Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Baroness Thornton Excerpts

Wednesday 15th December 2021 Lords Chamber

But above all, I echo the comments of many Peers from all sides of the House that these SIs are chaotic and confusing—but parts of them are absolutely vital in our public health fight against Covid. The noble Lord, Lord Cormack is right that this House should not use the fatal amendment procedure, but we will continue to hold this Government to account.

[Baroness Thornton (Lab)]

My Lords, this has been a proper House of Lords debate and I thank the Minister for introducing the regulations with such clarity. I need to declare an interest as a non-executive director of an NHS hospital.

I would like to start my remarks by quoting my honourable friend Wes Streeting, the shadow Secretary of State for Health and Social Care, who said yesterday that

“it should not be for me, as shadow Secretary of State, to point out”

to some Conservative MPs, following remarks made in the media in recent days,

“that we are not living in the 1930s and that the Secretary of State and his team are not Nazis.”—[Official Report, Commons, 14/12/21; col 954.]

It is sad that my honourable friend felt that he needed to say that. Our history is peppered with examples of where we required citizens to act in a way that served both their own self-interest and the interests of others. That does not make us a totalitarian state. I believe that the public are less outraged by the fact that some obligations are being placed on them than by the antics of those who blatantly and arrogantly imagine that the obligations do not apply to them.

On these Benches we will be supporting the Government today, as we did yesterday, and we will vote with the Government if the noble Lord, Lord Robathan, chooses to test the opinion of the House on either of the fatal amendments before us. Actually, the noble Lord said that these Benches would go further than the Motions before us. That is not true—but what is certainly true is that we have tended to be two or three weeks ahead of the Government. We have said “We think you need to do this, that or the other”—and I can testify to this, having been here for nearly two years, saying this —and the Government have said “No, no, no”, and two or three weeks later that is exactly what happens.

We will act in the national interest, as we have done throughout the pandemic, putting public health before party politics, by supporting the Motions under consideration now. Our task today—as it has been throughout the pandemic—is to consider what is best for the health of our nation and how to discharge our responsibility to protect our NHS.

The noble Lord, Lord Fowler, absolutely nailed it when he said that we had to listen to the CMO, the CSO, the other scientists and the public health experts, and follow the course of action that they were recommending. This was echoed by the noble Baroness, Lady Hayman, who said that we should be listening to the advice we are given. My noble friend Lord Davies put these regulations into proportion in terms of what they are seeking to achieve. There is no doubt that sacrifices have impacted on lives, livelihoods and liberties; that is why noble Lords need to scrutinise and question how the Government are dealing with this issue, or indeed mishandling it. I say to the noble Lord, Lord Robathan, and other noble Lords that we would be having this debate today whether or not he had put down his amendments.

On Sunday the Prime Minister made a totally unnecessary broadcast which served to panic people and create worry and confusion. Presumably he was trying to re-establish leadership credibility for himself, which clearly did not work with his own Conservative Benches. The broadcast was irresponsible in its lack of preparedness and clarity. As well as displeasing Mr Speaker, as the Prime Minister tends to do, it held Parliament in contempt yet again.

The lack of clarity is clear, for example, as NHS England and the Prime Minister have made conflicting promises on the booster rollout, leaving plans to deal with the rapid spread of omicron mired in chaos and confusion. On Sunday evening, the Prime Minister said:

“Everyone eligible aged 18 and over in England will have the chance to get their booster before the New Year.”


However, the NHS has promised a different target, pledging to offer all adults the chance to book a booster rather than receive one. Pressed on the conflicting advice, NHS England said:

“The NHS vaccination programme will offer every adult the chance to book a COVID-19 booster vaccine by the end of the year”.


Perhaps the Minister could clarify for the House which it is. If the Prime Minister has promised 1 million vaccinations a day, how is that supposed to be achieved?

I think it was even worse for local government than for the NHS. A local council leader in London, with a London-wide strategic role, said that 72 hours’ notice would have been helpful. It is not the need to up the vax and testing capability but the lack of planning—hence no tests, no testing ability and vaccinations not available. There was not one mention of local government in the Statement we heard on Monday. Had the relevant Government departments talked to local government, and when did they do that? It begs the question: did the NHS even know about Sunday’s statement before it was made?

We cannot yet be sure about the severity of the omicron variant, but we can be certain, as many noble Lords have said, that it is spreading faster than any other variant. Even if a smaller proportion of omicron victims are hospitalised, the rapid advance of the virus through the population could see large numbers of people admitted to hospital during the months in which the NHS is already under the greatest pressure. The winter months present pressures on the NHS in any normal year, and we know that this is far from a normal year.

The NHS is contending with winter pressures, a serious backlog, the delta variant and now this variant. Many of the challenges are understandable, given the unprecedented challenge of the Covid-19 pandemic, but we have got to be honest and acknowledge that confronting them has been made much harder because the country went into the pandemic with waiting lists already at 4.5 million, 100,000 NHS staff vacancies and a shortage of 112,000 staff in social care. My noble friend Lord Rooker was quite correct on that. We support the NHS and care services in the task they have been set. Let me say from these Benches to every NHS worker, every GP, every pharmacist, every public health official in local government, every member of the Armed Forces and every volunteer stepping up to meet this enormous task that we are with them 100% and thank them again.

The measures put forward for consideration today are an attempt to slow the spread of the virus, while trying to protect Christmas so that people can enjoy the festive season. They are about limiting interactions in the workplace, wearing face coverings in settings where the virus finds it easiest to spread, testing before we attend large indoor gatherings, and getting behind the booster rollout to ensure that everyone who can be protected is protected.

The goal in the end must be to learn to live with the virus. That means effective vaccination, antiviral treatments and public health measures that have a minimal impact on our lives, jobs and businesses. No one enjoys wearing a mask, but it is nothing compared with the costs that more draconian restrictions have for our lives, livelihoods and liberties. Masks are simply a price worth paying for our freedom to go out and live our lives during this pandemic.

On the introduction of a Covid pass for large indoor gatherings, the Labour Party argued against vaccine passports without the option of showing a negative test. Further, we argued that such passes should not be required for access to essential services. On both counts, I am pleased to say that the Government listened and amended the proposals, so we will support this measure today. I regret that colleagues on the Liberal Democrat Benches do not feel able to do so, but let me be clear: we in the Labour Party support Covid passes because we support British businesses. We want to give people the confidence to go out and about—to go to venues and to the theatre—despite the presence of this virus.

With passes and lateral flow tests, venues can operate at 100% capacity. Look at Italy, France and Denmark—countries with strict Covid rules. All have seen their retail and recreation sectors fare far better than those in the UK. However, for the passes to work, people must be able to access tests readily and easily. We cannot continue in this situation where tests are out of stock, so I ask the Minister whether this has been resolved or when it will be.

For months, we have called for workers to be given the flexibility to work from home and we support the guidance to work from home where possible. However, how does the Minister explain the contradiction that many noble Lords have asked about, which is why, at the same time, the Government are allowing them to go to Christmas parties? By limiting the interactions people have at work and by lowering infections, we hope to preserve their ability to go ahead with social events anyway.

Noble Lords have talked about ventilation in schools. We know that young people have borne the brunt of this pandemic, and we owe it to them and their education to support them and staff to make sure our schools are properly ventilated. The Christmas holidays seem to us to be an ideal time to get young people vaccinated. When does the Minister expect to know about this matter and share it with the House?

I hope this is my last contribution on Covid this year. I therefore end by wishing all noble Lords a safe and happy Christmas.

[Lord Kamall (Con)]

I start by thanking noble Lords for their valuable contributions to this debate. They showed the very best of debate in this place, in the range of views covered—some political, some scientific and some challenging the Government on constitutional issues. This demonstrates the importance of these discussions and I welcome all contributions, whether or not I agree with them. That is the purpose of debate and discussion.

I remind some of my noble friends behind me and other noble Lords why we have acted now and gone to plan B. We want to slow the spread of the virus, after looking at the replication rate; we want to buy time for more people, especially the older and more vulnerable, to get their booster dose; and we want to give our experts crucial time to gather and understand the data about omicron.

Noble Lords, and indeed noble friends, look at the experience of South Africa. As the noble Lord, Lord Birt, and others have said, its experience is different. It has a younger population, with an average age of about 29, when our average age is in the mid to high 40s. Given our experience at the beginning of the Covid pandemic, when a disproportionate number of older people died, surely it is right that we collect data to make sure that the most vulnerable people are safe before we go forward.

I turn to some specific points raised by noble Lords. As I said, my noble friend Lord Robathan asked about the data from Africa, which we will continue to monitor. We will monitor whether it is different or milder here.

The noble Baroness, Lady Bennett, mentioned the risk of exponential growth and I thank her for making that point. We do not want to see waiting times and patient numbers starting to overwhelm hospitals. By the time we had waited for exact data, it might be too late. The noble Lord, Lord Davies, rightly spoke about the limited data available. I assure the House that we will continue to review the data as it comes in.

Health Protection (Coronavirus, Restrictions) (Entry to Venues and Events) (England) Regulations 2021

Baroness Thornton Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Robathan (Con)]

My Lords, it gives me no pleasure, funnily enough, to oppose the Conservative Government whom I support, but I have to say that I am concerned. I am also rather concerned that a lot of people have said that it is wrong or even disgraceful to put down an amendment to something and that we should in some way blindly follow, to use the words of my noble friend Lord Dobbs, the Government and not question them and ask them to justify what they are doing—which is what I am doing.

My noble friend Lord Cormack referred to this being the second Chamber. Surely the second Chamber of Parliament should be doing something useful about asking the Government whether they have got it right. The noble Baroness, Lady Hayman, accused me of being extremist—I think that was the term she used. I do not think it extremist to ask to see the evidence on which government policy is based, and that is really what I am saying.

I do not pretend that this has been easy for the Government; it has been extremely difficult for them. They are under huge pressure, and international pressure as well. I do not doubt either that Covid is an extremely unpleasant disease that is killing people. I believe that I have had it. The ultimate irony would be if, having had three vaccinations, I caught it again over Christmas. I hope that that would bring a wry smile to some of those who have opposed me rather than anything else, but of course it would be an ultimate irony—I could easily do it; apparently, we can catch it a second time.

I of course agree with the Minister about being pragmatic, but I want a proportionate response and I do not think that “Covid passports”, as I call them, are a proportionate response. The noble Lord, Lord Rooker, said we should not divide the House if we are not going to win. Well, I want to register concern, and a lot of people would wish to register concern with this government policy. I am not satisfied with it. So I shall divide the House on what the noble Lord, Lord Scriven, referred to as a “chocolate teapot”. But before I do so, perhaps I may also wish a happy Christmas particularly to my noble friend the Minister and those on the Front Bench, as well as to those opposite, some of whom have not entirely agreed with me today or in the past.

[Baroness Thornton (Lab)]

Never.

[Lord Robathan (Con)]

Never? Well, actually I thought the noble Baroness, Lady Thornton, was going to agree about the importance of having the debate—but obviously not. I wish to test the opinion of the House.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021

Baroness Thornton Excerpts

Tuesday 14th December 2021 Lords Chamber

I hope that the Minister has some answers to all these contradictions. His concern for procedure is not matched by his department’s actions. Trust about the so-called “urgent business” is being squandered, given that our first debate on this matter was in July. The Government cannot argue that this is short notice. I hope that the Minister will give the House an undertaking that, in future, an impact assessment will be published in the proper way.

[Baroness Thornton (Lab)]

My Lords, I declare an interest as a non-executive director of an NHS hospital. I thank the Minister for explaining this statutory instrument, although I have to confess that I had a moment of panic during his opening statement. I thank him also for explaining his understanding of how the Government arrived at this point. I note that the department has at last produced at least something called an impact assessment, as well as other documentation. This was the subject of my Motion to Regret, now withdrawn. That does not mean that I no longer regret the lackadaisical manner in which this Government approach their accountability to Parliament and the legislative process.

As most noble Lords, including the noble Lord, Lord Cormack, have said to the Minister in clear language, we still wish to know how the legislation will operate. We hope that the Minister will be more forthcoming about, for example, the “significant workforce capacity risk” which the Secondary Legislation Scrutiny Committee mentioned in its very critical report. We note that the committee was damning in its criticism, and I thank my noble friend Lord Cunningham for speaking about the fact that these things are not an option but a requirement.

I say to the noble Baroness, Lady Noakes, that we agree with her criticism of the Government’s handling of these issues. We absolutely agree about the procedure, the drafting and the lack of justification that supports the legislation. I have been commenting on this from this Dispatch Box since March last year. However, the noble Baroness did not say that this was necessarily the wrong way to go. I withdrew my regret Motion because, today, given the new clear threat of omicron, we need to focus on the way forward. I do not believe that that is a political reason for withdrawing the Motion. Had the noble Baroness tested the opinion of the House on her fatal Motion, we on these Benches would have supported the Government, just as we are doing right now in the Commons. The Labour Party has acted, and will always act, in the best interests of our NHS, our public health and our nation.

Of course, we want everyone working in the NHS to take up the vaccine. It is safe and effective, and the Government should be focused on driving up vaccination rates through persuasion, education and support for the vaccine-hesitant, as many noble Lords, particularly those on the Liberal Democrat Benches, have said. We know that omicron is now a clear threat. It is important that the elderly and the vulnerable, and those being cared for in healthcare settings, are protected. Vaccination also protects staff from severe disease, so we will not oppose the Government on this.

Compulsory vaccination for NHS staff is a difficult question—of course it is—as the right reverend Prelate the Bishop of St Albans and my noble friend Lord Hunt explained to the House. We would all much prefer that all front-line NHS staff voluntarily agree to have the vaccine. The latest SAGE advice, however, suggests that omicron may increase the risk of hospital-acquired infections. Vaccination will not eliminate all transmission, but it will reduce the risks and protect both patients and staff in the NHS from severe disease. It may also reduce staff absences caused by Covid.

Of course, there is a precedent for certain NHS staff having to be vaccinated, for example against hepatitis, and given the evidence that being vaccinated reduces the risk of transmission, it is reasonable to ask whether those who are looking after our loved ones should themselves have taken every step possible to reduce the risk that they may pass the virus on to those whom they are caring for, many of whom may be elderly and vulnerable.

However, ahead of any rollout, the Government must ensure that this change does not make the staffing crisis in the NHS any worse and must work with the royal colleges, NHS Providers and the trade unions to agree a framework for how this change is rolled out. The trade unions and royal colleges have been critical of the proposals for compulsory vaccination, ahead of what will be, and is becoming, a very difficult and challenging winter for the NHS because of the implications this could have for staffing. So we welcome the fact that the Government have pushed the date back to April 2022, but we continue to be concerned about the implications that mandatory vaccination for NHS workers will have on staff shortages. We have asked the Government to set out a plan for this.

For the record, on the separate issue of mandatory vaccination for the public, the Prime Minister probably puzzled the whole nation—he certainly puzzled me—when he floated this idea. We are opposed to this—as is the Minister’s boss, I expect. We are opposed to the use of Covid status certification for access to essential services. Forcing the general population to have the vaccine would not only be wrong but impractical. The Government have not brought forward any measures to introduce this, and we would not support any future attempt to do so.

Finally, all of us want to enjoy Christmas safely this year. We all want to protect our NHS, which has been suffering from staff shortages and record waiting lists and has been performing miracles for the last 18 months. Our best defence against all variants of the virus, including omicron, is that we all get vaccinated.

[Lord Kamall (Con)]

My Lords, I thank all noble Lords for taking part in this debate. I apologise to noble Lords for getting the terminology wrong at the beginning. I will make sure that that is corrected in future.

I thank my noble friend Lady Noakes for raising this important issue, and for challenging us and rightly holding the Government to account on many procedural issues. I accept that your Lordships perform an essential role in scrutinising the measures that we have put forward today. That is one of the things that makes me very proud to be a Member of this House. I recognise the strength of feeling of your Lordships for and against what we are proposing and about the procedures thus far. I know that these feelings are sincere and heartfelt.

I now turn to some of the point raised by noble Lords. My noble friends Lady Noakes and Lord Cormack and the noble Baroness, Lady Brinton, raised questions about the red-rated impact assessment from the Regulatory Policy Committee. I hear the concerns of this House, and I acknowledge that, due to the necessity to move as quickly as possible and minimise the risk to those who are vulnerable, we were unable to publish the full impact assessment alongside the regulations being laid. We set out a statement of impacts, and the full impact assessment has now been published on GOV.UK, but I accept the argument made by noble Lords that this is rather late. We have also now published additional consideration of the points raised by the RPC in relation to private businesses.

My noble friend Lady Noakes also asked what the Government have done in response to the criticisms of regulations from the Secondary Legislation Scrutiny Committee. I reassure noble Lords that we have published the updated Explanatory Memorandum to provide additional information on the specific concerns raised. I also accept the criticisms that this could have been more timely. This includes more information on the scientific and clinical rationale for the policy, the exemptions that have been provided for, those not included, and the steps that we have taken to further encourage uptake of vaccinations and to mitigate work- force risks.

The SLSC also raised concerns about the impact assessment on process. We have worked hard and as quickly as possible to finalise the impact assessment that we feel best captures the likely impact of this novel policy in the uncertain circumstances that we are still living through and the need sometimes to react quickly. As my noble friend Lady Noakes rightly said, this impact assessment was laid before the House in advance of this debate.

My noble friend Lady Noakes also raised the question of whether a cost of £270 million is value for money, considering the impact assessment. While it is not possible to model the non-monetised benefits that this policy would have due to the limited data available, the health benefits through reduced infections and deaths among health and care users—as well as the wider community—from the workforce being vaccinated are likely to be large and should be considered when focusing on costs.

A key benefit is the impact of reassurance to patients and care users that they are being looked after by staff who are vaccinated. This avoids the very dangerous situation of people feeling wary of going to the NHS and other health and care providers, which can have dangerous long-term implications regarding health outcomes for our society. This is non-monetised, yet it remains a highly significant factor.

My noble friend Lady Noakes also asked about the workforce impact of this legislative instrument. As of 5 December, 521,000 staff in all care homes, or nearly 96%, have been vaccinated with the first dose, and 511,000 staff, or 94%, are reported to have received a second dose based on responses from 99% of providers. Although NHS workforce figures are dynamic as people join and leave, since the Government consulted on the policy in September, the latest published figures show an overall net increase of NHS staff vaccinated with a first dose of over 55,000.

My noble friend Lady McIntosh also raised valid questions about the impact on the social care workforce. We are not aware of any care homes where VCOD is the primary reason for closure, but we continue to work with our regional assurance team, which works closely with regions across the country to understand the local and regional pressures, and offer support and advice as appropriate.

In social care, we have already put in place a range of measures to help local authorities and providers to address workforce capacity pressures; indeed, I have announced some of those in this House. As in healthcare, there will be a 12-week grace period for workers in the wider social care sector before requirements come into force, which will give all unvaccinated staff time to get their jab. We are focusing every effort on promoting and encouraging vaccine take-up across social care, and £300 million was announced for the workforce on Friday 10 December to support the care sector over winter.

My noble friend Lord Cormack, the noble Lords, Lord Cunningham and Lord Hunt, and several other noble Lords have eloquently raised points about the use of retrospective legislation and emphasised the importance of parliamentary processes. I sympathise with noble Lords who are concerned about some of the procedural aspects of the passage of this legislation.

As my noble friend Lord Cormack rightly said, in unprecedented times such as these it is right that the Government do everything in their power to protect the vulnerable. Vaccination is our best defence against Covid. It reduces the likelihood of infection and therefore helps to break chains of transmission, as the noble Baroness, Lady Thornton, rightly acknowledged. It is safe and effective. The legislation will protect those receiving care in all health and social care settings as well as our valuable health and social care workforce themselves.

I agree with my noble friend on the point about reviewing the use of such legislation. I assure noble Lords that Regulation 5 sets out the requirement for the Secretary of State to carry out an annual review of these regulations, taking into account clinical advice and accessibility and availability of authorised vaccines, and to publish a report setting out the conclusions of this review.

On my noble friend Lord Cormack’s suggestion of an ongoing Joint Committee, I apologise if the response I suggested was inaccurate. I suggest that I discuss it with him so that I can learn from his experience of parliamentary procedures.

The noble Baroness, Lady Tyler, referenced the importance of encouraging the hesitant. I completely agree. We both come from the same part of London; indeed, she informed me that we went to the same school. We come from an incredibly diverse area, and we understand the different concerns and pressures in many of these communities; as noble Lords will recognise, I myself come from one of these communities. But as she will know, the NHS has focused in recent months on a targeted approach to improve uptake in hesitant groups by undertaking campaigns not only based on function, such as at midwifery staff, but directed at different communities, such as ethnic-minority groups and students, as well as using the booster campaign as an opportunity to re-engage staff. I repeat my gratitude to noble Lords across the House who have suggested to me ways that we can address many of these communities, including working with interfaith communities and networks which really understand these communities and have the trust of many individuals.

Breast Screening

Baroness Thornton Excerpts

Tuesday 14th December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for giving me advance notice of the question, and so giving me the chance to get some information. Data on cancer stages is currently published only annually, and NHS Digital is publishing the data from 2019 on Thursday 16 December. The latest data from 2018 shows that nearly 86% of breast cancers were diagnosed at stages 1 and 2, meaning that about 15% were diagnosed at stages 3 and 4, but this was pre-pandemic. I will make sure that I get the updated data as soon as possible.

[Baroness Thornton (Lab)]

My Lords, in October, when we last had a Question on this issue, the Minister was asked about the need to ensure that innovative new treatments such as Trodelvy reach patients as quickly as possible. I gather that this issue is still not resolved. As yet, there is no agreement between the drug company Gilead and the NHS, which means that access to this transformational treatment is extremely ad hoc and unfair. Will the Minister please help to expedite this issue with NICE, the MHRA and the manufacturer?

[Lord Kamall (Con)]

As the noble Baroness will acknowledge, the MHRA and NICE are independent, but I can, of course, raise the issue with them.

Covid-19: PCR and Lateral Flow Test Providers

Baroness Thornton Excerpts

Monday 13th December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for bringing that to my attention. I was in a meeting with my right honourable friend the Secretary of State for Health and Social Care as well as other Ministers today. We were told categorically that we have ordered many more tests to enable people to test more often.

[Baroness Thornton (Lab)]

My Lords, there are hundreds of private test companies to choose from when you are heading abroad, and that is part of the problem. Which? carried out some mystery shopping in the autumn and revealed a list of companies that give the most reliable and best-value tests—I share that information with the House—and also the ones to avoid as being rip-offs and unreliable. Is the Minister aware of this consumer research? What notice will the Government be taking of the ones that Which? recommends not to use? Have they yet been removed from the Government’s list?

[Lord Kamall (Con)]

I thank the noble Baroness for making noble Lords aware of that particular comparison website—let me put it that way. We try carefully not to recommend particular private providers or comparison websites, but this market is developing, and there are lots of comparison websites out there looking at this market. As we start to have more testing and do more diagnoses at home, this market will develop.

Covid-19 Update

Baroness Thornton Excerpts

Wednesday 8th December 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for reading the Statement tonight. On this side of the House, we have always put public health first at every point during this pandemic, so I repeat the words of my honourable friend Wes Streeting, shadow Secretary of State for Health and Social Care, in the Commons an hour ago, when he said

“I want to be clear with the House and the country that Labour will support these measures in the national interest.”

Of course, we know that this decision is not taken lightly. Restrictions impact on people’s lives, livelihoods and liberties and we do not take those for granted on this side of the House.

Everyone wants to be able to enjoy Christmas safely this year, given the trauma of last winter. But the omicron variant is a clear threat, as the Minister has explained, and clearly swift action is needed to limit its spread. I want to ask the Minister a question I have not asked for some time in your Lordships’ House: what is the R number today and what is it predicted to be in two weeks’ time?

On these Benches, we have said that scrapping the guidance on mask wearing was a mistake and have consistently called for masks to be worn in indoor hospitality settings too. We welcome the Government’s reintroduction of that measure, if that is what the Minister said. I seek some clarification on what is actually going to happen; I am not sure I understand the difference between an attraction and hospitality, so could the Minister go into some detail about what will happen in our pubs and restaurants—or will they continue as they are?

The House may remember that we have said that people should have the flexibility to work from home, so we welcome the updated guidance on that. On vaccine passports, I am glad that the Government have listened and responded following their previously abandoned plans to require vaccination status only, and that presenting a negative test will be an option. Can I ask for clarification about whether vaccine passports will be required for access to essential services?

The Minister is correct to say that the greatest tool against the pandemic remains vaccination. How do the Government plan to speed up the booster rollout, which is certainly not hitting the target of 500,000 vaccines a day and is not on track to get everybody boosted by the end of January?

Public health depends and relies on people’s willingness to comply with rules that affect their lives, livelihoods and liberties, and which, in return, relies on confidence in the people making those rules. The damage the Government have done to public compliance with the rules that have governed our lives during the pandemic is very serious indeed. We had the Cummings eye test—that seems like years ago—the former Health Secretary’s tryst with his special adviser, the former Education Secretary’s private party, the Prime Minister attempting to get out of having to isolate, and now the footage of his staff laughing on camera and joking about breaking the rules at a No. 10 Christmas party.

It is hard to overstate how this makes people feel when they have followed the rules and complied, sometimes at enormous personal cost—the businesses that were forced to close; the family weddings that were postponed; the chance to say goodbye to loved ones at funerals that we missed; and the NHS workers, educators and key workers who risked their own health to get us through the pandemic before vaccines and treatments arrived. The headline we saw today is why the laughter in the video from Downing Street is so stomach-turning; it feels as if they are laughing at us.

It is not just that they clearly feel that there is one rule for them and one for everyone else, infuriating though that is; it is the actions of the Prime Minister, which have undermined public trust and distracted from key public messaging at a critical time. This comes from the very top of our country. The problem is that we have a Prime Minister who does not believe the rules apply to him—his own conduct says that—and who also finds it almost impossible to own up, take responsibility and admit that he might have been wrong. The Minister needs to explain to the House how the Government will overcome that.

I was very pleased to hear the news that three doses of the Pfizer/BioNTech vaccine appear to neutralise the new omicron variant, according to preliminary studies; this is very good news indeed. However, it underlines that we have to get more jabs in arms if we are going to make that at all effective.

How will the Government support the people who cannot work from home and who need to continue to go to their workplace? As we know, millions of people who we depend on every day to keep our nation running have continued to go to work throughout the pandemic.

Will the Government set a deadline by which they expect all children to receive their first dose of the vaccine? Will they be able to get them vaccinated over the Christmas period? What are the Government doing to drive up vaccination in areas where there has been low take-up? Are they offering additional support ahead of the winter?

We have discussed in the Chamber before that many critically ill NHS Covid patients are unvaccinated pregnant women. Why is there only one mention of pregnant women in the Government’s COVID-19 Response: Autumn and Winter Plan 2021? In the Whittington Hospital, of which I am a non-executive director, we have set up a room for pregnant women to deal with the issues they may have about vaccination. The Minister might look at that as one of the ways of dealing with this.

Finally, do the Government accept that, if they have not done enough to drive down infection rates by improving ventilation in public buildings such as schools, they must institute a programme of investment in ventilation in schools? This pandemic is clearly a long way from being over and we need our children to be protected.

[Baroness Brinton (LD) [V]]

My Lords, I thank the Minister for repeating the Statement. The chaos to even get it heard in the Commons and the very late notice on whether we were having this or Monday’s Statement sum up the chaos that the Government find themselves in.

As the noble Baroness, Lady Thornton, outlined, the Government have once again lost the trust of the public. My first question is: how on earth will Ministers persuade people to follow these new, very important restrictions, with the chaos going on at the moment?

We understand that restrictions are disappointing but, from these Benches, we have always said we want people to remain safe. As for these proposals, we have said before and say again that we think the Government are once again late to move to plan B.

I note that the arrangements will remain until 5 January and that there is a sunset clause of 26 January. Please can we debate the regulations before they expire—preferably next week, before we rise for Christmas?

Today, there are 131 new cases of omicron, a rise of a third in one day, taking the UK to nearly 600 cases. This confirms that the doubling rate is between two and three days. Scientists are talking about an R rate of between 2 and 4 and it is also following the same rapid transmission trajectory seen in many other countries. Unfortunately, in the last 48 hours, we have seen that South Africa is now showing increasing hospital and critical care bed admissions, showing that, even if there is less likelihood of serious disease, there is still some serious disease.

Ministers are right to be concerned about superspreader events, which are being reported all over Europe. Assuming that doubling continues at this rate and with a million cases possibly by the end of the year, that is very worrying, as is the news of the lower immunity against omicron from the vaccine compared to delta.

Just this afternoon, Antonio Conte, head coach of Tottenham Hotspur, reported that eight of his first team members and five members of staff have tested positive ahead of a big European game. He said:

“The situation makes me very upset … It’s contagious and there is a big infection.”


He is right.

The Statement does not mention that there is a higher percentage of young children both contracting omicron and going into hospital in South Africa. What arrangements are being made to ensure that parents recognise that and understand the different symptoms that young children have?

From these Benches we have been urging the Government to move ahead with plan B since cases started rising steadily in September. Today, all cases—of whichever variant—still number over 51,000, with a further 161 deaths. It is vital that we make sure that those numbers do not go up.

Face masks are vital, especially with increased transmission. But do I understand the Minister to say that singing, which we already know is high risk for transmission, will be exempt? On what medical grounds is that sound? I understand that hospitality has exemptions too. Is this taking us back to when you could take your mask off if you were sitting at a table and eating, but had to wear one when you were moving around a pub, bar or restaurant?

Ventilation is vital. Can the Minister say how many schools have received the air filters they were promised a year ago?

I notice that we are moving now to lateral flow tests rather than isolation. Can the Minister say what the current percentage of false negatives is for lateral flow tests and how that is going to be managed?

It makes sense to follow both Scotland and Wales in asking people to work from home if they can. How is that likely to affect the working arrangements on the Parliamentary Estate, including your Lordships’ House? In particular, and as a minimum, should the House consider returning to remote voting to avoid noble Lords mixing together in large numbers? We know we have a large number of votes over the next few weeks.

There are also a large number of notable omissions from this Statement. The first is the difficult issue of social care and support for those in homes, or housebound, as well as the staff who look after them. I see that the Statement says that there will be information to follow.

The second is the lack of mention of the Covid app. Given that many people are saying that their third dose or booster dose information is still not being recorded properly, can the Minister say if these difficulties have been resolved? The consequences of having to have Covid certification will affect people from Friday.

Thirdly, there is not one word about the clinically extremely vulnerable: that is 3.7 million people, of whom 800,000 are severely clinically extremely vulnerable. Most of the larger group should have had their booster jabs by now, and should be reasonably protected, but can the Minister say yet if that is true of omicron, especially as no one will have had three doses of Pfizer?

I thank the Minister for arranging our meeting next week to discuss the problems that the severely clinically extremely vulnerable are facing. Doctors are already telling this group that they will have a less good and shorter-lived response—if any—to vaccines. Is there any data on vaccinations for this group and omicron?

Other problems remain, as the Minister will have seen from the responses to my tweet this morning. Many people are still finding that their GPs do not know they should have a third dose, because there is no register and their hospital consultants have not had time to write to every patient’s GP. The NHS app still is not recognising third doses. GPs are not sure if it should be eight weeks or 12 weeks between the third dose and the booster.

While the news about the antivirals and retrovirals is good, most CEV people do not want to catch Covid. So above all, following this Statement, where is the specific guidance to both groups who are alarmed by the high number of delta cases, the growing number of omicron cases, and the marked reluctance of people generally to follow mask guidance. This is not a “nice to have”. This is 5% of the population who risk severe disease or dying from Covid. Please can the Minister agree to advise this group in the same way that there will be advice for the social care sector?

Health and Care Bill

Baroness Thornton Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, first, I declare my interest as a non-executive member of a hospital trust in London; indeed, my chair is in the Chamber. I was also on a CCG for three years and it got absorbed into its local ICS, so I have lived this story, too.

I thank noble Lords for a debate that has done as much justice to this Bill as time has allowed. I congratulate the noble Lord, Lord Stevens, who is much too young to be a national treasure, if he does not mind me saying so. I also thank the outside organisations and the Library for the many briefs. Patient groups, royal colleges, regulators, trade unions, the EHRC, health charities, campaigns, and even a chocolate manufacturer, on behalf of the confectionery industry, and a large optician chain have a close interest in the Bill and have troubled to tell us so, and I thank them very much.

I particularly enjoyed the contribution from my noble friend Lord Howarth, linking, as he did, the arts and health and well-being. All I can say to my noble friend Lord Rooker is that I would not mind being on the prosecco experiment myself, particularly at this time of night. For my part, I intend to focus on the core of the Bill, the NHS reorganisation. The key questions about the Bill are surely these. What does it do for patients? How does it address health inequalities and the NHS workforce? Does it make things better or worse, or is it silent, and what can we do in this House to improve it to tackle those challenges? That is surely our job.

On the workforce, for example, my noble friend Lord Turnberg, the noble Lords, Lord Stevens, Lord Kakkar and Lord Patel, the noble Baroness, Lady Watkins, and many others pointed to the fact that, without a plan and a comprehensive strategy that covers all the health and social care workforce, it is not possible to deliver better care for patients to address health inequalities, which is why amendments about the workforce will receive significant attention as we move forward.

Many of us were in the House during the passage of the Health and Social Care Act 2012, which was never fully implemented because it was a bit of a mess, if I may say so. I remember the tangled spaghetti of organograms resulting from the 2012 reforms. If the noble Lord, Lord Stevens, thinks that this one is worse, I dread to think what that would look like. Of course, we will have to untangle that.

As my noble friend Lady Merron said in her opening remarks, we are not convinced that this is the Bill that the NHS and social care need at this time. In 2017, the Government should have prepared a Bill that simply implemented changes to reverse the worst of the 2012 Act, stop the pointless bureaucracy and ease the implementation of the NHS long-term plans. However, we are no longer in 2017: we have been through the biggest public health disaster of modern times. We can be grateful for the huge strengths of our NHS, but the pandemic has also amplified the inequalities and serious flaws that need addressing.

I will give three examples of what we have to address in the Bill. We all understand that primary care provides the vast majority of NHS care and will play a more significant role in prevention, tackling health inequalities and supporting capacity issues in the hospital sector under the NHS Long-Term Plan. Therefore, it is vital that primary care has an input into the new integrated care partnerships, which will advise the integrated care boards, which are usually much smaller. The key point is that working towards genuinely integrated health and social care, focused on the needs of individuals, is not recognised in the Bill as it stands. For example, where is the role of health and well-being boards? They are stuck in some kind of floating structure, as the noble Lord, Lord Lansley, pointed out.

I turn to the second thing that is missing. We know that social enterprises and charities are vital in the delivery of health services. Social enterprises, for example, are delivering one-third of all community health services and two-thirds of all out-of-hours health services. They deliver care services, dentistry, mental health services, addiction treatment and many more services. They are a serious and significant part of local health systems. These organisations should not be left out of the decision-making processes.

My point is that we must find a way to do two things. We must ensure that these excellent providers of services are involved in the planning of services at ICS level. We must also ensure that the issue of social value is recognised. The NHS is committed to using social value within commissioning and procurement decisions. Unfortunately, the Bill does not include any reference to social value, which means that the new procurement system for the NHS may go against the grain of the rest of the public sector.

The third issue to address is integration and social care. While the Bill was in Committee in the Commons, we learned that, at some point, there is to be an integration White Paper, which certainly was not in the disappointing document that was launched last week. There is still no overall strategy or plan to address the immediate scandal of inadequate social care. Many in government do not appear to understand that social care is about not just the old and care homes but children and young people with disabilities, as the noble Baroness, Lady Campbell, explained to us.

There is a 10-year vision in the paper launched last week, but it has no milestones, no targets, no strategy and not much funding. It has vague promises, and waters down the Care Act 2014, so we on these Benches will look carefully and critically at that part of the Bill. Let us not pretend: this is an NHS Bill and not yet a health and social care Bill. Surely our job is to make it into that.

Of the many briefings we received on the issue of health inequality, to which the Bill refers, I was struck by the one from the EHRC, which suggested that integrated care partnerships’ strategies should

“include an explicit focus on addressing inequalities in access to and outcomes from services, and that groups sharing protected characteristics”

should be

“fully consulted on their development … Integrated Care Partnerships are required to include representatives from social care and mental health to ensure parity of esteem and a genuine ‘whole system’ approach.”

My noble friend Lord Bradley, the noble Baroness, Lady Bull, and others have said this today.

In the Commons, the Government levelled criticism at my colleagues over their desire to put safeguards into the Bill and the Government’s desire to leave maximum latitude for local solutions. There is an irony here. The Government want to control appointments. They want to agree all the so-called flexibilities and not leave them to local planning at the moment. The Bill is far more top-down system management of the old school, so the Minister can expect some discussion around reconfiguration.

There are concerns about how the new bodies will be accountable. I join my noble friend Lady Morgan in a plea for clarity about this. How are the new bodies accountable and to whom? There is also nothing in the Bill at the moment about accountability to the public and patients.

We need to address issues about who can and should sit on boards that allocate the billions; about restrictions on deals with private providers, on which I am sure that my noble friends Lady Bakewell and Lady Chakrabarti will hold our feet to the flames; about making sure that procurement is done properly; about the new bodies being far more open and transparent than current ones; about respecting the whole NHS and social care workforce, not just doctors and nurses; about including children and safeguarding; about removing fragmentation between different flavours of provider bodies; about a genuine and active role for local authorities in preparation for real integration; and more. I fear we may be here for some time.

We on these Benches absolutely want the Bill to be amended to achieve the outcomes we all agree about—for example, the plea from the noble Baroness, Lady Blackwood, about innovation, and workforce rights, dealing with inequality, transparency, local design and population health. We want to work with our colleagues across the House to ensure that the Bill reflects all those things that we agree about.

The Commons had 21 sittings in Committee and did not even scrutinise the social care cap amendment and other government amendments inserted on Report and at Third Reading. We will have to do that too. I congratulate your Lordships’ House on giving the Minister a clear insight into the scrutiny we believe the Bill now deserves and will receive in the coming weeks. I congratulate him and the Bill team in anticipation of the efforts they will have to put into that. I look forward to the Delegated Powers Committee’s report. I also ask him to ensure that the House is given sufficient time in Committee and at the other stages to give the Bill the scrutiny and thought that our NHS and social care system deserve.

Health and Social Care

Baroness Thornton Excerpts

Monday 6th December 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I first declare my interest as a serving non-executive director on a local hospital board, which is in the register.

I thank the Minister for the Statement from Friday concerning the winter and the NHS. If the House will indulge me for a moment, I put on record what a pleasure and privilege it has been over these years to have had my honourable friend Jon Ashworth, former Shadow Secretary of State for Health and Social Care, as my boss. I welcome Wes Streeting MP to that position; his huge talent will challenge the health team in the Commons and keep them on their toes, I have no doubt, and I look forward to it.

Today, the Daily Telegraph carried a story saying that 10,000 hospital beds were taken up by patients waiting for home care. NHS Providers has done some research and warned that those beds are mostly currently occupied by elderly people who are medically fit to be discharged, but no care is available to look after them at home. The chief executive, Chris Hopson, said that hospitals are now having to deploy their own staff to take on care duties in the community in order to free up hospital beds.

The lack of social care surely lies at the heart of whether the NHS can cope with the winter pressures, deal with ambulances stacking up, tackle the backlog and deal with whatever Covid, and particularly the new variant, may throw at it. When Professor Stephen Powis, NHS National Medical Director, said:

“NHS staff have pulled out all the stops since the beginning of the pandemic, treating more than half a million Covid patients, while continuing to perform millions of checks, tests and treatments for non-Covid reasons”,


he could have added that they are exhausted and need our support and that of the Government to move forward.

We need to add in the fact that about one in 60 people in private households in England had Covid in the week to 27 November—up from one in 65 the previous week, according to the Office for National Statistics. One in 60 is the equivalent of almost 900,000 people. Although it is true that, thankfully, fewer people are hospitalised and even fewer are in ICU, that is still a significant number. But this rate of infection, with the new variant possibly being even more infectious, means that, apart from anything else, there will be a surge in people being off sick, including NHS and care staff.

It is too easy for the Government to say that the winter crisis and the huge waiting lists are simply the result of the challenges of Covid. The reality is that the entire health and social care system has been left dangerously exposed by this Government’s choices over the past 11 years. Before the pandemic, there were waiting lists of 4.5 million, staff shortages of 100,000 and social care vacancies of 112,000. This week, the National Audit Office starkly detailed that things are set to get even worse: waiting lists might double in the next three years.

Those NHS waiting lists stand at 6 million. Almost one in 10 people in England waits months, or even years, sometimes in serious pain and discomfort, because the Government have failed to get a grip on the crisis. Everyone understands that we are in the midst of a global pandemic that has placed the NHS under unprecedented pressure, but that does not excuse or explain why we went into the pandemic with NHS waiting lists already at record levels and with unprecedented staff shortages.

Of course, the investment described in the Statement is welcome, and the plan recognises the many challenges that the whole sector has faced over the past 18 months. Can the Minister say that the Statement is a credible plan to meet those enormous challenges? If it was a genuine plan to prepare for the winter, why did it arrive on 3 December? For example, I noticed that on one of the hottest days of the year, in August, people from GP practices, primary care networks and federations gathered to start to think creatively about managing their winter pressures in a session hosted by the NHS Confederation. When I served on a clinical commissioning group, we did our winter planning in June—it started in the early summer. The board on which I currently serve has been discussing winter pressures and our winter plans for months.

A serious plan to bring down waiting lists would have the workforce at its heart and would have clear targets and deadlines. A serious plan would recognise that, unless we focus on prevention, early intervention and fixing the social care crisis, there is no chance of bringing waiting lists down to the record low levels we saw under the previous Labour Government. A credible plan to tackle the NHS winter crisis—which was foreseeable and foreseen—would have been published long before 3 December. Without a serious strategy to build the health and social care workforce that we need, the plan is not a plan at all.

[The Deputy Speaker (Lord McNicol of West Kilbride) (Lab)]

I call the noble Baroness, Lady Brinton, who is taking part remotely.

Ambulance Response Times

Baroness Thornton Excerpts

Wednesday 1st December 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, it seems clear that the problem is a symptom of system pressures and will require a whole-system approach to resolve it once and for all—Covid, social care packages to help with discharges and local factors, and the fragility of the NHS infrastructure going in to the pandemic. The Minister has explained some of the short-term emergency plans literally to save lives, but in the absence of an NHS workforce strategy, how will the Government produce a system-wide resolution of this matter?

[Lord Kamall (Con)]

The noble Baroness makes a very important point: we should be looking at this in a systemic way. In fact, I did my PhD in a department of system science, where you look at problems in a holistic way—rather than analysing individual problems, you look at the whole system. We found odd unintended consequences. For example, a friend forgot his inhaler, could not get one from the chemist, could not get one from the A&E and, in the end, had to call out an ambulance. There are a number of times when ambulances are called out needlessly, and that is on top of the pressures we are already facing due to Covid. We are tackling the backlog, which, hopefully, will also reduce ambulance waiting times.

Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021

Baroness Thornton Excerpts

Wednesday 1st December 2021 Lords Chamber

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

I call the noble Baroness, Lady Brinton. No? I call the noble Baroness, Lady Thornton.

[Baroness Thornton (Lab)]

I was happy to wait for the noble Baroness, Lady Brinton, to speak before me. I thank the Minister for introducing and explaining the content of these statutory instruments. As we discussed on Monday, the omicron variant is a sobering reminder that this pandemic is not over. I think we all agree that we need to act with speed to bolster our defences to keep the new variant at bay and to keep each other safe through the difficult winter period.

We on these Benches were critical of the Government’s slow response to the delta variant—slow to protect our borders, slow to act to reduce transmission in the community—so we welcome swifter action regarding this variant. It is right to be acting urgently given the seriousness of the threat. While it is sad to be debating these statutory instruments after the fact again, it is definitely an improvement on discussing them after Christmas or weeks later.

Turning to the regulations and starting with the Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021—I still have a problem with all the numbers on these, but this is number 1340—as I said on Monday, it is right to reintroduce masks on public transport, in shops and other settings including banks, hairdressers and post offices for those who are not exempt. However, we believe this measure should never have been abandoned. While mask wearing in public spaces forms part of the Government’s plan B, as far as we are concerned it should have been part of plan A rather than an emergency measure, as should encouraging working from home.

Now we have the issue of building confidence for compliance in the new law. The guidance will be important. When will the guidance about wearing of face masks be issued? USDAW, for example, the shopworkers union —in fact, the union I was a member of when I worked for the Co-op—said:

“Shopworkers aren’t police officers and shouldn’t be expected to act like them. They’re key workers who have kept our country going during these tough times. They deserve our respect.”


I also congratulate my friend and Co-operative colleague Paul Gerrard, who was on “Good Morning Britain” yesterday. He said on Twitter:

“We’ll make sure customers know rules & we’ll help them to follow them but we won’t put colleagues at risk”.


The Co-op is a responsible retailer, as are most of our retailers, but they all need the Government’s support. Have the guidelines been issued yet and what are the Government’s plans to support retailers?

As I said, we think these regulations are too modest and will not provide the protection the Government have described. For example, you will wear your mask to go into the off-licence to get some booze, and then you will go to a party indoors where no one will be wearing a mask. If you attend the theatre, you may get a taxi to the theatre and will wear your mask, and in the theatre some of the people in the audience may be wearing a mask but some will not. Will the Minister explain the scientific justification for those differences?

--- Later in debate ---

[Lord Kamall (Con)]

Sorry, was that offensive? I apologise for any offence caused to my noble friend. I just assumed that because I like teacakes, my noble friend also does.

I will start with some of the questions. On the question of how many people have been helped by some of these financial services, as of 17 November 2021, local authorities have reported 362,573 successful claims since the start of the scheme, totalling £181 million in test and trace support systems.

Despite the easing of the restrictions at step 4 of the road map, the Government have continued to recommend that face coverings are worn in crowded and enclosed spaces. We accept that there is wide support for reintroducing mandatory face coverings, but we have always tried to balance these issues. As I said in previous debates, we look at a number of factors, not only medical but economic and social. Also, within health itself, many mental health experts are very concerned that we might go for more lockdowns and about some of the measures that a number of noble Lords have mentioned.

As we saw in the debate, there are noble Lords who believe that we have gone too far and noble Lords who feel that we have not gone far enough unless we effectively enter a second lockdown. That shows the range of views here and the difficulty, as my noble friend, Lady Altmann, said, that the Government are damned if they do, damned if they do not, but we accept that.

So, do face masks actually work? This is where there is still a debate. I thank my noble friend Lady Noakes for pointing out the article by Professor Simon Wood, who is professor of statistics at the University of Edinburgh, in which he analysed the BMJ paper. It is in effect a meta-analysis. A number of newspapers have taken a line saying that wearing a mask cuts Covid by 53%. I encourage noble Lords to read the article, in which he takes apart the statistics as a statistician and looks at, as those who have done statistics will understand, whether we have a significant number of samples to make it statistically sound. In addition, Professor Naismith of Oxford University has been quoted as saying that

“the Scottish and English approach to masking, although formally different since July, has made no meaningful difference to delta.”

Once again we see that there is a whole range of views, but we have listened to those views. Because we do not yet know enough about this variant, we will continue to review the data. For example, some say that it is very mild in South Africa so we should not be overly concerned about it, but we also have to remember that South Africa has a different demographic in terms of younger people. We know that when the virus first struck it disproportionately affected older people—as my noble friend Lord Robathan said, people aged over 85. On the balance of the data at the moment, we believe that wearing face masks works but we have always been very careful to make sure that it is proportionate where we do it.

On the expiry of some of these measures, as the Prime Minister said on Saturday, all the provisions that have been voted on will be reviewed in three weeks. They are necessary and proportionate while we learn more. I refer to the economics Nobel laureate Friedrich Hayek, who talked about humans having limited knowledge. He talked about the conceit of knowledge. The way to understand a lot of complex problems is to allow the discovery process to take hold and to look at what we can learn from that process. We should be very careful not to imagine that we have total knowledge. What we have to do is assess it proportionately.

It is our hope that these regulations will no longer be necessary in three weeks’ time and that we can return to the system that we lived under last week, but in the event that we need more time to understand the effect of the variant, or that the data shows that we need to take a different approach that requires new regulations, the House will return to Parliament ahead of the Christmas Recess for a debate and vote on the regulations ahead of their coming into force.

On regulations expiring, the international travel regulations will expire at the end of 16 May 2022. The face covering regulations will expire, unless extended, at the end of 20 December 2021. The self-isolation regulations at the moment expire at the end of 24 March 2022, but we will continue to review the data. Almost daily the data is being reviewed and conversations are going on. We will also continue to review the data on the new variant and we hope to update Parliament on the review in the week commencing 13 December.

A number of noble Lords asked about facilities. We are told that setting up dedicated testing facilities at border entry points such as airports is logistically difficult at the moment, and risks delays to passenger journeys and operations. Given the turnaround for a PCR test, passengers would still have to travel to their home or the place they are staying and isolate there before receiving a result. The Government are taking a measured and proportionate response. We want to try to protect the UK from omicron while allowing continued safe travel.

A number of references were made to points made by Dr Jenny Harries. As the Prime Minster said, the guidance remains the same as the measures that were in place to fight delta. We have now brought in tougher measures, but we continue to take advice from a number of experts. Individual experts are free to give their viewpoint but we look at the balance—some of it medical, some of it clinical, but also economic and social factors—and getting that proportionate.

[Baroness Thornton (Lab)]

I need to ask the Minister about the fact that our most senior adviser on these matters gave advice that was then completely denied by No. 10 and the Government. That will at least cause confusion. It is not a question of balancing this and that; Jenny Harries was very clear in her advice about what she thought should happen. It was quite the opposite to what the Prime Minister said should happen. The Minister needs to acknowledge that that will cause confusion.

[Lord Kamall (Con)]

I thank the noble Baroness for raising the point, but it depends on how it is reported. The real issue here is that a number of different experts are advising. Of course, you can pick and choose which expert you decide to listen to. A few weeks ago, noble Lords were picking up on comments made by the NHS Confederation. That is not a scientific body, but noble Lords claimed that it showed that we need to lock down. It is very easy to pick and choose your experts, but we continue to listen to a wide range of experts.

One of the great things about science that we should remember is that there is no such thing as “the science says”. Science should remain contestable. Can you imagine if science was not contestable? We would still be saying, “You can’t challenge the notion that the solar system revolves around the earth.” Scientists challenged that, and that is how we advance knowledge. It is really important that we continue to contest. Scepticism is one of the most important factors in science to make sure we make progress. We will listen to a range of experts.

I ask those noble Lords who really want to lock down more, and who say that we not only have not done enough but should do more and lock people down, to look at the impact that has on people’s mental health and on our economy. I ask them to think about the wider impact and to remember that we are not in the same place we were a year ago. We have been absolutely clear that vaccines work and that the best thing we can do to get through this is to get vaccinated. It is not too late to get your first or second vaccine. I am grateful to noble Lords who have asked questions—

[Baroness Thornton (Lab)]

The Minister is now saying that there is absolutely no doubt about the science behind vaccinations. That is not a matter of opinion; there is no doubt about the need for vaccinations. He is straying into dangerous territory when he says that there is science on this side and science on that, because the Government have rightly said that vaccination is the way forward.

[Lord Kamall (Con)]

I thank the noble Baroness for agreeing with the Government’s line that vaccination is the most important way forward.

[Baroness Thornton (Lab)]

The Minister is being patronising. We have always—always—supported the Government on vaccination; I am sorry that the Minister feels he needs to be sarcastic about that.

[Lord Kamall (Con)]

I apologise to the noble Baroness if I came across as sarcastic.

In terms of hospitality settings, quite rightly, as a number of noble Lords have said, even though we have mandated it in certain settings, it is being left to settings to decide. This is in line with property rights, but also something that people have been asking for—a number of noble Lords have asked “Why not just let the establishments themselves decide, so people can make a decision whether they go to somewhere where masks are mandated or somewhere where they are not mandated?” We are looking really hard at this and we want to make sure that we are proportionate. It could be that we find out that omicron is not that dangerous, but we have to make sure that we have the data and that we sequence it all. It could be that it affects us more in the UK that it would in South Africa because of the change in demographics. That is a really important point.

In terms of who is responsible for enforcement, the police and Transport for London officers have powers to issue fixed penalty notices for non-compliance with the regulations. They are using the four E’s in a proportionate way: engaging, explaining and encouraging before enforcement, just to remind people, if they can, to make sure that they wear a face mask.

The Health Secretary has also asked the JCVI to consider giving boosters to as wide a range of people as possible. If you are boosted, your response is likely to be stronger, so it is more vital than ever that we get our jabs.

On helping the rest of the world, the UK remains committed to donating 100 million doses by mid-2022. We are also extremely grateful to the South African Government; we have been talking to a number of partners, including South Africa directly, to make sure that we do not disincentivise other countries for doing the right thing by reporting the outbreak in the first place. We are doing all that we can.

I am trying to make sure that I answer all the questions; I apologise if I am not able to. My noble friend Lady Neville-Rolfe asked about exemptions for children under the age of 11 and those unable to wear a face covering due to health, age, equality or disability reasons. In terms of the impact to the economy, we do not know the extent to which the variant escapes the vaccine, but as soon as we do, we will be able to make a better measure. We do not at the moment expect there to be significant economic disruption. We have said that we believe face coverings are effective at reducing transmission indoors. The recent UKHSA study suggests that all types of face coverings are, to some extent, effective, but we also welcome challenges to that data. The advice remains the same: we believe that, on balance, it is better to wear a face mask. Many noble Lords have agreed and disagreed with that, but we have to balance these things.

Proportionate measures remain in place in schools. Face coverings should now be worn in communal areas by older students and teachers. The Department for Education is looking at how we make sure that there are clear guidelines on that. We advise staff, visitors and pupils to wear face coverings in communal areas.

I turn to the point from the noble Baroness, Lady Tyler, and that very personal case; it highlights—this should sober us up—those very powerful words that this is not over. We have said that consistently. It is not over. If we believed it was over, we would have removed all restrictions. It is highly likely, but not definite, that we may have to continue to get boosters. Just as we have an annual flu vaccine, we may in the future end up with an annual Covid vaccine, including looking at other strains.

We have said who is responsible. In answer to a point made by my noble friend Lord Cormack, may I suggest that he takes his point about continuous committees up with the Lord Speaker? That is not really in my remit as Minister for Health. My initial reaction is that it seems a good idea, but let us see what the Lord Speaker says.

I again thank all noble Lords for their contributions and for continuing to challenge. That is really important. I can assure my noble friend Lord Cormack that today I asked my department for a list of potential or forthcoming regulations so that we can lay them as early as possible, as my noble friend and other noble Lords suggested. I am grateful for the acknowledgement that we laid these regulations as quickly as we could, and I pledge that we will try to improve that as much as we can, I too, believe very strongly in procedure and the Government and the Executive being held to account. It is really important.