Covid-19 Update
Debate between Baroness Henig and Lord Bethell(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I hear my noble friend’s words loud and clear. The Government have indicated that we will leave it to those who run the transport systems themselves and to local politicians. There is a good case for a degree of devolvement and subsidiarity in this matter. He is right that masks do perform an important role, but they are not a catch-all, and it is therefore reasonable to leave those who run the transport systems to make decisions for themselves.
The Deputy Speaker (Baroness Henig) (Lab)
My Lords, the time for Back-Bench questions has now elapsed.
Alcohol Harm Commission: Report 2020
Debate between Baroness Henig and Lord Bethell(3 years, 8 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
That is a tremendous challenge by the noble Baroness. I will do my best, but before I do, I congratulate the noble Baroness, Lady Finlay, on securing this important debate. I commend her on her commitment to reducing alcohol-related harm and I pay tribute to her and her team for spearheading the excellent report of the Commission on Alcohol Harm. I welcome the report’s recommendations and the opportunity to debate them. Before I make progress, I shall make a disclosure that my wife is a director of the company Diageo.
I acknowledge the report’s emphasis on wanting to change the conversation within society about alcohol and challenge alcohol’s position in our culture. Alcohol is not something which affects only the “weak” or “irresponsible”. It affects many people. We know that most people drink responsibly. I take on board the warnings of the noble Lord, Lord Smith, and the noble Baroness, Lady Fox, that we must be careful about overstating the specific dangers of alcohol or demonising those who drink responsibly. There is some good news in this area: we are seeing an overall decrease in the amount of people drinking, especially young people, which is highly encouraging. But we cannot avoid the fact that there are still those who drink at very harmful levels and where alcohol misuse leads to significant harms for the people involved and their families. I speak as one whose mother died of her alcoholism when I was of a young age, and I know from personal experience the huge impact that alcoholism has on those concerned and their families.
We recognise that there is still much work to be done. I completely agree with the rapporteurs that alcohol has large impacts on society that include costs to health, lost productivity and poor quality of life. Excessive alcohol consumption is the biggest risk factor attributable to early mortality, ill health and disability among 15 to 49-year olds in the UK—full stop. It is considered to be the third-largest lifestyle risk factor for preventable diseases in the UK, after smoking and obesity.
The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling health harms from alcohol, and I would like to touch on some of that today.
I completely hear the call of the noble Baroness, Lady Finlay, for a new government alcohol strategy. The Government have committed to publishing a new UK-wide, cross-government addiction strategy. This will consider a range of issues, including drugs, alcohol and problem gambling and will involve many departments at the same time. While each comes with its own set of issues, there are large amounts of common ground and significant benefits in tackling addiction in a comprehensive and joined-up way. The scope of this addiction strategy is still being developed, so this debate is most timely as we consider what more can be done to protect people from alcohol-related harms.
On alcohol labelling, the Government completely agree with the noble Baroness, Lady Randerson, that people have a right to accurate information and clear advice about alcohol and its health risks to help them to make informed choices. We have worked with the alcohol industry to ensure that alcohol labels reflect the UK Chief Medical Officer’s low-risk drinking guidelines. The industry has committed to complying with this requirement, and we are closely monitoring progress. As part of the Government’s latest obesity strategy, we committed to consulting on the introduction of mandatory calorie labelling on pre-packed alcohol and alcohol sold in the on-trade sector. This consultation will be launched this summer.
My noble friend Lady Jenkin raised the shocking statistic on alcohol-related violence, and I completely agree with her analysis. It is shocking to me that between 2016 and 2018 alcohol was a factor in 66% of violent incidents that took place in the street, pub or club and on public transport; this compares with 30% of violent incidents in the home. Between 2017 and 2019, one in five homicide suspects is recorded as being under the influence of alcohol at the time of the homicide, as is a similar proportion of victims. I have a deep wad of statistics that make extremely grim reading on this matter.
On the specific issue of domestic abuse, we are making progress. We know there is frequent co-existence of domestic abuse, mental health problems and the misuse of drugs and alcohol. Research indicates that in 34% of incidents of domestic violence, the victim perceived the offender to be under the influence of alcohol. The Domestic Abuse Bill will see better protections for victims and more effective measures to go after the perpetrators. We will reflect the importance of joining up domestic abuse, mental health and substance misuse services in the supporting statutory guidance. One action of this important Bill is to establish in law the office of the domestic abuse commissioner, with strong powers to tackle domestic abuse. The description of the commissioner’s role states that they must adopt a specific focus on the needs of victims from groups with particular needs, which could include mental health or substance misuse.
My noble friend Lord Ribeiro asked about restrictions on alcohol advertising. I remind him that there are already substantial restrictions on the advertising of alcohol, but we are working to review and improve them. The Government are working with industry to address concerns over irresponsible promotions, advertising and marketing relating to alcohol. Material in the Committee of Advertising Practice and Broadcast Committee of Advertising Practice codes relating to the advertising and marketing of alcohol products is extremely robust already, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are protected. None the less, the Government are reviewing how online advertising is regulated in the UK, taking into account the many serious points made by my noble friend Lord Ribeiro and looking at how well the current regime is equipped to tackle the challenges posed by the development of online advertising.
The noble Baroness, Lady Masham, spoke so movingly about children and family life. The evidence is absolutely clear that growing up in a family affected by parental alcohol dependency can cause significant harm to children’s well-being and their long-term outcomes. Thanks to the personal testimony and campaigning of many noble Lords in the Grand Committee today, the Department of Health and Social Care and the Department for Work and Pensions have together invested £6.5 million on a package of measures, over three years, to improve outcomes and support for children whose parents are alcohol-dependent.
The noble Lord, Lord Rennard, asked pressingly on minimum unit pricing. There are no current plans to implement MUP in England. MUP has been in place in Scotland for less than three years and the Scottish Parliament will not consider its extension until April 2024, when much more will be known about the overall impact on consumption. We will continue to monitor the evidence as it emerges from Scotland and Wales. In the meantime, we are committed to reducing alcohol-related harm and so have already banned alcohol sales below the level of duty plus VAT. This means it will no longer be legal to sell a can of ordinary lager for less than 40p.
I close by reiterating the Government’s commitment to supporting the most vulnerable at risk from alcohol misuse. We already have a strong programme of work under way to address alcohol-related harms, and the new UK addiction strategy will provide an important opportunity to consider what more can be done. This activity will be informed by the best available evidence, including the report from the noble Baroness, Lady Finlay. I thank her very much for pushing so hard on this important issue and securing such a thoughtful, interesting and passionate debate today, and I thank all noble Lords who have taken part.
The Deputy Chairman of Committees (Baroness Henig) (Lab)
My Lords, the Grand Committee now stands adjourned until 4.30 pm. I remind Members to sanitise their desks and chairs before leaving the Room.
Covid-19
Debate between Baroness Henig and Lord Bethell(3 years, 10 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I am enormously grateful for the questions from the two noble Baronesses. By way of introduction, both the noble Baronesses are entirely right that the variants of concern have been a massive game-changer and the reason for this profound inflection point in our approach to border control. Having invested so much in vaccine deployment, having got it right so emphatically, having been ahead of the world in the identification, development, purchase and now deployment of vaccines, and having got so many people who were at threat of sickness and death into a position of safety, it seems entirely right that we now protect the country from mutations that might escape the vaccine by taking tough measures on the border.
That is different from the situation of a year ago: we had comparable infection rates and were all facing the same virus, which did not seem to mutate for months on end. At that point, the priority was to keep our borders open in order to keep the flow of goods, medicines and essential supplies in the planes, trains and boats that are necessary to support Great Britain. But the variants of concern have completely changed that view. That is why we brought in this new, robust and emphatic regime. It depends, in very large part, on existing legislation, but I reassure noble Lords that our plans are to bring in new regulations, where necessary, at the earliest moment. I hope that that will be very soon.
The noble Baroness, Lady Thornton, asked about international surveillance. That is an important part of our overall plan. In Britain, as noble Lords know, we have the most advanced investment in genomic sequencing anywhere in the world, by far. We are hugely investing in a great dash on capacity, turnaround times, accuracy and the geographic distribution of that surveillance in the UK. But we are also investing in international systems. We have made an open-hearted, big and generous offer to the countries of the world to do genomic sequencing for them, wherever necessary. If anyone wants to send their specimens to the UK, to the Sanger at Cambridge, we will do that for them. We are sending machines, often from Oxford Nanopore, the British diagnostic company, to diagnostic centres in countries that have some genomic capability, to enhance their testing and speed up their turnaround times.
The noble Baroness, Lady Thornton, asked about the enhanced measures we are putting in place to check when people arrive in the UK. I can reassure her massively, because the system for the passenger landing form has been digitised and hugely enhanced. We have dramatically increased the amount of validation of the data put into the PLF. The pretesting certificates are linked directly to the PLF, and we are working on linking it to the hotel booking and testing forms. We are also putting in enhanced surveillance of those isolating at home, which includes phone calls, SMSs and an increased investment in police time to follow up where there may be suspicion of a breach. We are also making a crystal-clear communication to those who have access to private jet travel that we will not tolerate those who have the resources to pay the fines but feel that they can, or want to, get around these measures.
The application of the hotel quarantine measures to all countries—both red list and amber—is something that we keep under review. There is a rolling review of the red list, and we are putting in place the necessary infrastructure, should it be required, for a blanket hotel quarantine protocol on all travellers to the UK.
The noble Baroness, Lady Brinton, kind of answered the question on the number of hotels, for which I am enormously grateful. We have currently booked 16 hotels with 4,600 rooms. However, I reassure her that this is an on-call framework, and we will have access to a massively increased number of hotel rooms if that should prove necessary.
But I have to be clear: the signal from the British Government and the instruction from the Home Office and the Department of Health and Social Care is that there should be no need to travel other than under the most exceptional circumstances. We are not trying to encourage anyone to travel, and we expect the number of people travelling to and from the UK to remain at a low level for the foreseeable future. For those who are currently overseas and seek to return but are experiencing some hardship because they were not expecting, did not plan for and cannot afford the considerable cost of the hotel quarantine, we will publish schemes to spread the payment of that to help people out.
Regarding the legislation, the noble Baroness, Lady Thornton, made a big point of saying that a sentence of 10 years was too long for a breach of contract. I remind her that Section 1 of the Fraud Act 2006 creates a general offence of fraud and introduces a number of ways of committing it, including fraud by false representation and fraud by failure to disclose information. Committing fraud is a very serious offence. Not everyone who commits their first fraud will get a custodial sentence, but if people repeatedly breach these restrictions or put the lives of others at risk, it will be up to either the magistrates’ court or, ultimately, the Crown Court to decide on the sentence. The maximum sentence is 10 years and it is quite right that it should be. The noble Baroness, Lady Brinton, made a very good point when she referred to Taiwan, which I shall mention in a moment.
The noble Baroness, Lady Brinton, asked about the data flows on undocumented migrants and the temporary amnesty. I reassure her that it is absolutely our intention to get everyone in the UK vaccinated, whatever their status. We are completely status blind when it comes to distribution of the vaccine, but we need to know who you are before we inject you with drugs—that is a basic clinical need and one that we cannot avoid.
She asked specific questions about the flow of data and whether this would be a temporary amnesty or would last longer. I do not have access to the precise answer to that question but am happy to commit to write to her on that important point.
The noble Baroness asked about prisons. She is entirely right to be concerned. We have had a terrific track record on protecting prisoners from this disease over the year, but she is right that in recent weeks epidemics have emerged in prisons. We are working incredibly hard to deploy a very large amount of testing and, where necessary, implementing isolation, and the vaccine has been rolled out to those who are qualified.
Turning to Sitel managers, I assure the noble Baroness, Lady Brinton, that we are enormously thankful to all those who have contributed to the tracing operation. We balance the workload between a variety of providers, and Sitel is just one of several that we have. There is no question of our backing off from our tracing operations—quite the opposite. Test, trace and isolate remains an important part of our armoury and it only increases. In recent times, we have doubled up on our commitment to the Lighthouse labs, which have proved cost-effective, accurate and fast. The genomics turnaround in tracking variants of concern has been remarkably efficient. On tracing and VOCs, Project Eagle is working extremely well and I saw incredibly impressive numbers on that this morning. Pharmacovigilance around the vaccine is being supported by test and trace, and the creation of the NIHP is apace.
Finally, the noble Baroness, Lady Brinton, mentioned Taiwan. Given that I am married to a Taiwanese wife, I can absolutely bear testimony to the remarkable achievement of that island nation. Taiwan was hard hit in 2003 by SARS, a time I remember well, since my Christmas was cancelled. It learned the lesson and applied important measures. The island has the advantage of social cohesion, but both the stick and the carrot were thoughtfully used, as the noble Baroness rightly pointed out. It created a green list country with a remarkably low level of infection and death, and that is a lesson we can all learn from.
The public are doing their duty and absolutely understand the threat of variants of concern. It is incredibly impressive and I am optimistic for the future.
The Deputy Speaker (Baroness Henig) (Lab)
We now 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.
Vaccine Rollout
Debate between Baroness Henig and Lord Bethell(3 years, 10 months ago)
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Lord Bethell (Con)
My Lords, the JCVI looked at this very question in great detail. It is very conscious of discrimination, but its focus is on morbidity. Its judgment, which I entirely back, is that age, more than anything else, is the driver of morbidity. That is why the prioritisation is structured in the way that it is. Those who are CEV are also prioritised. Many of those who are most vulnerable and who also have learning difficulties will qualify under the CEV threshold. However, I have passed her arithmetic to the vaccine taskforce. She makes a very good point that those with learning difficulties and autism have a different life profile and die at an earlier age. I have asked the system to ensure that this arithmetic has been considered in the prioritisation list. I will be glad to reply to her when I have the answer.
The Deputy Speaker (Baroness Henig) (Lab)
My Lords, the time allowed for this Question has elapsed.
Covid-19
Debate between Baroness Henig and Lord Bethell(4 years, 2 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I am grateful for the questions from the noble Baroness, Lady Thornton. If the noble Baroness, Lady Jolly, returns, I shall be happy to answer her questions, too.
The noble Baroness, Lady Thornton, asked a lot about the testing programme. Let me reassure her with some statistics about last week’s processes. Some 1,892,000 test were done in the week from 1 to 7 October—I repeat, 1,892,000 tests. That is a colossal number, and the vast majority of them were done promptly, accurately, and to the satisfaction of those involved. Of those, 89,874 results were positive, which is a substantial increase of 64% compared to the previous week. That is 89,874 people who would not have had a test six months ago, because we simply did not have the capacity, the knowhow or the systems to do that.
The number of people transferred to the test and trace programme since the beginning of August has increased by 10 times; 67,511 were reached, of whom 57,000 provided details of one or more close contacts. In other words, 67,511 people were taken out of the chain of transmission and asked to isolate, were provided with a financial supplement to care for them and were phoned—sometimes many times, it would appear but, generally, once or twice a week—in a pastoral call to ensure that they had access to local authority, charity and financial support. Of those non-complex cases, 55.9% were reached within 24 hours. That is not good enough, and we need to work on it more, but 55.9% is enough to make a serious impact on the progress of this virus. Without the test and trace programme, we really would not be match fit to combat this virus at all.
The story that the noble Baroness told of her friends was distressing. Anybody who has had the virus will know that it is a miserable affair. For the entire family to have had it is very sad, and my feelings are sincere when I say that I am sorry to hear about her friends who have had coronavirus. But the guidance is relatively straightforward. You are to isolate for 14 days from the original infection. That would have been the advice that they had on the telephone and, if their app said otherwise, the telephone supersedes anything that the technology might have told them.
On getting tests at all, I acknowledge that the general public are not at the top of the priority list right now. The top priority is to protect clinicians and NHS workers, as well as those in hospital care who have the threat of nosocomial infection. Secondly comes social care—protecting those who are vulnerable and live either in residential or domiciliary care. Those people are at the top of the list. We are building our capacity dramatically; we are on course to hit our ambition of 500,000 tests per day by the end of October, and many more beyond that.
The tests that the noble Baroness, Lady Thornton, described are incredibly impressive. The saliva testing is much easier to use, and the LAMP testing is phenomenally accurate. The capacity for those LAMP tests to be rolled out across social care and hospitals is enormous, and we are investing considerably in that.
The noble Baroness, Lady Thornton, also asked about Manchester, and there the situation is distressing. I cannot hide the fact that the increase in prevalence in Manchester is a source of enormous sadness, but I reassure her that the extra measures that have been taken there have been accompanied by the offer of extremely generous financial measures.
Those financial measures have been accepted by Lancashire and by Blackpool—but not, it seems so far, by Manchester. We hope very much indeed that Manchester will remain at the table. The negotiations being undertaken by the Government are generous and open hearted. We have already made available £465 million to help local authorities implement and enforce restrictions. Greater Manchester will definitely receive £22 million of this, and we will continue to work with the Greater Manchester councils to ensure that testing and local contact tracing are allocated in the right way. We will continue with those negotiations. The negotiations with Manchester were entirely proportionate to the support that we have given to the Liverpool City Region and to Lancashire, and it is a source of enormous regret that the mayor decided to reject it.
The Deputy Speaker (Baroness Henig) (Lab)
We now 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.
Health Protection (Coronavirus, Collection of Contact Details etc and Related Requirements) Regulations 2020
Debate between Baroness Henig and Lord Bethell(4 years, 2 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the virus continues to spread. We will put in place measures to break the chain of transmission and to protect the NHS, but at the same time our strategy is to support the economy, keep our schools open and, wherever possible, maintain normal life—for friends and family to meet and for businesses to remain open. These regulations play an important part in that objective by contributing to enhanced contact tracing, some, but not all, through the NHS app.
The instrument before the House requires designated venues to collect contact details and display an official NHS QR poster. To give a sense of the impact of these regulations, as of 9 am this morning there were 16,302,038 users of the NHS Covid app. Any one of them can check in at 634,488 posters that have been downloaded by designated venues. We know that this is proving popular, because there have been an astonishing 19,721,804 check-ins so far. I encourage noble Lords to exercise their digital skills and take advantage of this important protocol.
If local public health officials determine that one of these venues is linked to an outbreak, they can send a message with the necessary health advice to all those whose timing and proximity coincides with the infection. This might include a requirement to isolate for 14 days.
Privacy is key. An individual who has been in one of the venues in scope of this policy can rest assured that their contact details will be shared confidentially with local public health officials. This will then allow the individual to receive the necessary health advice. Alongside other requirements, this will increase public confidence to go out and use these venues.
I will now set out why this measure is necessary and how uptake has increased following the introduction of the regulations. On July 2, the Government issued guidance to the hospitality sector and asked designated venues to collect contact details. This led to manual, handwritten logs in some venues, and homemade and commercial logging systems in others. The guidance was in place for two months, but there was a growing level of non-compliance. Surveys indicated that around two-thirds of respondents were asked for their contact details some or all of the time, but many were not. According to our surveys, only 43% of people said that they were asked for contact details in all the venues they visited. We saw video evidence as part of media reports showing multiple establishments not adhering. My experience endorsed this coverage: I pay tribute to the Prince Bonaparte pub in Notting Hill for its diligent commitment to these protocols, but I shall not mention some other pubs I have visited where standards have been more lax.
This uneven application of voluntary rules meant that local public health officials often struggled to obtain the contact tracing information they needed. In one instance, a pub in Bolton had been identified as a potential outbreak source, as many of the positive cases had been on the premises. Unfortunately, when contact tracers contacted the venue to access its logs, they contained only names and postcodes. It took up significant amounts of precious time, using appeals on social media, to trace potential infection. This prevented public health officials providing targeted public health advice to those who had been at risk and raised needless worry among others. This is only one of many examples, and something needed to be done to address this significant risk at a time when daily case numbers were rising rapidly across the country.
This instrument has made the requirement on businesses clear. It has given local authority officials powers to enforce penalties on businesses which do not comply. Since bringing in this measure, we have seen the public and business community embrace this policy. It is hugely significant. If an outbreak is then linked to a venue, a message can be sent to the app user on the advice of local health protection teams, providing the necessary public health advice.
We know that the Covid pandemic has disproportionately affected vulnerable groups such as the elderly and people living in high deprivation. These at-risk individuals are less likely to have access to smartphones, so it is essential that a system is in place to contact-trace people who do not have the app. The logs that designated venues must have achieve this. From a recent engagement with industry, we know that designated venues are implementing these requirements. For example, one trade association found that 95% of businesses were fully compliant. Two-thirds of members are capturing data electronically in advance through online or telephone bookings, whereas remaining businesses have introduced customer and visitor logs.
Research in New Zealand, which has a similar system to ours, has assessed that rapid case detection and contact tracing, combined with other basic public health measures, has over 90% efficacy against Covid at the population level, making it as effective as many vaccines. This shows the importance of ensuring that NHS Test and Trace can reach more contacts overall, meaning that more people are provided with appropriate public health advice when they need it.
While these measures apply to England only, we have learned from the approach taken in Scotland and Wales. Colleagues have found a marked improvement in compliance, and although these regulations have been in place for less than three weeks in England, we are already seeing positive signs.
Because of the issues I have just described, we have used emergency powers to introduce these regulations. I recognise that in different circumstances, it would have been preferable to publish them in plenty of time before they were laid and to have brought them before the House before their enforcement. This point has been made in the past, it is acknowledged, and it is understood. We have put together a register of future potential regulations in an effort to improve our housekeeping. However, perhaps I may say a few words in mitigation.
We were hesitant about mandatory enforcement, as we seek to apply Covid-related regulations through voluntary compliance wherever possible. However, we decided to act because of the increasing rate of positive Covid cases, the evidence of non-compliance and the feedback from local public health officials, who were unable to contact people who may be infectious to provide the necessary public health advice.
I know these regulations place additional requirements on businesses and other sectors, which we have sought to mitigate. To reassure noble Lords, we continue to work closely with the sectors in scope to ensure that these measures do not cause undue burdens. Furthermore, the regulations set out that a review must take place within six months of their coming fully into force, and the Secretary of State for Health and Social Care keeps their necessity under consideration between formal review points. We will have these measures in place only for as long as necessary.
This instrument is already benefiting individuals and businesses, and as your Lordships have heard today, individuals and businesses recognise that this is a key tool to prevent further societal and economic restrictions, which we all desperately want to avoid. These regulations are enabling NHS Test and Trace and local public health officials to suppress the virus, to support the economy to remain open, and to protect individuals and their loved ones. The public should therefore be confident to visit and work in these venues, knowing that they will be contacted if they have been exposed to the virus. Providing this reassurance is essential to returning to a more normal way of life and supporting businesses to prosper. I beg to move.
The Deputy Speaker (Baroness Henig) (Lab)
As the noble Lord, Lord Liddle, is not contactable at the moment, I call the noble Baroness, Lady Barker.