(3 years, 3 months ago)
Lords ChamberMy 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.
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.
(3 years, 5 months ago)
Lords ChamberMy Lords, I am enormously grateful for the questions from both noble Baronesses. I will try to address them and if I omit any, I will be happy to write to them with more details.
I will speak first about supply and its importance to the rollout of the vaccine. We have always said that a vaccine programme of this pace and scale may have lumpy interruptions in supply. Noble Lords will be aware that we have done incredibly well to get to the kind of rates that we saw over the weekend in the way that we have; more than 800,000 in a single day is an absolutely astonishing figure. However, delays are envisaged. This is in part due to a delay to a shipment from the Serum Institute of India, which is doing a herculean job of producing vaccines in such large quantities, and because of a batch that we already have in the UK that needs to be retested. We will receive slightly fewer vaccines in April that we did in March but that is still far more than we did in February, and the supply that we have will still enable us to hit the targets that we have set. I emphasise that point. That means that by 15 April we will be able to offer a first dose to everyone over 50 as well as those who are under 50 but clinically vulnerable. It also means that we will be able to give second doses to everyone who has had a first dose within the 12-week window, which means around 12 million second doses in April. It also means that we will be able to offer a first dose to every adult by the end of July. I hope that provides the reassurance that the noble Baronesses, Lady Thornton and Lady Brinton, are looking for.
On the Moderna vaccine, it is a fantastic achievement that the British Government have secured 17 million doses. These will come into play by mid-spring, and my understanding at this stage is that they will be in time to help supplement the rollout of the vaccine to some of the cohorts 1 to 9 at the end of April.
The noble Baroness, Lady Brinton, asked about our approach to EU relations. I reassure her that the British Government are utterly committed to a spirit of partnership and to respect for contract law in all our dealings. If the noble Baroness has good networks and friendships in Brussels and other EU capitals, it would be much appreciated if she could communicate those values to those in her network.
On those without GPs who would like to have the vaccine, I reassure the noble Baroness, Lady Thornton, that it is possible to get the vaccine without a GP, an NHS number or an NHS login. There are systems in place, and if anyone turns up at a vaccine centre without any of those materials, they will be guided and given the assistance they need to get the vaccine they need. I emphasise that the vaccine has proved to be a terrific opportunity for a lot of people to get to know their NHS number a bit better, to bring their GP records up to date and for many to register with an NHS login in order to get to know their patient records a bit better. It will be a massive inflection point in the digitalisation of the NHS, and that is an opportunity we are grabbing with both hands.
I will take some of the noble Baroness’s questions about queue jumping back to the department. I do not know the specifics of the stories that she described, but I reassure her that NHS records are matched against those for the vaccine, as are those for social care. We do not take a blind or naive approach to the rollout of the vaccine, but it is true that it is not the role of vaccine centre staff heavily to police those who come forward for the vaccine. I am not aware that this has been a material issue, but I should be glad to find out more for her.
Of course we are fully aware of the dangers that the European rhetoric on the AstraZeneca vaccine might lead to a rise in hesitancy here in the UK, but I reassure the noble Baroness, Lady Brinton, that the signs are not there yet. It would seem that the British public remain incredibly committed to the vaccine rollout, the numbers coming forward remain astonishingly high and the public attitude surveys that we are doing seem reassuringly concrete.
We are extremely keen to nut through the last remaining numbers in the cohorts 1 to 9. These few weeks will give us a really good opportunity to give time to GPs and other healthcare staff to spend time in dialogue with those who have legitimate questions. That principle of dialogue and answering questions has been the way we have approached the entire vaccine rollout, and we will continue to use that dialectic method in order to get people over the line. We are also very keen to get the vaccine rolled out among younger people, including, perhaps—if the clinical advice is affirmative—children. It is of course the case that children are eligible for and encouraged to take the flu vaccine, not because they are particularly in danger of hospitalisation or severe disease from flu but because they are transmitters of flu. Exactly the same principle applies to Covid. That is why we are extremely keen to get the message across to young people, and it is extremely reassuring that the rollout of the vaccine among older people may have a profound effect on loved ones in the same family unit. We are hopeful that that will be a big influence on younger people.
On our international approach, I reassure the noble Baroness, Lady Brinton, that Britain is as collaborative as a country possibly could be on the vaccine. I take my hat off to AstraZeneca, which has an extremely collaborative approach and, as she knows, a no-profit protocol for the vaccine. The MHRA has led the way in transparency and sharing of data. On therapeutics and clinical trials, we have shared an enormous amount of data around the world. We remain enormous financial sponsors of all the major vaccine programmes, including COVAX, Gavi, ACT and the others. This approach will continue, and we remain convinced that Britain should take a leading role in the global rollout of the vaccine. We will be using our chairmanship of the G7 to play that role.
Lastly, I hear and appreciate the comments of the noble Baroness, Lady Brinton, on the shielding letter. Those who are shielding are in a very awkward position, but I am afraid that it cannot be solved overnight. The OCTAVE programme is extremely ambitious: it is looking carefully at extremely complex and difficult questions about those who, for one reason or another, have suppressed immunity, and that includes a very broad range of conditions. Professor Paul Moss at Birmingham University Hospital, who is leading that programme, is doing a terrific job, and I pay tribute to him and all his team. We are looking at whether they have the right amount of resources. I had reassurances very recently that everything was in place, but we are looking extremely closely at this area, because the noble Baroness is right: those who have suppressed immunity are in a very special case and we need to be absolutely sure that they have the right vaccine delivered at the right time and the right information to make the decisions necessary to go back into life. Those decisions simply cannot be rushed. A passage of time is necessary to understand the effect of the vaccine on the human body, but we are doing everything we can to answer those important questions.
My Lords, we now come to the 30 minutes allocated for Back-Bench questions: it is 30 minutes, not 20, which was printed in error on today’s list. Even with that extra time, I ask that questions and answers are brief so that I can call the maximum number of speakers. The noble Lord, Lord Lansley, has withdrawn, so I call the noble Baroness, Lady Hayman.
(3 years, 6 months ago)
Lords ChamberThe method of counting is done in the way that it is at the moment because we did try the way that the noble Baroness recommends and that led to all sorts of confusion. It led to people having dozens of SMSs and being called relentlessly by the same staff because other members of their household had been identified. It led to a very large number of complaints, including from noble Lords on the Opposition Benches who read to me at great length the complaints of their contacts. We rationalised the system along the lines we currently implement, and that has led to a much more effective system. The feedback from our questionnaires to households is entirely positive. Having isolated myself, with my considerable household of seven people, I can tell noble Lords that it is a huge relief that the account management system is now around households rather than individuals.
My Lords, the time allowed for this Question has elapsed. I apologise to the noble Lord, Harris of Haringey, and the noble Baroness, Lady Warsi, that there was not time to take their questions. We now come to the second Oral Question.
(3 years, 7 months ago)
Lords ChamberMy Lords, I also pay tribute to the Tessa Jowell Brain Cancer Mission and all its work in putting together a really thoughtful strategy for tackling this most difficult issue. NIHR cancer research expenditure has risen from £101 million in 2010 to £138 million in 2019-20, and its settlement in the recent spending review was generous. I am optimistic that there are more resources there. I reassure the noble Baroness that, although the £40 million for brain tumour research has not all been allocated yet, it is not going anywhere and we are working as hard as possible to ensure that the right kinds of research project are put forward for that money. I would like to see it allocated as soon as possible.
My Lords, the time allowed for this Question has now elapsed. I apologise to the noble Lords, Lord Carlile of Berriew, Lord Polak and Lord Jones of Cheltenham, that we did not have time for their questions.
(3 years, 7 months ago)
Lords ChamberMy Lords, the noble Baroness alludes to a conflict for which there is no easy answer. I completely sympathise with any parent whose child is exhibiting eating disorder issues. It is the most awful and frustrating situation for any parent to see their child in a self-destructive loop for which there seems to be no intervention possible, but patient safety is patient safety, and this is the conundrum that faces any mental health situation. The Mental Health Act is undergoing review at the moment—I am grateful to Sir Simon Wessely for his report, which we debated yesterday—and these are exactly the kinds of issues that we are looking at. I express profound sympathy for all those who find themselves in this awful situation.
My Lords, the time allowed for this Question has now elapsed. I apologise to the noble Lord, Lord McColl of Dulwich, that there was not time for his question.
(3 years, 7 months ago)
Lords ChamberI think the noble Lord has read too much into the AstraZeneca statement. Negotiations with AstraZeneca and provisions in manufacturing capacity are extremely well advanced. All the projections in the vaccine plan published yesterday have been bottomed out and secured with manufacturers and deployment. The Secretary of State was very clear about the objectives of 13.6 million by the end of February and the whole country by the autumn. Those are not vague reassurances; those are bottomed out and have business plans behind them.
My Lords, the time allowed for this Private Notice Question has elapsed. I apologise to the noble Baronesses, Lady Uddin and Lady Gardner of Parkes, that there was not time to take their questions.
(3 years, 7 months ago)
Lords ChamberMy Lords, we now come to the group beginning with Amendment 3. I remind noble Lords that Members other than the mover and the Minister may speak only once and that short questions of elucidation are discouraged. Anyone wishing to press this or anything else in this group to a Division must make that clear in debate.
Amendment 3
(3 years, 8 months ago)
Lords ChamberMy Lords, we come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.
I thank the Minister for being so frank and admitting that the initial rollout will not be uniform throughout the country this year. I want to ask him about those individuals prioritised for the vaccine on the grounds of age or having weaker immune systems—specifically, who will identify those individuals? Initially the role of GP surgeries was highlighted for that task. Is that still the case? What will happen in those GP surgeries—there are quite a number of them—that have no GPs? Will the nurse practitioners be able to perform the role of identifying those individuals? I would like a specific answer to that because it is important in the longer term for a great many people.
I remind noble Lords of the request for brevity.
I remind the noble Lord that the criteria sent out by the JCVI is extremely simple and mainly driven by age, so the selection procedure is very straightforward. He is right that the distribution of the vaccine is limited by both the size of the vials and the need for cold storage. That is why there will be an emphasis on hospitals over GP surgeries. That represents a challenge in places such as rural areas that may be distant from hospitals, but I reassure him that the deployment team is doing all that it can to ensure that no one is left behind.
My Lords, the support we are giving to social care throughout this period is incredibly important. I should be happy to meet with Care UK to discuss this. I cannot duck the issue. The JCVI has made its prioritisation clear. It is based on thoughtful science, infection rates and the calculation of how best to save life. While I feel compassion for carers, including some in this Chamber, we have to live with this tough decision. I cannot pretend I am going to try to change it. The inspection control fund is generous; we have put a large amount of money into it. If it proves not to be enough, we will be happy to revisit it. Protecting social care through these final few months is a big priority. I should be happy to discuss how we can do this better with the noble Lord at his convenience.
My Lords, all supplementary questions have been asked and answered. I congratulate noble Lords.
(3 years, 8 months ago)
Lords ChamberMy Lords, this is not an argument between tackling the virus and ignoring it, as my noble friend the Minister put it in his opening remarks. It is about whether, if one wants to change people’s behaviour, one chooses persuasion or compulsion. In this country, the theme behind our long migration from royal dictatorship to parliamentary democracy is that we think it possible to persuade people to do socially responsible things—not just because we recognise the rights and liberties of individuals but because it works better. Compulsion is often inefficient and counterproductive as well as cruel.
Why have we suddenly abandoned this for a purely authoritarian approach? Command and control, whether in the Ming Empire or in modern North Korea, always lead to misery, not because the commissars were not clever enough or not paid enough but because it is an impossible task to encompass in detail the complexities of deciding how society should be organised from the top down.
I fear that the current approach is taking away people’s agency, undermining their sense of responsibility and preventing them facing up to the challenge of stopping the epidemic through their own actions. As my noble friend Lady Neville-Rolfe said, all the hard work that firms did to make their workplaces safe has effectively been snubbed. We have Ministers and officials trying to devise minutely prescriptive rules about whether a scotch egg is a meal, whether Monopoly is safe to play, how long one can linger over a pint or whether one should take one’s own serving spoons to Christmas lunch with one’s relatives. I quote paragraph 14 of the legislation published yesterday:
“For the purposes of this paragraph, a ‘table meal’ is a meal eaten by a person seated at a table, or at a counter or other structure which serves the purposes of a table and is not used for the service of refreshments for consumption by persons not seated at a table or structure serving the purposes of a table.”
That is reminiscent of the sumptuary laws of the Middle Ages on who was allowed to wear what.
Konstantin Kisin, a comedian, said yesterday,
“I followed the rules during Lockdown 1.0 to the letter. I followed rules that made sense to me during Lockdown 2.0. I will openly disobey any further attempt at lockdown”.
Command and control stirs bloody minded recalcitrance, alienates people from the police and officials, foments conspiracy theories, fuels quack beliefs and boosts anti-vax nonsense. We need evidence that this authoritarian approach does more good than harm. SAGE published a document on 22 October to justify the closure of most pubs and restaurants. Christopher Snowdon of the Institute of Economic Affairs went through the eight footnotes in the section on epidemiology and found that each referred to a study that gave little or no support, directly or indirectly, to the argument that pubs are a problem. One of them is about traditional markets, religious gatherings and wedding parties in Indonesia, for example—it is not about pubs at all. The new legislation for tiers ends with this line on page 75:
“No impact assessment has been prepared for these Regulations.”
As my noble friend Lady Noakes said, the impact statement rushed out this weekend erects a ridiculous straw man that the only alternative is chaos: an exponential increase in infection and the overwhelming of the health service. Yet the increase has not been exponential since early October at the latest. Just four hospitals are currently busier than they were this week last year. That is partly because many of the Covid cases in hospitals are being caught in hospitals. It need not be this way. There are lots of places in the world that are controlling this virus with moderate, pragmatic and flexible initiatives that focus on what matters and do not try to define scotch eggs. To quote this week’s Spectator:
“Sweden believes that people, if treated like adults, tend to heed advice—so compulsion and lockdowns are not needed to control a virus in a mature democracy.”
Sweden has had no more death than Britain per head of population, and a far less severe economic shock, a far smaller increase in debt, and a far less brutal impact on the physical and mental health of people. Other Scandinavian countries have been almost as flexible. The Danish people have rejected a dictatorial law. A new study in Frontiers in Public Health has concluded that neither lockdowns, nor lockdown stringency, achieve lower death rates. It analysed data from 160 countries over the first eight months of the epidemic.
The pattern of excess deaths this autumn, occurring in precisely those areas that largely escaped the virus in the spring, points to an obvious explanation: that the virus naturally depletes the more susceptible population and then fades with very little help from lockdown. I have great respect for my noble friend the Minister, and for this Government’s brilliant work on securing vaccines, but I think he and his colleagues have been badly let down by their advisers who, as my noble friend Lord Lilley said, bounced them into this second lockdown with the most misleading and outdated set of charts ever used to influence policy. Unless the Minister shows us clear evidence that these new tier restrictions will do more good than harm, I will be voting for a regret amendment tonight because I think there is a better way. As the young journalist Tom Harwood put it yesterday,
“We mustn’t forget all that makes life worth living. After this the govt must repay a debt of liberty—with interest.”
The noble Lord, Lord Farmer, has withdrawn so I now call the noble Baroness, Lady Fox of Buckley.
This has been a fascinating evening, has it not? I wonder whether the Minister has any support. I also wonder what the Labour Party is up to, because they do not seem to be taking part at any level at all. We have had precisely two Labour speakers, and no more, one of whom is yet to speak and will undoubtedly tell us what is what.
I have a lot of sympathy for my noble friends Lord Robathan, Lady Neville-Rolfe and Lord Cormack, and I will support whichever of their proposals goes to the vote. I am sorry but this is becoming a complete shambles. We had a little family debate at the weekend about whether we should put granny by the window or whether we did not want her to get pneumonia. We decided that we wanted her not to get pneumonia, because who on earth would end up doing the washing up? When you have senior officials in the Government talking about putting granny by the window, you really know that you have lost something.
At the same time, there is a serious point here. There is a catalogue of misery within the health service of people who cannot see their relatives, of the disabled who are stranded and lonely in homes, and the NHS does not appear to care. Why do we have a Minister for vaccinating people but no Minister for sorting out the NHS—for opening hospitals, opening surgeries, and getting visitors back into homes where people have been isolated, often for months? They are not a compassionate Government; they are in the grip of a handful of so-called experts, one of whom I remember had the distinction some years ago of having half of the cattle in Britain slaughtered quite needlessly. I hope that he does not turn those latter abilities to the general population.
Last Saturday, the shroud-waver in chief, the Cabinet Minister Mr Michael Gove, told us that we would be physically overwhelmed, with
“Every bed, every ward occupied”,
and all the capacity built into the Nightingales and requisitioned from the public sector too. Let me ask this of the Minister: as of today, how many Nightingale beds are full, both as a number and as a percentage? How many of the private sector beds are full, and how many are sitting there, not taking in private sector patients because they are getting big dollops of public money—I speak from some knowledge because I have a number of friends in the medical profession—for leaving the beds empty and not taking in patients? This is the rather sad state that we are in.
What do I propose, apart from what I have said already? We need a wider view among the people who make the decisions. Why are people like Professor Heneghan and Professor Gupta voices in the wilderness? With all their scientific abilities, why are they not at least in the room where the decisions are made? They would be a small minority, but at least they would be able to put forward their views. Why are we not listening to the Chancellor and to industry? We are bankrupting the country. We are running it into debts that it will take years to pay off because we are obsessed with a handful of supposed experts—I say “supposed” because I do not think they are. I also do not think that we can continue to bankrupt the country, which is what we are doing.
I am sorry for those in the Labour Party, but their answer is always, “Give us a chequebook”, and never, “Let us sort out how to get back to normal.” That is what I want to see. I also want to see something that has been alluded to many times in the debate, which is an end to the withdrawal of civil liberties and the chip-chipping away at everything that we stand for. Let me say this: half of the people of the city I live in, which is Cambridge, do not understand the regulations. The other half who do are interpreting them in their own way—and that does not necessarily mean that they are obeying them, because many are not doing so. The Army is now involved in vaccinating people. We are beginning to look like Poland in the 1980s and we need to step back from this. Will the Minister please take tonight’s debate as a serious contribution?
Also, and finally, we must stop persecuting people. Some 45 years ago, I first met Mr Piers Corbyn. When Labour had a leader called Jeremy, people used to say, “What do you think of him?” I would always reply, “You should meet his brother.” What I will say is this: you cannot conduct society on the basis of persecuting a handful of loonies who run around demonstrating. Please stand back, think about it, calm it down, and start all over again.
The noble Baroness, Lady Hoey, and the noble Lords, Lord Shinkwin and Lord Moylan, have withdrawn so I now call the noble Baroness, Lady Jolly.
(3 years, 9 months ago)
Lords ChamberWe all respect the word of Professor Spiegelhalter, who is a great man, but we have instead the Office for National Statistics and the publication of the graphs and the data behind them. I would be glad to send to the noble Lord a link, both to the slides and the data behind them, so that he can check them out for himself.
The noble Lord, Lord Fairfax of Cameron, is unable to join us, so I call the noble Viscount, Lord Waverley.
Communications and the manner of briefings set a benchmark of standards in these challenging times. So why are the Government insensitive to the needs of those who are hard of hearing or sight by not making the Prime Minister’s and other briefings appropriate?