Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022
(Limited Text - Ministerial Extracts only)
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Lord Kamall
That the Regulations laid before the House on 22 February be approved.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, I understand that there is an amendment to the Motion. Given that, I think it would only be appropriate to allow the noble Baroness, Lady Brinton, to speak first so that I can respond at the end. I beg to move.
The Deputy Speaker (Lord Faulkner of Worcester) (Lab)
My Lords, the noble Baroness, Lady Brinton, is participating remotely.
Amendment to the Motion
Lord Kamall (Con)
I begin by thanking all noble Lords who have taken part in this debate today, and in the previous debate on this issue last week. I will try to answer the questions posed, some of which were raised again today.
I think we should be clear about one thing: in every government Statement, we have been quite clear that we are not saying that the pandemic is over. I am surprised when people say that we say it is over. Every government Statement says the pandemic is not over, that we need to be aware, and we need to take precautions. We would not have a living with Covid strategy if we believed it was over. I am slightly puzzled when it is claimed that we are telling people that it is over, and it is “Freedom Day”. We have used the term “Freedom Day”, but we have also said it is not over, you have to live with it. We have repeated that, and we have been clear in every message. I am slightly concerned when every time the Secretary of State or I get to the Dispatch Box, we are told that we are giving the impression that it is over. We have a living with Covid strategy precisely for that reason.
Throughout our management of the virus, our strategy has always been about vaccines, therapeutics and antivirals. The successful rollout of this programme has weakened the link between infection and hospitalisation, and between hospitalisation and death. Evidence suggests that the link between infections and progression to severe disease is substantially weaker than in earlier phases of the pandemic. For instance, the numbers of patients in hospital per 100 infections have remained very low over the last few months. The proportion of patients being admitted to intensive care and requiring mechanical ventilation remains lower, with rates declining even when prevalence has increased.
The Government’s approach has always been informed by a wide range of scientific and medical advice. As I said clearly in the debate last week, when I asked one of the modellers about their data, they said that first they give us scenarios, including a worst-case scenario, not because they want us to work towards a worst-case scenario, but because we need to know what we can do to make sure that we do not reach the worst-case scenario. Then I asked about the other considerations, such as mental health, the backlog, and people’s jobs and livelihoods. The modeller said, “Minister, all we do is give you the data on where we think coronavirus is. It is for you, as a Government, to balance all the other competing issues.” That is what we do: we look at the data and we balance it up with other medical data, such as people who have missed diagnoses or operations, the significant mental health issue and the increase in eating disorders, and we have to consider all that in the round. We have to consider the spread of Covid, but at the same time we have weakened the link—and this is widely acknowledged—between catching Covid and hospitalisation, and between hospitalisation and death.
We are also continuing to monitor a number of variants. We have looked at the BA2 variant, which is more transmissible than omicron, and has become the dominant variant in the UK. It is not driven by increased immune evasion and BA2 does not appear to cause more severe disease at the moment, but we are continually monitoring it.
A number of noble Lords asked about surveillance, and due to the reduction in serious illness and deaths we have begun a new phase of living with the virus. We continue to monitor Covid-19 through our world-leading studies such the ONS Covid infection survey, SIREN and Vivaldi, and there were claims in last week’s debate that we had ended some of these, so let me put it on record: we have not ended them. I wish that any claims made were factual. We will also continue genomic sequencing of cases to provide further insights. We thank all the participants for supporting our surveillance work and the UKHSA will maintain the critical surveillance capabilities, including the population-level COVID-19 Infection Survey, genomic sequencing and additional data. This will be augmented by the SIREN and Vivaldi studies.
Previous debates on the coronavirus have not always pointed to this data, but have pointed to other data produced by global, regional and local academic institutions, so there are many sources of data out there. If I may give an analogy, when I used to look at financial services, there were concerns when the American Fed stopped publishing data on M3 as a measure of money. People said, “Why aren’t you doing this?” but academics and other experts were out there, and they were reconstructing M3, so there was no need for the Fed to do it because those experts were able to look at it. This is what is happening in academia and elsewhere; many people are looking at the data, and will continue to do so, and some of their grants are given on this basis.
We will continue to work with public health partners to make sure that people have the information they need. We are quite clear that the GOV.UK guidance was updated to reflect the legal end of self-isolation on 24 February 2022, and we have always been clear that it is not over, and we have to learn to live with Covid. We also expect it to be managed regionally and locally as part of a wider all-hazards approach, using existing health protection frameworks, and we need a continued focus on protecting the settings at highest risk, through local outbreak investigation and management activities led by UKHSA and the existing local health protection frameworks. Local government has been a vital partner in all this and will continue as such. The Government will continue to provide limited symptomatic testing for a small number of at-risk groups, and free symptomatic testing will remain available to social care staff, and we will look at this in more detail.
We will also look at affordability. This is quite right, as disparities have been a constant theme throughout the Health and Care Bill. We want to encourage a thriving private market, and one of the conversations we are having with private providers is to how to make sure it is more affordable. We are also having conversations across government to make sure that we tackle issues of access for those who are poorer. Noble Lords may have different levels of income, but people do buy tablets, and will buy testing, as part of their personal responsibility. Are noble Lords suggesting that we make it free to everyone, or just the very poor? We have to remember that any money spent on giving free tests to those who can afford to pay for them are resources that could be used elsewhere in the health service. We have to focus on tackling this backlog in particular—it is important that we get more people to diagnostic centres.
The noble Baroness, Lady Brinton, asked about the immunosuppressed, and we recognise the importance of this cohort. The noble Baroness and I had meetings with the Anthony Nolan charity, Blood Cancer UK and Kidney Care UK. I understand that on 22 February there was a meeting of the Disability and Health Charities Communication Forum, at which the Anthony Nolan charity, Blood Cancer UK and Kidney Care UK were present, and there was a follow-up meeting on 8 March. These meetings will continue, and the issue of the immunosuppressed is raised with those charities at the meetings, where we talk about communications measures, as well as what we can do to continue to protect those people. I spoke to one of the officials today about their plans, and he told me that the meetings will continue, and in addition they are looking at the idea of inviting the noble Baroness, Lady Brinton, along with the three charities that came to the original meeting, to a further meeting, and after that will discuss whether there should be regular conversations. At government level, the effort is led by Jenny Harries of the UK Health Security Agency. We make sure that there is continued engagement with these vital charities to ensure that those whom the noble Baroness referred to as the clinically extremely vulnerable continue to have the appropriate advice, but also that we are informed about the best way to get that advice out to the many sufferers.
We looked at the data and at the public sector equality duty, and we know that there are issues that we have to look at in further detail, such as health and social care staff getting free testing, and some of the other issues raised today. We are really looking into that to make sure that it is targeted, but I recognise that some people can afford to pay for their testing.
We are having conversations across government on the employment support allowance, statutory sick pay, and where an individual’s income is reduced while they are off work sick. I am not sure of the exact status of those conversations, but we are fully aware of the issues that noble Lords have raised and the provision of further financial support, including universal credit, and hardship funds from local authorities.
Employers are responsible for people who enter their workplace, as has always been the case, but we are quite clear that employers should not ask any workers with Covid-19 to enter the workplace. We must get the right balance between personal responsibility and safety. We have always been clear that it is not over. We must learn to live with Covid. It is not defeated. We are monitoring, with these surveys and outside surveys, the different variants: those which become variants of concern, their severity, and whether we need to scale up some of the measures that we have just scaled down. One of the conversations that I have had was about how quickly we can scale up some of the measures that we are scaling down if there is a significant outbreak or variant of concern. We are aware of it. All this, including the Living with Covid-19 strategy, shows that we are not saying and have never said that this is over. We must simply continue getting the precautions right, getting vaccinated, ventilating shared spaces, wearing a face covering in crowded or enclosed spaces, getting tested if you have Covid-19 symptoms, and staying at home. We are not ignoring the virus.
I end by thanking all the people who have got us to this point: the scientists, the health and social care workers—
Baroness Walmsley (LD)
I am sorry to interrupt the Minister and I thank him for all that information, but is he in a position to answer the question asked by my noble friend Lady Tyler about vaccination of primary age children? There is an awful lot of Covid in primary schools. Vaccinating children was slow to start and the delivery of the programme has been even slower. Perhaps he could tell us something about that.
Lord Kamall (Con)
Yes, I apologise for my enthusiasm to answer.
We have accepted the JCVI advice to offer the vaccine to all children aged five to 11. The advice follows a thorough review by the MHRA, which approved Pfizer’s paediatric vaccine as safe and effective for children aged five to 11. The NHS is also prepared to extend the offer to all children in April, so parents can ensure good protection against potential future waves of Covid-19. Every parent will have the opportunity to make an informed choice. I remember an email from my younger son’s school saying there was a vaccination clinic at the school. Sometimes vaccinations are done in schools, sometimes in an NHS setting, and sometimes in these pop-up centres that we have debated previously. I hope that answers the question asked by the noble Baroness.
I am sure that all noble Lords will want to join me in thanking all the scientists, the health and social care workers, the volunteers, the life sciences industry, and the postal, courier and transport workers, the Uber Eats people—all those who brought stuff to us while we protected ourselves. We have always sought to get the right balance between the safety of the public and keeping the country open. We were criticised sometimes when we went into lockdown and we were criticised sometimes when we came out of lockdown. We have looked at the scientific debate. Whatever you do, there will be scientists who agree with you and scientists who disagree with you. You just have to do the right thing on balance, with all the economic and social factors, as well as all the health factors.
We will continue to monitor the data, listen to scientific advice, build defences and encourage people to get vaccinated. We are always making it clear that it is not too late to get your first and second vaccine. We have targeted community groups, sometimes through faith organisations and sometimes through local community organisations, to reach people who are distrusting of authority, asking who the right people are whom they will trust. We must understand the motivations and why people are not getting vaccinated, rather than tell them that they are silly or complain about them. We must understand and work with them.
I end by saying that we agree with noble Lords who have said that this is not over. We must learn to live with Covid; we must get vaccinated, ventilate shared spaces, wear a face covering in crowded or enclosed spaces, and get tested. Lifting these restrictions does not mean that we are ignoring the virus. We have this Living with Covid-19 strategy, and I welcome all noble Lords’ scrutiny of it and their helpful suggestions. If I have not answered any questions, I will read Hansard and make sure that I sweep up all the other answers.
I hope that I have offered some assurance and answered most questions. I ask the noble Baroness, Lady Brinton, for whom I have incredible respect for her championing of the clinically extremely vulnerable, to withdraw her amendment.