Covid 19: Winter Plan

Lord Newby Excerpts

Tuesday 24th November 2020 Lords Chamber

[Lord Newby (LD)]

My Lords, this is the most positive Statement the Prime Minister has been able to give since March, as we now have the real prospect of effective mass vaccination against coronavirus, which offers a route—of whatever length—back to normality. Huge congratulations are due to the team in Oxford and the other groups which produced the vaccine in record times. Reading accounts of how this has been achieved, I see that the key improvement on normal practice has been a willingness to work outside the normal silos in which scientists and others usually work. I hope this lesson will be learned for future vaccines, other areas of scientific research and public policy more generally.

There will no doubt be valid discussions about which groups other than those in care homes and the elderly should have priority on vaccine programmes, but the experience of the flu vaccination programme earlier this autumn should give us all some confidence that the programme can be undertaken speedily and effectively. I have one question about the vaccination programme. Do the Government intend that all those who receive the vaccine will get a vaccination certificate? One can certainly see many attractions of this, not least in that, if it were part of an international agreement to recognise such certificates, it could facilitate the return to greater normality in international travel, with the attendant benefits for the airline and tourism sectors.

The Statement sets out four criteria against which decisions on the placing of regions into tiers will be based and says that the tiering will be reviewed on a fortnightly basis. Can the noble Baroness clarify how that will work? The Prime Minister said yesterday that there will be a uniform approach, but the Health Secretary said it would depend on local circumstances. Which is it to be?

It is clear that, in tier 3 areas, the hospitality sector will continue to be very badly hit. Obviously, I understand the need for that, but will the Government look at additional, narrowly targeted support for this sector so that, when the toughest restrictions are lifted, there is still a hospitality sector able to reopen?

The Statement says that another £7 billion will be allocated to the test and trace system, bringing the total spend on this to some £22 billion—a huge sum which is, for example, greater than the total cost of Crossrail. I do not think that a single person believes that this has been money well spent so far. I hope that the new rapid tests will prove effective, but unless people who should get tested actually do so and then self-isolate if necessary, they will be ineffective. Equally, unless the tracking system also works, the money will be wasted. On all those grounds, the system to date has underperformed, to put it kindly.

In Liverpool, although the headline number of people tested is high, in the most deprived areas the take-up has been only 4% of residents. How do the Government aim to tackle this particular take-up problem? The proportion of people who self-isolate when asked to do so is still abysmally low. This is in no small measure due to the financial costs of doing so. There is of course the grant of £500 per week theoretically available so that those on low pay can be compensated for isolating. However, this is subject to so many conditions that, at the moment, apparently some 80% of all applications are rejected—this from a Government who have shown no such rigour when doling out PPE contracts worth millions of pounds. Will the Government now urgently recast the £500 scheme so that it can be accessed by those who need it?

Finally, I have a very specific question, of which I have given the noble Baroness prior notice. Page 24 of the winter plan document states that places of worship will be allowed to reopen but that there will be limits, depending on the tier, on the number of people with whom congregants can “interact”. Can the noble Baroness explain what “interact” means in this context, given that before the lockdown people were required to socially distance, wear masks and certainly not touch each other? Does it mean that there will be more or less “interaction” in churches now than there was a month ago?

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

I thank the noble Lord and the noble Baroness for their questions. We have published our winter plan, the aim of which is to take us through to spring. I will first answer a few questions on the tier system, which both the noble Baroness and the noble Lord touched on.

We have adapted our tiers in this plan on evidence that gives us the best chance to control the virus, developing community testing with scientific advice from national advisers and local directors of public health. The noble Baroness is right: these tiers are designed to reduce and keep the R below 1 and to support areas moving down tiers. That is the aim of where we are going. I will move on to vaccines, mass testing and other elements that we think will play an important part as we move towards the spring and, I hope, some kind of normality.

The noble Lord and the noble Baroness are absolutely right. To provide clarity and consistency, all tier restrictions have been standardised and will not be negotiated locally—so that is tiers 1, 2 and 3. Both asked about decisions on moving out of tiers. Decisions on the areas that go in and out of tiers will be based on a range of indicators, including: case detection rates in all age groups; case detection rates in the over-60s; the rate at which cases are rising or falling; the positivity rate—so the number of positive cases detected as a percentage of tests taken; and pressure on the NHS, including current and projected occupancy. Tiering allocations will be reviewed every 14 days, so there is a process and range of measures that will be published around which decisions will be made. While we appreciate that people would like to see firm thresholds, because areas and localities are different we will need to take into account local factors as well, but the indicators that I mentioned are key ones.

The noble Baroness rightly asked about local engagement on the basis that there is now some consistency among tiers. Absolutely, there will be local engagement. In particular, we will offer local authorities in tier 3 areas the opportunity to participate in a new community asymptomatic testing programme to help to find people who have the virus but do not show symptoms. Local authority directors of public health will be able to select their own approaches for delivering tests and priority testing targets and, as the noble Lord said, we hope that will mean that there is proper targeting of local areas, and some of the issues around take-up that he mentioned can be addressed through this local programme.

The programme will involve a six-week surge of testing capability to enable regular testing to be rolled out to the community in a way that works for the local authority with support from national government, including sufficient test supply, funding to cover support set-up costs and staffing test sites and support for extra contact tracing to break up clusters before they become outbreaks. That is where the additional funding that the noble Lord mentioned for test and trace will be focused.

The noble Baroness asked about contracts, and I can only reassure her that we will, of course, follow all the proper processes, procedures and oversights in awarding any future contracts.

In relation to Christmas, just as we came in discussions finished with the devolved Administrations, and they have reached some conclusions. Between 23 and 27 December, up to three households will be able to join together to form an exclusive Christmas bubble. The noble Baroness rightly asked about the clinically extremely vulnerable. Everyone must continue to take personal responsibility for spreading the virus and protecting their loved ones. For someone who is clinically extremely vulnerable, forming a Christmas bubble carries additional risk, but it will be a personal choice. People should take all precautions, including maintaining social distance from those they do not live with at all times, and they should consider seeing their bubble outside, where the risks are lower—but that will be a personal choice for people.

From 23 to 27 December, travel will be permitted between tiers and nations for the purposes of joining a Christmas bubble. People coming to or from Northern Ireland—and I see the noble Lord sitting there—will be permitted to travel a day either side of 23 and 27 December. I am sure there will be further information coming out, but that has come hot off the press.

In relation to care homes, we have launched testing pilots across 20 care homes, using PCR and the new rapid turnaround tests to allow up to two specific visitors to take two tests a week so they can do indoor visits to residents, including some physical contact. We intend to roll out this approach in a phased way across December, because we have made a commitment to provide tests to enable care home residents to have two visitors tested twice a week.

The noble Baroness and the noble Lord asked about vaccines, which is a key part of our route out by spring, we hope. It is about a combination of the mass testing that I have talked about and, obviously, the improved therapeutics that we have, which are having an impact when people are in hospital, but also vaccines. We anticipate that a number of safe and effective vaccines will be available in 2021, and we have taken steps to ensure that the UK has access to them. As everyone will know, we have agreements with seven separate vaccine developers, but we accept that the shift will not happen overnight, which is why spring is the timescale that we are looking towards.

The noble Lord, Lord Newby, asked about a vaccination certificate. I am not aware of that, but I will take that issue back and raise it. I reassure him that an enormous amount of preparation is taking place to make sure that we have adequate provision, transport, PPE and logistical experts to ensure that the rollout is successful. As he rightly says, the NHS is working from a great base—every year for the flu vaccine we have to roll out a vaccination programme, so we are starting from a good base.

I will attempt to answer the question from the noble Lord, Lord Newby, on interaction in places of worship. Social distancing rules should continue to be followed within places of worship, including during communal worship, which can of course now take place in all three tiers. That means that in areas under tier 1 restrictions, people should attend only in groups of up to six—the rule of six—and in tiers 2 and 3, people must not mix outside their household or household bubble. People should stay socially distanced. There should be closer distance only when absolutely essential to enable a faith practice to be carried out—for example, contact with a faith leader—and time spent in such contact should be kept to an absolute minimum.