Public Health

Lord Mackinlay of Richborough Excerpts

Tuesday 6th October 2020 Commons Chamber

[Mr Steve Baker (Wycombe) (Con)]

May I begin by thanking my hon. Friend the Minister, the other Ministers in the Department and officials? They are obviously working extremely hard, and I completely accept their good faith in extremely difficult circumstances. I particularly want to pay tribute to the drafters of these very complex regulations. I know from my time as a Brexit Minister that when there are a lot of statutory instruments to do it is extremely hard work for them, and they do not get anything like enough thanks, so I want to put all of that on the record.

It remains the case that this is a dangerous disease for people with risk factors, and I certainly see why the Government wish to introduce measures. My friend and constituent, the epidemiologist Dr Raghib Ali, has written in The Telegraph that both the REACT—real-time assessment of community transmission—and Office for National Statistics studies

“showed that the levels of infection have increased in all age groups, including the most vulnerable older age groups, and also in all regions, but with much larger increases in the North, Midlands and London.”

However, he goes on later in the article to state:

“They all show this is not a repeat of the first wave as infections are rising much more slowly, doubling roughly every 11 days now vs. three days then. And crucially, they also show that the rate of increase is slowing down significantly.”

He goes on, it has to be said, to say that the Government are getting it broadly right.

I have real concerns about the very high cost of the measures. The hon. Member for Westmorland and Lonsdale (Tim Farron) gave some examples, and the hon. Member for Twickenham (Munira Wilson) talked about the need for two families to meet, making eight, but what about two parents and three children? They can meet only one grandparent under the rules.

Elsewhere, we have other stories that are out of the scope of the statutory instrument. If I can get away with one anecdote, there was a story on the BBC website of a wife talking about springing her husband in his 80s out of the care home so that they can spend some time together at that late stage. People are bearing an absolutely appalling set of costs, and anecdotes of poor compliance are rising. Indeed, there seems to be a gap between people’s intentions to comply and what they actually do, as was revealed in the King’s College London research that the Government commissioned.

It is not clear now that the benefit of lockdown outweighs the costs. Although the report fell rather flat, The Telegraph covered some Department of Health and Social Care analysis that seemed to show that in quality-adjusted life years, adjusting for co-morbidities, the cost of the first lockdown was greater than the cost of the disease. In a spirit of good will, where we all mean to minimise harm and maximise human flourishing in the fullest sense, we have to ask whether this set of circumstances is really what we want.

Time and again in our own constituencies, and talking to colleagues in the Tea Room, we hear about people who are being destroyed by this lockdown. Strong, confident, outgoing, gregarious people are being destroyed and reduced to repeated episodes of tears on the phone—all around the House, people are agreeing with me about that. The situation is having a devastating social impact on our society. I believe people would make different choices were they able to take responsibility for themselves, so I have really quite deep concerns about this statutory instrument.

[Craig Mackinlay (South Thanet) (Con)]

My hon. Friend is making the powerful point that there are other health issues and other effects of such draconian rules. Does he agree that the Government should now be publishing what those other effects are? Rather than just the bald figures on infection rates, hospital rates and deaths attributed to covid alone, there should be broader figures on mental health, cancer and all the other treatments, and the deaths that we are not seeing yet but are simply stocking up for the future.

[Mr Baker]

I do agree. I call on Ministers to publish robust data about the balance of costs and benefits. I understand that there is no impact assessment to go with this statutory instrument—I was certainly told that when I picked it up. We really should now be looking extremely carefully at the balance of cost and benefit to overall human flourishing. I am certainly not currently persuaded that the benefit is net positive.

I pay tribute to 66 GPs, led by Dr Ellie Cannon, who have written to the Secretary of State to say that it is now time for him

“to consider non-covid harms and deaths with equal standing as the reported deaths from covid”.

They have suggested that there be a GP on SAGE; I suggest that we also have some economists on SAGE and have made some other proposals about competitive scientific advice, devil’s advocates and other measures that could improve things. The letter from GPs is extremely important. It is time to listen to GPs.

As I reflect on this statutory instrument, I have to say that it is also time to start to think about another way. The Government’s strategy is clearly to suppress the virus, through instruments such as the one we are discussing, pending a vaccine. But what if a vaccine does not come? What if a vaccine, when it comes, does not achieve the ends aimed at? What if we still need some kind of measures alongside a vaccine? I have talked to specialists in this area, and it seems to me—with great sadness—to be pretty clear that we might be in those circumstances, in which case the Government will need a plan B.

For that reason, I was very glad to sign the Great Barrington declaration and to encourage parliamentarians of all parties and both Houses to sign it to show that there is political consensus in both Houses and across all parties for another way. This is plan B, authored by Dr Martin Kulldorff, Dr Sunetra Gupta and Dr Jay Bhattacharya and signed by 1,120 medical and public health scientists, 1,241 medical practitioners and more than 19,000 members of the public, including me. I commend it to the Government.

--- Later in debate ---

[Helen Whately]

I appreciate that my hon. Friend did not take the “let rip” position, but some have done so. The majority of those who have spoken this evening have absolutely supported the fact that we need to have restrictions in place, which is good to hear.

[Craig Mackinlay]

Will the Minister give way?

[Helen Whately]

May I just finish responding to my the point made by my hon. Friend the Member for Wycombe (Mr Baker)? He says that for the vast majority this is a mild illness and that the deaths have particularly been among those with underlying health conditions. It is true to say that the majority of those who have died were older and with underlying health conditions, but, sadly, some have died who did not have known underlying health conditions and were younger. I well remember reading about a nurse not far from my constituency, in Kent, who had three young children and was only slightly younger than me but who died early in the pandemic. So it is not true to say that this affects only older and unwell people, although we should also mourn the older people whose lives have been taken before their time, many of whom were in receipt of care.

The other point is that among those who have had mild illness we are seeing increasing evidence of the condition known as “long covid”, where, sadly, there are long-term health consequences of covid. We are learning about those all the time; they are making it materially difficult for people to lead their lives some weeks and even months after they had the illness, even if they had it mildly in the first place.

--- Later in debate ---

[Helen Whately]

If my hon. Friend would allow me, I would like to make a little bit of progress, otherwise I will have remarkably little time left.

We have a clear strategy, which is to control and suppress the virus while doing all we can to protect the economy, people’s work, schools and the NHS, so that it, in turn, can care for us.

Let me turn to some of the points made by hon. Members. Various reasons have been suggested for the rapid introduction of the regulations. In fact, the shadow Minister made some suggestions. The Government have had to act fast. When we see the rates of increase—particularly when we take away the average across the country, and look at specific areas and parts of the population where the doubling rate can be going up really quickly—it is clear that we need to act fast. The alternative is to act slowly—and if we did that for several days, it would be inaction. That just means that the virus would be left to spread further and faster.

Colleagues have asked for further information about the impact and effectiveness of measures. I get the sense that some Members would like to hear, “If you do x, you get y,” in a very mathematical way. We are dealing with a new disease that simply is not known to the level of “A leads to B exactly.” We look at a huge amount of evidence, including at what is happening overseas, the difference made by local lockdowns and evidence from the test and trace system. All that evidence informs the decisions that are made. We know that social contact is a particular cause of the spread, so we must reduce social contact.

[Craig Mackinlay]

Will the Minister give way?

[Helen Whately]

I am really sorry, but I have so little time.

We have seen reduced levels of socialising since introducing the rule of six, but that is against a backdrop of rates rising in particular parts of the country, which are now under further restrictions. We will continue to look at the evidence and ensure that we are putting in place effective interventions.

The measures that we are debating today are clearly coupled with the vital rules such as hands, face and space. We all have our part to play. We will continue to assess the effectiveness of the measures, but we need restrictions in place until covid rates come down.