Tuesday 18th May 2021

(2 months, 1 week ago)

Lords Chamber

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Department of Health and Social Care

Statement

The following statement was made in the House of Commons on Monday 17 May.

“With permission, Mr Speaker, I would like to make a statement on coronavirus. Since January last year, and especially since 8 December, when the world’s first clinically authorised coronavirus vaccine was given in Coventry Hospital, we have been engaged—all of us—in a race between the virus and the vaccine. As a nation, we have taken some huge strides forward and we can make careful further progress today, and we must remain vigilant.

I can report to the House that there are now fewer than 1,000 people in hospital in the United Kingdom with coronavirus, and the average number of daily deaths is now nine. This progress means we are able to take step 3 in our road map today, carefully easing some of the restrictions that we have all endured. People have missed the things that make life worth living, businesses have endured hardship, and everybody has made sacrifices. While we can take this step today, we must be humble in the face of this virus. We have all learned over the past year that, in a pandemic, we must look not just at where we are today, but where the evidence shows we may be in weeks and months down the track. The vaccination programme can give us confidence, but we must be alert to new variants that could jeopardise the advances that we have made.

Today, I would like to update the House on the work we are doing to tackle variants of concern—in particular, variant B16172, which is the variant of concern first identified in India—so that we can protect the progress that we have worked so hard to achieve. There are now 2,323 confirmed cases of B16172 in the UK; 483 of these cases have been seen in Bolton and Blackburn with Darwen, where it is now the dominant strain. Cases there have doubled in the last week and are rising in all age groups. In Blackburn, hospitalisations are stable, with eight people currently in hospital with Covid. In Bolton, 19 people are now in hospital with coronavirus, the majority of whom are eligible for a vaccine but have not yet had one. That shows that the new variant is not tending to penetrate into older vaccinated groups, and underlines again the importance of getting the jab—especially, but not only, among the vulnerable age groups.

In Bolton and Blackburn, we have taken the approach that worked in south London against the South African variant. We have surged in our rapid response team: 100 people so far, who visited approximately 35,000 people this weekend to distribute and collect tests. We have installed six new testing units, brought in more than 50 new vaccinators and set up two new vaccination centres, as well as extending opening hours and capacity at our existing sites. In Bolton, we have quadrupled the rate of vaccination. We carried out 6,200 vaccinations over this weekend, and it is brilliant to see so many people from the most vulnerable groups coming forward to get the protection, whether it is their first or second jab.

All in all, this is the biggest surge of resources into any specific local area that we have seen during the pandemic so far. It has been co-ordinated by Dr Jenny Harries, the chief executive of the new UK Health Security Agency, drawing on all the health capabilities, locally and nationally, that we have built in the past year. I thank everyone who is working so hard to make it happen, including everyone at the two local authorities; the rapid response team; all the volunteers, including those from St John Ambulance; and, most importantly, the people of Bolton and Blackburn for the community spirit that they are showing.

It has been really heartening, as I am sure the whole House will agree, to see the videos published over the weekend of people queuing up to get the jab. I say to anyone who feels hesitant about getting the vaccine, not just in Bolton or Blackburn, but right across the country: just look at what is happening at the Royal Bolton Hospital. The majority of people in hospital with coronavirus were eligible for the jab but had chosen not yet to have it and have ended up in hospital—some of them in intensive care. Vaccines save lives. They protect you, they protect your loved ones and they will help us all get out of this pandemic.

This is not just about Bolton and Blackburn. There are now 86 local authority areas where there are five or more confirmed cases. The next biggest case of concern is Bedford, where we are surging testing. I urge everybody in Bedford to exercise caution and engage in testing where it is available.

I also want to tell the House the latest scientific assessment of this variant. The early evidence suggests that B16172 is more transmissible than the previously dominant B1117 variant. We do not yet know to what extent it is more transmissible. While we do not have the complete picture of the impact of the vaccine, the early laboratory data from Oxford University corroborates the provisional evidence from the Royal Bolton Hospital and the initial observational data from India that vaccines are effective against the variant. This, of course, is reassuring, but the higher transmission poses a real risk.

All this supports our overriding strategy, which is gradually and cautiously to replace the restrictions on freedom with the protections from the vaccines. The data suggests that the vaccine has already saved more than 12,000 lives and prevented more than 33,000 people from being hospitalised, and we are protecting people at a very rapid pace. Last week was the biggest week of vaccinations since the end of March. Some 36 million people have now had a first dose, and yesterday we reached the milestone of 20 million people across the UK having had their second dose.

I am delighted to see the figures released by YouGov today, which show that the UK has the highest vaccination enthusiasm in the world, with 90% of people saying that they have had or will have the jab. This was no accident. We began planning the campaign for vaccine uptake a year ago. I thank the huge range of people involved in promoting the benefits of vaccination, from Her Majesty the Queen to Sir Elton John, Harry Redknapp, Lenny Henry, Holly Willoughby, Lydia West and many, many others. Our campaign has been based on positivity and science, and I am grateful to everybody who has played their part.

I can confirm that from tomorrow we will be inviting people aged 37 to come forward, before expanding this further later in the week. It has been brilliant to see people’s enthusiasm when they have been invited to come forward, and we want to make it as easy as possible for them to show that they have had the protection the vaccine provides. I am delighted to say that, as of today, people can demonstrate whether they have had their jab, quickly and simply, through the NHS app.

Since January, we have been following a dosing interval of 12 weeks for second doses. Because of the extra protection people get from the second dose, particularly among those most likely to end up in hospital or dying, it is incredibly important that everyone comes forward for that second dose at the right moment. The approach we have taken aims to give the most vulnerable the strongest possible protection against this virus. Since January, that has meant getting the first dose to as many people as possible, as quickly as possible. The research shows that this approach has saved about 12,000 lives.

Now, it is important to accelerate the second doses for all those most vulnerable to ending up in hospital or dying. Our vaccination strategy for all parts of the UK, including the areas of surge vaccination, will therefore stick by the clinical advice set out by the Joint Committee on Vaccination and Immunisation: first, prioritise anyone over 50 who has not yet been vaccinated; next, second doses to those over 50 are vital—that will now be done on a schedule of eight weeks; and then, follow the cohorts in priority order, and the age groups as we open them. This clinically approved approach is the best way to save the most lives, rather than jumping ahead with first doses for younger people. Although the JCVI of course keeps this under constant review, we are clear that its advice is the best way to protect those most in need of protection and so save as many lives as we can. The NHS will be reiterating this advice to all vaccination centres and all directors of public health, and I am very grateful to everyone, in the NHS, local authorities and in the whole system supporting this vaccination programme, for following it.

Today’s opening and step 3 marks an important step on our road to recovery. We must proceed with caution and care, and bear down on the virus, in whatever form it attacks us, so that in this race between the vaccine and the virus, our humanity, science, and ingenuity will prevail. I commend this Statement to the House.”

Baroness Thornton Portrait Baroness Thornton (Lab)
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My Lords, I thank the Minister for being here to take this Statement. We keep meeting like this; it is over a year now. I wonder whether our relationship needs to move on.

The Covid variant first detected in India looks as though it has now seeded in 86 areas and is set to become the dominant strain in the UK within the next few days or weeks. Indeed, many experts think that it was a mistake for the Government to go ahead with the easing of lockdown restrictions implemented yesterday. I suppose that there must be increasing doubt about whether the further lifting of lockdown measures will be able to go ahead as planned next month. I will not ask the Minister to give any definitive answers on that because I absolutely accept that uncertainty is the name of the game. However, I quote one of the four tests that the Government set out for proceeding with the road map out of lockdown, which is if

“our assessment of the risks is not fundamentally changed by new Variants of Concern”—

in other words, if there are new variants of concern, that may be the issue. Is this still the case?

The Royal Statistical Society, which promotes the proper use of data, is concerned that the Government have failed to publish the information justifying their decision that stage 3 of lockdown easing should go ahead because the new variant threat has been met. Will the Government publish the framework for that decision and the data that fed into it so that people can be assured that the facts justify the policy? Can the Minister confirm reports in the Times that officials have drawn up plans for local lockdowns modelled on the tier 4 restrictions introduced last year, and that, under these measures, people will be advised to stay at home and non-essential shops and hospitality will be closed, if the new strain is not brought under control?

On Bolton and Bedford, I regret to say this, but it seemed that the Secretary of State reverted to a blame game yesterday, perhaps to deflect from the fact that the Government did not do enough to protect us from this new variant. He said that people infected by the new variant in hospitals in Bolton had refused or not taken up the vaccine and had chosen not to take the jab. I felt that was very unfair.

My honourable friend the MP for Bolton, Yasmin Qureshi, says that the vaccine is not easily accessible to some of the poorer and BAME communities in Bolton: for example, some people have to take three buses to get to the vaccine centre in the centre of the town. If you are not mobile and do not have flexibility in your working hours, or are a key worker and have caring responsibilities in a multigenerational household, you are not refusing the vaccine if you cannot get to it.

Turning to Bedford, the Secretary of State, Matt Hancock, has said that Bedford is now to be among the areas given surge testing, as the borough recorded the second highest rates of Covid-19 infection in the country, and that cases were doubling every five days. This comes after the MP, the mayor and the health chiefs all called on the Government to act quickly to prevent further spread of the variant in Bedford. For days they have felt ignored. They have felt that the Government wanted to recognise the new variant as a northern problem, which clearly is not the case because it is in Bedford. My honourable friend Mohammad Yasin MP said that, after a fair bit of dither and delay, he welcomes surge testing in Bedford.

Can the Minister tell us whether it is true that Bedford has no access to the Pfizer vaccine at the moment? This must limit a comprehensive vaccine campaign in that town; you cannot do a comprehensive vaccine campaign, especially if you are dealing with the under-40s, if you do not have two or three of the vaccines that are available. I am aware also that reports of many people choosing to delay their jab were about concerns over side effects and whether they would be available for work or might struggle to manage their responsibilities. So the Government must give resourcing and support on these issues and improve the flexibility, information and understanding at a local level.

The Minister is also aware that achieving the truly remarkable vaccine take-up among adults will still leave 20% of the wider population—our children—unvaccinated, meaning of course that the virus can still spread. So can he update the House on any plans to vaccinate the under-18s? It also remains unclear for how long vaccines prevent Covid-19. Initial studies suggest that it may be six months, or possibly longer. Well, those who were vaccinated in December are rapidly approaching that. So we need to know whether there will be declining protection from Covid and what assessment the Minister has made of this risk. Can he update the House on plans to roll out booster shots this autumn?

Finally, at this critical time when we need to work internationally, why are we the only G7 nation cutting our aid budget? How can the Government defend cutting our contribution to vital science and research projects? Given the Government’s total silence on President Biden’s support for the temporary lifting of patent protections to increase vaccine production, should we assume that the British Government do not agree with the President?

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, I too thank the Minister for coming before the House to deal with this Statement, and also for his work ethic in dealing with Covid-19 over the last 14 months.

From these Benches, we have always said that we will support whatever is proportionate and follows evidence to keep people safe. The more that you delve into the Government’s reason for not including India on the red list at the same time as Pakistan and Bangladesh, the more it feels like a big ball of candyfloss that initially seems tempting but disintegrates on touch. Yesterday, both the Minister and the Secretary of State said that India was not put on the red list at the same time as Pakistan and Bangladesh because of the positivity rate.

Looking at the figures for the two weeks before Bangladesh and Pakistan were put on the red list, the positivity rate for India was 5.1%. For Pakistan, it was slightly higher at 6.2%, yet for Bangladesh it was lower, at 3.7%. The same data—the Government’s test and trace data—shows that in the same two-week period, 50% of all new variants entering the UK, including those of concern, were from India: the largest country by far. Therefore, variants of concern and positivity rates show India to be on a par with, or ahead of, Bangladesh and Pakistan. So what data were the Government actually using, if it was not their own test and trace data? Can the Minister place on the record that data and the raw data which made him, and the Secretary of State, say that India’s positivity rate was three times higher?

Another area of concern is people entering the UK being huddled together at the border with people entering from red-list countries. One needs only to look at the significant Twitter feeds from yesterday of people arriving from green or amber countries, who were spending up to four hours in queues to get over the UK border and having to stand next to and mingle with people entering from red-list countries. Heathrow and Manchester Airports were responding that, despite asking the Government for more border staff to deal with the issue, none had been forthcoming.

This was planned. We knew that international travel was allowed and the Government knew that the traffic-light system was being introduced, so why have the Government not carried out the wishes of the airport operators to ensure that more border staff and more guidance are available to segregate those entering from red-list countries? This is a clear public health crisis at our border, and the Government have not, to date, solved it. So, as a matter of urgency, when will this public health breach right at our borders be solved?

Finally, as variants of concern continue to enter the country and replicate at speed, “isolate, isolate, isolate” becomes vital. Yesterday, the Secretary of State in another place indicated to Munira Wilson MP that the Government were worried that isolation might not be as robust as required, and that some pilots were taking place. Can the Minister outline where they are, what the parameters of the pilots are and when the results will be made public? Also, overwhelming evidence now shows that people on lower salaries must be paid their full wages and given support to ensure that they can comply with full isolation requirements. Will the Government now look at this as a matter of urgency?

Lord Bethell Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
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My Lords, I am enormously grateful for the very detailed and thorough questions from the noble Baroness and the noble Lord, and I am also appreciative of and touched by their kind comments.

The noble Baroness asked about the Indian variant and the uptake of the vaccines. I reassure her that we are doing absolutely everything that we can to ensure that there is a thorough uptake of the vaccine among all communities. She spoke touchingly about the feeling of blame associated with those in hospital who people hear have not taken the vaccine. I hear her comments, but there is no attribution of blame meant in this. It is a simple statement of fact that if you do not take the vaccine that is offered to you, or if you do not take two doses, and you then expose yourself to the virus, that is putting yourself in substantial danger, and it is a clinical observation that many of those who have ended up in hospital with severe disease are those who have not had the vaccine, even though they may have been offered it.

The noble Baroness asked about accessibility. She is entirely right that there are some people to whom we as a healthcare system have not made ourselves accessible enough. During this pandemic we have moved on from using the phrase “hard to reach” and we now think of it in terms of people who find us “hard to access”. She makes a perfectly reasonable observation in that respect, but I reassure her that we have absolutely bent over backwards to do everything we can to put the vaccine in front of all groups in the country, particularly those in areas such as Bolton, which we recognise have in the past been places where we have not got our message across.

I personally am hugely touched by the videos I have seen of people now queueing to have the vaccine. I applaud all community leaders and those who work with communities in Bolton, who have clearly mobilised a huge amount of public sentiment behind the vaccine programme. We are seeing a transformation in the penetration rates among some very important communities.

There is more that we can do. I am open to any suggestions from noble Lords on how we can do better, but I would like to reassure noble Lords that we have strained every sinew in trying to achieve vaccine equity across all groups in the country. That is true not only in Bolton but in Bedford, and I am disturbed to hear that people in Bedford feel they may have somehow been overlooked. I do not believe that is the view of the Vicky Head in Bedford, the DPH, and we have worked extremely closely with her. I assure the noble Baroness that cluster 2, linked to 12 cases in Bedford, was targeted immediately. An MTU went to the community on 8 May, and two community sites were opened up on 10 May. We have absolutely prioritised Bedford, as we have Sefton, Leicester, Nottingham and London—all areas where clusters have broken out. There is absolutely no question of prioritising one area over another. On the availability of the Pfizer vaccine in Bedford, that is news to me. I will be glad to look into that and to write to the noble Baroness accordingly.

On children, as noble Lords will be aware, this is an area in which some of the vaccine companies are making considerable progress in their clinical trials. None is categoric yet. It is too early to have agreed policy in this area, but the noble Baroness makes a very good point. Opening up the Covid vaccine, as we have with the flu vaccine, means that not only are children with some kind of vulnerability, particularly to long Covid, put into a safe place but that the transmissibility of that important age group can be reduced.

I am afraid we cannot know for certain the long-term effect of the vaccine until time has passed, but the CMO’s view is that the indications on the body’s immune system are extremely strong. At this moment it seems the vaccine is working, and our confidence is at a reasonably high point, but we remain vigilant. VoCs could emerge that either reduce the effectiveness of the vaccine or, for instance, effect some kind of decline in protection from the vaccine. That is why we have put in place contingent plans for boosters in the autumn. Those boosters might be of the existing suite of vaccines that are proving extremely effective. We are also looking for VoC vaccines that may be used to supplement the range of immune responses so that they cover any new mutations or variants that may emerge.

I cannot immediately recognise from the Bench the data the noble Lord, Lord Scriven, gave on the India VoCs. I wonder whether it was data that emerged after we made the decisions, because a lot of the sequencing data is retrospective; it takes between a week and 10 days to emerge from the Sanger Institute. That is one of the difficulties in making these decisions, which sometimes seem so clear-cut in retrospect. When you have the data available to you on the day, the decisions are not necessarily quite so apparent.

I do not really recognise the criticisms the noble Lord makes of the red list system. The red list system we have in the UK is an incredibly important shield and is proving extremely effective. Segregation is unbelievably difficult during travel. It is very difficult to segregate amber list and red list passengers on a plane, train or ferry. Within an airport it is very difficult to segregate people, because of the physical proximity. That is why travelling is dangerous, why we tell people not to travel and why, when people do travel, we tell them to isolate. Travelling is dangerous, and that is not news to us or to the people who get on those planes in the first place. The ultimate sanction here is that, particularly as we go into the summer, we tell people: travelling is not for this year. Please stay in this country.

On the isolation pilots the noble Lord referred to, we are running a large amount of work on pilots for isolation generally. If he would like to write to me about the particular pilots he was referring to, I will be glad to give him an update. I am afraid I am not quite clear at this stage which ones he is referring to.

Baroness Garden of Frognal Portrait The Deputy Speaker (Baroness Garden of Frognal) (LD)
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My Lords, we now come to the 30 minutes allocated for Back-Bench questions. We do not have that many Back-Bench questioners, but it is still quite good discipline if people keep their questions and answers as brief and relevant as possible.

Lord Popat Portrait Lord Popat (Con) [V]
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My Lords, I thank my noble friend the Minister for his repeat of the Statement. It is indeed welcome news for people and the economy that we are able to move to step 3 in our road map. However, as the Health Secretary said,

“we must be humble in the face of this virus.”—[Official Report, Commons, 17/5/21; col. 424.]

While the UK has had the highest vaccination enthusiasm in the world, does the Minister agree that it is deeply worrying that many people eligible for a vaccine, particularly among vulnerable age groups, have still not had one? This was seen in Bolton, where the majority of the 19 patients admitted to hospital with the new Indian variant, especially people from ethnic-minority communities, have not had a vaccine. What further support can the Government give to promote the better uptake of vaccines among ethnic minorities?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, my noble friend refers to humility and he is right: we have all had to develop a stronger sense of humility in the face of this awful virus and this dreadful pandemic. It has taught us that, despite all our 21st-century healthcare systems, we are all vulnerable to its awful effects. His words are absolutely spot on. I repeat the statistic that 69.4% of adults across the UK have had the vaccine, because the overall story of the vaccine rollout has been one of incredible participation by the British public. Not only have I never been involved in anything quite so successful in my life but there are very few national projects anywhere in the world that have been as successful. I really applaud all communities in every part of Britain for the way in which they have stepped up to the vaccine. My noble friend is right that there are some communities in which those levels are not as high as they should be. That has led to higher transmission among younger people, and in a few cases that has led to severe disease among older people who, frankly, should have taken their vaccine. I urge everyone to step up to their opportunity.

Baroness Finlay of Llandaff Portrait Baroness Finlay of Llandaff (CB)
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As the Minister, who has worked tirelessly during Covid, knows only too well, an outbreak anywhere can become an outbreak everywhere. Can he tell us how the UK plans to increase vaccine distribution globally through COVAX to control the pandemic and decrease the risk of further variants arising in countries with high rates of infection, particularly as the risk of vaccine-resistant variants will remain high for at least a decade?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the Tedros principle of us being safe only when we are all safe remains the most profound insight. The noble Baroness is entirely right: we must do more to try to help those in the developing world. The frustrating truth is that the world simply does not have enough capacity for the manufacture of these very complex and tricky substances. We are straining every sinew to try to deliver the 9 billion vaccines we need to deliver worldwide vaccination, but the rate of manufacturing is not as high as any of us would like. I take my hat off in particular to AstraZeneca, which has provided licences for the vaccine worldwide on a no-profit basis, but I also pay tribute to the other vaccine companies, which, despite what one might read in the press, are trying all they can to set up manufacturing sites all around the world. Progress is being made.

Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath (Lab)
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My Lords, I too salute AstraZeneca for its noble efforts. However, I would like to take the Minister back to the SAGE meeting of 13 May, when the Government were warned:

“In the areas where numbers of infections are increasing rapidly … an even faster increase can be expected if measures are relaxed”.

The Government went ahead with relaxing the measures yesterday. I know that Mr Dominic Cummings can perhaps not be regarded as the most reliable of commentators, but was he not right to say that fast, hard and effective action is the best policy for the economy, as opposed to always delaying taking decisive action? When it comes to the next stage, can we be reassured that the decision will not be taken until the evidence in June is fully assessed and evaluated?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I am a big supporter of the “fast and hard” principle. In our response in Bolton, Bedford, London and elsewhere, we have demonstrated that principle in our handling of the Indian variant. I point out that the use of testing and social distancing measures in schools has been enormously effective. One of the remarkable aspects of the infection rate so far is that transmission levels among school-aged children have not increased in the way that SAGE and others, including myself, once feared. We should take a “glass half-full” moment to applaud that fact. I reassure the noble Lord that we will absolutely make these decisions on the data. Space has been put in between the steps for exactly that reason, and we are not going to rush it.

Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (LD) [V]
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My Lords, could the Minister outline the Government’s plans for test and trace as lockdown is lifted, particularly in areas such as Bolton and Bedford where surge testing is currently being deployed? With former centrally based Public Health England staff being disbanded and senior civil servants returning to their own posts, what financial resources are being passed to the local resilience teams, run by local directors of public health, to operate test and trace, which will be so critical to controlling the spread of the virus alongside the vaccine rollout?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the outbreak in Bolton, Bedford, London and elsewhere has demonstrated, if that were needed, the paramount importance of keeping resources for test and trace at a critical level, and that is what we have done. Since the national infection rate is lower, there is a much greater emphasis on the kind of surge activity and outbreak management that the noble Baroness describes. Sequencing has proved to be an essential part of that process, and we have brought sequencing from the back of the laboratory to the front line of test and trace operation. Every single positive case is now treated as though it were a VOC, with the same amount of tracing and sequencing that a VOC would have had a few weeks ago. We have the full operation on standby. Should another wave of infections arrive, as it may well do with the relaxing of social distancing, we have the systems in place to be able to deal with it.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, I declare my interest as Deputy Colonel Commandant of the Brigade of Gurkhas. The Indian variant is spreading not just across the United Kingdom but across the north Indian plains and into Nepal, a country ill-equipped to deal with such a pandemic. Given the speed of response and support offered to India, I simply ask my noble friend whether the Government will respond positively to Nepal’s request for 2 million doses of vaccine.

Lord Bethell Portrait Lord Bethell (Con)
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I am grateful for the briefing on Nepal I had earlier from my noble friend. The scenes that we have seen in north-west India are heart-breaking. Nepal is such a good example of the kind of country that the global community needs to surround and support with vaccine technology that, frankly, is for G7-style countries to help to provide to developing countries. I take my noble friend’s point completely on board. I do not have immediately to hand the statistics about what Britain is doing for Nepal on the vaccine front, but I will be glad to write to him with any data that I can put together.

Baroness Bull Portrait Baroness Bull (CB)
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My Lords, I declare my interests as set out in the register. With the move to stage 3 of the road map, university students can now return to campus. Most of them are too young to have received vaccines so students around the country will form a significant cohort of young people undertaking regular and frequent testing as a matter of course. What consideration has been given to the benefits of sustaining PCR testing and sequencing at scale in universities as a way of rapidly identifying and understanding new variants? Will the Government consider providing funding to support that in future?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay tribute to the vice-chancellors and to the universities and colleges of Britain for the way in which they have embraced campus testing. It has been a salutary lesson in what can be done, and it has helped to keep infection rates down on campuses where there has been a small number of returning students to date. That is done mainly through LFD testing. Positive tests then have a complementary PCR test, and the PCR test is automatically sequenced if it is positive. The combination of LFD, PCR and sequencing is the right one for keeping infection rates down, but we tweak the formula as and when best advice comes in.

Lord Sikka Portrait Lord Sikka (Lab) [V]
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My Lords, the pandemic has hit the low-paid and the poor the hardest. The Government need to commit to a road map to a better post-Covid society so I invite them to make two pledges. First, at the very least, they need to reduce the NHS waiting lists in England from the present 4.95 million to 2.5 million, which was the case in 2010. Will the Minister pledge to do exactly that by the end of this Parliament or even sooner? If not, why not? Secondly, the poorest 10% of households pay 47.6% of their income in direct and indirect taxes, compared with 33.5% for the richest 10% of households. This condemns millions of people to poor food, housing and health, which is a key reason for deaths during this pandemic. Will the Government pledge to eliminate that injustice by the end of this Parliament?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I recognise some of the noble Lord’s insights. It is undoubtedly true that the low-paid and the poor have been hardest hit by Covid, both by the infection rates themselves and by the lockdown. That is a frustrating truth that is completely recognised and acknowledged by the Government. It is also true that the low-paid and the poor have health inequalities that have themselves made people more vulnerable to sickness, both from Covid and from the non-Covid diseases that have been exacerbated by limited access to some parts of the NHS. We are absolutely committed to reducing NHS waiting lists—that is an incredibly important part of the “build back better” mantra—but we need to do more to bring a degree of levelling up to all parts of society in order to address the symptoms that the noble Lord rightly describes.

Baroness Uddin Portrait Baroness Uddin (Non-Afl)
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My Lords, I welcome the remarkable progress of the uptake of the vaccine in all communities, and I thank the Minister for coming to us with this Statement. However, I am sure he will understand that serious questions remain about the Government’s decision not to red-list being a direct cause of this dangerous Indian variant—I am sure that at some point the Government will have to answer fully to Parliament—and that it is not true, even as a clinical assessment, despite the media repeatedly and consistently suggesting this, that the uptake of vaccinations is the responsibility of certain communities. The Minister will appreciate the likely and even inevitable consequences of rising Islamophobia and hate crimes, as has been reported by Tell MAMA. What are the Government going to do to monitor and support local communities to ensure that they do not face such consequences? Also, echoing the noble Baroness, Lady Tyler, what plans and resources are in place to monitor and support compliance as we enter the next phase of the road map?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I have to be honest with the noble Baroness: I am not sure it is helpful to try to connect healthcare policy decisions with a commentary on hate crime. The people who have not stepped up to the vaccine come from a very wide variety of communities; it is not one single community that has been singled out. We are talking about everyone from migrant workers in the apple yards of Herefordshire, to hard-working off-book sweat-shop labourers in east Leicestershire. In between there are people from many different communities who have not taken advantage of the vaccine opportunity. We are working really closely at NHS level to reassure community leaders and individuals concerned that the vaccine is safe and will provide protection. That is the right conversation to have.

Lord Bradshaw Portrait Lord Bradshaw (LD) [V]
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The bus industry has cleaned up its buses and introduced lots of ventilation, and people are wearing masks. Is there any hope that the amount of social distancing on buses will be reduced in the near future, because there is a lot of unused capacity?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay tribute to the bus industry. Many noble Lords will remember those terrible stories at the beginning of the pandemic about bus drivers having an extremely high incidence of severe disease and even death. But the noble Lord should have hope as there is a really good reason why the buses will one day be full, and that is the vaccine. The vaccine gives us all hope that the kind of life we once had can be revisited, although we have to take some time to ensure that the vaccines are working as well as they should. We have to ensure that booster shots, if needed, are delivered. We have to ensure that the vaccine cuts through to all communities and that hygiene—the social distancing, handwashing and other personal hygiene disciplines which are going to be a long-term commitment by the entire nation—is truly imbedded in everyone’s habits.

Baroness Verma Portrait Baroness Verma (Con)
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My Lords, I thank my noble friend for the Statement repeat and congratulate him on the work he has been doing over the last many months. Does he agree that the public health messaging, which has been very good in all communities, should continue because we are going to get many other forms of variant? As the noble Baroness, Lady Finlay, says, this is going to be an ongoing issue, probably for a number of years, and continuous messaging will be key. Will he also tell me, given the recent new variant, what conversations he is having with counterparts from the countries concerned to see how that variant is reacting, what is happening there and whether it is reproducing rapidly or slowly, so that better informed decisions can be made in our own country?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I am extremely grateful to my noble friend for her insight. She is entirely right; this awful pandemic does have a silver lining, which is that it can be an inflection point for a complete transformation in our public health messaging. The work we are doing on communicating the threat of the variants is one example of that. The next front line will be the flu jab rollout in the autumn, where take-up rates have been okay but not great. I hope that, when the flu jab campaign begins this autumn, a completely different generation and spread of people will step up to that opportunity. We are working extremely hard to use the public mood and sentiment behind preventive medicine to full effect to ensure that the flu jab works, that therefore a much smaller proportion of the population will transmit flu, and that deaths and severe disease from flu will be reduced. That can be the legacy of this awful pandemic.

Baroness Watkins of Tavistock Portrait Baroness Watkins of Tavistock (CB) [V]
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My Lords, I welcome the vigilant focus described in this Statement that has been adopted by the Government, and that the response is being co-ordinated through the UK Health Security Agency. Could the Minister explain how England is working with the other three countries in the UK to ensure that a proactive approach is taken to the new virus variant, that the uptake of vaccines increases, that the monitoring of transmission continues, and to enable early intervention should the number of cases increase? In particular, what data are the Government collecting on the number of people in quarantine hotels testing positive for coronavirus and how many people have absconded from quarantine? Would the Government consider adopting a process similar to the electronic tagging undertaken in South Korea, to more accurately monitor the movement of people in and out of the country at its borders?

Lord Bethell Portrait Lord Bethell (Con)
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I am enormously grateful to the noble Baroness for that creative and thoughtful question. The good news is that the number of absconding residents from managed quarantine is minimal; it can be counted on one hand and many of them have been retrieved. The bad news is that the positivity rate in managed quarantine is far too high. I do not have the precise number in front of me and do not want to guess at it, but it is clearly true that far too many people are getting on planes when they are infected and far too many people are catching the disease on their travels. When we think of how to manage any vaccine-evading and highly transmissible variants, we have to look to the red list for secure protection for this country. She asked another question I cannot remember, but I will be glad to write to her about it.

Lord Randall of Uxbridge Portrait Lord Randall of Uxbridge (Con) [V]
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I was genuinely excited to be able to attend a Saracens rugby match last night, and I notice from my noble friend’s Twitter feed that he too was out last night enjoying a thoroughly well-deserved visit to Sadler’s Wells. My sincere thanks go to all those who have made this step to normality possible, particularly my noble friend. However, like others, I have concerns about the entry arrangements at airports. While I fully understand the difficulties of segregation and that international travel should be strongly discouraged, does he agree that more should be done to prevent passengers arriving from red, amber and green countries mixing—particularly at airport border entry points with those from red countries, where, as he has just said, there is obviously a high degree of infection?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I enjoyed the contemporary dance at Sadler’s Wells, which really lifted my heart, but I rather wish I had been at Saracens for that thumping victory and to see my favourite team doing so well after a difficult year. I very clearly hear the concerns of noble Lords about social mixing of amber and red route passengers at airports, and one reads about it in the papers. I reassure noble Lords that the amount of segregation in place in the airports is the focus of both Border Force and the Home Office. We are absolutely doing our best. We are looking at red list terminals, but the practicalities of that when there is a relatively low level of flights are very challenging indeed. I reiterate my point that if you are travelling you are putting yourself at risk, and there is no way we can pretend otherwise. If you are travelling, you should isolate yourself for a substantial amount of time when you touch down in the UK. This question of mingling in airports is, to some extent, a red herring.

Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP) [V]
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My Lords, it is clear that the B16172 variant of SARS-CoV-2 is now established in the community, but that only highlights the need to keep out further variants of concern that will inevitably arise around the world as the coronavirus runs rampant. Following the question of the noble Baroness, Lady Watkins of Tavistock, can the Minister reassure me about the security arrangements in quarantine facilities given the number of cases of transmission in New Zealand and Australia, who have long practised quarantine? How often are staff being tested? Are they being paid in ways that mean they do not have to take other jobs, particularly jobs where they may have contact with large numbers of people? Are ventilation systems being checked regularly?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Baroness is entirely right to cite the examples of Australia and New Zealand and the challenges they have had with staff manning managed quarantine facilities. I am extremely grateful to officials from both Australia and New Zealand for the very thorough briefings we had when we set up our managed quarantine facilities. We totally took on board their profound insight on that area and that was the number one thing they told us to get right. We focused on it, we have invested in it, and that has worked well to date.

Lord Lexden Portrait The Deputy Speaker (Lord Lexden) (Con)
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My Lords, all questions have been asked and answered.

Sitting suspended.