Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) Regulations 2021

Lord Bethell Excerpts

Monday 7th June 2021 Grand Committee

Moved by

[Lord Bethell]

That the Grand Committee do consider the Health Protection (Coronavirus, Restrictions) (Steps and other Provisions) (England) (Amendment) Regulations 2021.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, on 17 May we moved to step 3 of the road map, which seeks to maintain a balance between our social and economic priorities. We need to save lives and prevent a surge in infections, and we need to relieve businesses that have suffered from closures and restrictions on social contact.

As ever, the decision to move to step 3 was informed by data from the Joint Biosecurity Centre, the Scientific Pandemic Influenza Group on Modelling and Public Health England. I express profound thanks to the analysts and academics who support these efforts. The surveillance evidence, epidemiological modelling and policy analysis that support these decisions are a tribute to the highest standards of the British Civil Service.

I want to seize this opportunity to set out some of the very latest data that has been presented to Ministers. As noble Lords will remember, there are four tests. The first is that the vaccine deployment continues successfully. As of 6 June, vaccination uptake is at 76.6% for the 18-plus UK population for the first dose and 52.5% for the second. These figures are aligned with the Government’s published plans and they are a remarkable achievement, but there is more to do.

The second test is that the vaccine continues to be effective at reducing hospitalisations and deaths. Data available at step 3 suggests that two doses of the Pfizer vaccine reduced overall symptomatic disease by up to 80% or 90%, hospitalisations by 90% to 95% and deaths by around 95%, with a similar effect reported for the AstraZeneca vaccine. This is hugely encouraging. In the week ending 21 May, when we moved to step 3, the weekly registered deaths had reduced by 70%. More recent figures show that between 31 May and 6 June there were 59 deaths within 28 days of a positive coronavirus test. That is clear evidence that the vaccine works. However, we must not be complacent. As restrictions ease and social distancing measures are relaxed, we must continue to be vigilant.

The third test is that infection rates do not risk a surge in hospital admissions, putting undue pressure on the NHS. This risk is massively mitigated by the progress of the vaccination programme across the UK. Daily hospital admissions continued to fall throughout March, April and early May. Since we moved to step 3, the number of infections has also been increasing. This is what we expected when lifting some restrictions on social contact. For the seven-day period ending 1 June there were 25,888 new cases across the UK, at a rate of 38 per 100,000. There are some regional variations, with particularly high case rates in parts of north-west England. Despite that rise, the positivity rate in England remains low and is currently at 1.3%. There were 151 daily hospital admissions in the UK on the last complete collection date of 1 June. It is steady as it goes.

The fourth test is that our assessment of the risks is not fundamentally changed by variants of concern. For the seven-day period ending 19 May, there were 2,111 new cases of the delta variant recorded, making 3,424 total confirmed cases. In the same seven-day period there were 7,066 new cases of the alpha variant, making 249,637 total confirmed cases. At this point, the delta variant made up less than one-third of all VOCs.

With cases, admissions and deaths continuing to fall, surge testing in place, the vaccine rollout on track and vaccines proving effective, we judged that the tests to move to step 3 had been met. This does not mean that there is no risk. Indeed, we are extremely alert to the potential for new variants of concern to lead to a rapid worsening of the pandemic.

The assessment from SAGE and the evidence from PHE is that the delta variant is much more transmissible. We deployed a widescale test and trace response across the areas affected by the delta variant, including surge testing in areas such as Bolton and Blackburn. In addition to the existing test and trace support payment, local authorities have significant discretionary funding to offer additional financial support to those who need it. In Blackburn and Bolton, this will include trialling broadening eligibility during surge testing, so that all those who are required to self-isolate, who cannot work from home and earn under £26,000, receive a £500 payment. As ever, we continue to keep the data under close observation, and the Government will not hesitate to take firm action if necessary to protect lives and livelihoods.

That is the context of the decision, and it is a decision that has led to a real lift in the mood and optimism across the country, as a result of the changes made by these regulations. Many businesses have reopened and people are enjoying greater freedoms; they can meet more friends and family and more people can now attend funerals to say goodbye to their loved ones. Weddings, receptions and other commemorative events can be bigger, and we have moved from legal mandating and government rules to guidance which asks people to take personal responsibility when meeting friends and family. The regulations also made some important changes on face masks and table spacing, and we listened to the expertise of the Joint Committee on Statutory Instruments and made some minor technical changes to clarify drafting.

I regret that we are debating these regulations only now, and I regret that they were not laid before they came into force, but, despite our best efforts to lay out a clear and timetabled road map with a predictable parliamentary programme, events moved very quickly—much more quickly than the processes of parliamentary procedure. Noble Lords will remember that the Prime Minister addressed the nation on 14 May to set out that the delta variant was more transmissible and there were some important unknowns. This gave us good reason to consider very carefully our approach and to fine-tune arrangements, and that delayed the smooth running of this process.

I know more than anyone the frustrations felt by noble Lords about those delays, but I very much hope that noble Lords will remember the concerns of that time and appreciate that we waited to have the appropriate data to make these vital decisions. We have sought to expedite these important regulations as much as we can while juggling a difficult situation. The easing of restrictions thus far is hugely welcome and, while we must continue to be cautious, we have good reason to feel optimistic about the future. We will remain vigilant and continue to manage the risk to safeguard the benefit of our collective effort so far.

Finally, I thank once again every person and organisation who is supporting the fight against coronavirus and colleagues here for their contribution to this Committee sitting. I commend the regulations to the Committee.

--- Later in debate ---

[Lord Bethell (Con)]

My Lords, I am enormously grateful for a very thorough debate on these regulations and I will try to pick off the key points. One point is the question of guidance versus law, which almost all noble Lords spoke about. My noble friend Lord Lansley put it extremely well. He is right that it is the British way to seek to use guidance and to appeal to people’s best nature wherever we possibly can; it is our default setting in this country. I for one very much welcome the move from legislative impetus to guidance. I think almost all have welcomed that principle.

However, I am afraid that it is an inevitable consequence of moving from law to guidance that you leave a degree of interpretation up to the British people. That is a dilemma we have to wrestle with in government. I acknowledge the communication challenges. I have said from the Dispatch Box and that I thought one or two things might have been done better, but we have given the British public discretion on how they interpret some of the guidance, particularly on travel.

The truth is that the British public are very clear about the guidance we have provided and are incredibly consistent in their behaviour. Despite the suggestion made by some noble Lords, there has not been an explosion of foreign travel. Quite the opposite: the number of people who went to Portugal while it was open was relatively small. Adherence to isolation, which was raised by the noble Lord, Lord Scriven, remains incredibly high. For positive cases it is around 90%, and for contacts of positive cases it is around 85%. The British public are much clearer in their heads than perhaps some would give them credit for. The public understand that the Government sometimes allow people to do something while not recommending it, much like with smoking.

We are at a stage of the pandemic—the infection rate is currently relatively low—where it is proportionate and reasonable to use guidance over the law and to accept that there are some friction costs to that, but they are within the range of acceptable risk. We are at a stage where things are generally getting better. We hope that we are on a journey out of this dreadful pandemic. It is therefore entirely right that we seek to move away from legislation wherever we possibly can.

My noble friend Lord Lansley made the point on testing, and the noble Baroness, Lady Brinton, raised my noble friend Lady Harding’s comments earlier. My noble friend Lord Lansley is right: the capacity of testing to make an impact on the infection is possibly underestimated at the moment. I cite the example of schools, where 65 million LFDs have been used since the beginning of the year to huge effect. We were extremely concerned about infection rates in schools on their return, and the presence of a new, highly transmissible variant is something we watch extremely closely indeed, but pupils, parents and teachers have worked incredibly hard to use the latest technology to keep a lid on transmission rates. That has worked incredibly well. I note my noble friend Lord Lansley’s points about business travel and will take them away with me. The cost of tests is coming down dramatically, and I would be glad to share details of that with him.

The noble Lord, Lord Scriven, and others spoke about the late arrival of these regulations, for which I express genuine personal regret, but I push back against noble Lords who express outrage and concern. I remember the run-up to 14 May extremely well indeed. I have in front of me, on my computer, the chart of the growth of the Indian variant. Even now it puts chills down my spine as I look at it. Naturally, we were extremely worried about a relatively unknown variant for which we did not have a genomically sequenced example. We had no idea about its impact on hospitalisation and death, but we kept our nerve. We waited for the data to come in from the clinics and for the virologists and biologists to do their work. In the end, we had made the right decision and were able to proceed with these step 3 regulations as intended, and as very clearly outlined in the road map. Although there was a delay in the paperwork, we were able to deliver on our commitments in that area.

There is no way we can ignore the data. In fact, in other matters noble Lords are absolutely emphatic that we should follow the data. This is just a direct and unavoidable consequence of that commitment. We face the same dilemma today. We are not fully clear about the serious illness and hospitalisation impacts of the delta variant. We are waiting for NHS statistics to come in. The CMO has made it clear that he feels we will have significantly more information on that at the end of next week. Until then, we have to hold our course. This is the pattern of these waves and will continue to be so. The fact that our constitution allows us to have agile legislation that adapts to the circumstances is a benefit, not a disbenefit, of the British way of doing things.

I reassure the noble Lord, Lord Scriven, that the Coronavirus Act will last until March 2022. The PCMs to which he referred are largely driven by Section 2 of the 1984 public health Act. Analysis of emergency powers is currently being undertaken by the Constitution Committee, to which I have already given evidence. I recommend that the noble Lord engages with it.

The noble Baroness, Lady Brinton, talked about the immunocompromised, a subject that I am extremely concerned about, as I know she and other noble Lords are. I pay tribute to the work of Birmingham University and the Octave trial. This is a huge challenge for those who have little by way of an immune system. The vaccine clearly will not work in the same way as it does with those with a fully charged immune system. There are huge opportunities from therapeutics and antivirals. We are chasing those down very actively, but I would be glad to meet with her, Anthony Nolan, Cancer Research UK and any other charities she would very helpfully like to convene.

My noble friend Lord Bourne spoke about travellers from the red list. I pay tribute to the managed quarantine system. Last week, there were 115,000 passengers into the UK. Only 9,000 of them were from the red list; 92% of those were through Heathrow. I pay tribute to Heathrow and the creation of its new red terminal. We have to accept that the red list may well be here for some time, but I am very optimistic that we can make huge progress on foreign travel. The mutual recognition of double vaccination protocols is being discussed at the very highest levels and offers a way out from the impact of this awful pandemic. I am optimistic that foreign travel will be able to start soon.

By way of a wind-up, I shall address the noble Baroness, Lady Tyler, who said that the pandemic is not going away anytime soon and give evidence of how dramatically our lives will change, largely for the worse. I am much more positive. Ultimately, the vaccine does work. If it works on the variants we have today, there is every reason to hope that it will work on future variants. We have learned a huge amount about therapeutics, antivirals, diagnostics, tracing, surveillance and treatment of the ill. Where we have a challenge as a nation is in public health, which has been found wanting. The health of the nation is far too poor. We weigh too much, smoke too much and drink too much, and we go into illness in a poor condition. That is the challenge we face as a nation, and the one we will turn to once the pandemic is out of the way.

Motion agreed.