Draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

Lord Mackinlay of Richborough Excerpts

Tuesday 17th January 2023 General Committees

[Craig Mackinlay (South Thanet) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Latham.

Interoperability of data across different systems in the NHS between GP surgeries and hospitals has always been somewhat of a vexed issue. I note that the regulations relate to NHS England. A number of differences were highlighted during the covid period relating to certification in NHS Scotland—I note that no member of the SNP is present. Are moves afoot to make sure that data fields maintain some degree of regularity across Scotland, Wales and Northern Ireland? If the worst happens to any of us, our constituents or our families when we are in one of the devolved areas, can we expect that there is half a chance of data readability across the systems in different parts of the United Kingdom? Or, as time goes on, are processes getting more and more diverse and more complex? That would be a great sadness in my view.

Covid-19 Update

Lord Mackinlay of Richborough Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

I think the approach that we have taken to mask wearing, which I have set out, is the right one.

[Craig Mackinlay (South Thanet) (Con)]

We seem to be on a slippery slope towards lockdown based on precisely no real data, which is a worry. It seems to be the precautionary principle gone completely mad. However, I will give my right hon. Friend credit in that I am very pleased that daily testing is going to replace the self-isolation proposed just a week ago. I am sorry to say to my right hon. Friend that he is looking a little silly on these things as we shilly-shally between different rules. Could he answer me this: is he proposing a reformulation of the vaccine and then keeping these or similar restrictions in place for the period until that new vaccine is in arms, then in a year’s time when we get a new variant, we do it all over again ad nauseam—like a stuck record, only more annoying?

[Sajid Javid]

First, I hope that my hon. Friend will agree with me that one of the reasons for these measures is precisely to avoid a lockdown. We all want to see a lockdown avoided for all the obvious reasons, and taking the right proportionate measures now will certainly help to do that. On the vaccine, I am not proposing reformulation. I think the most important thing right here and now, and more important than even before, is the booster programme—not a reformulation, but getting a third shot to boost everyone’s immunity. On the future, where I see vaccines going is multi-variant vaccines, a number of which are already being developed. Just as we see that with flu, I am sure we will see that with covid.

Covid-19 Update

Lord Mackinlay of Richborough Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

Yes. That facility may not be in the app—it may be through a letter or a process—but it will still provide what is needed in terms of travel for that age group. That hopefully will start next week.

[Craig Mackinlay (South Thanet) (Con)]

I fully understand that my right hon. Friend is treading water until we know more about the omicron variant, its response to the vaccines and its virulence, but can I press him on the nature of any likely Government response if those answers are poor? We know what lockdowns mean: damage to youngsters, damage to businesses, damage to lives and damage to liberties—not least the £400 billion while we waited for the vaccine and got it rolled out over a seven-month cycle. Can he please assure me that under no circumstance will we do the same all over again and hope for a different outcome? He knows as well as I that there will be yet another variant some time down the line.

[Sajid Javid]

I do not want to pre-judge the review, but I know that my hon. Friend would agree that our best form of defence is our vaccine programme, and the fact that we are doing better than any other country in Europe in our booster programme gives us a really strong level of defence.

Public Health

Lord Mackinlay of Richborough Excerpts

Tuesday 30th November 2021 Commons Chamber

[Sir Graham Brady]

My right hon. Friend is absolutely right. It is a very serious concern that we might be entering a world where we lurch from one set of restrictions to another, where no business and no individual can get used to the idea of the freedoms they are able to exercise or what restrictions might be in force at the time.

What really concerns me—I think we all know and recognise this—is that we are dealing no longer with a pandemic, but with an endemic virus that will be with us for many, many years and probably forever in some form. Further variants will emerge. They might do so every couple of months or every year. We tend to have a new flu strain on an annual basis and some are much worse than others. But surely, we need to get back to an assumption that people will make decisions for themselves and have control over their own lives. We cannot move, as we appear to have done, to an environment in which the Government simply assume they can instruct us whenever there is the first small evidence from anywhere in the world of a new strain that might behave in a different way, and new and potentially swingeing public health measures are put in place. I ask Ministers to consider the implications of that and for looking at other diseases. Will we start to treat other diseases and viruses in the same way, assuming the best thing to do is to compel people and instruct them on what actions they need to take?

[Craig Mackinlay (South Thanet) (Con)]

My hon. Friend is starting to explore the issue of what happens when there is a variant. What we see from the Government thus far is a load of new measures and, possibly, the pharmaceutical companies saying, “We can make a new vaccine for that within about 90 days”. We would then have many months to get it in everyone’s arm. Having done that and gone back to a sense of freedom, another variant would emerge and we would be on that track all over again. Has he considered the madness of that type of policy?

[Sir Graham Brady]

We should all be afraid of the madness of that kind of policy. The difficulty is that 18 months ago, when some of us started raising these concerns, it was possible for some people to suggest that we were being fanciful. We have now lived it for 18 months and we can see this reaching ahead. We think back to when the Coronavirus Act 2020 was renewed again, taking us through to spring next year, and the assurances we were given that that would be the last time. I thought we would not need this kind of legislation again, but we see the Government’s immediate assumption that they should reach for new controls, new compulsion and new rules to inflict on the British people. We need to move away from that and back to a world where we trust people, engage with the public and recognise that the Government are there to serve the people, not the other way around.

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[Dr Whitford]

I was not claiming that it was, because genomic testing takes a couple of weeks generally and it is therefore too late for someone to isolate. What I am saying is that with this variant, as in alpha but not in delta, the missing S gene means that on that initial test—which takes six hours or until the next day, or whatever it is—we already get a heads-up that we are dealing with an omicron case. We can go on to do the genomic analysis, but we can say to the patient, “We think you have this variant. You need to isolate thoroughly and for longer.”

[Craig Mackinlay]

I thank the hon. Lady for bringing her medical knowledge to the House. It is very interesting, particularly on the S gene. I do not know what magic goes on in a lateral flow test. We put the drips in at one end and then one band, hopefully, appears and not two. Could a lateral flow test be adapted to be specific for this type of variant?

[Dr Whitford]

I think we would be talking about redesigning the test for a whole new antigen. I mentioned just one advantage that we get from PCR testing, which basically looks at genes—I will not talk about the whole long name and what PCR stands for—and the benefit is that we get a heads-up. I do not think it is feasible on any reasonable timescale to change lateral flow tests, so we are lucky that this one has S-gene dropout and that we will get an early warning.

One issue with focusing only on a day-two PCR and then, if someone is negative, they are released—unlike what is being discussed for domestic isolation—is that the incubation period of covid, generally, is much longer than two days. It has generally been reported as an average of five days and it can extend for longer. If someone who may have had contact arrives in the UK, gets a negative PCR result on day two and then goes about their business, there is a real danger that that is a false reassurance. That is why the Scottish and Welsh Governments have asked for a Cobra meeting to debate the evidence on a four-nation basis and to discuss having at least an eight-day isolation period for travellers, with a negative day-eight test required before people can be released.

The Prime Minister should listen on that, because one issue that we had in Scotland when we tried to maintain stricter and broader hotel quarantine was that the majority of long-haul passengers arrive through hubs such as Heathrow. The devolved nations have no ability to have an impact on that and we should be working with the Republic of Ireland to make the whole common travel area safer from the point of view of how we move about inside it.

--- Later in debate ---

[Craig Mackinlay (South Thanet) (Con)]

I understand the dilemma that the Government face and are in. There are two main questions that we need to ask and to which we all—including the Government as much as anyone—want to know the answer: first, what is the state of the omicron variant’s resistance to our vaccine programme? Secondly, if someone becomes infected, is their illness weaker or worse than it would have been with the delta variant that we have got used to? In some ways, it does not matter what happens with the vaccine if the omicron variant does not cause bad illness. Frankly, if it does not cause bad illness, I do not care about this thing at all. My hon. Friend the Member for Bexhill and Battle (Huw Merriman) just made an interesting point: if, as we all hope, the omicron variant is weaker than the delta variant in terms of illness and effect, we are going backwards a long way today, because we will all have to lock down when we get the text, email or phone call to tell us we have been close to somebody with the new variant. That makes little sense at all.

Let me address the proposals before us in some sort of order. Like my hon. Friend the Member for Winchester (Steve Brine), I do not have too many concerns about the face-mask regulations: they are an extension of rules that we have pretty much got used to and there is very little difference from what I have been doing on public transport, where I have been wearing masks religiously. I am still a little bemused as to how a fairly flimsy mask with a filter size that is far greater than a coronavirus particle can somehow be the salvation, but so be it. I am not terribly concerned about that.

We are, though, left with a gross absurdity that will perhaps face everyone in the House over the next few weeks. When someone goes to the off-licence on the way to a party later, it might take them only 45 seconds to get their tiple of choice but they will have to wear a mask on pain of a fine. They can then make their way to a house party, with 100 people or perhaps more—perhaps an infinite number of people—where it will be enclosed, warm, cosy and friendly and they can take that same face mask off. Really? It is an infantile proposal and we are in danger of falling down the same absurdities as we fell down before, with the madness of the couple who could walk across a golf course but dare not play on it. This is the absurdity that I have voted against previously and will vote against again.

Let me move on to the self-isolation requirements. I am afraid that the proposals mean we are going to fall into a new pingdemic. There is nothing in the regulations, in anything the Minister has said or in anything else I have heard to date to say that the testing regime will be backed up with proper genome sequencing at the right rate, so we can get back to a situation in which people can be told, “No, your contact was not omicron. You’re fine.” My hon. Friend the Member for Winchester picked up on a very dangerous phrase in the regulations, and that is “suspected of”. I do not know what that means. I know what “confirmed as” means—to be confirmed through a proper genome-sequence test—but what about “suspected of”? When people get that phone call, text, email or ping from the NHS—if they have been daft enough to have the app on their phone—are they now going to hear, just because the words “suspected of” have been added, “Thou shalt be held indoors for 10 days”? This is where we end up with mission creep and the chilling effect that my hon. Friend the Member for Winchester mentioned.

I am going to be somewhat concerned about going to that Christmas party or that pub, because I have friends and family coming round for Christmas day. This legislation is going to have a dangerous pingdemic effect, either through a proper pingdemic or just through the effect of fear. I asked the hon. Member for Central Ayrshire (Dr Whitford), who spoke for the SNP and is knowledgeable on these matters, whether we might be able to get a new lateral flow test that is specific to omicron, but I think the answer is possibly no. We are in a confused state and I am concerned that the regulations will shatter businesses that are getting ready for Christmas. With the support of Opposition parties, sadly the regulations are likely to go through.

I am somewhat confused, as are many other Members, that we are not considering the regulations on travel today. It seems somewhat bizarre. There is a new requirement for a PCR test within two days. I am afraid we have seen far too much of what I call wild-west behaviour out there when people try to obtain a test. We have a well-established, well-working, accurate and fast PCR network that has stood up throughout the whole country. For instance, I can go on the NHS website and organise a PCR test tonight, probably within a mile or two of where I live, and I would probably get a result back tomorrow. The system works very well and that is to the Government’s credit. We went down a stage, for good reason, and said that lateral flow tests for people who travel in are fine. We are now back to the confusion—do lateral flow tests work or do they not work? If they work, surely that will do; if they do not work—if they are not reliable—why on earth have we spent billions of pounds over the past few months and why are everybody’s draws and cupboards full of these things, which are handed out like candy in the streets? It is something of a nonsense.

We have not yet discussed the regulations on the travel restrictions, so perhaps we have a chance of changing them for the good. We are introducing new requirements so it is only fair that we offer the ability to meet those requirements within the NHS PCR testing system, either for free or at a minimal cost. That way, we will not have these situations involving what I have described as wild-west companies that have not served us well.

Sadly, we are allowing ourselves to go back into a rabbit hole, and I am concerned that we will never get out. Last year, before we had the big vaccine roll-out, there were reasonable reasons, although I did not support them, for the levels of restrictions: we were waiting for the cavalry of the vaccinations and wanted to protect the NHS from being overloaded. We did that, it all worked and we got back to a semblance of normality. But we have a new variant, so we introduce new measures, then await a new vaccine formulation, then wait another few months to get that into people’s arms, and then we might be able to go back to normality—but then we will find another new variant and do it all over again. This has to stop. We have to live with this ever-changing virus. Enough is enough: it is done.

[Several hon. Members rose—]

National Health Service

Lord Mackinlay of Richborough Excerpts

Tuesday 13th July 2021 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

My right hon. Friend is making a fantastic argument, as he always does in this place. I have interweaved these new regulations into where they would fit in the Health and Social Care Act 2008 and the 2014 regulated activities regulations, and have found that we are asking care homes to be the policemen of delivery people, plumbers and window cleaners with a possible £4,000 fixed penalty fine. I do not know whether my right hon. Friend was aware of the extent of the fine that backs up these regulations.

[Mr Harper]

I am grateful to my hon. Friend for bringing that information to the attention of the House.

I will bring my remarks to a conclusion, because Mr Deputy Speaker wants to make sure that we get everybody in. My final point is that, coming back to the consultation that took place, it is very clear that most of the people responding did not support these proposals. They were very concerned about them; certainly, the care homes and those involved in the sector who I have heard from are very concerned about them. The proposals do not command wide support, so I say to the Minister that I would listen to the concerns that are being expressed, take these proposals away, and come back with some well-thought-through proposals to secure the support of the House. If she presses them to a vote today, I regret to say that I will be forced to vote against them.

Covid-19 Update

Lord Mackinlay of Richborough Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

The hon. Lady raises the importance of vaccination, and she is right to do so. As I mentioned earlier, according to the ONS, nine out of 10 adults in this country have antibodies, which are part of the wall of protection.

The hon. Lady is right to mention that cases will rise in this wave. We have been very open about that. I hope that she heard earlier in my statement that there is no perfect time to start opening up. The risk is that, if we do not do it now and wait until after the summer, the schools will be back, and if we wait longer it will be winter—there is a real, serious risk, which we have been advised about, that the wave could be even bigger than what is anticipated at this point. Many more people would then end up getting infected and, by extension, getting long covid.

I hope that the hon. Lady can consider all that together in a balanced way. If she would like to meet any Ministers or officials in my Department to understand the situation better, I will be happy to arrange that.

[Craig Mackinlay (South Thanet) (Con)]

From previous answers given, I am delighted that my right hon. Friend is now looking at the underlying settings of the Track and Trace app—I ask him to do that as a matter of urgency. Those settings take no account of vaccination status or any other behaviours; it is just a blunt, bluetooth signal. It might have had value when there were few other tools in the box, but it must now be highly questionable to condemn potentially millions of people to unnecessary self-isolation and the economic impact thereof.

[Sajid Javid]

My hon. Friend makes an important point. I hope that he noted my comment that, precisely for the reasons he set out, given the high rate of vaccination, we are taking a fresh look at the app. I have asked for advice—and have just started to receive some of it—about how we can take a more proportionate and balanced approach.

Coronavirus

Lord Mackinlay of Richborough Excerpts

Wednesday 16th June 2021 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

I want to discuss two sides of the science—science as the liberator and science as the captor. We have seen through this process that new vaccines have been created using messenger RNA of a completely new type that will, I am sure, serve us well globally into the future. We have rapidly created them, tested them and rolled them out, and that is all to the good. We have repurposed existing drugs such as the very cheap steroid, dexamethasone. We have used antivirals that were used before, remdesivir being just one, and we have discovered new treatments such as monoclonal antibodies. We have created a testing regime that enables us to rapidly test vast numbers of the population for their covid status.



These were the new tools that I had hoped would prove science as the liberator, and the results are extremely good. Let us look at those facts again. We have heard them many times, but I think they are worth putting on record once more. With just one dose of any of these vaccines, protection is good. With two doses, it is truly exceptional at over 90% protection against hospitalisation. Even those who do find themselves in hospital after vaccination are generally not finding themselves dreadfully unwell. We have seen hospitalisations reduced. We have less than 1,000 people in hospital, or 1,000 or thereabouts, which is just 1% of NHS capacity.

I am sure Ministers would respond to that by saying that this is the way they want to keep it, but I am afraid that argument will never end. We have a death rate of about 10 deaths per day out of a background death rate in the country of 1,100 per day, which is currently under the usual average. However, let us look at those 10 deaths per day within 28 days of a positive covid test. They are husbands, wives, brothers, sisters, parents and friends. Each is a tragedy, each is a family loss and each is a dreadful event. But surely with such low levels we should now be provided with the data as to why: what were the deeper underlying reasons behind those deaths? I certainly hope that Ministers have been provided with that information. There is a world of difference, and a difference of interpretation that this place would make, between the death of a young, fit person and that of somebody with comorbidities, perhaps in a hospice with life-threatening conditions.

Let us examine science as the captor. Our ability to sequence the genome is incredible. The UK is a world leader. Hundreds of variants have been discovered, and doubtless once the delta variant has passed through, just as the alpha Kent variant has been and gone, we will discover more. Will it be a Californian one, a Buenos Aires one, or the epsilon or the zeta? I am sure we will simply run out of Greek alphabet over the coming months. However, each one causes hysteria, and the media go berserk. With the scientists, it is like having the decorator in your house: you get sucking of teeth and shaking of head, and you know there is bad news around the corner. We have seen the modelling. The five key modellers have come up with a road map, published in February, which the Government understood, and it led to the road map we are on, but every one of our figures are better than that, and that makes this statutory instrument so unintelligible.

I would rather trust the people. What if we were to go for freedom on 21 June? What would I do, because I think I am pretty normal? Would I be throwing away my mask in the supermarket? I very much doubt it. I carry sterilising gel in my pocket, and I can say to you, Madam Deputy Speaker, that more alcohol goes through my hands on a daily basis than on a night out with George Best and Oliver Reed. Would that stop? No, it will not. The public outside this bubble have already moved on. They have broadly given up on these pettifogging rules. We should trust the public, and I will not be supporting the Government this evening.

Covid-19 Update

Lord Mackinlay of Richborough Excerpts

Wednesday 30th December 2020 Commons Chamber

[Matt Hancock]

We have not set that out yet, because while our general approach is to vaccinate, as soon as possible, as many as possible of those who are vulnerable to this disease, and to then be able to lift restrictions, as I said in my answer to my right hon. Friend the Member for Forest of Dean (Mr Harper), the exact timing depends on the roll-out of the vaccine and its impact on bringing down the rate of transmission. The change in the dosage schedule from four weeks to 12 weeks means that we can get the protection to as many people as possible sooner, and in a more accelerated way, than we would previously have been able to do.

[Craig Mackinlay (South Thanet) (Con)]

The approval by the Medicines and Healthcare Products Regulatory Agency of the Oxford-AstraZeneca vaccine is great news at the end of a truly wretched year. Does my right hon. Friend agree that the speed of roll-out should be governed only by the rate of vaccine production? Will he assure me that his Department will cut through all and any pettifogging rules and bureaucracy to ensure that newly retired nurses and doctors, or those on career breaks, can be approved as vaccinators, so that the only limiting factor is vaccination production, not the availability of vaccinators or locations?

Covid-19

Lord Mackinlay of Richborough Excerpts

Monday 14th December 2020 Commons Chamber

[Adam Holloway]

I completely agree with my hon. Friend. I said the other day that the last time I went into the Compass Ale House in Gravesend, it was literally like putting myself under the control of a manager saying, “Sanitise your hands. Do this. Do that. Sit down. Don’t do that. Why have you taken your mask off?”

I am absolutely not suggesting that pubs open as normal—in fact to the contrary, and that is the point. They are ready to operate safely in the new normal that they have arranged at such huge cost. I suggest a well-run pub is a safer environment for people to meet their friends than their front rooms, but like everyone in Whitehall and across the country, we have absolutely no idea either way. It is just a hunch.

[Craig Mackinlay (South Thanet) (Con)]

To assist my hon. Friend, he may be aware there was a report out based upon some work in south-east Asia. That seems to have been the basis of this risk assessment for hospitality, and it was not long ago that Public Health England itself said that potentially only 5% of infections were caused in the hospitality sector. I share his concerns, and I am sure he is critical of the risk assessment, just as I am.

[Adam Holloway]

I wish I had spoken to my hon. Friend last night when I was looking for precisely that research. There is absolutely no reason why councils and the police cannot be given draconian powers to shut down establishments that are operating unsafely.

My second point is that we are looking forward to the Christmas relaxation of the rules, which I know will be hugely welcomed by hundreds of thousands of families across the country who have had it very hard over the past few months. At present, the virus appears to be circulating among school-aged children and their parents. Thank heavens that is usually without serious effect, although we have had many tragedies.

Over the Christmas period, people have been told that they can mix and that generations can mix. I strongly suggest to my constituents that while we may be allowed to do so, some might choose not to. It strikes me that there is a great risk of parents and children passing on the virus to grandparents, leaving the country in a very poor position as we enter the coldest months of the year, when transmission rates will inevitably be highest.

After the extraordinary foresight of the Government in securing the vaccines and with the likelihood soon of many, many millions of doses of the Oxford vaccine coming online, I suggest that while families are allowed to do something, it might just be better to wait another four or five months. I know a lot of people are talking about Australia at the moment for some reason. My constituent, Mr Hamilton, suggests that some families should consider, like Australia, celebrating together towards the beginning of the summer, once the vaccines are rolled out and we are out of the worst of the winter. We may be allowed to do things, but people should listen to the Prime Minister and be very careful.

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[Craig Mackinlay (South Thanet) (Con)]

It is good to have the floor for more than the 180 seconds that was allowed in the debate before the last lockdown, which only gave us time to say our name and serial number.

I pay a very great tribute to the Government for what they have achieved. I think one of the crowning glories of what has been achieved in some of the testing data is the granularity of borough-by-borough data, which I will refer to that a little later. We have rolled out polymerase chain reaction—PCR—testing to a higher percentage of our population than anywhere else in the world. I had some doubt that we would ever reach 100,000 a day, let alone half a million, so this has been a real triumph in flexibility that our country has been able to achieve. We are now seeing the roll-out of lateral flow testing. Thanet schools will have the mobile testing units landing very shortly, as will other parts of Kent.

We have had a level of financial support that is almost unparalleled anywhere in the world. Of course, some businesses have not got what they thought they deserved, but we have to accept that this was new ground; we did not know what was around the corner and different support schemes had to be rolled out very quickly.

Then, of course, our own MRHA, the council that approves medicines, has rolled out at high speed but with absolute safety the first of the vaccines for licence around the world—the Pfizer/BioNTech vaccine—and there are others coming round the corner. The one that we all hope for is the home-grown Oxford/AstraZeneca vaccine—a rather more traditional vaccine, which is easier to store and administer. What is coming out of the billions that have been spent around the world in a very short time is this new messenger RNA-style of vaccine. Once we are out of covid, there could be—maybe, doubtless, possibly—a similar type of pandemic in years to come, and we will be better armed to respond rapidly to it, so hopefully our planet will not be in this situation once more.

We look at the vaccines as the way out of this, but we have to tell some truths. Some are being rolled out as we speak: my father of 86 is getting his vaccine No. 1 this Friday, and tomorrow vaccinations are being rolled out locally from GP surgeries in my Thanet constituency. That is all great news, but there are 66 million people in this country, and we need two vaccinations. We have limitations on the delivery of the vaccines and there is global demand for exactly the same product, so we need honesty about how we will scale it up and deliver it. It is not just about the numbers; it is also about the availability of staff and those who are able to vaccinate. It is a major undertaking.

We must pay real tribute to the NHS staff who have stepped up to the plate, shown massive flexibility and kept the show on the road. We all have fantastic communities that have been looking after the old people in their streets, church groups that have done their bit, and food banks and similar organisations that have risen to the challenge. The Minister, who is looking at me intently, can be quite sure that that is the end of my unalloyed congratulations for where we have got to thus far. I still have a number of fundamental concerns about the moving science that we are living under, and I aired some of them in the previous debate.

We had the ridiculous situation that, as we approached lockdown version 2, we pretty much banned everything. We banned swimming, gyms, golf courses and non-essential shops. We had what I then called the Wilkinson conundrum: the big shops could open, but the small shops selling some of what the big shops were selling were not allowed to open at all. We could not have group worship. Thankfully, under tier 3 and tier 2—obviously, 99% of the country is now under tiers 2 and 3, and the whole of Kent is under tier 3—some common sense has prevailed. All those shops can open, and we can indulge in group worship and do quite a number of the things that we could not before. That indicates that there has been some granularity of thought about these things—funnily enough, exactly what I was saying some months earlier—and it determined that those things were not so dangerous after all.

I am not here to be part of the difficult squad. I know I am in the Covid Recovery Group. I am attempting to be a serious critical friend of the Government, but we still have our hospitality industry, which many right hon. and hon. Members have mentioned this evening, and I suspect that more following me will do so. I feel that, because we are getting somewhat desperate to get out of this mess, we are losing sight of what works and what does not work. I find it hard to believe that we will all be going Christmas shopping. I am sure the density in our supermarkets will be that much higher over the next 10 to 12 days, as we scramble around for the cranberry sauce and the turkey. That is allowed. The nail bars and the hairdressers, thankfully, are allowed. [Laughter.] Well, my nails are not looking too bad. But we are not allowed to go to a well-managed location of hospitality, and I just cannot see the sense of that.

I still have my concerns about the economics of tier 3 and lockdowns. I think London will suffer greatly over the next couple of weeks. We still have not really seen the analysis of what other deaths may be caused because people are too fearful of going to health locations. Macmillan Cancer Support said just this morning that lockdown version one is likely to have led to 50,000 people not seeking the help for an early diagnosis that they might have sought. That means that once they are diagnosed, their cancer may have advanced to a higher level and treatment will be more invasive, more expensive and more unpleasant—and there will be deaths.

I am not sure we are considering the effect on mental health sufficiently. I know that has been mentioned on the Floor of the House many times. There is not just one example, but I think very much of the multi-generational family business of some standing, with a bit of a status in the community, that goes bankrupt through no fault of its own. I worry about the likelihood of suicide in such instances.

Her Majesty’s Treasury is very capable of modelling almost anything—it certainly tried to model Brexit over many years—yet it seems incapable of properly modelling the economic impact of these ongoing lockdowns. We had the spending review and the Office for Budget Responsibility report just a couple of weeks ago, which suggested that, at the mid-way point—a sort of tier 2 point—there is a permanent 3% scarring of our economy. Obviously, tier 3 has to be a little worse, if not a lot worse. As we have discussed on the Floor of the House over many years, there are reports from diverse organisations that say that long-term poverty, and the scarring of our economy that this will cause, will lead to worse life opportunities, fewer life chances and shorter lives. None of that has been factored in at all.

Let me turn to a couple of points that I hope the Minister will take away. I mentioned how useful the granularity of borough data has been. I think we all watch that avidly. Strangely, Thanet, part of which is in my South Thanet constituency, was at the very highest level of infection rates per 100,000 a few weeks ago, despite having been in the very lowest league at the end of the summer. I cannot explain that; I do not know why. We have our backs to the sea, and we do not have a community that mixes like a big city may. Thankfully, though, it is the only borough in the whole of Kent where the figures are now just on the way down. We are at 425 per 100,000 today, whereas we were at over 500 just a couple of weeks ago. That compares with a national average of 181.

My concern as we go forward is that we have seen that the tiers only get stricter. We have these five bases on which we are trying to interpret whether an area should go up or down. We have the pure numbers—that rate per 100,000, which we have all become very familiar with. I do not know what the threshold is between tier 1 and tier 2; it seems to be around 200, but I am really not sure. The shape of the graph is important: is it going up exponentially, or is it plateauing and going down? There are also the bases of the rate of infection among the over-60s, the most at-risk group for obvious reasons, and the positivity rate and whether that is going up or down. I have no idea about positivity rates—whether a rate of 2% is good or 10% is bad. Then, of course, there is the pressure on the NHS.

Concentrating on the pure numbers, however, I think that could be one of the tools by which we keep a lid on this—squash the sombrero and bide our time until we get to the vaccine. I do not know about any other Members in this House, but those numbers have really worked on me. At the end of the summer, when Thanet numbers were low, we had a spring in our step; we were not quite so worried—we were quite happy to walk down the high street to go shopping, and if we saw somebody without a mask on it did not really worry us too much. However, as those numbers have got to very high levels, I know that my behaviour has changed. If I see someone in the supermarket without a mask on —thankfully, it is a pretty rare event these days—I give them a very wide berth, of not just 2 metres but perhaps 3. I think we just do more careful things, too: we carry our hand sanitisers with us on a daily basis when our local numbers are high. I have the feeling that those numbers could be the most powerful tool in affecting behaviour.

Of course, the last of the five bases that we have to consider is pressure on the NHS, and I have a number of concerns about that. The community can affect the other bases—people can do something for themselves—but they can do very little, I am afraid, about what is happening in our hospitals.

I am very concerned. Last week a number of hospitals were reporting the percentage of their in-patients who had acquired covid within the hospital location. If our hospitals are under pressure, that creates more pressure for them. I find it hard to believe that this—the so-called nosocomial infection rate—cannot be solved. It was reported last week in The Daily Telegraph that 10,000 patients could have been affected, and we are all hearing about this. I am afraid I am hearing about it far too often; I hear about when patients go in for a routine treatment and are placed in a hot ward—in a mixed ward with others who are covid-positive. Last week, I watched ITV—national ITV—report on a situation at Medway Maritime Hospital. Few things really shock me these days, but this really did. A chap called Paul Tucker, aged 57, went into hospital with a serious condition that was nothing to do with covid and he died because he was in a mixed ward with covid-positive patients.

I can give another example, about someone I know: an old gentleman who broke his leg and went in for treatment. He came out solved, but he had had a covid test the day before discharge and no test result came forward. He went home for five days, and in those five days he had up to five carers attending to him every day—he is a gentleman on his own with no family living nearby—and on day five the hospital rang and said, “Ah, really sorry, but the test was a bit late: you’re positive.” Five carers every day had been attending a man they thought was covid-negative, and those same carers would be going out to possibly 10 different clients on a daily basis. The declared hospital-acquired infection figures that we are hearing do not count infections that have been created by such new spider’s webs because of a failure in a hospital. If there is a takeaway from tonight, Minister, it is that I beg you to get infection control under control in our hospitals.

I think I will leave it there, Madam Deputy Speaker, but these are serious times. We are not going to be out of this immediately or any time soon. Rolling out 66 million vaccines, times two, will take time. We need to live with the virus in a sensible way, and going in and out of lockdown, with the damage to health, the economy and mental health, must form part of the balance sheet of how a nation deals with this infection.

I give the Government great credit for their achievements. They are world class. Very few nations in the world can say that they did it as well and as rapidly as we have tried to do it. It is all very well being the specialist after the event, saying what might have been or what we could have done that might have been better, but the world is not like that. I give top marks to the Government, but there are some takeaways that could make it even better before we are fully out of the woods.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. There is not that much pressure on time, but we have to be slightly conscious that everyone will want an equal go.

Public Health: Coronavirus Regulations

Lord Mackinlay of Richborough Excerpts

Tuesday 13th October 2020 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

Lockdowns do work if the desire is merely to flatten the curve, flatten the sombrero, reduce the R number, and covid is the only thing in town. But of course it is not the only thing in town. That ignores the corollary effects on other health issues, wellbeing and, of course, the economy.

The benefit of what the Government are proposing today, with tiers 1, 2 and 3—medium, high and very high—has the benefit of clarity, which I think has been lacking thus far. But I do have concerns and I would like clarity from the Minister before the end of today’s debate as to how he proposes to move areas in the future, as necessary, between the different tiers. My reading of the SIs is that that can be done without recourse back to Parliament. Areas can be moved between 2 and 3 or vice versa with no negative or affirmative procedure in this House. The worry has to be that there is an ability to recreate a national lockdown in piecemeal fashion, so I certainly hope the Minister will be able to answer that.

I have the same concerns this week as I did last week—raised by many hon. and right hon. Members—about the rule of six, and I was a Teller last week against that SI. There seems to be very little rationale today and there was none last week. If six is the magic golden number, surely four has got to be better and, if not, why not 10? Let us discuss that. I was particularly taken by the speech—he is not in his place—of my right hon. Friend the Member for Forest of Dean (Mr Harper), who made the very reasonable point that a mother and a newborn, never detached from each other, under these counting units count as a two. That has to be patently absurd when, under any reasonable measure, they have to be counted as a one, and that absurdity would continue into any close living family unit.

My real concern is, of course, about the 10 pm curfew. Just considering this great city of London, the restaurants close, the pubs close, there is no takeaway available at 10 o’clock, and guess what? The first train out of London or the next tube at 10.10 is going to be rocker-chocker solid—mixing and mingling with people at close proximity. For great clarity of any Whips listening to this debate, I will be voting against the, albeit superseded, negative procedure SI on the 10 pm curfew, which is in motion 9. I remain very concerned about the SI in motion 3 on the Order Paper about the lower level tier 1 —medium. Again, the 10 pm curfew has crept into all of these SIs and I see no rationale for it to be relevant for the lower level—the safer level. So I remain to be convinced, but I am currently concerned and may vote against.