Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Lord Rooker Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Fowler (CB)]

My Lords, perhaps I may intervene briefly as the last Secretary of State who had responsibility for a major epidemic, that of AIDS.

It is in no way exceptional that there should be profound differences in view among politicians and others of the way in which an epidemic or pandemic should be handled. In my day, we had chief constables openly attacking the patients and the Government. We had religious leaders, I regret to say, arguing that it was not a public health issue at all, but one of morality. We had Ministers, particularly Scottish Ministers, arguing that giving free needles to drug addicts was condoning crime, although there was absolutely no evidence that crime increased, and the example of our Government was followed worldwide. We had a Treasury which refused to provide extra resources for the pandemic.

Debate, controversy and difficulties on the way forward are absolutely nothing new in debates of this kind. The crucial question is: what advice do we follow? My view now, as then, is that we should follow the advice of the public health experts inside the Department of Health who work on these issues year after year, in particular the Chief Medical Officer. I pay particular tribute to my old CMO, Donald Acheson, and the new CMO, Chris Whitty. Chris Whitty and the Chief Scientific Adviser have done a remarkable job for this country over the last months and deserve full credit for that.

It is said that this is a question of freedom; obviously, I do not discount that argument, but surely the exercise of that freedom should not put others at risk. That seems to be a matter of common sense. It should not lead to infection being spread or hospitals having to prioritise which patients they treat because some have decided to remain unvaccinated and then become dangerously ill.

As is evident, after my spell on the Woolsack, I am now a Cross-Bencher, so I am not an automatic or whipped supporter of the Government—I am not whipped at all. My days as Conservative Party chairman are behind me—noble Lords might be very grateful for that—and no more than noble Lords in the Labour Party do I automatically follow the lead of the Government Front Bench. However, I must say that I think their case is totally overwhelming. The success of the national vaccination programme has moved us ahead in the race to get people vaccinated in this country and worldwide but, with the new omicron variant, we have to work even harder to stay ahead. That is the lesson of the whole thing.

Last week, we learned two things about this variant. The first is that no variant of Covid-19 has spread this fast—if you want a definition of an emergency or a need for action, surely that is not a bad one. We expect the numbers to increase dramatically in the days and weeks ahead. I do not think that is seriously disputed by anybody so, again, this is an argument for action. As the Prime Minister said—for once, his language is not over the top—

“there is a tidal wave of omicron coming”.

That seems to be the view of the public health experts as well. We know that a third or booster dose provides strong protection, with analysis from the UK Health Security Agency showing that a third dose is 70% effective at preventing symptomatic infection. We expect the booster to take effect more quickly than the second dose. Again, I would have thought that this should provide an incentive to us to do what is not just the best thing in terms of public health but the right thing, as I would term it—and action is the right thing.

What I really wished to say to this House in the few minutes that I have spoken is that we should do our utmost as a House and a Parliament to appear united. It seems it is not the best day to make that case or plea, after the rather dismal vote in the House of Commons yesterday, but I hope that the House of Lords will give support to this struggle. Parliament consists of two Houses—a fact that seems to be conveniently forgotten by much of the media and the press—and this House can give a real lead as far as the handling of this pandemic is concerned.

Like the noble Lord, Lord Cormack, whose speech I enjoyed, I hope that the noble Lord who has proposed a series of amendments will not persist with them. The Government have far more support than I think they realise. Far more people outside this confined area of Parliament are signing up to the case that they are putting. Ministers should persist in their case and fight for it as strongly as they can.

[Lord Rooker (Lab)]

My Lords, I make two preliminary points before my main point. First, it would be quite contrary to the way in which this House works and to the conventions under which we operate to throw out secondary legislation. This is just not on. We do not do it, and it would be quite wrong to attempt to do so. Secondly, I follow up on what the noble Baroness, Lady Walmsley, who spoke for the Liberal Democrats said. As many other people have done, I tried to order lateral flow tests this morning. They are not available; you cannot order them. Every week for the past two months, I have succeeded in ordering them and the pack has arrived within a couple of days. The Minister must have an answer to this fundamental issue. Now, you cannot just walk into the chemist and collect them, or order them via a QR code, as you could do months ago—at 8.30 am today, it was not possible.

The Minister said that we are doing all this to protect people—which is true—and also to protect the NHS. I make no apology for asking why is it that we need to protect the NHS? It seems self-evident: we need to protect the NHS because it is incredibly vulnerable compared with how it was. In recent years, we have lost 17,000 beds, systematically and deliberately. Why?

I cite two or three examples from the recent NAO report on NHS backlogs pre pandemic. The OECD is the rich countries—or rather, the richer countries— of the world. In the context of the health systems within the OECD, the UK has fewer resources than many of the other rich countries. The UK has 2.4 hospital beds per 1,000 of the population. France has 5.8 and Belgium 5.5—and they are not the highest. Sweden has 2.1, which is less than the UK but, at 2.4, we are way down the list. With 8.5 nurses per 1,000 of the population, the UK is 11th on that list, whichever way you look at it. Ireland has 12.9; Germany 14; and France 11.1. This is all before the pandemic. The UK has three doctors per 1,000 of the population. Sweden has 4.3 and Spain has 4.4. They are not the highest; the highest is much greater. Finally, in 2019, we did 175 CT, MRI and PET examinations per 1,000 of the population. France did 332; Austria 349, and Belgium 313. In other words, the NHS has been deliberately run down since 2010. The other thing that has happened since 2010 is that life expectancy has stalled—read the Marmot reports. Why has life expectancy stalled since 2010? More people are dying earlier as a result of life expectancy stalling. There is something systematically wrong.

Of course, we need to carry these orders for public health reasons. I have no problem with that. I am 100% with the noble Lord, Lord Fowler. When it comes to protecting the NHS, we have to ask ourselves why it is so vulnerable. It is because we have lost out on doctors and nurses and because of the other issues that I have raised. It has been done systematically. I do not know why—a national policy has never been announced on that. We always talk about protecting the NHS. We need to ask why.

I hope that the noble Lord will not push this to a vote. He would be breaching the conventions of the way in which this House is run. I presume he is only pushing for a vote because he wants to win—you do not push for a vote if you do not want to win. Throwing out the regulations would breach the conventions and the elected House would be after us pretty damn quick—and rightly so.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021

Lord Rooker Excerpts

Tuesday 14th December 2021 Lords Chamber

My amendment is, at its core, a plea for the Department of Health and Social Care to stop taking Parliament for fools. The department must respect the role of Parliament by facilitating rather than evading effective parliamentary scrutiny. That means full impact assessments for all significant policy interventions, whether of long or short duration; and, of course, it means they must be timely. At the very least, I hope the Government and, in particular, the Department of Health and Social Care will reflect on their duty to ensure that Parliament can do its job of oversight of the Executive. I beg to move.

[Lord Rooker (Lab)]

My Lords, I did not intend to contribute, but I just want to thank the noble Baroness, Lady Noakes, for that speech. I shall get Hansard tomorrow, make my little checklist and wait for what is coming from the other place—the borders Bill; the human rights Bill; the electoral reform Bill—and I will check off her claims about parliamentary scrutiny and believing in the House to see how sincere that speech really was.

[Lord Cormack (Con)]

My Lords, I would not doubt for half a second that my noble friend was entirely sincere. I also believe that she made some extremely powerful points which apply right across the legislative pattern, and which apply equally to both Houses. I hate to say this of a Conservative Government, but they behave as if they treat Parliament with contempt. Whether one is talking about Christmas tree Bills, Henry VIII clauses or the lack of impact assessments—a point made so very powerfully by my noble friend—the Government are found wanting. If we were marking in Greek letters the performance of the Government, I would, as an old schoolmaster, give them “gamma double-minus.”

It really is sad that we have a Government who are treating Parliament in this manner. I sincerely hope that, when he comes to reply, my noble friend the Minister will give a firm undertaking to draw the attention of his parliamentary masters in government to this debate and to the speech of the noble Baroness, Lady Noakes, in particular. They should read, mark, learn and inwardly digest it—to quote the collect for the second Sunday in Advent.

When it comes to the substance, I always deplore anything that smacks of retrospective legislation, because that again is treating Parliament with studied contempt. I know how difficult it has been during these last 18 months or more. We all know that—and we all know that mistakes have been made, sometimes with the very best of intentions. But it is deeply disturbing that there has not been a recognition that retrospective legislation is the very antithesis of democratic parliamentary government.

I have suggested many times, including very recently, that there should be a continuing committee of both Houses looking at Covid legislation and being able to pronounce on it quickly. I made this point only recently to my noble friend. He completely, I am afraid, misunderstood it and told me quite inaccurately that this was a matter for the Lord Speaker—but anybody who knows what the Lord Speaker is able to do and not able to do knows that that is fundamentally wrong.

I know that he is new to Parliament and is serving his apprenticeship with great distinction—we all appreciate that—but it is important that the powers that be realise that in an unprecedented situation unprecedented measures are sometimes needed. They have shown that by issuing diktats; they have not shown it by creating a vehicle for continuous parliamentary monitoring—and they should.

On the subject of compulsory vaccination, my noble friend Lord Bethell knows very well that I have been on about this almost from the very beginning, urging that care home workers should receive compulsory vaccination, and I believe that it is entirely logical to extend that to those who work, because people who come into close proximity to patients at their most fragile and their most vulnerable should not themselves be a potential risk to those patients. We know that in some care homes during the early months—I appreciate that it is much better now—you could find that 30%, 40% or even 50% of care home workers, looking after the most fragile and physically feeble of people, themselves not vaccinated.

How do you solve this? It is, of course, a combination of persuasion and cajoling, but at the end there has to be a point where you say that we cannot allow this to continue indefinitely. Therefore, I think on that point the Government are right and I am grateful for it.

However, we are a Parliament and therefore I come back, as I began, to the admirable speech from my noble friend Lady Noakes. She pointed out—as many others have over the past two or three years, particularly the noble and learned Lord, Lord Judge, who I think must go to bed with an image of Henry VIII by his bedside—how cavalier has been the treatment of both Houses of Parliament by the Government. We are approaching a new year. Let it be a resolution of the Prime Minister and all his Ministers that they are accountable to Parliament; they are not the masters of Parliament.

Health and Care Bill

Lord Rooker Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Rooker (Lab)]

My Lords, I, too, congratulate the noble Lord, Lord Stevens of Birmingham, particularly on his robust defence of fluoridation in Birmingham. I am going to concentrate on one clause, one schedule and one issue: Clause 144, Schedule 17 and part of the Government’s plan for tackling childhood obesity.

I have lost count of the reports from Select Committees and the National Audit Office on this vital issue, which, irrespective of the damage to health, is on course to bankrupt the National Health Service. I am informed that, since the early 1990s, there have been 14 reports containing 700 recommendations. No Government have done enough. When the coalition came in in 2010, there was a flurry of activity. The outcome, a serious plan, was effectively squashed by Theresa May in 2016 under pressure from the food industry. I was at a meeting of the Parliamentary and Scientific Committee when I heard officials—I shall not name them as I had worked with one of them before—spell out what was planned, but it did not come about.

So, it is better late than never that the Government are acting. There is increased political will to act; this is to be welcomed and actively supported. We have moved on from the “nanny state” arguments nurtured by the food industry. Besides this Bill, though, I would like to know what the Government have been doing since September 2020, when the National Audit Office published HC 726, its report on childhood obesity. Its key findings were worrying, and the five recommendations were a serious plan of action. I have looked but, to be honest, I have not been able to get the detail.

The figures on childhood obesity are startling and on the move. They are not static—we are getting fatter. The National Audit Office’s report pointed out that 20.2% of 10 to 11 year-old children were obese in 2018-19. That figure rose to 26.9% for children in the most deprived areas. The brief from the Obesity Health Alliance gives more up-to-date figures. The last year has shown the fastest increase in child obesity on record. More than 40% of children are obese by the time they leave primary school; for year 6 children, the figure is up from 21% in 2019-20 to 25.5%. It will be really difficult to reverse this trend.

I am about to make my only politically incorrect point. I could not help but notice, in recent years, the astronomical size of some teachers in primary schools. Emerging evidence shows that, besides a 1% year-on-year growth in obesity, the Covid pandemic’s impact is likely to have accelerated the pace of increase in childhood obesity, so there is even more reason to be concerned.

I will support the Government’s action and spur them to do more. They could do a lot worse than adopt the 10-year Healthy Weight Strategy published by the Obesity Health Alliance in September this year. “Healthy weight” is a good way of describing the desired outcome. It does not conjure up too much negativity. I will be watching to ensure that there is no watering down of the modest proposals by the men who made us fat. In this respect, I prefer the evidence from the National Audit Office to that from the food industry on the effects of advertising.

Talking of the men who made us fat, the BBC should show again the 2012 BBC Two documentary “The Men Who Made Us Fat”. The science and methods, both physical and behavioural, that the food industry uses to get us to eat more are eye-watering in their lack of concern for the consequences to public health. I commend the Government and urge them to do more, and I will oppose any watering down.

As an aside, exactly two years ago this week I lost two weeks of my life without warning, with clots, sepsis, pneumonia and a lump. The staff at Hereford County Hospital stopped me going over to the dark side. So far, so good, and I am very pleased to say that I am part of a clinical trial to check the effect of the booster on those who have had leukaemia and lymphoma —a trial called “Prosecco”.

NHS: Elective and Cancer Care Backlog

Lord Rooker Excerpts

Tuesday 7th December 2021 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government what assessment they have made of the reasons for the backlog of NHS elective and cancer care work that pre-dated the COVID-19 pandemic.

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

The backlog in elective and cancer care before Covid-19 was caused by a range of factors including a mismatch in demand and activity, which drove waiting lists’ growth. To address this, the Government have provided additional investment of £33.9 billion by 2023-24 for the NHS long-term plan to grow the amount of planned surgery, cut long waits and reduce the waiting list.

[Lord Rooker (Lab)]

That answer comes nowhere near responding to the NAO report on the NHS backlog published last week. When will we be able to return to Labour’s legal legacy of 92% of patients getting treatment in 18 weeks, instead of the miserable figure under the Tories of 83% because they are running down the NHS, which has led to hundreds of thousands extra on the waiting list?

[Lord Kamall (Con)]

I thank the noble Lord for this Question on an otherwise quiet day for me. There was growing demand on the NHS before the Covid-19 pandemic, with growing referrals across elective and cancer care. This is driven by an ageing, more affluent population. On what we do about it, we set out our ambitions in the NHS long-term plan. I do not call a £33.9 billion budget increase by 2023-24 an abandonment of the principles. We are looking at the waiting lists and are looking to get them down.

Covid-19: Plan B

Lord Rooker Excerpts

Wednesday 20th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for his question. I do not have the detailed data and I will write to him. But in terms of the link between cases, hospitalisations and deaths, it is quite clear that the vaccine has been working to break the link between the number of cases, hospitalisations and deaths.

[Lord Rooker (Lab)]

Would the Minister accept that one of the unfair criticisms, in some ways, over the last 18 months, has been “too little, too late”? That cannot happen again. We need to set good examples. At Prime Minister’s Questions today, there was not a single Conservative MP wearing a mask in a crowded Chamber. What on earth is that as an example to the people on the Tube and everywhere else? Clearly, some small measures now will save the big measures later.

[Lord Kamall (Con)]

I agree with the noble Lord that it is important that we take as many measures as possible to make sure that we do not have to move to plan B. I assure the noble Lord that I do wear my mask to, hopefully, set an example, and I hope others will too—but it is really important that we understand what factors are driving this rise in numbers and the most effective way of tackling it.

Flu Vaccination and Blood Test Cancellations

Lord Rooker Excerpts

Tuesday 14th September 2021 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government what assessment they have made of the level of cancellations of influenza vaccinations and routine blood tests.

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

My Lords, I regret to report that there was a shortfall in the supply of blood tubes of around 13% in the last two weeks of August, which led to some disruption. That has been mitigated through use of government stockpiles, importing tubes and changes in practice. Supply has now returned to normal. It is not true that there is a flu vaccine shortage; the delivery from one supplier was delayed by one or two weeks, but this should have no impact on the flu vaccination programme overall. I am pleased to say that we are in regular contact with doctors, and no issues of cancelled appointments have been raised.

[Lord Rooker (Lab)]

What the Minister just said about blood tests is good news for those who have regular serious blood tests. But on the subject of flu jabs, does he recall telling me earlier this year that the flu jabs were made in the UK? They are not imported. The lorry drivers problem is a UK issue, so this is a home-grown issue. The websites this morning are saying that, up and down the country, GP after GP has been thrown into chaos because they are having to cancel appointments that were made weeks ago. I have personal experience of this, because even in Ludlow we are having appointments cancelled. The idea that this is not a problem is not the case. Why has this been allowed to happen? Everything involved is under our control in the UK.

[Lord Bethell (Con)]

My Lords, it is not my understanding that appointments have been cancelled. If the noble Lord has any anecdotes, reports or evidence of that, I would be very grateful if he could send me that material. Seqirus, the company concerned, brings its vaccines in from overseas.

Covid-19

Lord Rooker Excerpts

Thursday 15th July 2021 Lords Chamber

[Lord Rooker (Lab)]

My Lords, I have listened very carefully to the Minister but I did not quite hear the answer to the questions asked by the noble Baronesses, Lady Tyler and Lady Finlay, about the forthcoming pressures on the NHS. The hospital I was at on Tuesday morning is, I was told, working at full stretch; it is at winter levels in July. Covid is taking up ICU beds and stopping elective surgery now, even before the pressure starts. There are constant references in the Statement about not wanting unsustainable pressures on the NHS, but we are putting such pressures on it by allowing the figures to rip without seeming to have proper back-up services and resources. Can the Minister answer the questions from the two noble Baronesses?

[Lord Bethell (Con)]

My Lords, I thought I had answered the questions put by the two noble Baronesses. I will seek to answer the noble Lord. He is absolutely right: our hospitals are working flat out but this is not mainly because of Covid. As of 11 July, hospital admissions in England were running at 502 a day. As of 13 July, there were 2,970 patients in hospital in England with Covid, of whom 470 were on mechanical ventilation. Catching up on all the backlog—not Covid—is what is consuming the hospitals and making them run so red hot. This is the focus of our healthcare system at the moment, and it will remain so for some time to come. We are under no illusions: there is a massive backlog which includes many people who have not come forward with symptoms of severe disease and will need to be addressed and treated. This is a huge national project that we are undertaking.

Folic Acid

Lord Rooker Excerpts

Tuesday 13th July 2021 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government, further to the reply by Lord Bethell on 3 September 2020 (HL Deb, cols 444–5), whether they have yet been able to form a conclusion on the outcome of their consultation on the proposal to add folic acid to flour which closed on 9 September 2019.

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

My Lords, I am pleased that substantial progress has been made on this work since I spoke to the House in June, including positive dialogue with all devolved Administrations. It is right that we remain committed to proceeding on a UK-wide basis and I am grateful to colleagues in the devolved Administrations for their energy and support. I assure the House that we are progressing this as a priority, and I look forward to updating the House after the Recess.

[Lord Rooker (Lab) [V]]

Can I assume that the Minister is aware of the statement from the Ministry for Primary Industries in New Zealand on 8 July, five days ago, that as a result of its consultation on folic fortification in 2019 it will fortify all non-organic wheat flour from mid-2023 and therefore join Australia and more than 80 other countries in mandatory fortification? Why are we so far behind New Zealand? The women of New Zealand had the vote 30 years before British women. Can I be assured that British women will not have to wait as long to have safer, healthier pregnancies and fewer babies with a lifelong disability?

[Lord Bethell (Con)]

My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.

Medical Devices (Coronavirus Test Device Approvals) (Amendment) Regulations 2021

Lord Rooker Excerpts

Monday 12th July 2021 Grand Committee

[Lord Rooker (Lab) [V]]

My Lords, I do not wish to be at all critical of the figures that the Minister gave in his first few sentences regarding our capacity and what we have been able to do in our laboratories. I suspect, by the way, that he has a new speechwriter, as his speech was slightly different from what I have heard from him before. The reality is that I put my name down for this debate for one simple reason: last week’s reports that the Government intend to charge for devices that are currently free on the NHS. These regulations are about tests for sale.

The eighth report from our Secondary Legislation Scrutiny Committee is a masterclass in drafting. It clearly states that the market is “overwhelmingly dominated” by free NHS tests. Paragraph 3 states that

“the Government want to support a ‘thriving private sector market for COVID-19 detection tests’”.

Paragraph 4 says that these regulations are

“for a time when privately bought tests play a more significant role”.

Well, they certainly will be when the Government start charging for NHS tests. It is a £3 billion market, after all—at least I think so, from the figures I have seen.

In April, when the tests were first brought out, we were told that handing them out—and, indeed, encouraging people to take them—was vital to getting the country back to normal. The Secondary Legislation Scrutiny Committee has been very critical of the failure to supply documentation when the regulations were laid. In at least two paragraphs of its report, the committee makes it clear that free NHS tests must continue.

It is clear that the Government want to charge for the tests. I understand that the promise—and I have made checks—was made to supply them free only until the end of next month, August. There has been no commitment to go beyond that, hence the rush to get these regulations through. Quite clearly, that is what it is all about. It is being pushed through at this last minute, a few days before the Recess, so that the Government can abandon free tests at the end of August. I realise that the Minister has come briefed on the regulations and I am asking about something extra, but let us face it: it was predictable that this would be raised. He has not taken any opportunity to say anything about the maintenance of free tests. I think that is sad because he is going to be asked that repeatedly until the Government are clear about their intentions.

My final point is a question: why do we need to buy the NHS Test and Trace kits for the lateral flow test, the one being given out by local chemists, from one of the Chinese Communist Party-approved companies? How do we know they are not made with slave labour? What kickbacks go to that corrupt political party? What efforts are being made to get them made in the UK—dare I say Europe—or, indeed, Commonwealth countries? We now have the capacity to check the tests in laboratories. Why have we not done something about manufacturing capacity? Why are we reliant—we appear to be reliant—on the fix of the Chinese industrial structure, which is controlled by the Communist Party or it cannot operate? In winding up, the Minister has the chance to be clear. I do not expect him to answer everything, but it would be useful if he would say that the Government intend to pursue free NHS tests for a period beyond the end of August. After all, that is in Recess. We will not have time to query that, as we are not back until 6 September, so that decision would be taken outwith Parliament sitting, and I do not think that would be right.

Covid-19 Update

Lord Rooker Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have a prioritisation list for the booster and the third jab. It is my understanding that octogenarians are in category 1, but I am happy to write to my noble friend to confirm that point, in case I have got that wrong. I share my noble friend’s aspiration on care home workers. We are in a consultation; I cannot make the guarantee that he asks for because it is an honest consultation. We have to take people with us: this is not something that we can impose on people against their will. When the consultation has passed, I am hopeful that we will be able to take the steps that he describes.

[Lord Rooker (Lab) [V]]

I congratulate the Minister on his track record of appearances in the House. I will raise two brief subjects with him, both of which have been raised today, neither of which he has addressed. First, are there plans to charge for the lateral flow test? It is now being delivered to people less than 24 hours after they request it, and requests will certainly go down if there is a charge. A clear answer on that would be useful. The second issue is shielding. When the Prime Minister makes a Statement on Monday, in advance of 19 July, it is crucial that something is said about people who were shielding before; they must not be left in limbo and ignored. They could at least be given a warning that they will be given, say, a week or 10 or 14 days before they need to shield, which would remove part of the worry from the large changes due to take place on 19 July. I ask the Minister to respond on lateral flow test charging and shielding, please.

[Lord Bethell (Con)]

My Lords, on lateral flow tests, I said that I did not recognise the press reports that the noble Baroness mentioned, and I still do not. On shielding, I completely agree with noble Lord. Some 1.5 million patients are identified as CEV-equivalent through the new QCovid model, and they have been added to the shielding patient list, with 820,000 who had not previously been invited as part of the JCVI cohorts 1 to 4 given priority access to vaccines. Overall, 3.8 million—I think I said 3.5 million earlier—individuals are on the shielded patient list, and we continue to maintain that through the NHS. We will look at the QCovid model and see if we can apply mix-and-match vaccines, booster shots and third shots to that model, and if we can bring together a new risk assessment for those who are vulnerable. That list could therefore be applied to any future shielding or protection that may be needed.