(4 years, 1 month ago)
Commons ChamberWe face a difficult winter. Many areas of England are under heightened restrictions, including Elmbridge, part of which forms part of my constituency. We face the national challenge of a new disease, with a population that is largely unexposed to it and has built no immunity to it through either prior infection or other means, such as vaccination. It spreads easily and quickly, and can make people in high-risk groups, particularly the elderly, seriously ill. It can spiral out of control and overwhelm our health service.
I supported the first lockdown and I support the current restrictions. As an NHS doctor, I say with all my body and soul that we cannot let the NHS be overwhelmed. But lockdowns and restrictions are deeply harmful in themselves. The long-term effects will be profound—a higher burden of disease from poverty, with associated costs in lives; loss of livelihoods; misery and damage from isolation, and reduction in liberties. We need a way out.
My constituents are feeling it—especially those who are now in tier 2 restrictions in Elmbridge—and I pay tribute to them for their resolve. They rightly ask me, “What’s the way out? How does this end? How do we escape the cycle of lockdown?” The current strategy is to suppress until there is a vaccine, but what if there is never a vaccine? As people start to tire of lockdown, increasing coercion and punitive measures are being put in place. On my commute from Runnymede and Weybridge, I travel to Waterloo station, and I have seen the signs there change—from a £100 fine for not wearing a face mask, to £3,000, to £6,000—in the course of a few months. It is inevitable that greater coercion will be needed. When does that stop?
Coercion is illusory. It works briefly, but after a while it fails, unless we take people with us and they own the decision. Of course, in a public health response to an infectious disease, we cannot have a free-for-all, but at the same time, in my constituency, I see people at low risk from covid who ignore the guidance because it will not directly affect them and all they see is harm from restrictions. I see people at high risk ignoring guidance because life is short and they want to see their grandkids. I see people terrified of covid hiding away from the world. Day in, day out, people make decisions about their health risks, such as to smoke or not to smoke—indeed, given that 76,000 people die every year from smoking, probably more people have already died this year from smoking than from covid. People decide whether to put salt on their chips, or not to eat chips. We all make compromises and trade-offs, but rather than the state deciding those trade-offs, we must find a way to let people decide their own.
Is not the problem that whether I choose to have salt on my chips is a matter for my health, but when I take risks with covid, I take them not just for myself but for everybody else with whom I interact, and for the whole of society?
I thank the hon. Gentleman for his intervention, and I will come to precisely that point in due course.
I supported the first lockdown, and I support the current restrictions, but we need a way out that works, irrespective of the invention of a vaccine. We need a way out that supports people to take their own decisions and respects free choice but, as the hon. Gentleman said, we must also protect society from an infectious disease. Such a system needs to be sustained for a long time, and those measures will need to be in place for a long time.
It is easy to criticise, but it is more difficult to put forward other options. We therefore need a debate about what a plan B could look like. We started with a national lockdown, but that was too blunt. We rightly moved to targeted measures, which are better, but still not great. The geographical area is too large, and people do not live their lives by local authority boundaries. The next logical step is to shrink the geography further—to the household or individual—and to have a system that allows people to make decisions for themselves regarding their own risks and the people they come across socially or at work.
We must use our testing capabilities in a targeted, risk-based manner, so that those at high risk, should they choose to, can shield and have support to do that. Those at low risk would be able to live their lives more freely, should they choose to do so. At the same time, we must ensure that things do not spiral out of control, with broader measures and restrictions available in reserve if needed. We must invest in our NHS surge capacity, and carry out research into vaccines and treatments.
The challenge, of course, is how we support those at medium risk, or those who live or work with high-risk individuals, and we need to have that debate. Lockdowns are not a cure for covid. They only regulate the pressure on the health service and, important as that is, in time they can, and will, be worse than the disease itself. We need to have that difficult debate and there is no easy solution. While I suggest that we wait for the phase 3 trials of vaccines, which come out imminently, we must start putting flesh on the bones of a plan B, based on individual choice, and consider a pilot in the UK. To get through this pandemic, whatever we do will be difficult. Difficult decisions have to be made, and more difficult decisions remain to be made.