Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020

Lord Bethell Excerpts

Friday 18th September 2020 Lords Chamber

Moved by

[Lord Bethell]

That the Regulations laid before the House on 23 July be approved.

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

My Lords, I beg to move that the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020 and the three instruments amending those regulations on the Order Paper in the name of my right honourable friend the Secretary of State for Health and Social Care be approved.

These regulations were made by the Secretary of State on 23 July and came into force on 24 July. The Government introduced the regulations to make it mandatory to wear face coverings in some indoor settings, such as shops, supermarkets and indoor transport hubs in England, and we have subsequently amended them to ensure that we continually took the necessary steps to protect public health as lockdown restrictions eased over the summer. Amendments were made on 8 August, 22 August and 28 August accordingly to extend the requirement to wear a face covering to a wider list of indoor settings now open to members of the public, providing clarity on who is exempt, the circumstances in which a face covering is not required and around continuing to ensure the enforcement powers given to police and Transport for London are reasonable and proportionate.

These regulations are helping to save lives. They are exceptional measures, brought forward to mitigate the unprecedented impact of the Covid-19 pandemic, and comply with all the Government’s obligations in relation to human rights. I urge the Chamber to approve these regulations and the amending regulations so that we may continue to use these powers to protect the public.

The people in this country have played and continue to play a vital role in helping us in our national effort to beat coronavirus. We therefore introduced these regulations to give members of the public the confidence to visit public indoor spaces safely and enhance protections for those working in these settings. This was explained by the Secretary of State when he addressed Parliament on 14 July and announced these measures, and reiterated this week by my ministerial colleague, the honourable Nadine Dorries, in the other place.

Since 24 July it has been mandatory to wear a face covering in indoor places such as shops, supermarkets and enclosed shopping centres. We have received positive support from the retail sector, including the chief executive of the British Retail Consortium, who has said that face coverings can

“make shoppers feel even more confident about returning to the High Street.”

Additionally, the chair of the Federation of Small Businesses has said:

“As mandatory face coverings are introduced, small firms know that they have a part to play in the nation’s recovery both physically and financially, and I'm sure this will be welcomed by them.”


The Government continue to review and refine their advice on face coverings, informed by the latest scientific evidence. Prior to these regulations, the Government had already been encouraging the public to wear face coverings in enclosed spaces where they may find it difficult to maintain social distance and come into contact with others they would not usually meet. Furthermore, face coverings have been mandatory on public transport in England since 15 June. While face coverings are not a substitute for social distancing and good hand hygiene, the scientific evidence suggests that when used correctly, face coverings may have some benefit in reducing the likelihood of those with the infection passing it on to others, particularly if they are asymptomatic.

As further sections of the economy have reopened and more people have been returning to work, we have amended the scope of the regulations to cover an extended list of indoor public settings such as museums, galleries and places of worship. Additional amendments aimed to provide further clarity to members of the public on where face coverings would be required, who is exempt and the circumstances which may constitute a reasonable excuse. The regulations have also been amended to help deter repeat offenders across public transport and indoor settings. Similar measures have been introduced across the UK with the requirement to wear face coverings in shops, other indoor premises and on public transport—and internationally in countries such as France, Germany and Spain, to name a few.

I will now outline what the regulations do and then set out the policies and processes underlying their development, implementation, monitoring and review. The regulations we are considering today require members of the public to wear a face covering in relevant places, such as shops, supermarkets, enclosed shopping centres, banks, post offices and indoor transport hubs. There have subsequently been amendments to include further indoor premises, including museums, galleries, cinemas, bingo halls, libraries, community centres, public areas in hotels, crematoria and places of worship.

The regulations do not apply to children under the age of 11 or to employees working in those settings. The wearing of any protective clothing or personal protective equipment by the workforce is a matter for their employers following a risk assessment and is part of their health and safety responsibilities.

The regulations include a definition of “shop” to ensure that this captures the majority of retail premises, as well as a list of further premises included and a list of premises excluded from the requirement to wear a face covering—for example, a gym. Those lists have changed as more premises have been able to open.

The guidance on GOV.UK describes a face covering as a covering of any type covering the wearer’s nose and mouth. People need to make or buy their own, and guidance has been published online that shows how to make and wear a face covering. We are asking people not to use medical-grade PPE, which should be reserved for health and care workers. However, someone wearing actual PPE would be compliant with the regulations.

While the Government expect that the vast majority of people will comply with the rules, as they have done throughout the pandemic, the regulations give powers to the police and TfL officers to enforce the requirement to wear a face covering. TfL officers may enforce only inside a transport hub. This could include denying entry to the relevant place and/or directing members of the public to wear a face covering. The police will use their usual “Four Es” approach: engage, explain, encourage, and enforce only as a last resort. In the event that a person fails to comply with a direction by a police constable or TfL officer, they are able to remove the member of the public from that relevant place.

The regulations also include powers for police constables, police community support officers or, in relation to the relevant TfL hub, a TfL officer, to issue a fixed penalty notice to anyone over the age of 18 who is in breach of the law. This is a fixed penalty of £100, reduced to £50 if paid within 14 days of a notice being issued. Amendments that came into force on 28 August allow for fines to double for each offence under these regulations or the equivalent regulations on public transport up to a maximum value of £3,200. This is intended to address repeat offenders across indoor settings and public transport. There is no reduction for early payment from the second or subsequent penalties. The National Police Chiefs’ Council data published on 27 August shows that eight fixed penalty notices were issued between 24 July and 17 August.

Although we want as many people as possible to wear a face covering, we recognise that some people are not able to wear one for a variety of reasons. The regulations exempt children under the age of 11, employees or officials acting in the course of their employment in their premises and emergency responders when on duty. Subsequent amendments to the regulations to extend the scope of indoor places led us to add an exemption for elite sportspersons acting in the course of their employment, training or undertaking competition, and pupils under the age of 19 undertaking education or training within a place of worship as part of the curriculum of a religious school.

Although there is no general exemption on health or disability grounds, we recognise that for some, wearing a face covering is not possible on medical or equalities grounds or would cause distress or difficulty, and that there are certain situations where wearing a face covering is not practical or reasonable. The regulations therefore make provision for “reasonable excuse”, which may apply in certain circumstances and which provides persons in those circumstances with a reasonable excuse for not complying with the requirements set out in the regulations.

The regulations set out a non-exhaustive list of specific circumstances that are considered to be a reasonable excuse for not wearing a face covering. This includes where a person is unable to put on, wear or remove a face covering because of a physical or mental illness, impairment or disability, or where a person is speaking to or providing assistance to someone who relies on lip-reading, clear sound or facial expressions to communicate.

We have also taken into account other circumstances where there is a reasonable excuse to fail to wear a face covering, or where a face covering can be removed for reasons of safety or practicality. Members of the public can remove their face covering to avoid harm or injury to themselves or others, to take medication and, if it is reasonably necessary, to eat or drink. People do not have to wear a face covering if they are entering a relevant place to avoid injury or to escape a risk of harm and do not have a face covering with them.

Employees in these settings can also ask a member of the public to remove their face covering for identification purposes. We have been working with stakeholders to make sure that staff and the public are aware of the exemptions in place and that some people may have a reasonable excuse for not wearing a face covering that may not be apparent. We are also clear that people do not need to prove that they are exempt from the requirements to wear a face covering or have a reasonable excuse, and they should not be challenged about this. Authorised persons enforcing these regulations are expected to use their discretion and judgment when considering reasonable excuses and exemptions in the circumstances.

These regulations have been supported by a communications campaign explaining where face coverings are mandatory, how to wear one safely and encouraging understanding and awareness of those who may not be able to wear a face covering. We have set out the full detail of this policy in our guidance.

As expected, reports indicate widespread compliance with the requirement to wear a face covering in relevant indoor settings, and surveys suggest significant public support. The Office for National Statistics public surveys showed that from 29 July to 4 September, at least 96% of adults in England had worn a face covering when shopping. This figure has remained consistently high. However, we should not expect participation to reach 100% as there will always be people who are exempt or have valid reasons why they cannot wear a face covering.

A review clause is included in the regulations, requiring a review of the need for the requirements imposed by the regulations within six months. A sunset clause is also included so that the regulations expire at the end of 12 months after the day they came into force.

We will continue to monitor the impact and effectiveness of this policy in the weeks and months ahead, and we will develop our approach to enforcement and communicating the policy as necessary.

--- Later in debate ---

[Lord Bethell (Con) [V]]

My Lords, I thank all those involved in this debate for a really important contribution. This face-coverings debate is always a very tough one. It is tough because in many of our areas of response to Covid we have really clear evidence-based decision making. In the area of lockdowns, we have a huge amount of information from the ONS, REACT and our test and trace system. With the clinical trials of our therapeutics, we have incredible data from patients and from recovery. We have a numbers-driven approach to a lot of the response on Covid, but in this area of masks—there is no two ways about it—it is heavily contested. The proof points on whether masks make a difference are not proven. Different groups have different perspectives. Therefore, we are left to rely on principles of common sense, taste and preference, and those are not the principles on which we can run an effective epidemiological response to this horrible disease.

Our epidemiological response has two levels. The first and by far the most important level is reliance on hygiene and social distancing—the “Hands, Face, Space” protocol. That is the one that will beat the virus and it is the one advocated by the CMO, and the CMOs from all the nations of Britain, and it is our primary front in our battle against Covid. The second tier is test, trace and isolate, which is effective and important for surveillance, and is proving to be impactful in breaking the chain of transmission.

Turning to face coverings, I am grateful to all noble Lords who have contributed to this debate. Like my noble friend Lord Blencathra, I particularly thank the noble Lord, Lord Campbell-Savours. He has provided evidence-based commentary and been an advocate, in very reasonable terms, for the wearing of face coverings and we are grateful for his characteristically energetic contributions. I hope to answer his specific questions in turn.

The noble Baroness, Lady Bowles, put it well. We cannot lean on clinical trials and scientific modelling to provide clear-cut solutions on this one. Where does that leave us? Since 11 May, we have brought in a proportionate and evolving strategy on masks. It has been brought in in a way which does not compete with social distancing and hygiene as the Government’s priorities. The messages we have put forward on face coverings are designed so that they do not confuse the public about their importance. My noble friend Lady Sanderson put it really well. We cannot give the public the idea that wearing a mask is in any way a defence against the disease or an effective substitute for social distancing. If we did that, we would be blowing up our first line of defence.

Turning to noble Lords’ questions, the noble Lord, Lord Campbell-Savours, made a strong point about valves. These are typically used in medical PPE, where they are highly regulated, but he has observed, as I have, their clumsy use in retail face coverings. Any face covering that fails to stop the transmission of droplets is not achieving its basic objective and would therefore be in breach of our guidelines, which are clear. We will look into whether further communication is needed on this point.

Many noble Lords, including my noble friend Lady Hooper asked about compliance. As my noble friend Lord Hayward, the noble Baroness, Lady Barker, and others have stated convincingly, the ONS statistics on compliance do not completely align with one’s personal experience. We therefore took the decision to strengthen the penalty system for face-covering regulations to discourage non-compliance, in particular for repeat offenders. The laddering of fines which was brought into force on 28 August has coincided with a massive increase in the public’s use of face masks, or at least that is my perception.

As several noble Lords have rightly argued, it is important that people who are exempt are not accosted or abused in any way. I welcome the appeals made in this Chamber for “No mask” badges for those who are exempt. I celebrate the fact that a design for such a badge is published on GOV.UK.

A number of noble Lords, including the noble Lord, Lord Rooker, and the noble Baroness, Lady Barker, have accused the Government of mixed messages. We have worked hard to communicate well on this, but we are competing with our principal messages of social distancing and good hand hygiene. For that reason, we have not put the marketing and messaging about face masks at the top of our messages.

A number of noble Lords asked about recent research. The noble Baroness, Lady Noakes, is entirely right. In August, the WHO updated its guidance on,

“specific considerations for the use of non-medical masks, also known as fabric masks, by children as a means for source control in the context of the current … pandemic.”

It also advises on the use of medical masks for children under certain conditions. We are seeking to follow that guidance.

In August, SAGE SPI-B reviewed evidence which suggested that mandating face coverings was one of the key behaviours to help deliver Covid-safe large events in large venues. This is in conjunction with other behaviours, including regular handwashing and social distancing.

Other research has been published by the Health and Safety Executive for the benefit of employers. This includes research on the effectiveness of surgical masks against a range of airborne particles and older research to help inform greater compliance with wearing face masks. Further research is being funded by UKRI about the effectiveness of face coverings and face masks and the factors underpinning compliant behaviour with face-covering regulations. Emerging findings are published on the UKRI Coronavirus Hub. I encourage all those with an interest in the area to keep track of that source of evidence.

In September, SAGE reviewed evidence which suggested mitigation of the risk of transmission of the virus in higher education settings through measures including face coverings. This is particularly in educational settings and areas of universities where social distancing may be more difficult.

In response to the question asked by the noble Lord, Lord Greaves, about testing, let me clear that we are by no means at the end of our ramping-up of testing. His testimony about his experiences in Pendle is powerful, and I would be glad to meet the noble Lord to discuss them.

My noble friend Lady Hooper raised an important point about ensuring that guidance for face coverings is clear and communicated to all. I reassure her that we will publish accessible guidance, including in other languages, which will cover how, when and where to wear them safely.

The noble Baroness, Lady Massey, asked specifically about the use of face coverings in schools. The Department for Education has updated its guidance on wearing face coverings in schools following both the WHO and SAGE statements on children. The Government’s priority is to get children back to schools and colleges safely.

The noble Baroness, Lady Ritchie, asked about a potential Covid-19 vaccine and when it might be possible. I reassure her that the department, along with NHSI and PHE, is currently planning for the delivery of any successful vaccine candidate.

We keep the area of face coverings under close review. The public mood on this has shifted considerably. We are aware of a more nuanced understanding about the use of face coverings by many in the public. We will revisit this subject regularly. This has been an informative and powerful debate. I hope therefore that the noble Baroness, Lady Thornton, feels able to withdraw her amendment.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) Regulations 2020

Lord Bethell Excerpts

Friday 18th September 2020 Lords Chamber

Moved by

[Lord Bethell]

That the Regulations laid before the House on 7 August be approved.

Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee

Motion agreed.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) (No. 2) Regulations 2020

Lord Bethell Excerpts

Friday 18th September 2020 Lords Chamber

Moved by

[Lord Bethell]

That the Regulations laid before the House on 21 August be approved.

Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee.

Motion agreed.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) Regulations 2020

Lord Bethell Excerpts

Friday 18th September 2020 Lords Chamber

Moved by

[Lord Bethell]

That the Regulations laid before the House on 27 August be approved.

Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee.

Motion agreed.

Coronavirus

Lord Bethell Excerpts

Wednesday 16th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, the Prime Minister claimed again today that the UK does more Covid tests than anywhere else in Europe. This is not true. Denmark does almost twice as many per 1,000 people, and the UK figure includes antibody tests, which others do not do, and is based on when tests are sent out and not on results. So it is more hyperbole.

I hope today we can look at facts. There is now a backlog of 185,000 swabs and tests are being dispatched abroad. Can the Minister advise the House how many tests have been sent abroad, to which countries, the processing time and the void rates? If the Minister does not have that information at his fingertips today, can he please to write to me and put the answer in the Library?

Secondly, Coronavirus infection rates among middle-aged people have reached the same level now as rates among those in their 20s two weeks ago, and Professor Neil Ferguson has warned us that infections are back where they were in late February. So what discussions have the Government had with the Joint Biosecurity Centre and the CMO about raising the alert level from three to four?

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

I am grateful for the noble Baroness’s questions. In terms of European rates, Britain is way ahead of many of its fellow countries in Europe. On Friday last week, we did 240,312 tests. It is a massive number and, I believe, the highest we have done on any day. This is a huge achievement and I pay testimony to those in the NHS and in test and trace who have contributed to that figure.

In terms of tests being sent abroad, our testing environment and economy are part of an international system. Reagents, swabs, consumables and machines are regularly exchanged between countries and I pay tribute to the enterprise and energy of the NHS and the test and trace scheme for using whatever schemes they can find in order to process the tests accurately, efficiently and promptly. I will be glad to send the noble Baroness details of the rates which she asked for.

In terms of the increase in prevalence among the middle-aged—yes, we are deeply concerned about this. As I have said at the Dispatch Box before, as night follows day, rates progress from the young to the middle-aged and, I fear, to the elderly. We are keeping a close eye on this progress.

[Lord Scriven (LD)]

My Lords, we know that the Minister is an avid listener of Radio 4’s “More or Less.” In today’s episode, Professor Alastair Grant of the University of East Anglia pointed out that 70% of coronavirus test results were completed within 48 hours at the start of August. Looking at official figures and analyses, he pointed out that by Monday, it was just 11.8%. The Minister may dispute the exact figures, but the trend clearly is down, which is worrying when we need an effective trace and isolate system to trace and isolate people as fast as possible. Can he tell the House and the country by what date all results of coronavirus testing will be turned around within a maximum of 24 hours?

[Lord Bethell (Con)]

My Lords, I am indeed an avid listener of “More or Less,” although I have not heard the episode to which the noble Lord referred. Can I just explain that not all tests need to be done within 24 hours? There are tests that are done for surveillance, to support clinical trials and to help our investigation into vaccines and therapeutics. Those kinds of tests have a much longer turnaround time, and that is entirely appropriate and will be built into the numbers to which “More or Less” referred. Some 89.6% of in-person test results were received the next day after tests were taken; those are the ones that need fast turnaround times and the ones that will be delivered promptly.

[Lord Balfe (Con)]

I want to talk about care homes and hospital in-patients, many of whom have been marooned for literally months. One of the problems is the testing regime. Could I ask the Minister, first, to give priority to relatives of people in care, so that they can be tested and go in and see their loved ones? Secondly, there is clearly a problem with a lot of the staff, because they are moved around a lot. Can the Minister undertake that his department will consult UNISON, the main trade union for those staff, and see what it can do to open things up so that people in care homes and hospitals are able to be visited again?

[Lord Bethell (Con)]

My Lords, I note my noble friend’s comments. However, I flatly deny that the social care system and social care homes have been in any way marooned. We have made a profound commitment, particularly in the testing environment, to supporting social care. One hundred thousand tests a day out of our capacity of between 200,000 and 250,000 are ring-fenced for social care and delivered to social care every day. Many of the challenges that we have for walk-in and drive-through testing centres are exactly because we are so committed to the ring-fenced testing for social care. That is a commitment that we are proud of and remain committed to.

I want to clarify with my noble friend that it is not an appropriate use of government test and trace capacity for relatives to use test and trace as a convenient method to find out whether they have the disease before they go to see relatives. That is not an appropriate use and not in the guidance.

As for UNISON, we are very much engaged with the union and are supporting staff in every way we can. However, I very much take on board my noble friend’s notes, and we will maintain that correspondence.

[The Lord Bishop of St Albans]

My Lords, can the Minister clarify one or two issues? Does the rule of six mean that it will no longer be possible to have any public marking of Remembrance Sunday outdoors this year? Will he also clarify whether this effectively means that all public protests and demonstrations are now illegal?

[Lord Bethell (Con)]

I thank the right reverend Prelate for his question. I thank greatly those local authorities and charities that are putting in place Remembrance Day service arrangements that will abide by the new rule of six. Some of those guidelines are being written now, and I will be glad to share the guidelines with the right reverend Prelate when they are published. One thing I note is that virtual attendance at these services and the use of virtual remembrance books will be an aspect of Remembrance Day this year.

[Lord Bilimoria (CB) [V]]

My Lords, Professor William Hanage of the TH Chan School of Public Health at Harvard University has said of the lack of mass testing that:

“By the time you become aware of the problem it is likely to already be much larger. You are not going to detect outbreaks if you don’t look for them.”


He also said that you need

“very good diagnostic tests as well as tests that may be less sensitive but can be used more frequently.”

I am totally with the Government in their aim for mass testing, but would the Minister agree with Professor Alan McNally of the University of Birmingham that the £500 million already announced

“could have funded around 33 million standard swab PCR tests that could have been run in well-equipped university labs”?

Why is that not happening? On rapid saliva tests, the Abbott Laboratories’ BinaxNOW $5, 20-minute test has been FDA approved, with 10 million tests produced this month and 50 million to be produced next month. Why are we not getting on with it? We need to do this really urgently. Does the Minister agree?

[Lord Bethell (Con)]

I completely support the noble Lord’s commitment to mass testing. We are looking at ways in which to use less sensitive machines to provide the kind of prophylactic testing to which he alludes. I thank very much indeed all universities for their contribution to our testing programme.

[Lord Triesman (Lab) [V]]

My Lords, in the course of the pandemic, a significant number of contracts with private companies have been signed without tender and a number of these have been in areas such as PPE and test and trace. Most appear to have failed to deliver essential services and equipment—

[Lord Triesman (Lab) [V]]

I do not think I can get much closer to the microphone without eating it.

In the course of the pandemic, a significant number of contracts have been issued to private companies without tender. What is the value of the contracts that have been signed without competitive tender? Will the Minister place in the Library a list of all such contracts, their value, the companies involved and their ultimate beneficial owners?

[Lord Bethell (Con)]

That list is already published. I would be glad to send the noble Lord a link.

[Lord Lansley (Con) [V]]

My Lords, one of the big risks this autumn is from students going to university and, perhaps more particularly, returning from university in the run-up to Christmas. How has the guidance been prepared with universities to try to mitigate that risk? I know that Cambridge University is looking even at the possibility of testing all its students on a weekly basis.

[Lord Bethell (Con)]

My Lords, I thank colleagues at the DfE for their hard work in providing guidelines to universities and to vice-chancellors for implementing thoughtful arrangements for the return of students. It is very much the ambition of this Government that universities are brought back to life and that education and the impact of their work continues. None the less, it is not just the campus environment that concerns us—it is also the off-campus activities of students. For that, we look to universities to provide pastoral guidance to students to ensure that they are socially distanced and behave responsibly. We are keeping an eye on those behaviours and, should outbreaks or prevalence rise among students, we will have to review those guidelines.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, the time allowed for this Question has now elapsed.

Covid-19: NHS Long-term Plan

Lord Bethell Excerpts

Tuesday 15th September 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government, in the light of the Covid-19 pandemic, what plans they have for changes to the NHS long-term plan.

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

My Lords, I pay tribute to the NHS for its remarkable achievements in response to Covid-19, from freeing up an additional 33,000 beds for Covid patients, to maintaining access to primary care by ensuring that 93% of GP surgeries offer video consultations, and swiftly mobilising an additional 65,000 former clinicians to help fight the virus. Learning from the Covid response will naturally inform future service priorities. However, at present, the Government’s focus remains on supporting system recovery and any amendments that may be needed to the NHS long-term plan will be considered in due course.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister and echo his tribute to the magnificent efforts of health service staff. I remind the House of my membership of the GMC board. He will know that the NHS entered this crisis underpeopled and under-resourced, and that a huge backlog of work has built up. There have been estimates that as many as 10 million people will be waiting for treatment at the end of the year. There is an issue with cancer patients waiting for tests and treatment. Can he give an indication of the work being done, despite the pandemic, to get the NHS back on track? Surely he agrees that the NHS five-year plan will have to be recalibrated to take account of this.

[Lord Bethell (Con)]

I thank the noble Lord for his generous comments towards the NHS. Undoubtedly it is true that, after a massive epidemic such as the one we are living through, we will have to rethink some of our priorities and learn from Covid, but I will add a few comments about the restart. The focus on getting patients back into hospital is having a huge impact on cancer waiting lists. Attendance at GP surgeries is increasing all the time, and waiting lists are coming down dramatically. I pay tribute to NHS staff for their hard work on this matter.

[The Lord Bishop of Carlisle]

My Lords, given that the health protection remit of Public Health England is to be subsumed into the new national institute for health protection, can the Minister tell us what steps Her Majesty’s Government will take to ensure that health inequalities are robustly addressed through programmes of health education and promotion, as envisaged in chapter 2 of the NHS Long Term Plan?

[Lord Bethell (Con)]

My Lords, the right reverend Prelate is right; health inequalities are a massive priority for the Government. Covid has demonstrated how health inequalities play out when an epidemic such as this one hits the country. That is why we put education and levelling-up on health generally as major government priorities, why we are investing in 50,000 new nurses and 40 new hospitals, and why health remains a number one priority for this Government.

[Baroness Browning (Con) [V]]

My Lords, my noble friend will be aware that the long-term plan has set an ambitious target for 2028 of 75% of cancers being diagnosed at stages 1 and 2. Does he agree that this must involve GPs, and that GPs having face-to-face consultations with patients is the only way that this target will be achieved?

[Lord Bethell (Con)]

We are enormously proud of the commitment to early intervention on cancer. This is the absolute core of our life science priorities. It is envisaged that we will have a revolution in the diagnostic capabilities of the NHS in order to hit these targets and, where necessary, face-to-face GP appointments will be made available. However, I am not sure that every single appointment needs to be face to face. One of the learnings of more than half of the 100 million consultations that took place between March and June was that telephone and video appointments can be extremely productive.

[Baroness Masham of Ilton (CB) [V]]

My Lords, is the Minister aware that late diagnosis causes many disasters in many health specialties? Does he agree that the respiratory programme is vital and has been highlighted by Covid-19? Should we not be training and employing more doctors, nurses and physiotherapists as respiratory specialists across the country in the long-term NHS plan?

[Lord Bethell (Con)]

I completely agree. It is a grave shame that too many diagnoses happen late. We are proud of our acute care, but it is this Government’s mission to move to a priority around early intervention which will have a huge impact on the quality and length of people’s lives and make modern healthcare more affordable. The noble Baroness is entirely right that respiratory interventions are an important priority.

[Lord Desai (Lab) [V]]

My Lords, it is not good enough just to praise NHS staff. Will the Government commit to spending a certain percentage of GDP on health as soon as possible? I suggest that 12% of GDP should be spent on health; then we would not have a repetition of this disaster.

[Lord Bethell (Con)]

We do not just stand and praise. We are recruiting a huge number of new staff—50,000 more nurses and more GPs—and we invest in them through our people plan.

[Baroness Jolly (LD)]

My Lords, the long-term plan cannot be delivered without effective community nursing support. Community nurses get people out of hospital and prevent others from being admitted. Currently, the service is short of several thousand nurses. What changes does the Minister expect to be made to get these nurses recruited, trained and operational?

[Lord Bethell (Con)]

I am grateful to the noble Baroness for raising the importance of community nursing, and all community-based healthcare, including community diagnostic hubs. The interest in nurse recruitment has risen dramatically—by 138% in recent months—partly because of our massive advertising campaign and the renewed focus of NHS trusts in community nursing, which will be matched by opportunities to provide training for those who step forward for jobs.

[Baroness Altmann (Con)]

My Lords, in light of the experiences of people relying on social care during the current pandemic, might the NHS long-term plan make some adjustments to account for the need for integration between NHS and social care? When can we look forward to the proposals for radical social care reform, to ensure parity of esteem for the NHS?

[Lord Bethell (Con)]

My noble friend is entirely right to raise the importance of social care. Undoubtably, one of the things that we have learned through Covid is that the NHS and social care sectors must work more closely together. That was always envisaged as one of the pillars of the long-term plan. It is now an increased priority. That has been witnessed through much closer collaboration in recent months between trusts and the social care industry. We continue to invest in social care, providing councils with access to £1.5 billion for adult and social care in 2020-21, as extra support during this difficult time.

[Baroness Thornton (Lab)]

Following on from the question asked by the noble Baroness, Lady Altmann, I must try to pin the Minister down. Can he commit to publishing a plan for the future funding and provision of social care by the end of this year, as the Prime Minister promised in January? My honourable friend Liz Kendall MP has today written to the Secretary of State about the need for a clear social care winter plan. What steps are the Government taking to ensure that no one with Covid-19 is discharged from a hospital to a care home, to prevent a repeat of the terrible impact that this had in the first months of this crisis?

[Lord Bethell (Con)]

My Lords, I cannot commit to a social care plan before the end of the year. It will require a huge amount of political collaboration and I suspect it will take longer than the next few months. I remind the noble Baroness that we have a £600 million infection control fund to help social care through the winter.

[Lord Stirrup (CB)]

My Lords, despite additional Covid funding, many NHS trusts are having to cut back on crucial capital investment programmes because of increased financial pressure. For example, some hospitals are having to replace obsolete and ineffective scanners with slightly newer but far from up-to-date models. Does the Minister agree that when the NHS long-term plan is revised, it will need to include a recovery schedule from these perhaps inevitable but nevertheless damaging short-term responses?

[Lord Bethell (Con)]

My Lords, the Chancellor has made it clear that catch-up support for the NHS to recover from the impact of Covid is an important part of his financial projections. However, I remind the noble and gallant Lord that we are investing in 40 new hospitals. It is a massive capital investment and the impact on our healthcare service should not be underestimated.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now move to the next Question, which is from the noble Lord, Lord Storey.

Anti-obesity Strategies

Lord Bethell Excerpts

Monday 14th September 2020 Lords Chamber

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the impact of anti-obesity strategies on people suffering, or recovering, from eating disorders.

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

My Lords, eating disorders are serious life-threatening conditions, and it is important that people have access to the right mental health support in the right place and at the right time. We carefully consider all views on our measures to reduce obesity. This includes feedback from a wide range of experts in response to our public consultations on specific policy proposals.

[Baroness Bull (CB)]

My Lords, as the Minister says, eating disorders are indeed serious mental health issues, but their relationship with obesity is complex. Many obese people also live with eating disorders, which means treatment is not always as simple as rebalancing calories in and out. Does the Minister accept the expert advice that elements of the new strategy, like food labelling and calorie counting, are dangerous triggers for eating disorders, and that slogans emphasising personal responsibility stigmatise people whose obesity has more complex roots than a failure to get a grip? Will he agree to meet with me and eating disorder specialists to discuss how this important strategy can be more effective for its intended audience and avoid collateral damage for those people for whom “Eat less, exercise more” is a dangerous message?

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Baroness that serious eating disorders are complex, and we need to resource the medical attention required by people with serious mental health issues. However, I do not completely align with her view that all obesity is not a matter of personal responsibility, nor that the education of people about the content of their food through labelling cannot be an important part of our battle against obesity. Covid has spelt it out clearly to all of us. Some 67% of the country is overweight in some way or another. But this is a policy that we are determined to get right, and I would very much welcome the opportunity to meet with the noble Baroness and her team.

[Baroness Thornton (Lab)]

My Lords, following on from the noble Baroness’s question, do the Government have eating disorder experts, including those with lived experience, advising them as part of their anti-obesity strategy? It seems to me that is one way of making sure that the messages do not disadvantage those who have eating disorders. There is a reason why advocates for those with eating disorders have been very critical of the language being used. Could the Minister commit to reviewing the campaign in light of this?

--- Later in debate ---

[Lord Bethell (Con)]

The noble Baroness is entirely right: we do rely on the advice of charities, academics and experts in eating disorders. We do not do anything without full consultation with those who have expertise in eating disorders. We review the campaign regularly, and we will be taking into account the view and feedback of those experts, charities and patient groups as a part of that review.

[Lord Truscott (Ind Lab)]

My Lords, what action are Her Majesty’s Government taking to tackle eating disorders, especially among the young, whose mental health may have been severely impacted by the current Covid-19 pandemic?

[Lord Bethell (Con)]

My Lords, the Government are committed to ensuring that everyone with an eating disorder has access to timely treatment. That is why we set up the first waiting times to improve access to eating disorder services for children and young people so that, by 2021, 95% of children with an eating disorder will receive treatment within a week. Figures show that in Q1 of 2020, 87.7% of children with an eating disorder received treatment within one week in urgent cases, and 86.8% within four weeks.

[Baroness Warsi (Con) [V]]

My Lords, I welcome the Government’s recent announcement of additional funding for community-based mental health initiatives and ask my noble friend whether the Government can ensure that their latest obesity strategy is mindful of and responsive to the underlying emotional issues, as detailed by the noble Baroness, Lady Bull. The causes are often far more complex than the Government’s current approach.

[Lord Bethell (Con)]

My Lords, I completely endorse my noble friend’s views. When it comes to mental health challenges and connections between obesity and mental health, the resources need to be put in place and the sensitivity she speaks of applied. I return to my earlier comments: 87% of the country is involved in this. Not all have mental health issues; some simply need to take responsibility for their weight.

[Baroness Parminter (LD) [V]]

The National Audit Office’s report last week on tackling obesity confirmed that there is limited evidence that calorie labelling in restaurants reduces total calories consumed. How will the success or otherwise of the Government’s proposed calorie labelling in restaurants be evaluated? Will it take into account the potential harm caused, given that the ability to track calories can be highly triggering for those with or vulnerable to developing an eating disorder?

[Lord Bethell (Con)]

My Lords, we are tracking the success of this obesity strategy, although it should be understood that this is generations in the making and may well take a while to work through. I come back to my previous comments: calorie labelling is a very important element of people’s education about the content of their food and often their drinks, including alcoholic drinks. We support that measure as an important part of our strategy.

[Baroness Verma (Con)]

My Lords, will my noble friend take into account that in the south Asian community there are larger numbers of people with diabetes, heart disease and a lack of vitamin D? Through his campaigning and communications—he has been really mindful of this—will he try to ensure that we are also reaching communities in which exercise and sport do not always come as a first priority? Is he willing to meet with me and a team of people working on this?

[Lord Bethell (Con)]

My noble friend is right, and Covid has really spelt out the challenge in this area to the NHS and the Government. The incidence of serious Covid effects on BAME communities has been more intense because of the prevalence of diabetes and overweightness in many of those communities. We have relooked at our marketing and communications to those communities and need to redouble our efforts. That is why, as part of the obesity strategy, we are putting in serious, concentrated efforts in reaching the communities, as my noble friend advised. I would be glad to talk to her about how we can do that better.

[Baroness Uddin (Non-Afl)]

My Lords, children and adolescent adults with eating disorders battle multiple debilitating physical and mental effects. Eating disorders have one of the highest morbidity rates among psychiatric conditions, causing untold helplessness and grief for families and professionals constantly struggling with a lack of adequate financial resources and services, as evidenced by Ignoring the alarms: How NHS eating disorder services are failing patients, a report by the Parliamentary and Health Service Ombudsman. In light of this report and a significant body of evidence known to health services and experts in the field, can the Minister assure the House that sufficient advice has been sought and a thorough, evidence-based risk analysis undertaken to mitigate the potential harmful, detrimental impact of the public anti-obesity campaign on those suffering and recovering from disorders?

[Lord Bethell (Con)]

My Lords, I am not sure I agree with the premise of the question. It is not my belief that the anti-obesity campaign will generate massive negative repercussions. The NHS’s work in this area has developed immensely and we are putting a huge amount of money into it, including through our mental health strategy. I support the strategy we are applying.

[Lord Rennard (LD)]

My Lords, the need for psychological support for people with such eating disorders is often identified through face-to-face meetings with GPs. Is the Minister satisfied that it is possible, in safe conditions, for people to obtain such meetings at the moment and that, if such a need is identified, sufficient psychological support is available for them?

[Lord Bethell (Con)]

The noble Lord is probably aware that a letter has been sent to GPs inviting them to step up to their responsibilities for face-to-face meetings. Everyone should have a face-to-face meeting if that is what they require and need. One of the surprising and interesting outcomes of the Covid epidemic is that many mental health services have been successfully delivered through video links. It has meant that people who may feel vulnerable about attending a GP’s surgery or mental health clinic have had the opportunity for consultations. We will look at how to expand that kind of interaction.

[Baroness Gardner of Parkes (Con) [V]]

My Lords, I have spoken to GPs about this issue. Particularly in cases of obesity—which they all agree is more common for people living in deprived areas—they say the difficulty now is that patients do not come in person to a surgery. Therefore, if someone tells you their obesity is still well under control, you have no way of assessing that. They suggested that I put it to the Government that there should be better liaison between schools and GPs, because schools see families all the time and become good judges of whether people are putting on weight. They can also provide exercise and advice on diet. GPs are willing to look after these people but say that if you cannot actually see them, how do you know that what they are telling you is the truth? What will the Government do to encourage liaison between schools and GPs?

[Lord Bethell (Con)]

My noble friend makes an incredibly thoughtful, practical point. Of course, it is easier to tell whether someone is abiding by their obesity commitments if you see them face to face. With regard to schools, I remind her about the hundreds of millions of pounds going into school exercise through the sugar tax payment. That is completely transforming exercise in schools and will have a profound effect over many generations.

[The Senior Deputy Speaker (Lord McFall of Alcluith)]

My Lords, the time allowed for this Question has elapsed.

Covid-19 Update

Lord Bethell Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Scriven (LD)]

My Lords, these Benches welcome anything from the Government that is based on rational evidence and can prove to be effective in this public health crisis to keep people safe and reduce the spread of the virus. So does this Statement live up to that? Unfortunately, yet again the sales pitch from the Secretary of State last week fell short of what is required to be effective. It has to be based on fact and scientific evidence that the public have confidence in and understand.

I have some simple questions for the Minister. Now that the scientific evidence has been produced, members of the public are asking why children under 12 and 11 are included as part of the six. Why can they be in a school in a class of 30 but from 3.30 pm they cannot be in a house with seven people, including their two grandparents? What scientific evidence exists to suggest that that causes more harm than 30 children in a classroom?

There is something else that people have asked me. Why is it that I can go to the office and be there with 20 people until 4 pm, but at 4.15 pm, if I go to the pub, I have to be in a bubble of no more than six? The evidence may be there, but it has to be explained in a way that those questions can be answered and the public have confidence in those answers. Inconsistency, rather than the public not having confidence, is one of the issues that the virus breeds on.

The public health message has to be clear and consistent. The regulations do not just bring in a power of six; there are quite a number of exemptions, including a legal definition of “mingle”: for the first time since 1393 it becomes illegal to “mingle”. Can the Minister give a legal definition of “mingling”? I can go to an event with six people but I cannot mingle beyond those six if it is an event run by a charity, a public body, a philanthropic organisation or a business. If I open the door for somebody and speak to them to thank them, am I mingling? If I stop somebody who I know and speak to them, am I mingling? What is the legal definition? That is going to cause confusion and not be consistent.

These regulations and rules have to be developed in a collaborative manner with local areas to be effective. Why was the Local Government Association informed of the Covid-secure marshals only one hour before? If the rate is rising so fast and we need to be effective today to monitor six people and no more, where are those marshals’ powers as of today and in which legislation?

It is quite clear that action needs to be taken to stop this virus, but it is time for the Government to stop and be much more strategic and considered and to implement legislation and systems in a more collaborative way. People’s lives and livelihoods depend on the Government getting this right, but unfortunately this Statement is not a complete and right answer.

[Lord Bethell (Con)]

My Lords, I thank the noble Baroness and the noble Lord for their perceptive and thoughtful questions. On the noble Baroness’s questions about the level of alert, to my knowledge it has not changed. It was reduced from four to three on 19 June; it remains subject to review on a weekly basis, but we are not in a position to raise it at the moment.

The noble Baroness asked about the rule of six and why we had committed to six as opposed to anything else. The short answer is that we are seeking to have rules that are simple to understand and straightforward to apply. We accept that during the last few months the guidelines have grown increasingly complex and difficult to understand in all their detail. Across the board, with “Hands, Face, Space”, the rule of six and other measures that we are seeking to publish, there is a genuine effort to engage the public in a really simple lexicon of how we can beat the coronavirus.

Sir Mark Walport, the head of UKRI, was right in his warning that the jeopardy is enormous. If we do not get this communications challenge right, and if people think they are confused and think they have a way out because it is in some way complicated, we will fail, the disease will come back and we will have tens of thousands of deaths; we will have an NHS that is challenged; we will have an economy that is shut down; and we will have a generation that is lost to education. Those are the stakes, so we are determined to get it right. I am happy to stand here for as long as it takes and be pub-quizzed on “What about this? What about that?” if it means that we get it right.

However, the public seem to understand these simpler rules. The response from the public in our planning focus groups and in the response since their publication has been extremely positive, and we think we are on the right track. This is advice that was informed by SAGE and we went through its models in great detail.

The noble Baroness and the noble Lord, Lord Scriven, asked why children are included. The bottom line is that we want to keep it simple. Children are vectors of infection; they can pass the disease from one generation to the next. Time and again, in city after city, we have seen an infection that starts with a young person, moves to mum and dad, then to grandma and grandpa. It takes weeks or sometimes months for that progress to take place but, as I have said at this Dispatch Box before, as night follows day, the infection moves through the generations unless we take steps to break the chain of transmission. The rule of six is a critical, unambiguous step in the Government’s strategy for doing just that.

The noble Baroness and the noble Lord, Lord Scriven, asked about marshalls, so let me just say a word about that. This measure came from our engagement with local authorities. Local authorities are looking for ways in which they can implement the right measures to disrupt crowds forming and, as the noble Lord, Lord Scriven, said, mingling—a concept which, frankly, I do not think needs much description and nor do members of the public. In order to break things up, they are looking for ways in which they can have both the authority and the personnel to do that, and we have responded by putting in the right regulations to do that and by providing the right resources. But it will be up to local authorities to implement that in detail.

The noble Baroness asked about shooting and hunting. My understanding is that guidelines on all sorts of sports and activities where the rule of six is in any way ambiguous will be issued in the coming days.

The noble Baroness asked about Hammersmith, and I am extremely grateful for the tip-off. I will look into it, as I have done when other noble Lords have alerted me to concerns they might have. I am extremely concerned that there might be a breakdown in the asylum centre in Hammersmith. However, I reassure the noble Baroness and the House that directors of public health are responsible for this kind of implementation, and the benefit of directors of public health is that they work across all departments. Some directors of public health have a health background, some have a police background and some come from a leisure background, but they all hold the ring when it comes to local implementation of local measures, and therefore they are the best-placed people to ensure that situations like this are not overlooked.

The noble Baroness asked whether we should be reviewing the current measures for pubs, clubs and workplaces. The simple answer to that is yes, absolutely; we should be reviewing it—and we do review it every single week. We are on tenterhooks because, if we get this wrong, the jeopardy is enormous. We are working as hard as we can, with regulatory measures such as the rule of six, marketing measures such as “Hands, Face, Space” and containment measures such as the test and trace programme, in order to keep the economy open, to keep our educational institutions open and to keep life as normal as we possibly can. If we do not—if we fail—it will go back to where we were before, and I hope memories are not so short that people do not remember quite how imposing and draconian the former lockdown was.

On test and trace, the noble Baroness quite reasonably asked about the capacity and about demand. I can reassure her that the capacity has literally never been higher. We are up 7% week on week and—if I can provide the right figures here—we will have a capacity of 500,000 by the end of October. We have 500 centres, including five major laboratories, 236 mobile testing units, 72 walk-through testing sites, and more sites opening all the time. For every 1,000 people in this country, we test 2.43 a day; that compares with Germany at 1.15, Spain at one and France at 1.15.

We are throwing everything we can at the test and trace system, but it is true that demand has gone up. Part of that demand is through children returning to school. I welcome enormously the return of children to school, but it is an un unambiguous fact that this has led to a very large increase in the number of children being sent to testing centres—often bringing their parents and other household members with them—and that has put an enormous pressure on the system.

Another feature is asymptomatic testing. Estimates are that between 20% and 25% of those turning up for a test are currently asymptomatic. If we had all the tests in the world, that would not be a problem and I would welcome it, but right now we are building the system, we are under pressure and we need to communicate more clearly to the public that asymptomatic testing is not supported by our current testing system.

The noble Baroness asked about social care—quite rightly, as this is a major feature; we are concerned about it, and I know that noble Lords are concerned about it. I reassure the noble Baroness and the House that care homes are absolutely our number one priority. This was reiterated in meetings with the Prime Minister last week. Some of the capacity challenges in places such as walk-in and drive-in centres are because we have put care homes front of the queue and because those tests are taking priority.

The noble Lord, Lord Scriven, asked a number of extremely detailed questions, some of which I have touched on. He asked why we have included children. He is entirely right that, in Scotland, they have not included all children and in some other countries they do not do so either. We have taken a different view. Partly, that is on the epidemiological advice from SAGE; partly, that is on the marketing advice from our communications department, which is insistent that we are clear and unambiguous with the population; and, partly, that is the CMO’s advice—he rightly identifies children as potential vectors of infection, particularly in intergenerational households.

The noble Lord, Lord Scriven, asked for consistency. Well, we are consistent in that we are determined to break these chains of transmission. The science is not simple; if it were, the disease would have been beaten. It bounces around, and we are doing our best to fight it. We are communicating as best we can on all the science we have.

In terms of collaboration, I pay a massive tribute to all my colleagues at the department, in other departments, in local authorities, at PHE and in the NHS. It is difficult for me to explain in great detail in a short amount of time the immense amount of cross-departmental, inter-agency collaboration that has sprung up around Covid. The amount of data that is shared, the number of Zoom calls and the working together are absolutely phenomenal. The noble Lord cited that the LGA did not know about the marshalls plan until the last minute; I am afraid to say that it must have been the last one on the list.

[The Deputy Speaker (Baroness Finlay of Llandaff) (CB)]

My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.

[Viscount Eccles (Con)]

My Lords, last week I pursued the question as to whether there were precedents for using emergency powers under an old Act—this is an Act from 1984—and also whether the Government had any plans to change the procedure to one that is more like what we have come to expect over many years, so that we debate these regulations before they came into force. Many of the questions that are asked would be much sharper if the debate was before the regulations came into force. It would be better, because the future is more interesting than the past—and doubly so in these hybrid days, when debate is not as easy as it is in normal circumstances. Indeed, one reason for thinking that we should change is that there must be an impression that the Executive are riding roughshod over us, when what is actually needed is consensus—as has been indicated by the two Front-Bench speeches today—and I think that consensus is available. Will the Government have another think, decide it is better to be in front and implement some changes that will make Parliament’s job easier?

[Lord Bethell (Con)]

I thank my noble friend for his comments, but my perspective is slightly different. The fact is that this disease is incredibly aggressive and nimble; we sometimes have to turn decisions around literally within hours. I cannot think of another situation, other than war, where the decision-making has to be quite so quick. I would love to be able to bring regulations to this House for full debate in advance of their implementation, but no human institution can move at that kind of speed—it is just not possible. In answer to his question, we have no plans to switch horses at the moment. We are working as hard as we can to bring regulations here as quickly as we can, and I pay tribute to the House authorities for doing everything they can to put regulations in front of the House as quickly as they can.

[Lord Patel (CB) [V]]

My Lords, the Office for National Statistics records over 52,000 deaths of people whose death certificates have Covid-19 as a contributory cause. More than 42,000 of these deaths were of people over the age of 65. As the numbers of infections increase, which they are, more older and vulnerable people will be infected—as has happened in France—leading to a rise in hospital admissions and deaths. What plans do the Government have as the rate of infection increases in our country to protect the elderly and more vulnerable?

[Lord Bethell (Con)]

My Lords, we are discussing, among other things, the very regulations we are putting in place to protect the elderly and vulnerable. The rule of six, although not part of this provision, is an emphatic commitment to protect the people whom the noble Lord cites. I add that we are concerned about not only the elderly and vulnerable; we are increasingly concerned about the phenomenon of long Covid, which hits the young. It is one of our objectives to rid this country of Covid altogether and to protect all demographics.

[Baroness Donaghy (Lab) [V]]

My Lords, in answer to my noble friend Lady Thornton’s question about the alert level, the Minister said that to his knowledge it had not changed, although it was subject to weekly review. However, these are the Government’s own levels. How can the level stay at number 3, which means “virus contained”, when number 4 means “virus not contained”? Does the Minister really think that an average travel requirement of 6.4 miles to a testing centre, with 10% of people having to travel up to 22 miles, is acceptable after all these months?

[Lord Bethell (Con)]

The change in the alert level is done in consultation with the CMO and it is his advice that the circumstances have not changed enough for us to move it. On the average travel time, most reasonable people would consider six-and-a-half miles a reasonable distance to travel for such an important test.

[Baroness Barker (LD)]

My Lords, why is it safer to allow six individuals from different households to meet together indoors, rather than limiting it to members of two families?

[Lord Bethell (Con)]

My Lords, the phenomenon we had noticed was that large groups of people, sometimes in pubs and sometimes in other congregations, would seemingly be from two households, but that the actual definition of “household” was proving to be extremely flexible in the minds of many people. Therefore, putting an integer into the formula makes it much clearer.

[Lord Dobbs (Con) [V]]

May I return to the issue of political gatherings, which my noble friend and I discussed last Thursday? He mentioned that protests such as those we have seen recently from Extinction Rebellion might not be outlawed quite yet, but it is not really a matter of outlawing political protest—I did not ask for that. However, can he understand how deeply outraged many would feel while spending their Christmases abiding by the very difficult rule of six if, out their window, they were watching political protesters who do not give a monkey’s about the rules? Will he confirm that political protesters are subject right now to precisely the same rules as the rest of us?

[Lord Bethell (Con)]

My Lords, I sympathise with my noble friend’s point, but I remind him that the regulations come into force later today. It is up to the Metropolitan Police to implement crowd dispersal but the sentiments he expresses are ones that I share.

[Lord Laming (CB) [V]]

My Lords, will the Minister please accept that while there may be good reason for the Government to ratchet up further the restrictions on social distancing, it is surely unreasonable to at the same time pressure people to return to their offices? These two objectives are incompatible, as was shown by government officers last week. Surely the Government should accept that they can press either greater social distancing or a return to offices, but not both?

[Lord Bethell (Con)]

My Lords, I do not think that this Government are pressuring anyone into doing anything. We are keen to give those who have a reason to, whether personal or professional, the confidence to return to their workplace. I pay tribute to the very large number of employers who have invested a huge amount in making those workplaces socially distanced and safe for employees.

[Lord Rooker (Lab) [V]]

My Lords, the Statement makes it clear that the numbers of cases are rising. Will the Health Minister give the House his personal assurance that sufficient personal protective equipment will be available, unlike during the first wave?

[Lord Bethell (Con)]

I am very glad to make that assurance: 13 billion items of PPE have been procured and made available for NHS, social care and other key workers. I pay tribute to my colleague and noble friend Lord Deighton, who has led our efforts on this. The situation is completely transformed from that of earlier this year.

[Baroness Hussein-Ece (LD) [V]]

My Lords, in the past week, over 700 schools have reported Covid cases among teachers and pupils, but getting a test is difficult for many. I declare an interest: my seven year-old grandson went back to school last Monday and got a high temperature. He was told to stay at home and his parents tried all week to get a test for him. They were sent to Brighton and eventually managed to get one 10 miles away, but that is because they have a car. What happens to families who do not have a car but want their children to go back to school and not lose out? Why are test kits not being made available to schools or local authorities, maybe in clusters, to enable equal access for all children and teachers to such kits so that they do not have to self-isolate unnecessarily for 14 days and can—like my grandson, whose test was thankfully negative—go back to school?

[Lord Bethell (Con)]

I thank the noble Baroness for her testimony, which completely resonates with me. The current national prevalence is around one in 1,500, so there is a strong likelihood that, in a school with 1,500 kids, one of them will turn up with Covid. We are aware of the challenge of febrile children who have a temperature, as children often do, and are naturally anxious to get a test. We therefore provide kits of tests to schools, but we are not able to turn schools into testing centres—I do not think that parents, teachers or schoolchildren would like us to do that. We have also prioritised social care, the protection of hospitals and the asymptomatic testing of key workers over schoolchildren for the moment. As our capacity increases, that will be reviewed.

[Baroness Redfern (Con) [V]]

My Lords, this virus has shown it is extremely difficult to eradicate or keep under control until a vaccine is produced. I ask the Minister about people being asked to isolate because data has shown that some are facing real hardship. We are told that this is a central reason for people sometimes ignoring advice. Are Ministers looking at the possibility of helping with extra financial support?

[Lord Bethell (Con)]

The noble Baroness is entirely right that the isolation protocol is extremely onerous for some people and has a huge impact on their life, mental health, income and social life. I completely understand the point she is making. We are keeping the question of financial support under review and will continue to look at this important subject.

[Baroness Coussins (CB) [V]]

My Lords, picking up on one of the points made by the noble Baroness, Lady Thornton, what arrangements have been made to enable compliance with the rule of six for asylum seekers living in reception centres or hostels that have communal facilities for eating, sleeping, washing, cooking and leisure time? This could be a national issue, not just in Hammersmith. Also, why is there no link on the National Asylum Support Service website to any Covid information or advice in languages other than English and Welsh?

[Lord Bethell (Con)]

My Lords, asylum hostels are one example of a very great many that will have to put thoughtful arrangements in place in order to comply with the rule of six. I pay tribute to their efforts.

[Lord Campbell-Savours (Lab) [V]]

My Lords, why insist on a mask-wearing policy totally at variance with international practice? Surely, by now the Government can admit to the major benefits: they alert others to danger, signal an element of risk and, when worn without valves, protect both users and those in the immediate vicinity. Therefore, why not revisit the whole policy and promote the enforcement of wider and appropriate usage—a very, very much needed U-turn?

[Lord Bethell (Con)]

My Lords, I pay tribute to the noble Lord’s campaigning on this issue; he has contributed to the Government changing their strategy on mask wearing. However, we are here discussing the onerous burden that these measures put on people in this country, and we have to be careful not to overburden them. The CMO’s guidance on masks is that the science remains ambiguous. I know the noble Lord does not agree with that, but that is the CMO’s advice. We have come a long way on masks in order to change policy on this and, as the scientific evidence changes, we will review that policy.

[Lord Taylor of Goss Moor (LD) [V]]

Since the Minister wants to keep things simple, could he explain to families that are separated what the rules now are? In my case, I am a single father of three young boys who live with me every other week. They live in a household of six on the other weeks, and it includes another child who also lives in another household part of the time. Which of us are allowed to get together when?

[Lord Bethell (Con)]

My Lords, that is the pub-quiz question of all pub-quiz questions. There are special provisions for families that are, like the noble Lord’s, separated or complex. Those guidelines have been published, I believe, and I would be glad to send him an email with a link to them.

[Lord Blencathra (Con)]

[Inaudible]—simple rule and the long overdue emphasis on better and stricter enforcement. Does my noble friend not agree that when a law is systematically and routinely broken and not enforced, it brings the rest of the law into disrepute? Therefore, will he encourage the police, in the strongest possible measures, to stop turning a blind eye to massive house parties, raves and woke demonstrations and tell them to get off their knees and enforce the law?

--- Later in debate ---

[Lord Bethell (Con)]

My Lords, I completely endorse my noble friend’s comments on raves, but the effectiveness of these measures is reliant not just on police implementation but the compliance of the British public. While I understand his point on mandation and police action, it is really the personal decisions and social pressure of the British public that will make these work, and I cannot help but pay tribute to them for their sensible approach to Covid to date; that is where our trust really lies.

[Lord Mackenzie of Framwellgate (Non-Afl) [V]]

My Lords, following on from the previous question, effective policing requires the consent of those being policed, and those enforcing it need good training and interpersonal skills. Covid marshals—when they are actually implemented—could well face some resistance from those who have had enough of being told what to do. Will marshals have the power to issue fixed penalties, and does the noble Lord agree that friction with them could cause breaches of the peace and place even more demands on the police themselves?

[Lord Bethell (Con)]

My Lords, I do not know the precise legal powers of the marshals, but I remind the House that city centres and public areas frequently have civilian marshals of one kind or another to help guide public gatherings. This is a not uncommon aspect of city and public life, and I have an enormous amount of faith in the good sense of the British public to go along as requested without legal mandation.

[The Earl of Clancarty (CB) [V]]

My Lords, the WHO’s watchword has been “test, test, test” to isolate the disease, so I am in favour of the Prime Minister’s stated ambition of mass testing. With regard to Operation Moonshot, have the Government a date in mind for testing audience members at theatres and sports venues? Secondly, does the Minister agree that we should now be testing at airports, as British Airways is asking for?

[Lord Bethell (Con)]

My Lords, we have embraced the “test, test, test” recommendation in a very big way, and the noble Earl is entirely right to aspire to using testing to enable a return to the economy, theatreland and all sorts of public gatherings. We are looking energetically at this, working with suppliers, academia and the NHS to figure out ways of using the new testing technologies in the way he describes.

However, we are at a relatively early stage and I am not able to make announcements on this here today. We have funded—to the tune of £500 million—a huge amount of investment in these technologies and, when they are right, we will roll them out in the theatres and airports of Britain.

[Lord Hunt of Kings Heath (Lab)]

My Lords, we have heard a lot from the Minister today about the importance of obeying the law, yet a Bill has been introduced in the other place today that essentially sees the Government seeking to break the law. I refer him to what Geoffrey Cox, the former Attorney-General, said this morning:

“When the Queen’s minister gives his word, on her behalf, it should be axiomatic that he will keep it, even if the consequences are unpalatable. By doing so he pledges the faith, honour and credit of this nation and it diminishes the standing and reputation of Britain in the world if it should be seen to be otherwise.”


He went on to say:

“It is unconscionable that this country, justly famous for its regard for the rule of law around the world, should act in such a way”.


Does the Minister think this a good example to the public, and does he not fear that the appeal to the rule of law regarding the rule of six might just fall on rather stony ground?

[Lord Bethell (Con)]

My Lords, I am here to support the regulations before the House, not to comment on the issues about which the noble Lord asks.

[Lord Greaves (LD)]

My Lords, the noble Lord has previously congratulated people in my part of Lancashire on how well we are doing, which I do not quite agree with; we are working hard. Why are people, whether in our borough or the surrounding ones, still not able to book tests locally when we usually have three testing stations going? Some are being told to ration the number of tests they do each day, which involves gaps of perhaps two hours when they will not accept any bookings, even though the testing kit and the people are there, and the tests could be carried out. However, people are not being allowed to use them.

[Lord Bethell (Con)]

My Lords, the amount of testing we are doing is increasing enormously. Most people who book a test do get it locally, and that test is delivered quickly and on time. The result arrives within 24 hours and we are doing a million tests a week, which is well within the bounds of our business capacity.

The noble Lord is right that the system is under scrutiny and pressure. Not everyone is getting a test where and when they want it. However, overall, it is reasonable to ask people not to make frivolous demands upon the tests, and to ask that those who are asymptomatic wait until there is further test capacity before they step forward to ask for their test.

[Lord Forsyth of Drumlean (Con) [V]]

My Lords, can my noble friend tell me what the Government have identified in English children under 12, including babies, that makes them, to use his phrase, “a vector of infection and a Covid hazard”, that does not apply to children in Scotland, who have been back at school for weeks? And on the subject of making things easier to understand—simplifying matters—why is it okay in England to meet one’s grandchildren in the pub but not in their family home if the household consists of six people?

[Lord Bethell (Con)]

My Lords, Scottish children are just the same as English children, but the Scottish Government have decided to take a different approach; we celebrate the differences between our two nations in this. With respect to meeting in the pub, you cannot meet more than six people in the pub and you cannot meet more than six people between two households. The arithmetic is reasonably straightforward.

[Viscount Waverley (CB) [V]]

My Lords, it is clear that face masks are a critical component of slowing the virus. Following on from the observations of the noble Lord, Lord Rooker, and other noble Lords, how self-sufficient is the UK expected to become in the supply of PPE, and are there targets for the supply of face masks in particular?

[Lord Bethell (Con)]

My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.

[Baroness Blackstone (Ind Lab)]

My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.

[Lord Bethell (Con)]

My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.

[Baroness Uddin (Non-Afl)]

My Lords, in the US 513,000 children have been infected as of 3 September, with 70,630 cases reported in the past two weeks. Only this morning in my locality, all reception classes bar one were shut down due to the Covid infection of a teacher. As a father, the Minister will understand that many parents remain fearful and are seeking assurance and evidence of safety. Holding the Government to account after a tragedy has occurred would be meaningless. What lessons can we learn from our friends in the US and elsewhere about minimising the spread of infection among teachers and children in the UK, with the inevitable consequence of transmission to their homes and vulnerable loved ones in their families?

[Lord Bethell (Con)]

My Lords, policymakers around the world are facing exactly the same dilemma. We are determined to have the schools back, because the long-term effects on young people—particularly the least advantaged—will be profound if we shut the schools. The noble Baroness is entirely right to say that parents are naturally concerned that the safety of children, and other generations that they may come into contact with, is at risk. That is why we are massively prioritising the return of schools and introducing measures such as the rule of six to break the chain of transmission and thereby protect the schools from closure.

[The Deputy Speaker (Baroness Finlay of Llandaff) (CB)]

I apologise to the noble Baroness, Lady Verma, who I should call now.

[Baroness Verma (Con) [V]]

Thank you, Deputy Lord Speaker. My noble friend has talked about Covid, but I think it is important in the same debate to talk about the flu injections that are available to help people reduce their ability to catch Covid. Will my noble friend ask the pharmacies that are distributing flu injections to step up their communications, in particular to people with south Asian backgrounds, who are slightly resistant to going into pharmacies to get flu jabs? I know from my experience of having to persuade my mother that this is an issue, and it would be helpful to get the communications about getting flu injections out as quickly as possible, so that people build up their immunity as quickly as possible.

[Lord Bethell (Con)]

My Lords, we are hopeful that this season the number of flu injections will be a massive increase on previous seasons. We will, therefore, be putting huge responsibility on the shoulders of pharmacies and pharmacists to deliver them. I take on board completely the very good advice from my noble friend about the reputation of pharmacists compared to GPs, particularly in certain communities. I trust that the pharmacy profession will be doing an enormous amount to promote the flu injection itself, and to reassure its customers about the efficacy of its service. It is, however, an idea that I will take back to the department.

[Baroness Noakes (Con) [V]]

My Lords, when we had questions on the Statement last Thursday, I asked the Minister two questions that he did not answer. I have another opportunity now. Can the Minister say what evaluation the Government have made of the economic and societal impact of alternative responses to the spike that we are seeing in infection rates? Secondly, will they publish that evaluation?

[Lord Bethell (Con)]

My Lords, we have a very clear example of what will happen to the economy if the infection comes back. We will have to close down society as we did before, and the economy will suffer profoundly as a result.

[Baroness Neville-Rolfe (Con)]

Most of the Covid measures made under the Public Health Act 1984 have major adverse effects on the economy and on the treatment of other fatal diseases. We cannot go on like this indefinitely until we have a vaccine. We need a new strategy that offers a degree of protection where it is needed, for example in care homes and for the very elderly, and that restores economic and social life. Are the Government now developing such a strategy, and when will we hear about it?

[Lord Bethell (Con)]

My Lords, my noble friend describes in the most beautiful and succinct way exactly the strategy that we are following. It balances on the one hand a fight against disease, a breaking of the chain of transmission, the protection of the NHS and the saving of lives, and on the other a measured, thoughtful and reasonable opening up of the economy, workplaces, schools, shops and other valued economic assets. We are working hard to get that balance right. I believe that we have got it right, but we are open to suggestion and we review the situation incessantly. Until we have a vaccine and other therapeutics to fight this disease, that is the life and the road that we will be walking.

Covid-19 Update

Lord Bethell Excerpts

Thursday 10th September 2020 Lords Chamber

[Baroness Barker (LD)]

My Lords, this is a Statement made two days ago in the other place, but it has been largely overshadowed by yesterday’s deluge of hyperbole and hokum. The Prime Minister said yesterday:

“We know, thanks to NHS Test and Trace, in granular detail, in a way that we did not earlier this year, about what is happening with this pandemic. We know the groups that are suffering, the extent of the infection rates, and we have been able, thanks to NHS Test and Trace, to do the local lockdowns that have been working.”—[Official Report, Commons, 9/9/20; col. 609.]


If that is true—and given the record of the Prime Minister and Health Secretary, one is always entitled to ask whether it is—how come local authorities and directors of public health are given only limited access to the test and trace case management system and not given full access to the contact system? Why are the Government sitting on data or passing it to companies run by their mates, instead of passing it to local authorities, which, for weeks, have been trying to predict and manage the inevitable spike in infections that follows people starting to travel and going to school and university. Why are they not getting that data in a timely manner?

From the start of this pandemic, experts advised the Secretary of State to invest in public health teams and NHS labs that are numerous and easily reached by many communities, including in rural areas. Instead, he gave the money to outsourcing firms such as Serco and G4S, which have no expertise and have not had to compete for the contracts. He could have invested in local public services; instead he has built a system on a foundation not fit for purpose. On Tuesday, in the Statement, the Secretary of State for Health said of care homes that

“we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.”—[Official Report, Commons, 8/9/20; col. 517.]


But on Monday, the Government were forced to apologise for continuing delays to Covid-19 testing for care home bosses and GPs, who are threatening that these will lead to more infections among vulnerable people.

The Secretary of State’s own department, the Department of Health, admitted to breaking its promise to provide test outcomes within 72 hours. Care managers have described the Government’s centralised testing service as “chaotic” and “not coping”, amid reports that whole batches of tests are coming back not only late but also void. Testing officials told care homes by email on Monday morning that

“immediate action has been taken at the highest levels of the programme to bring results times back”

within 24 hours.

“We apologise unreservedly to … you … and your staff.”

The ring of steel that the Secretary of State claimed to have put around care homes never was. With upwards of 40,000 deaths, when will the Government sit down with care home providers, local authorities and CCGs to develop a comprehensive system of testing and supply of PPE? It does not have to be world beating; it just has to work.

The Prime Minister’s Statement yesterday would have been risible were the consequences not so serious. Most ludicrous of all was the announcement of a team of Covid-secure marshals to enforce the new laws on public gatherings. The Government could have done any number of things. They could have announced resources to enable the rehiring of retired public and environmental health professionals, since there is a shortage. They could have given funding to local community and voluntary groups to communicate ongoing health risks and the law to communities. They could have given additional funding for trained police officers to work with health officials and businesses to improve adherence to infection control. But, no, instead we got another vacuous attempt to steal the headlines. Maybe these marshals, with no training, no resources, no local management and no authority could join up with the 750,000 volunteers for the NHS and the trackers, and like them they could sit and twiddle their thumbs, waiting for the phone to ring.

One thing we can be sure of is that this is another stunt which will be an utter waste of time, money and resources. Local authorities, police forces, health authorities and schools are using their professional expertise and local knowledge to plan effective public health interventions. They are not only following the science but also using it to actively protect people in their authorities. In stark contrast, this Government ignore advice, misrepresent the science and carry on winging it, but the data on infections and the lack of reliable testing are evidence that the Prime Minister’s bumbling bombast and the Health Secretary’s growing litany of half-truths are indicators of world-beating incompetence and, sadly, people in black and minority ethnic communities and poor communities will suffer the consequences. It is time for the Government to change.

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

My Lords, I am enormously grateful for the thoughtful and informed questions from the Front Bench, and I echo the comments about teachers made by the noble Baroness, Lady Thornton. The return to school is a fundamental priority of the Government. It is a massive challenge for those involved, for governors, teachers, parents and school kids. I endorse the thanks the noble Baroness gave to teachers, who are performing incredibly well. The high return rates—percentages in the mid to high 90s—is remarkable and shows enormous confidence in the system among schoolchildren and their parents.

I also echo the noble Baroness’s thanks to NHS and social care staff who are preparing for winter. Enormous amounts of preparation are going into that. In response to the point made by the noble Baroness, Lady Barker, I reassure the Chamber that engagement with social care, local charities and local councils is incredibly intense and we are working extremely hard with local partners in all areas.

The noble Baroness, Lady Thornton, asked when the new regulations will be delivered. I am afraid that I cannot confirm the precise date, but I can reassure her that this Government are committed to being accountable to Parliament for those regulations and I look forward to that debate.

The noble Baroness also asked about the sequence of announcements. I reassure her that the Prime Minister brought his Statement to Parliament in good faith to update Parliament first. We cannot prevent leaks from happening, and leaks that get on to social media and then into the papers are something that we did not design or deliberately create. They are something that we regret. It would have been massively our preference for the Prime Minister to put Parliament first in his announcement.

The noble Baroness also asked about the testing system. The capacity of the testing system has never been higher: it has increased by 10,000 per day for the last two weeks and continues to increase dramatically. But demand has never been higher either, and there are good, laudable reasons why that demand is going up. The number of tests for supporting the vaccine programme has gone up. The number of tests to support our therapeutics programme has gone up. The surveillance of local prevalence has gone up, and the marketing around the use of tests by those who show symptoms has proved to be much more effective and the take-up among those who have Covid-19 symptoms has gone up. For those reasons we are extremely pleased by that effect.

However, there has also been a significant rise in the use of tests by asymptomatic individuals, largely tied to children returning to school. That is why we have been clarifying the guidance on the use of tests—that they should be used by those who have symptoms and not by those who are asymptomatic. One day, when the capacity is there and the system can bear it, I hope that we will move towards a system where anyone can have a test whenever they like, however they feel, but right now we must live within the system that we have. We are doing hundreds of thousands of tests per day and clarifying with teachers and parents that tests should be used by those who show symptoms and not by those who are seeking some other form of guidance.

Regarding the questions asked by the noble Baroness about the moonshot, I am a little confused. “If we cannot do millions of tests today, how can we expect to be able to do millions of tests tomorrow?” seems to be the question. I will answer it very clearly. The innovation around testing has moved much quicker than anyone could have expected in terms of scale, cost, accuracy and speed. The industry and the professionals in the NHS, academia and private business have come together in a triple helix to collaborate in a massive revolution in testing, which has changed considerably in this country from the days when we were struggling to do 2,000 or 3,000 tests per day to when we had the capacity to do 200,000 or 300,000 tests per day.

We have a clear view of how we can dramatically increase the tests. That clear view has two components: those tests that use existing technology that is purchasable in today’s world, and a clear idea of where innovation will take us in the very near future. This Government are committed to grabbing the opportunity of that innovation in order to dramatically increase the number of tests. There will be nay-sayers who will question whether that innovation will deliver, and undoubtedly there will be set-backs. Not everything will deliver as promised. However, I am extremely optimistic that we will be able to harness the power of science and innovation to invest in the backbone of our data and our delivery mechanisms, and to engage with the British public to deliver a testing system that enables us to return to the life that we love.

The noble Baroness, Lady Thornton, questioned whether the testing system could be relied on to deliver results. Let me explain: the people of Luton and Leicester have used testing and contact tracing, and infection rates are dramatically lower—less than half what they were in late July. Those are two excellent case studies of how our system of testing and contact tracing has turned around difficult situations and pushed back the spread of Covid by breaking the chain of infection. The noble Baroness also asked what we will do to improve the system as it stands. There are three areas of improvement: first, technology; secondly, infrastructure, by which I mean the data and the presence on the ground; and thirdly, engagement with the public so that they understand how to engage and we understand better how to interact with the public.

The noble Baroness, Lady Barker, asked about the contact system and gave some statistics. I reassure her that since 28 May we have rung 272,000 people who have been reached by the test and trace system. Where communication details have been provided, the service has reached 88.6% of close contacts, and 78.4% of people who have tested positive have been reached. Within the bounds of epidemiological effectiveness, these are extremely impressive statistics. Compared with those from other countries, they range among some of the highest. It is an incredibly impressive set of results for a system that was stood up in relatively recent history. Local public systems are complementing the central contact tracing hub, and I pay thanks to all those local authorities that either work with their full-time employees, or, as is often the case, have employed local businesses, to support it.

We have hit our target on care homes—the noble Baroness, Lady Barker, might like to take a moment to celebrate that. We are also trying to work with a degree of transparency in our operations. I do not regret for a moment the fact that the operational senior leadership in the track and trace team has been on the level about the present supply constraints, with social care and the general public. I reassure the noble Baroness, Lady Barker, that care homes absolutely remain top of our priorities. Many of the frustrations the public face, such as longer distances to travel, are exactly because we have put care homes first and have therefore had to dial down some of the availability of tests to the public. We sit down with care homes to discuss winter preparations. An indication of that is the 31 billion items of PPE that we have contracted to buy for this winter—an astonishing figure. That pays great tribute to the work of the noble Lord, Lord Deighton, and the PPE team, who have built up a fantastic stock.

Finally, I would like to express a small amount of confusion about the remarks from the noble Baroness, Lady Barker. On the one hand, she attacked the involvement of major private companies and central control of our track and trace system, but on the other hand, she attacked civic engagement, the volunteering of members of the public to support our track and trace system, and local initiatives whereby NHS trusts have brought back retired staff. The combination of these two themes is the heart of our success, and I celebrate both.

[The Deputy Speaker (Lord Rogan) (UUP)]

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can maximise the number of speakers.

[Lord Lansley (Con) [V]]

My Lords, the consistency of messaging over time is immensely important to secure public support and adherence. Over the last six months, we have consistently explained that indoor and outdoor gatherings are significantly different, and that the scientific evidence has clearly shown much greater risk for indoor gatherings. Can my noble friend the Minister explain to the House why the Government appear to have abandoned this important distinction in their current guidance?

[Lord Bethell (Con)]

My noble friend is right to point out this important change. The truth is this: from the feedback we had from the public, and from our own analysis of the facts, we see that our guidance was growing increasingly complicated and was confusing the public. While the science may suggest all sorts of clever differences between one situation and another, and between inside and outside, the guidance is effective only if it is clear, understood and obeyed. At the end of the day, what we have done is to clarify some of the more complex areas of our guidance to make it more effective.

[Baroness Meacher (CB) [V]]

My Lords, sadly, Professor Spiegelhalter has seriously questioned the Prime Minister’s rather splendid Moonshot mass testing proposal. I understand his concerns. Nevertheless, can the Minister assure the House that he will press for a significant investment in saliva home-testing kits, to enable families with a parent in the former shielded group and with children at school to live a reasonably normal life? Children need to be at school, but the lives of these parents are now in grave danger—I am sure the Minister appreciates this—with the R number above one and, as yet, no daily testing capacity. Can the Minister say when daily testing will be available for these families and other top-priority groups in the country?

[Lord Bethell (Con)]

I reassure the noble Baroness, Lady Meacher, that saliva testing is a massive priority for the Government. I reassure her and Professor Spiegelhalter that the positive error rate in the saliva test trials in Southampton has been incredibly low—virtually zero. From that, we take great reassurance that this will be an effective vector for testing.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, will the Minister accept that the reason for scepticism about the Moonshot gimmick is that the Government have a consistent record of overpromising and underdelivering? The Minister will know that the latest test and trace stats are not good: they show that 69.2% of close contacts of people who have tested positive with Covid-19 in England were reached—that is the lowest percentage since the scheme was launched. What would he say to Bridget Phillipson, the MP for Houghton and Sunderland South? Because Sunderland has a rising number of cases, she checked online this morning the availability of tests: no home tests were available and no drive-through tests could be found. Later in the morning, the only test offered was a two-hour drive away in Scotland. Why should anyone believe the ideas that the Government float from week to week?

[Lord Bethell (Con)]

My Lords, I completely and utterly reject the noble Lord’s suggestions. I remember well the nay-sayers, the sofa epidemiologists and the sceptics who, when we had testing at the level of 5,000, poured cold water on the idea we would get to 100,000. We hit that target. We have made amazing progress since and we will continue to push for more testing.

[Baroness Walmsley (LD) [V]]

My Lords, the Secretary of State has blamed the recent failure of laboratories to process tests in a timely way on members of the public who are not eligible—as he calls it—seeking to take a test. Is this not another example of Ministers blaming someone else for their failures? How do people know if they are not eligible? If they are concerned about something, what system is in place to enable testing centres to know who is eligible, so that they can refuse to test those who are not?

[Lord Bethell (Con)]

The noble Baroness is right, but it is sometimes difficult to know whether you have the symptoms of Covid, the flu or something else. That is why it is a complicated matter. What we have seen through our engagement with the public in the last few weeks is people who show no symptoms of anything but who seek a test to provide themselves with reassurance. It is not a question of blame, but rather of clarification: we simply do not have the national resources to support that kind of activity.

[Baroness Noakes (Con) [V]]

My Lords, as a Conservative, it grieves me that the Government are pursuing policies, such as the rule of six and Covid-secure marshals, which belong in a police state. The Government have chosen a highly risk-averse approach, driven by guesstimates of hospitalisation and mortality rates, and doubtless derived from mutant algorithms. In the meantime, the economy is tanking. Can the Minister say what evaluation the Government have made of the economic and societal impacts of different responses to the small spike we have seen in infection rates? Will they publish that evaluation?

[Lord Bethell (Con)]

My Lords, it is not a mutant algorithm that is sending people to hospital in France, Spain, Belgium and other countries up and down Europe, and it is not a desire to introduce a police state that is seeing prevalence leading to hospitalisation and death in many countries in Europe. It is our fear that Britain is going that way that leads us, regretfully, to put these measures in place; it is not any desire to exert state influence.

[Lord Patel (CB) [V]]

My Lords, I am sorry that the Minister keeps having a hard time, but that is partly because he is having to defend the indefensible. I had a completely different question to ask, but I have changed my mind and, instead, will follow on from the question asked by the noble Lord, Lord Lansley, and the Minister’s response to it. In terms of transmission of the disease indoors as opposed to outdoors, which bit of science is confusing?

[Lord Bethell (Con)]

I answered the question as clearly as I possibly could. This is about communication and clarity and making sure that people understand the instructions; it is not about science. If that is not effective then the guidelines are pointless.

[Baroness Andrews (Lab)]

My Lords, perhaps I may take the Minister back to the question asked by the noble Baroness, Lady Walmsley. I was sorry to hear him say rather dismissively that people are clogging up the system because they seek some sort of reassurance, although they do not have symptoms. That seems to me a perfectly natural and human reaction. Can he confirm that basically government policy now is actively to discourage anybody without any symptoms in any situation seeking a test? If that is the case, what is his answer to the letter that he received from the directors of public health in the south-east, who are deeply worried that an area of low infection could easily become an area of high infection? What will he say to the universities that have introduced testing for all students, asymptomatic or not, because they want to protect their local communities, given what we know from America—from Chapel Hill, for example—about the absolutely devastating effect that university populations can have?

--- Later in debate ---

[Lord Bethell (Con)]

My Lords, it is not a question of blaming anyone or of in any way condemning people’s natural curiosity. However, the bottom line is that we have only so many resources, and people know full well whether they are showing symptoms of some sort. It is not appropriate that someone who shows no symptoms whatever uses valuable, scarce resources that could and should be used for more important priorities. We could not be more clear about that. Universities are using private testing facilities, and we applaud and support them on that. It is my sincere hope that one day we will have sufficient testing facilities to be able to offer everyone a test whenever they like. However, we do not live in that world today, and that is why I deliver the message that I do.

[Lord Taylor of Goss Moor (LD) [V]]

The Minister has just said that a significant plank of the policy is not the science but communications. I fear that the Moonshot programme falls into exactly that category. I do not believe that it can be delivered at the scale that the Prime Minister has talked of, but, if it could, it would throw up false results that would overwhelm track and testing and mislead people, throwing both education and the economy into further chaos. Is not the right policy to target the groups that we know are vulnerable to this disease with the protections that they need, starting with care homes, and to allow the rest of us, and the economy and education, to move forward?

[Lord Bethell (Con)]

The noble Lord is right to be concerned about false positive results. However, our experience, our piloting and the emerging technologies suggest that that will be the case in a relatively small proportion of the tests and is entirely manageable within a mass population testing system. With regard to the idea that we can somehow identify vulnerable groups and target them pre-emptively, I wish that that were true, but this disease constantly confounds expectations and turns up in places where we least expect it. If we could tell people that they were going to get the disease, we would not have this problem in the first place.

[Baroness Blackwood of North Oxford (Con) [V]]

I thank the Minister for his answer, but those who were formerly shielding, those whom we had identified as being most at risk, will be watching the rise in cases and some of this debate with anxiety. There were a number of problems with the rollout of the shielding programme the first time round, and we have new evidence about who is most at risk from Covid. Has there been a reassessment of the criteria for those who might need to shield this winter? If so, what is the Minister doing to ensure that this is communicated early and much more clearly to both those who will not need to shield this winter and those who might need to, so that we can reduce anxiety among those groups and protect the most vulnerable?

[Lord Bethell (Con)]

I completely recognise the problem identified by my noble friend. I reassure her that the expert sub-group NERVTAG is developing a predictive risk model to enable a more sophisticated approach to clinical risk and to identify more clearly those who need to shield. The model incorporates known relevant risk factors, such as age, sex, BMI and ethnicity. We are working at pace and will continue to engage patients, those on the shielding list, healthcare professionals and the voluntary sector as we embed this important insight into what we do.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, the Minister will be aware of the difficulties faced by disabled and older people during the first major lockdown, such as insufficient social care support services. Will the government guidance to this group now change to address those difficulties, especially if the R rate keeps rising over the coming months? Will he now consider switching off the social care coronavirus easement powers, which were meant to be only a temporary measure, especially as local authorities are now telling us that they no longer use them? These easement powers are a major cause of anxiety among older and disabled people, and it would be an easy thing to do—just switch them off. They are no longer needed, yet they cause untold anxiety.

[Lord Bethell (Con)]

My Lords, I am not sure that I have a precise answer to the noble Baroness’s question on easement powers. It was my impression that they had not been used in the vast majority of areas—only in a few areas—and that, where they had been applied, their use had been of a mainly administrative rather than practical nature. However, I am happy to look into the question that she asks and to reply to her by letter.

[Lord Harris of Haringey (Lab)]

My Lords, the noble Lord has responded rather testily to a number of your Lordships in providing answers. In particular, he failed to answer the substantive question from my noble friend Lord Hunt of Kings Heath about why people were being sent, or being told to go, such extraordinary distances when they wanted and needed a test. He says that he does not want to have the blame game, but that is blamed on people who did not need a test going for one. First, can he tell us what those figures are and, secondly, can he reassure us that the messages he is now giving out will not lead to people who should be tested feeling that they should not bother the system? That would be just as big a danger.

[Lord Bethell (Con)]

I shall be extremely careful about how I reply to that question because I would not want to come across as testy. The noble Lord is right: it is a challenge to strike the right balance between guiding towards testing those who truly need tests because they have symptoms and trying to get those with less of a priority away from testing. I reassure him that, even under current circumstances, 90% of those who apply for a test get one within 20 miles and the average distance to travel is six and a half miles. Therefore, even though some of the anecdotes about being recommended to travel long distances might seem extraordinary, the lived reality of most people who go for tests is that they are quick, near, accurate and effective.

[Lord Truscott (Ind Lab)]

My Lords, will the Minister confirm that Her Majesty’s Government will not let people die for ideological reasons? Are the Government prepared to buy a vaccine from any country, provided that it is safe and it works?

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[Lord Bethell (Con)]

My Lords, this country has been absolutely on the front foot on vaccines. We have negotiated agreements with six different vaccine providers for 340 million courses of vaccine. We are completely open to anything that is effective, and we have championed the cause of fair vaccine distribution on a global basis.

[Lord Robathan (Con)]

My Lords, I regret to say that this Government’s policy on Covid is contradictory, confusing, hugely damaging to the country and, frankly, nonsensical. Should I have the opportunity, I will vote against it. We were exhorted, from the very beginning of this public health crisis, to save lives. As noble Lords know, some 11,000 people die on average every week in the UK under normal circumstances, so can the Minister tell us how many people under the age of 65 have died of coronavirus in the last 26 weeks? Of those, how many did not have some serious underlying health condition such as diabetes, obesity, respiratory problems or the like? If he does not have those figures to hand, perhaps he might write to me and put them in the public domain by putting them in the Library.

[Lord Bethell (Con)]

My Lords, I entirely welcome the challenge from my noble friend but, respectfully, I completely disagree with his approach. I want to flag two issues. The first is the enormous public support for the Government’s response to Covid and their adherence to the measures we have introduced. The second is the recent King’s College survey, published today, showing that on top of the deaths, 300,000 people in the UK have reported symptoms that last more than a month and 60,000 have been ill for more than three months. The effects of this disease go far beyond the “simply recover the next day” effects of flu; it is a profound illness that we are right to try to suppress.

[Baroness Masham of Ilton (CB) [V]]

My Lords, how is new technology being brought to the front line to deliver critical care and services across the country? Is the Minister aware of the desperate shortage of doctors and nurses working on the front line of infections, and that they are exhausted? What can be done to solve this problem?

[Lord Bethell (Con)]

The noble Baroness absolutely speaks my language when she talks about the technology that is being brought into the front line. My sincere hope is that Covid will bring a benefit to the healthcare system by being an inflection point whereby we introduce new technologies in a whole host of fields to bring in much greater community-based treatment for people, digital technology and the more effective sharing of data, among a wide range of technical advances. Regarding the workforce, I completely sympathise with the noble Baroness’s comments. I pay tribute to those who work hard on the front line and am aware of the challenges and difficulties they face. This Government have committed to recruiting 50,000 more nurses. We are more than half way there already, and we will continue to recruit to ensure that we have the human resources needed to meet our commitments.

[Lord Dubs (Lab) [V]]

My Lords, what is the policy regarding the testing of domiciliary social care workers? What is being done to ensure that these people—who are at risk themselves and meet and support the very vulnerable, travelling around to different people every day—have full protective equipment and that they use it?

[Lord Bethell (Con)]

The noble Lord is entirely right to emphasise the challenge of itinerant domiciliary care. Such workers were always a vector for potential disease and are putting their own lives on the line. That is why we have radically changed the guidelines. We have put more resources in place to ensure greater support for domiciliary care, PPE is stocked for them to use and there is regular individual testing

[Lord Dobbs (Con) [V]]

My Lords, the new guidelines require political protests to be “organised in compliance with” government rules and

“subject to strict risk assessments”.

Who will undertake these assessments, when and how will they be undertaken—I presume they will have to be undertaken before any protest is mounted—and does this mean that the type of protest we saw the other day by Extinction Rebellion will by definition be unlawful?

[Lord Bethell (Con)]

My Lords, my understanding is that the risk assessment is done by the local police force in conjunction with Public Health England, but I am happy to check that and write to my noble friend. With regard to Extinction Rebellion, I found the protest last week particularly tedious but I am not sure if it will be outlawed quite yet.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, the Minister has taken great pains today to stress the need to ensure that our limited number of tests are well used. I want to revisit the issue I have raised with him before: the list of symptoms as a result of which people are encouraged to take a test. I am sure he is aware of the University of Belfast study of paediatric infection rates, which showed that among children with antibodies a cough was no more common than among those without, while gastrointestinal symptoms such as diarrhoea, vomiting and abdominal cramps were significantly associated with coronavirus infection. Given that many other countries, including the United States, and the World Health Organization list a greater range of symptoms, will the Government consider communicating clearly with the public when the tests are needed, based on the scientific evidence?

[Lord Bethell (Con)]

The noble Baroness raises a very difficult subject. A huge amount of work has gone on in this country and others to define the most effective possible list of symptoms. The honest truth is that this disease manifests itself in different people in a great many different ways, and we have done a huge amount to try to understand the list of symptoms to be described in a way that will capture the greatest number of people in the clearest way possible. We keep that under review, but the work that has gone into it could not have been more thorough.

[Lord Bilimoria (CB) [V]]

My Lords, a programme of nationwide mass testing is exactly the ambition we will need to build confidence in the public and businesses before a vaccine becomes available. Professor Devi Sridhar of Edinburgh University says that the only safe way is mass testing. I agree with the Minister: look at where we were in March, with 2,000 tests a day, and now we have the capacity for well over 300,000 tests. Given that, why can we not get on with instant mass testing? The Abbott BinaxNOW test laboratory in America is producing antigen tests—10 million this month and 50 million next month—that give results within 20 minutes, and they are already FDA-approved. Why can we not do that at such speed? Can we get this into the market quickly? Likewise, Germany started testing at airports in June, and France did so in August. Why can we not start testing at airports quickly? Jobs, the economy and lives are at stake.

[Lord Bethell (Con)]

My Lords, we could not be moving more quickly to engage with the producers of tests in order to sign up the resources we need to put in mass testing. That cannot be switched on overnight, but we could not be moving more quickly. On airport testing, the CMO has been crystal clear: he is deeply concerned about day-zero testing and about any but the most thorough airport testing measures. We were caught out on this at the beginning of the epidemic and we remain extremely cautious.

[Lord Berkeley (Lab)]

My Lords, I want to follow up on the Minister’s answer to the noble Lord, Lord Bilimoria, about airport testing. Apparently, we have this world-beating system and many millions of tests that we can do, but now we have limited resources. The number of people who have had to cancel their travel arrangements, lost money and not come back—for whatever reason—is enormous and it is affecting the air industry as well. If our testing system is so good, surely it can be done at airports, plus track and trace, which has worked quite well, even for one plane that came from Greece. I hope the Minister will take this away and try to move it forward a bit more quickly.

[Lord Bethell (Con)]

The noble Lord, Lord Berkeley, is entirely right that the impact of this on our economy is profound, affecting the tourism economy, business and the professions. It is not something that we undertake lightly. However, it is the science-based belief of the CMO that the challenge presented by global travel is so profound that this is a step we have to take. When there is a surfeit of testing—when there is a vast amount of it—we may be able to put in place much more extensive measures, but, even so, the CMO remains extremely cautious on this point. However, we are working with Heathrow, the airlines and the airports to keep the matter under review. We take into consideration pilots and are working closely with them to try to resolve the issue.

[Baroness Neville-Rolfe (Con)]

I do not want to add to my noble friend’s difficulties, but I have received some worrying reports that pregnant women are prevented having the father of the baby with them right through labour or when undergoing related treatments, such as scans. This can be devastating, especially if there is bad news, such as a miscarriage. Can my noble friend the Minister do his best to get the rules changed across the country, so that parents can support each other at this vital time?

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[Lord Bethell (Con)]

I completely understand the point that my noble friend is making. The issue of scans is compounded by the problem that many scanning machines are in small, airless rooms, where the risk of contagion is high. None the less, I completely recognise the point she makes about the pastoral and psychological effect of splitting people up at this incredibly sensitive time in their lives. We are reviewing it and we very much hope to make some progress.

[Baroness Blower (Lab) [V]]

My Lords, can the Minister say whether the Government will publish the science behind the decision not to test teachers and education staff—I congratulate them on being back at work—routinely and regularly, bearing in mind that there have already been school closures due to outbreaks? Is it a matter of science or of testing capacity?

[Lord Bethell (Con)]

My Lords, the regulations are not in place at the moment to test the millions of teachers and other important workers who are returning to the workplace on a regular basis. We have neither the science nor the capacity to do so, but we are reviewing this and looking at ways of using testing to restore confidence and enable a return to workplaces or other situations where social distancing is more challenging.

[Lord Lucas (Con) [V]]

My Lords, I encourage the Government to be completely open with the data and research regarding this epidemic and to put it all on the GOV.UK website. When we opened up the data on BSE, the problem was solved within two weeks by researchers who were outside of government. When Ofqual refused to open up on its algorithm, it resulted in our recent troubles and disasters. Being open with data results in much more criticism, but that criticism is much better directed. And it makes it much easier for people like me to accurately defend government policy.

[Lord Bethell (Con)]

I completely agree with the sentiments shared by my noble friend. Transparency has the effect of sunlight, putting a spotlight on information. It helps those who wish to contribute to make their efforts felt. We have embraced transparency: I cite the example of SAGE, where the minutes of its meetings and the data it works on are routinely published. I completely endorse my noble friend’s comments.

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, given that there have been hardly any tests available to Londoners for at least the last four days, and probably much longer, can the Minister say what belief we should have in the statistics for the prevalence of the virus in the country, and in particular in London? Furthermore, the Health Secretary—when he was not blaming the public for the shortage of available tests—did admit that there were problems with a couple of contracts. Could the Minister explain what those problems are and why, according to the Health Secretary, it will take a couple of weeks to sort them out?

[Lord Bethell (Con)]

My Lords, the statistics on prevalence are provided by the ONS. They were published yesterday and today—both the ONS and REACT figures. I would be happy to share links to those publications with my noble friend. Regarding the troubled contracts, I do not know the quotation to which she alludes but if she would like to correspond with me, I would be glad to try to figure it out.

Covid-19: Rise of Positive Tests

Lord Bethell Excerpts

Wednesday 9th September 2020 Lords Chamber

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

My Lords, our assessment of the recent rise in positive tests is that we are deeply concerned, particularly about rates among young people, and particularly at a time when children are returning to schools and people are returning to the workplace. We are constantly looking at the latest data on the spread of coronavirus and have worked hard to contain outbreaks early to reduce the spread, protect the NHS and social care sectors, and save lives.

[Baroness Thornton (Lab)]

I thank the Minister for that Answer. I was finding it difficult to know in which direction to point myself in framing a question about our testing system, but he has given me the two issues that I want to raise. First, can he tell the House what effect the increase in Covid infections is having on R? What is SAGE advising? The second question is to do with schools. What is a head teacher to do when they have successfully got their pupils back into school and then inevitably have pupils who have symptoms, are at home and need a test—as do their families—but are unable to get one because the nearest centres are either not carrying out tests or have run out of them, the labs cannot process them, or they have been offered testing many miles away and may not even have a car? How are our schools to remain open and safe if the national testing system is not working as it should, and when will this be resolved?

[Lord Bethell (Con)]

My Lords, the impact on R is not entirely clear at the moment. ONS and REACT figures will be published shortly, and they will have the statistical analysis that the noble Baroness asks for. However, it is safe to say that R is up. With regard to schools, the Government have made it clear that our support for the return to schools is completely emphatic. However, I remind the noble Baroness that the average distance travelled for tests, even at this stage, remains 6.4 miles. Ninety per cent of people who book a test travel less than 23 miles, and 90% of tests undertaken in our mobile sites are still converted in 24 hours.

[Baroness Lawrence of Clarendon (Lab)]

My Lords, the Government have imposed 14 days’ isolation on people travelling from certain countries where the virus is increasing. What steps have Her Majesty’s Government taken to ensure that children travelling back with their parents are not returning to schools—so that a child with the virus goes to school on day one and the children then have to be isolated?

[Lord Bethell (Con)]

My Lords, the quarantine arrangements we have put in place are essential for containing the spread of the disease. We completely sympathise with parents who have found themselves caught overseas. However, we implore them to abide by the quarantine arrangements and return their children to school once the 14-day quarantine has passed.

[Baroness Jolly (LD) [V]]

My Lords, when Covid-19 first struck, care homes were almost forgotten. Will the Minister explain to the House what is the recommended Covid-19 testing regime for residents, visitors and staff in care homes, and what organisation monitors the tests in those local care settings?

[Lord Bethell (Con)]

Testing arrangements for care homes have, as the noble Baroness, Lady Jolly, alluded to, risen dramatically. Testing is done in a large variety of ways. For large care homes, mobile testing facilities are put in place; for care staff, facilities at local NHS hospitals are in place; and we invite visitors to have tests in advance of visiting their loved ones. This is all overseen by the NHS Test and Trace programme, and the CQC remains the auditor of the care sector.

[Lord Kakkar (CB) [V]]

My Lords, I draw noble Lords’ attention to my registered interests, in particular my membership of your Lordships’ Science and Technology Committee. In his appearance before that committee in July, the Government’s Chief Scientific Adviser suggested that the higher the number of cases in circulation at the beginning of winter, the greater the likelihood of a significant peak of disease. What assessment have Her Majesty’s Government made of scientific evidence on the threshold at which the number of new cases might suggest that we can no longer be confident that the NHS will have sufficient capacity to deliver both its routine winter service and manage resurgent Covid-19 admissions?

[Lord Bethell (Con)]

My Lords, we are well within the threshold that the noble Lord, Lord Kakkar, alludes to, but we are concerned about winter. That is why we are putting in place new restrictions and new arrangements to stop the spread of this disease, protect the NHS and save lives.

[Baroness Manzoor (Con)]

My Lords, the level of coronavirus has risen significantly since late July and, as my noble friend the Minister knows, the disease is having a disproportionate effect on black and ethnic minority people. Can he therefore say exactly what the Government are doing to ensure that these groups are fully accessing NHS Test and Trace, and what additional support is being given to those who work in the hospital and care sectors?

[Lord Bethell (Con)]

My Lords, we are deeply concerned about the BAME incidence of this horrible disease. We have put in place extensive new marketing arrangements targeted at BAME audiences. We have targeted our testing arrangements through mobile testing and door-to-door availability at that communities that have been hardest hit, and there are guidelines to NHS trusts to put in place the necessary safety arrangements for those with a BAME background.

[Baroness Jay of Paddington (Lab) [V]]

My Lords, following the Government’s statement that the rise in infection rates is due largely to increased spread of the virus among young people, what strategies do the Government propose to adopt to ensure that returning students, for example, and others, comply more stringently with public health regulations?

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[Lord Bethell (Con)]

We are deeply concerned about the spread among students. Some of that spread will take place in universities, and I pay tribute to the efforts of vice-chancellors to put in place social distancing arrangements in universities; we hope that they will have an impact. However, some of the effect is in their social life—in pubs, clubs and bedrooms up and down the country. That is the responsibility of the students themselves, and we are looking at measures to enhance and enforce the social distancing measures that will stop the spread of this disease.

[Lord Scriven (LD)]

My Lords, on a day when the Prime Minister will order us not to meet in large groups of more than six, why have the Government agreed to support 3,600 people congregating at Doncaster Racecourse today? Have the Government not learned the lessons of the superspreader event in Cheltenham?

[Lord Bethell (Con)]

My Lords, any new regulations will be in place from Monday and will capture events such as the one the noble Lord describes.

[Lord Bilimoria (CB) [V]]

My Lords, I was delighted to hear the Secretary of State, Matt Hancock, announce the Government’s investment of £0.5 billion for testing innovation. Is the Minister aware of Abbott Laboratories’ new $5 antigen test, released just two weeks ago in the United States? On a card, within 15 minutes it can give results anywhere—at a school, a university, in the workplace or at the airport. Ten million are being produced this month in America, and 50 million next month. How soon will we have access to those sorts of tests, which will be a true game-changer in being able to have mass testing around the country?

[Lord Bethell (Con)]

My Lords, I am aware of the Abbott test. I spoke to Chris Scoggins from Abbott yesterday, and I pay tribute to innovators in this country, in America, and around the world for the dramatic increase in the speed, accuracy and scale of these tests. We hope that they will make a big difference.

[Baroness Verma (Con) [V]]

My Lords, given that the virus is spreading and we are fast approaching autumn and winter pressures, can my noble friend ensure that the NHS and local authorities are communicating in different languages to communities to encourage them to go and get their flu injections as quickly as possible?

[Lord Bethell (Con)]

The use of different languages for promoting all aspects of our Covid response is critical. We have massively increased the number, accuracy and stylistic resonance of our marketing materials in order to reach all audiences. I very much welcome the noble Baroness’s remarks.

[Lord Mackenzie of Framwellgate (Non-Afl) [V]]

My Lords, many law-abiding people are offended by the organisation of raves in blatant contravention of the rules on numbers and social distancing. What assessment have the Government made of the use of intelligence by the police to stop people travelling long distances to attend such illegal gatherings?

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[Lord Bethell (Con)]

My Lords, I used to organise raves, and I used to love them—but I implore all those who organise raves to stop, because they are creating a massive public health disaster. Fines have been put in place, and we will come after them. But I ask them, “Please, look into your conscience. Stop the raves. Protect lives.”

[The Deputy Speaker (Lord Faulkner of Worcester) (Lab)]

Lord Desai? Lord Harries of Pentregarth.

[Lord Harries of Pentregarth (CB) [V]]

Moving on from the question asked by the noble Baroness, Lady Jolly, about care homes, and the Minister’s response, are the Government publishing the number of cases and deaths due to Covid in care homes? If not, why not?

[Lord Bethell (Con)]

I advise the noble and right reverend Lord that those figures are published on the PHE website. I would be glad to send him an email with the link.

[Lord Dobbs (Con) [V]]

My Lords, what I am about to ask implies no criticism, because this is such a difficult question. The increase in restrictions on social gatherings that have just been announced will be so difficult to enforce. Is there at least a case for us to consider focusing more on mortality rates rather than simply on infection rates, and finding better ways of identifying and protecting the truly vulnerable, while allowing the rest of society to get on sensibly with their lives as best they can in the circumstances, before the costs of trying to protect everyone become both economically and politically unsustainable?

[Lord Bethell (Con)]

My noble friend is entirely right to say that the measures that the Prime Minister will describe will impose a huge burden on the whole country. However, he alludes to a hope that I am afraid cannot be borne out in practice, because we have seen, in country after country, that after prevalence follows hospitalisation and mortality, as night follows day. There is an immediate and strong connection between the rise of mortality and the rate of prevalence in the country as a whole. Children see their parents, and parents see the grandparents, so if we really want to protect all those in society, we have to lean into the disease at every level. In addition, it is emerging that the long-term effects of Covid on young people can be profound. Even those with relatively low or asymptomatic reactions to the disease can be affected by fatigue, loss of memory, breathing difficulties and other long-term effects. It is for those reasons that I ask all young people to ensure that they take every step to avoid catching this disease.

[The Deputy Speaker (Lord Faulkner of Worcester) (Lab)]

My Lords, all supplementary questions have been asked.