Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Baroness Brinton Excerpts

Thursday 17th March 2022 Lords Chamber

Moved by

[Baroness Brinton]

As an amendment to the above motion, at the end insert “but that this House regrets that the Regulations are (1) contradictory to guidance provided by the UK Health Security Agency and NHS England on what action to take when you test positive for coronavirus, (2) an example of public health messaging that has caused confusion amongst the public, and (3) financially exclusionary to those on low incomes who cannot afford either the costs of tests or to isolate without financial support.”

[Baroness Brinton (LD) [V]]

My Lords, I want to make it clear that this amendment to the Motion is not a discussion about plunging the UK back into lockdown or imposing mass restrictions on individual liberties. I am talking here about the Government’s decision to scale back sensible public health measures—measures that would help us to continue to manage and monitor this pandemic, which is far from over.

Last week, the WHO reminded nations such as the UK that even when a virus is endemic, it needs managing, including testing, self-isolation and mask wearing. Even if not required by law and regulation, the WHO says that messaging and communications from Governments are vital in ensuring that people can take personal care. I am talking about clear and consistent messaging from our leaders about what they mean by “personal responsibility”. I am talking about support and guidance for those who still want to do the right thing and avoid spreading Covid-19. We still need to protect our NHS and ensure that those who are most likely to get severe disease, even if vaccinated, are also protected. I hope that we can all agree on these principles.

By the way, the Government keep changing the terminology for the group who have variously been called shielders, the clinically extremely vulnerable, immunocompromised and immunosuppressed. I hope the House will forgive me if I just refer to them as the CEV as a shorthand; otherwise, it becomes a real mouthful.

Time and again over the course of this pandemic, we have seen boom and bust policies relating to controlling Covid, stretching our NHS and care systems to the brink of breaking point and then introducing half-baked policies to tackle a fire that is already raging. Now we are seeing the bust again, with the withdrawal of almost all our tools to tackle this pandemic.

While we continue to allow Covid to spread through our hospitals, we cannot possibly hope to tackle the backlog of over 6 million patients waiting for treatment. The weekly average for Covid hospital admissions last week was 1,500 per day—an increase of 18% on the previous week. I am hearing that the NHS in the east of England and in London regions is already at level 4, and cases are still rising extremely quickly. Can the Minister say what plans there are if hospital admissions continue at this pace, and, given that they are a lagging indicator to cases, which have risen over 50% on the government dashboard in the last few days, how will people be protected from infection without access to test and trace from 1 April?

Sickness absences everywhere are also rapidly increasing. What are Ministers doing specifically to help keep infection levels lower among key workers, especially, but not only, in the NHS and social care sectors? Today, the Health Service Journal reports that Covid sickness absence in the NHS is up 20% in one week. What is the contingency plan if that continues to rise?

Those against any precaution say that we have to learn to live with Covid, but many people with omicron BA2 are saying that it is more like a cold at the start, and then it is like flu and worse. The problem is that it is ultra-transmissible when it is asymptomatic and in those early sneezing days. Would Ministers consider a campaign to strongly encourage wearing face masks, and at the very least try to protect key workers and the clinically extremely vulnerable?

The difference between what is being said at the Dispatch Box and in the Government’s living with Covid plan and guidance published at the end of February is most concerning. The UKHSA webpage is very clear: you must self-isolate if you have symptoms and are unwell. But this is not a clear message coming from our leaders, with statements such as “Stay at home if you can” and “Take personal responsibility”. Can people afford to? Can they manage to arrange deliveries? Can they even be bothered? Will the Minister today state in clear terms that, even though the legal requirement to self-isolate has ended, it is still absolutely expected that anyone who tests positive for Covid-19 will self-isolate? Will employers be told that they should not tell staff—as Wilko and Asda have already done—that they must work even if they test positive?

Speaking of testing, the policy document on living with Covid mentions the continued availability of

“limited symptomatic testing available for a small number of at-risk groups”.

As for who is included in these at-risk groups, yet again the public are still in the dark. We are only two weeks away from 1 April and we still do not know. We are told that information on who will have access to tests is coming. Surely this has to have been decided already. Why are we left waiting for this vital information yet again? We know already the groups that should have access to tests: the clinically extremely vulnerable and their close contacts; pregnant women; NHS staff; those working with vulnerable patients; those who attend hospitals regularly; unpaid carers; and, frankly, at the moment, our military as well. These groups will make up a sizeable proportion of the population, and I wonder how the Government are planning to identify those who will qualify for free tests.

Portsmouth City Council is so concerned at the 74% increase of positive Covid cases in just one week—to 630 cases per 100,000—and the 50% increase in cases at the Queen Alexandra Hospital to more than 150 Covid beds that it took the decision yesterday to provide free lateral flow tests to residents for three months if the Government will not. This is really tough, given that local authority public health budgets this year have not even covered inflation, and there is no extra money for any Covid mitigations such as test and trace. By the way, the Minister said on Monday that local resilience forums will now cover test and trace as the central ones are being closed down. But what are they going to do that with? No money at all. But in Portsmouth, a city full of key workers, the council feels that it has to do it.

By not providing tests for asymptomatic contacts of the clinically extremely vulnerable, we are placing them in perpetual lockdown. Not providing asymptomatic testing in hospitals also puts patients at risk. It is interesting that PPE is still going to be provided free of charge for NHS trusts until March 2023. But why has PPE been prioritised over testing? We need to know where the Covid is, and we need to protect our patients and staff. Can the Minister please confirm that this “limited free testing” will be only for people with symptoms and that the plan is to end all asymptomatic testing?

From these Benches, we have talked about the lack of financial support for those who should be self-isolating, and the revocation of that means that many people will have no choice but to go into work unwell. We ask again for this to be reinstated. By taking away the little support that was offered, the Government are clear that people’s self-isolation sacrifices are not worth anything to them—it just does not matter. Ministers talk about personal responsibility but people need to be supported financially to do the right thing, especially with reinfection rates as high as they are.

To conclude, the Government are determined to tell everyone that we have to learn to live with Covid. But by throwing away all surveillance testing and tracing, leaving individuals, employers, our NHS and even the Government completely blind about what is happening, and standing down SAGE at exactly the time that we have the highest level of infection rates, with spiralling cases and hospital admissions and, sadly, a likely increase in deaths in the next couple of weeks, how on earth is the country meant to assess and take their own responsibilities? I hope that the Government will change their mind on these epicentral precautions and mitigations. I beg to move.

[Lord Hutton of Furness (Lab)]

My Lords, I have some sympathy with the arguments that the noble Baroness has just made, but I think this is probably not the time to have a general debate about the Government’s handling of the Covid-19 pandemic.

These regulations are fairly narrowly drafted and are designed to repeal the earlier regulations that required vaccination against Covid-19 to be a condition of deployment in the NHS. I support the repeal of these regulations. The Government have made a good case for the repeal in the Explanatory Memorandum, but none the less, it represents quite a significant and dramatic U-turn in government policy.

I do not think it made a lot of sense to require compulsory vaccination; there were other ways of ensuring the protection from harm of NHS patients. Of course, the loss of critical front-line NHS staff which the earlier regulations might well have produced would itself have represented quite a significant risk of harm to NHS patients.

Today, I have only one question I want to ask the Minister. Again, it is something that is contained in the Explanatory Memorandum. Paragraph 7.29 says that the Government will engage with NHS employers to review their policies on the hiring of new staff and the deployment of existing staff to take into account their vaccination status. I ask the Minister what the Government want to see change in NHS hiring and employment practices. Will new employees in the NHS, for example, need to have been vaccinated against Covid-19? What does this paragraph in the Explanatory Memorandum actually mean?

--- Later in debate ---

[Baroness Brinton (LD)]

My Lords, I thank all noble Lords who have spoken.

The Minister said that we were saying that the pandemic is over. Not one person speaking today has said that it was over. We have all said that is has been moving to endemic and that the WHO advice was about making sure that, as formal restrictions lift, there should be continuing precautions. The Minister said that omicron BA2 is substantially weaker. Yes, it is, but the maths is also simple. He said that it is the dominant strain, but, if you have a very high level of case numbers, hospital admissions, ICU admissions and deaths will also rise. The point about testing was well made by the noble and right reverend Lord, Lord Sentamu. If local government’s public health is a vital partner, will the Government please fund this extra work?

The Minister asked us whether we only fund the very poor for lateral flow tests. The point is that the virus does not distinguish and it is really important that those on low incomes, who are facing astronomically high cost of living rises, are given some support. I thank him for his comments about the CEV forum, but just talking, without any active support for the clinically extremely vulnerable, is a chocolate teapot. The noble Lord, Lord Hutton, asked a key question on whether this is the right time to change all these mitigations and, while the Minister thanked all the doctors, scientists and other NHS key workers, I think we all agree that most of them are saying that it is too early to lose these mitigations.

I regret that the Minister has not given me reassurance. However, I withdraw my amendment.

Amendment to the Motion withdrawn.