Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020

Baroness Thornton Excerpts

Wednesday 14th October 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, my amendment says that

“that this House regrets that Her Majesty’s Government have failed to implement an effective test, trace and isolate regime for COVID-19 and calls upon Her Majesty’s Government to give all local authorities the resources they need to operate an effective contact tracing system in their areas; furthermore notes that these measures may not be sufficient to address the impact of the COVID-19 virus; and calls upon Her Majesty’s Government to provide the support local businesses and communities need to have confidence in responding to the COVID-19 pandemic.”

I speak to my amendment with a sense of real regret and sadness because, as the Minister tells us from time to time—and I believe him—he and his colleagues are working hard to deliver test and trace and fight the disease on our behalf. I recognise what a huge job the Government have. I wish to make it clear to the Minister that we will not vote against the regulations, but we will see whether we test the opinion of the House on this amendment. However, it is time to come clean. What follows is a sad account that justifies the House expressing an opinion of regret.

I hope that the Government have a plan to make test and trace, as well as investment in local communities, work. When NHS Test and Trace was launched in late May, the Prime Minister promised that it would help “move the country forward”—that we would be able to see our families, go to work and stop the economy crumbling. In the absence of a vaccine, the Prime Minister’s “world-beating” system would be worth every penny of the £10 billion-plus that the Chancellor announced in July would be spent.

This week, we learn that the Government’s SAGE scientific advisers have concluded that the current test and trace system is not working. They say that too few people are getting tested, results are coming back too slowly and not enough people are sticking to the instructions to isolate. They say that the system is having a “marginal impact” on transmission as a result and that, unless it grows as fast as the epidemic, the impact will only wane.

Tasked this spring with rolling out millions of coronavirus tests, the Health Secretary, Mr Hancock, opted for a centralised system using private firms. The business consultancy, Deloitte, was handed a contract to run testing through local drive-in and walk-in test centres, with swabs being sent for analysis at a network of national laboratories, many of which were also outsourced. Serco was also handed a deal to run contact tracing, subcontracting work to other firms as well. I am not making an argument for public versus private; it is a case of the Government not taking cognisance of the assets they already had to carry out this function.

At the same time as this was happening, local efforts were forbidden, not funded or sidelined and ignored. Local directors of public health knew much from their experience of tackling sexually transmitted diseases and food poisoning outbreaks, but their role was being limited, leaving many of them exasperated. The stakes are very high. The Imperial College study found that if test and trace worked quickly and effectively, the R number could be reduced by up to 26%.

As the system got up and running over the summer, ONS surveys of the virus’s prevalence suggested that NHS Test and Trace might be picking up only a quarter of actual cases. In July, one of the system’s senior civil servants, Alex Cooper, admitted privately that the system was identifying only 37% of the people

“we really should be finding”.

The clamour from mayors and local public health officials for a bigger role was growing. Finally, this week the Government admitted that cities and regions should be given help to do more—something that some of us have been advocating literally since February and March.

In the last week of September, the percentage of close contacts reached fell to 68.6%, the lowest level yet. Dido Harding—the noble Baroness, Lady Harding, who is the system’s head—said last month that the number of people wanting tests was three to four times the number available, while the national Lighthouse Labs in Milton Keynes, Cheshire, Glasgow and Cambridge had hit capacity. There were website warnings that no tests were available, exposing the British public on an almost daily basis this summer, especially in September when the schools went back and we saw people being sent all over the country to get tests. The scale of the task was shown when the noble Baroness told MPs that around half the available tests were actually being used by NHS patients and social care and NHS staff.

The need for testing will only increase as the virus grows and winter comes upon us. Of those transferred to the contact-tracing system in the week ending 30 September, 74% were reached. We are already a long way off the target and the system will come under greater pressure in the coming weeks. On Tuesday, the Government finally said that visitors to care homes could be tested regularly to try to end the isolation caused by their visits to loved ones being banned. There are 400,000 care home residents, so the new laboratories in Newcastle, Bracknell, Newport and Charnwood cannot come too soon.

As far back as May, SAGE experts said the speed of the results had a significant impact on the reproduction rate of the virus. The Prime Minister pledged on 3 June “to get all” non-postal

“tests turned around in 24 hours”,—[Official Report, Commons, 3/6/20; col. 839.]

but this has not been happening. The percentage of returns is too low, and the data blunder that caused nearly 16,000 tested coronavirus cases to go unreported in England last month is only exacerbated by this IT problem.

We have heard embarrassing stories about contact tracers making no calls for days on end. By contrast, local public health officials have been setting up their own call centres and deploying environmental health officers and sexual health experts with local knowledge. Being properly trained to do the job, they reckon that they are tracing up to 100% of the contacts. If they want to back a winner, it seems that that is the winner the Government really need to back.

All of this leads to the Motion I have tabled. The Government have to move quicker; that is clear and has been since March. They have to stop overpromising, share information and data more openly, trust local leaders to know their patch, and support local businesses and communities more readily when they face restrictions. The question of who gets the extra resources to be able to test, trace and isolate, and support local communities, should not depend on their alert level—that is a perverse incentive if ever I heard one. Everyone in all these communities needs to have a level of local support; then, we might see the R number reduce.

--- Later in debate ---

Moved by

[Baroness Thornton]

At end to insert “but that this House regrets that Her Majesty’s Government have failed to implement an effective test, trace and isolate regime for COVID-19 and calls upon Her Majesty’s Government to give all local authorities the resources they need to operate an effective contact tracing system in their areas; furthermore notes that these measures may not be sufficient to address the impact of the COVID-19 virus; and calls upon Her Majesty’s Government to provide the support local businesses and communities need to have confidence in responding to the COVID-19 pandemic.”

[Baroness Thornton (Lab)]

I start by congratulating our new arrival, the noble Lord, Lord Moylan. I did get confused by all the “Moy”s and so on, but I now identify the noble Lord. Frankly, that was a very disciplined maiden speech, and the noble Lord will be very popular in this House, particularly with his own Whips, if he continues to exercise such discipline in his remarks to the House.

We will not be voting against this or any statutory instrument today. We on these Benches would not actually support the noble Lord, Lord Robathan, in his amendment. I am clear to the noble Lord that I do not regard him as being the least bit wet. I thank my noble friends Lord Hain, Lady Massey, Lord Dubs and Lord Desai—my noble friend Lord Desai being my former economics tutor at the LSE many years ago. I always listen to his remarks with interest and respect.

We are grappling with a virus that spreads with speed and severity. Worldwide, in nine months, we have seen well over 1 million deaths. Here, in the United Kingdom, more than 42,000 people have died. Throughout this crisis, we on these Benches have urged the Government to adopt an approach with a strategic aim, suppressing the virus and bringing the R rate below one in order to save lives, minimise harm and keep our children safe. That has been our priority, and that is the right approach. We have supported the Government throughout on the restrictions they have brought forward. In the case of this statutory instrument, these are very heavy restrictions, but we accept that restrictions are needed. Nobody in any of the areas where the infection rates are going up is calling for no restrictions. It is in the national interest that we have a circuit break now, and we will not be voting against restrictions in the meantime.

I note that the Prime Minister chaired COBRA yesterday or the day before, and that was attended by the Liverpool City Region Metro Mayor, Steve Rotheram. COBRA confirmed the new restrictions and the ones the Prime Minister announced and were discussed in the Commons yesterday. I was encouraged that the metro mayor was at the COBRA meeting, and I wonder if the Minister could tell us how many of our mayors and leaders have been invited to COBRA, because that seems very important indeed.

That meeting followed a briefing earlier in the day from Deputy Chief Medical Officer Jonathan Van-Tam; the medical director of NHS England, Stephen Powis; and Dr Jane Eddleston, the medical lead for the north-west. They set out the latest data on the rising infection rates across the country. The latest infection rates show that the north-west has 40% of all Covid-19 cases, with an eightfold increase in patients being admitted to hospital. Currently, 30% of the north-west’s intensive care capacity is taken up with Covid-19 patients. They warned that in four weeks’ time, the north-west could see more patients in intensive care than at the peak of the first wave unless action is taken. That is one of the reasons my honourable friend Sir Keir Starmer made the statement last night about the need for a circuit-breaker. I listened carefully to what the Minister said in answer to this debate and to the issue about the nationwide local programme.

In March, I asked the Minister what would happen if I had a positive Covid test. This was right at the beginning. I asked: who would be notified? Would it be the GP? Would it be the local public health people? Would they contact my contacts? I did not get a very satisfactory answer. It emerged, within a few days, that testing regimes stopped completely in the UK, and six months later, we are crawling slowly towards an effective local testing, contact tracing and supporting system—six months later. Given that this House cannot make a meaningful intervention in these statutory instruments except by expressing an opinion—and I am glad it is the day after and the day they are coming into force, not three weeks later—after much thought, I am going to move this amendment. I think we need to regret that we do not have a satisfactory system of testing, tracing, isolating and support for our businesses and local communities. So I beg to move and to test the opinion of the House.