandemic Preparedness Summit for the Coalition for Epidemic Preparedness Innovations, and we are working with international partners on future pandemic preparedness, including through a new pandemic treaty, an effective early warning system—or global pandemic radar—and a mission to make safe and effective diagnostics, therapeutics and vaccines available within the first 100 days of a future pandemic threat being identified; this is, of course, a global problem.
Baroness Brinton (LD) [V]
My Lords, the 3.7 million clinically extremely vulnerable people already follow government advice for them, regularly checking the daily Covid dashboard to see how many cases there are in their area. This will be even more important when others no longer have to self-isolate when they get Covid. They cannot do this when widespread testing and the daily dashboard stop. What advice would the Leader give these people on how to assess their own risk after 1 April?
Baroness Evans of Bowes Park (Con)
The noble Baroness is absolutely right that throughout the crisis we have led the way on data reporting, and have ensured that data is always available to the public. UKHSA will keep the content and frequency of reporting on Covid—including the GOV.UK dashboard—under close review, to ensure that statistics are being produced of the appropriate quality and transparency, and that they remain useful and relevant in accordance with the code of practice for statistics. So we will continue to publish information.
Lord Hunt of Kings Heath (Lab)
My Lords, I refer to the SAGE advice, from the last meeting, that the Leader mentioned. It was said that some people may take the removal of free and accessible testing as a signal that they should continue to attend workplace social gatherings while showing Covid symptoms. What is the Government’s response to that? Why are they getting rid of free testing?
Baroness Evans of Bowes Park (Con)
We have always made it clear that as we move through Covid we would move away from free testing, and that is what we intend to do. As there are now high levels of immunity across the population as a result of vaccination and natural infection, future testing and isolation will play a less important role in preventing serious illness, and, as I have said in response to the noble Baroness and the noble Lord, we will be working with retailers to establish and develop a private market for lateral flow tests.
Lord Bilimoria (CB)
My Lords, last summer and winter the CBI, of which I am president, said that there must be a three-pronged attack. The first prong was vaccines, and hats off to the Government for an excellent vaccine programme. The second was providing free lateral flow devices to businesses and citizens, and the Government have been the best in the world at doing this so far; no other country has done it like we have. The third was antiviral treatments, and the Government have almost 3 million. Why are the Government withdrawing the free lateral flow tests so early, when it has taken one year for people to get used to using them regularly? We ran out of them in December and January. They are very effective. Why are the Government doing this? Surely they are being penny-wise and pound-foolish. Businesses and citizens should be using them. We need them for a while longer.
Baroness Evans of Bowes Park (Con)
The noble Lord will be aware that we have announced that we will end free testing, but it will not finish until the end of March; we are not stopping free testing immediately. There will obviously be the opportunity for people to get tests during that time. As the noble Baroness said, the test, trace and isolation budget in 2020-21 exceeded the entire budget of the Home Office. It cost a further £15.7 billion this financial year and £2 billion in January alone, at the height of the omicron wave. We want to move to the next phase as we begin to live with Covid, and ending free testing is one aspect of that approach.
Lord Robathan (Con)
Unusually, I congratulate the Government—first on the outstanding success of the vaccine programme, which really has been world leading, and secondly on this policy of living with Covid. It is extremely important that we rely on personal responsibility and common sense, and do not listen to the siren voices from SAGE and others who say that we must stay locked down for ever. Can my noble friend please tell me what the death rate has been in the last month, compared with the death rate in 2018-19?
Baroness Evans of Bowes Park (Con)
I thank my noble friend. I do not have the exact figures to hand but, as I said, the reporting of deaths is always slightly delayed. It has started to decline now and we expect this to continue. The latest evidence suggests that the risk of presentation to emergency care or hospital admission with omicron is approximately half that for delta.
Baroness Ritchie of Downpatrick (Lab)
My Lords, access to free testing with lateral flow tests ensured that many of those who cannot afford to pay for tests were able to take them and to help prevent the transmission of highly transmissible variants. Will the Leader therefore tell the Prime Minister from your Lordships’ House today that we want the free lateral flow tests to remain for a considerable time longer to ensure that the Government have the necessary contingency capabilities to respond rapidly to any new variant, as outlined in the Government’s Statement in the other place yesterday? We know that unless other countries have the capacity to deal with variants, we are all in a state of danger.
Baroness Evans of Bowes Park (Con)
As I mentioned in response to a previous question, we are giving notice that free lateral flow tests will come to an end at the end of March. But, as I also said in an earlier answer, we will retain laboratory networks and diagnostic capabilities to ensure that PCR testing can be stood up in the event of a resurgence or a dangerous new variant.
Baroness Browning (Con)
With these changes in various settings, can my noble friend update the House on what the guidance is now for in-patients in hospitals? Exactly what level of barrier nursing will there be to make sure that Covid patients—like those with any other contagious disease—are protected, in their own interests and those of other vulnerable in-patients?
Baroness Evans of Bowes Park (Con)
As I said, in due course we will set out further details on which high-risk groups and settings will be eligible for continued free testing. As I also said, we will publish guidance specifically in relation to adult social care and other high-risk settings well in advance of when we move towards the end of free testing.
Baroness Meacher (CB)
My Lords, I want to raise a very particular issue raised initially by the noble Lord, Lord Newby, and the noble Baroness, Lady Brinton. The Government are rightly retaining free tests for exceptionally vulnerable people but by the time an exceptionally vulnerable person is found positive, it is too late; he or she may die. Will the Government consider tweaking the rules to enable the children— and maybe the husband and other members of the household—of exceptionally vulnerable people to have free lateral flow tests so that the exceptionally vulnerable person can then take exceptional measures to protect themselves if one of their household is found to have Covid?
Baroness Evans of Bowes Park (Con)
As I say, we are not ending free testing immediately. There is some time and obviously, as I said, there will be further guidance and information on a whole range of issues including, I am sure, the situation the noble Baroness mentions. We have announced that the end of free testing is coming but we have also made it very clear that for vulnerable groups there will be further guidance and information about where testing will continue to be available.
Lord Alton of Liverpool (CB)
My Lords, will the noble Baroness return to a question put to her by the noble Baroness, Lady Smith of Basildon, about the number of lateral flow tests that have come from the People’s Republic of China? Is she aware that by the summer of last year over a billion such tests had been bought by the United Kingdom? This week in another place, it was confirmed that we have bought 24.1 billion PPE items with China registered as their country of origin, including 10.7 billion gloves. Before we consider this further during the course of the Health and Care Bill, on an amendment from her noble friend Lord Blencathra, will the noble Baroness undertake to tell us how much has been spent on these items and what we are doing to build up our own resilience and reduce dependency?
Baroness Evans of Bowes Park (Con)
As I said in response to the noble Baroness, we are working with manufacturers in the UK to encourage the build-up of supply and capability in this country and we will continue to do so because we want resilience in this area.
Lord Roberts of Llandudno (LD)
My Lords, may I remind the House that we are not dealing with one nation but with four nations? The devolved Administrations —Northern Ireland, Scotland and Wales—all take their own decisions and rightly so because they held referendums and so on to give that authority to the particular nations. What discussions have taken place to try to get some resolution? For instance, yesterday I was on the train from Llandudno Junction—a wonderful area for a holiday—and I had to wear my mask until I got to Shotton; at Shotton we were entering England so I could discard my mask. Have we learned any lessons at all about international UK relations following this pandemic?
Baroness Evans of Bowes Park (Con)
We have worked very closely with devolved Administrations throughout the pandemic to effectively support citizens but, of course, health is a devolved issue so the Administrations have made their own decisions. We have also provided £860 million to the devolved Administrations so they can take the precautions they consider necessary on top of the combined £77.6 billion confirmed in the autumn Budget, so we have worked well together. As I say, however, devolution means that it is for the Administrations to decide their way forward. I believe the First Minister of Scotland, for instance, made an announcement today about changes to the rules in Scotland so I think we are moving forwards together, albeit perhaps at a slightly different pace.
Lord Forsyth of Drumlean (Con)
My Lords, does my noble friend agree that St Augustine is alive and well on the Opposition Benches? We should remember that these measures were brought in to stop the NHS being overwhelmed. There is no sense whatever that that is happening. If we cannot remove these measures now, at a time when we have done so brilliantly in getting the population vaccinated, we never will and the cost to the economy will be enormous. To hear the president of the CBI, no less, describe £2 billion a month as penny-pinching makes me wince.
Baroness Evans of Bowes Park (Con)
I thank my noble friend. He is right that our plan for living with Covid prioritises moving to a world where the country manages Covid like other respiratory diseases. Our response is underpinned by four principles: living with Covid by removing restrictions while encouraging safer behaviours; protecting those most vulnerable to Covid; maintaining resilience to be able to spot and respond to new variants; and securing innovations and opportunities from our Covid response, including investment in life sciences.
The Lord Bishop of Coventry
My Lords, thanks to the noble Lord, Lord Londesborough, earlier this afternoon your Lordships’ House considered the matter of global vaccine equity, and my sense was that, in many among the House, there was a feeling that more could be done on that front. Would the Leader say whether the Government also feel that more might be done to ensure vaccine equity in the UK itself, as an expression of the noble and laudable commitment to levelling up?
Baroness Evans of Bowes Park (Con)
Certainly, we have been very focused on targeting those communities which have not taken up the vaccine as much as we would like—for a whole array of reasons. For instance, we have invested a further £22.5 million in a community vaccine champion scheme to support 60 local authorities with the lowest take-up, following a £23 million investment in the initial scheme. We have vaccine ambassadors speaking 33 languages between them who are promoting uptake across the country. The recently launched Office for Health Improvement and Disparities will systematically tackle the top preventable risk factors associated with ill health and improve the public’s health and health disparities.
Baroness Chisholm of Owlpen (Con)
My Lords, I am pleased to hear my noble friend say that the Government are still thinking about free testing for social care areas. Would it be possible for her to take back to her colleagues that, if we are not going to have free testing anymore, it would be good to ensure that there are public announcements to tell the public how they should self-isolate if they think they have any Covid symptoms—in the same way as they would with the flu, cold or other illnesses?
Baroness Evans of Bowes Park (Con)
I entirely agree with my noble friend and, as I said, we will be producing further guidance in advance of the end of March, when free testing, for the vast majority of the general public, comes to an end. We will also be publishing further details about the high-risk settings and groups who will be eligible for continued free testing.
Baroness Fox of Buckley (Non-Afl)
My Lords, good riddance to the draconian Coronavirus Act, but could the Government commit to reviewing public health laws which have been used so damagingly to attack civil liberties? Secondly, beyond rolling back laws, how are the Government planning to counter disproportionate fears and risk aversion? The nudging seems to have been rather too successful in frightening people. For example, so many in care homes are still not allowing family members to see relatives and there are miserable rules in place which are the opposite of homely and welcoming. This matter is beyond laws—there is a lot of encouraging to do.
Baroness Evans of Bowes Park (Con)
I agree with the noble Baroness, and that is why we will continue with public health campaigns, as we have seen in the past. We will also be reiterating to the public the safe behaviours we have learnt: the washing of hands; improved hygiene; ventilation; and all those other measures that we can take which do not involve restrictions on people’s lives but which can help ensure we keep Covid at bay—which is what we all want.
Baroness Finlay of Llandaff (CB)
My Lords, when people are in hospital and seriously ill, they are often desperate to see their own family and their family are desperate to visit them. However, at the moment, there are very severe restrictions in place. Will free testing be provided to families to facilitate them visiting and to help take a more compassionate view towards those who are often disorientated, frightened and find that they cannot even telephone their own family because they are in a hospital unit where the phone does not work?
Baroness Evans of Bowes Park (Con)
As I have said, we will be publishing further guidance and information on the high-risk groups and settings where free testing may be available. However, I cannot make that commitment to the noble Baroness.
Lord Dubs (Lab)
My Lords, of course the vaccine programme has been a success, and I concede that. However, almost all of us here know people who have died of Covid. We have had the highest death rate in western Europe, and that sits badly with the tone of self-congratulation which characterised the Statement. Is it not time that the Government showed some humility as well?
Baroness Evans of Bowes Park (Con)
I am sorry the noble Lord felt that way; I do not think that was the tone at all. However, this Statement gives people hope that we are beginning to move out of a very difficult period for citizens across the country. We are all trying to move together to a world where we can manage Covid like other respiratory diseases, because the emotional, social and economic cost of what we have all been through in the last two years has been devastating. I think the public as a whole, and all of us here, I am sure, want to try to move on while understanding the risks ahead, making sure we have surveillance and the ability to ramp things up if we need to—let us hope we do not—to make sure we can keep everybody safe.
Baroness Altmann (Con)
My Lords, I understand the sensitivities and nervousness being expressed around the House about this move, but there is no right time to do this. We must move on from this virus; it is two years on. To restore confidence to the public in living with this virus, I think the Government’s decision is commendable, just as the decision not to impose isolation before Christmas turned out to be correct. On the £2 billion cost of free testing, the national insurance increase that we are about to impose—although I hope the Government may reconsider it—is planned to raise £12 billion. That is just six months’ worth of free testing.
Baroness Evans of Bowes Park (Con)
I thank my noble friend and am grateful for her support for the approach we are taking. As she rightly says, we need to move on and learn to live with Covid. This is another step in that direction.
Lord Brooke of Alverthorpe (Lab)
My Lords, I regret that the noble Baroness dismissed the noble Lord, Lord Dubs, so peremptorily. We have one of the worst records on deaths from Covid in Europe. We have seen that we have one of the unhealthiest countries in Europe. We now have the freedom with Brexit to make many changes which people previously said we were unable to make. When will a programme be set out to make this country the healthiest in Europe?
Baroness Evans of Bowes Park (Con)
As I have said, we have launched the Office for Health Improvement and Disparities, which will systematically tackle the top preventable risk factors and associated ill health, such as smoking and obesity, to improve the public’s health. We will also set out a strategy to tackle the core drivers of inequality in health outcomes in a new White Paper on health disparities this year.
Viscount Thurso (LD)
My Lords, what advice will the Government give to employers? Will responsible employers be expected to provide testing for their employees?
Baroness Evans of Bowes Park (Con)
We will revise the workplace guidance for employers and work with them; again, it will be published shortly, before the full measures we announced yesterday come into effect.
Lord Hannan of Kingsclere (Con)
My Lords, at the weekend Her Majesty the Queen was reported to have tested positive. I am sure noble Lords on all sides will join me in wishing her every success, but I was struck that, immediately, some commentators and politicians jumped on the announcement, saying that therefore we must not go ahead with the unlocking. Surely the two most salient facts are that omicron will reach even the most protected person in the country and that, if a 95 year-old woman can carry on working with her typical devotion to duty, we have reached the point where these non-clinical, non-pharmaceutical interventions are, if not wholly purposeless, certainly disproportionate?
Baroness Evans of Bowes Park (Con)
On behalf of the whole House, I am sure, I wish Her Majesty the Queen all the best and a quick recovery from her current illness.