Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Debate between Lord Sentamu and Baroness Merron

Thursday 17th March 2022 Lords Chamber

[Lord Sentamu (CB)]

My Lords, as I said in this House on Monday, I had to stay at home for seven days because I had a very bad chest cough, a bad cold and a lot of catarrh. I tested myself and the test was negative. Those bad symptoms continued for nearly six days and I tested myself every other day. It was very clear that I had a sudden form of flu, but its effects on me were quite strong. I was encouraged because I was able to test myself and the lateral flow tests revealed that I did not have Covid but had an awful cold and flu.

The programme that the Government embarked on in testing and tracking was world class. When we are still in the middle of this very cold weather, why withdraw free testing in April? It is the only assurance we have. I hope the Government will think again about that possibility, although the regulations have gone. To take responsibility for yourself, you need to know whether you have Covid, otherwise you will go out and infect other people, which you should not do.

The messaging still needs to go out. I was quite shocked when “Look North” said that people in our area who are testing positive and sometimes ending up in hospital had stopped washing their hands. That is a shock. It may be said that we have all grown up and know how to wash our hands regularly, but I am afraid that in some places that has gone, so the messaging should still be going out that for the protection of other people we must take responsibility and wear a face covering, not because it is regulated but to be considerate towards others. Sometimes you should keep your distance when you hear people coughing. You are keeping your distance to try to protect people.

When these regulations have all gone and such things are no longer mandatory, will the Government please continue to inform people that there are some places where you still need to keep your distance, some places where you must continue to wash your hands and some places where wearing a face covering is the responsible thing to do? Although it is not going to be policed, we need to create that culture. It happened during lockdown. I used to be shocked when I went to a toilet and people who had not washed their hands came out. We are now going back to our bad habits. Although the regulations have gone, could the messaging still go out to persuade people that the steps we took during lockdown and before these regulations are still worth doing?

[Baroness Merron (Lab)]

My Lords, we, too, do not want to see restrictions in place for a day longer than necessary but, as noble Lords have said, lifting the legal requirement to self-isolate needs to be backed up with a plan and an understanding. While it is one thing to acknowledge that free tests cannot go on for ever, while the number of infections remains so high, it is surely sensible to monitor the situation and guard against any new and potentially more severe variants. Not to do that risks being somewhat blindsided by future mutations of the virus. We know that testing is one of the key ways that the return of the restrictions can be avoided. It makes long-term sense to make tests widely available while the threat of a new wave remains.

Questions remain about the implications of the revocation for people’s lives. For example, if you need to care for a clinically vulnerable relative, will you be left out of pocket for that test? After all, should we not be encouraging people to make sensible decisions rather than making it harder for them to do so? I remain unclear about whether unpaid family carers, in particular, will retain access to free testing to allow them to look after their loved ones safely. Perhaps the Minister will comment on this point in addition to confirming that free tests will remain for NHS staff. We cannot have vulnerable patients going into hospital and being treated by NHS staff who have been unable to get tests.

I agree with my noble friend Lord Hutton that this does not feel like the right time to be having this debate, but we are in the situation we are in. In acknowledging that, I echo the points made by the noble Baroness, Lady Brinton, about those who are clinically extremely vulnerable and immunosuppressed. We should have regard to how they are feeling as well as giving them continued practical support. I am sure the Minister will respond to the questions asked by the noble Baroness, Lady Brinton.

I have a question about plans and support for those who live with long Covid. We should not forget that it continues to be a blight on the lives of a number of people. In this regard, it would be helpful if the Minister will tell us about any discussions that have been held with the Secretary of State for Work and Pensions about working with employers to protect clinically vulnerable employees and to assist, through support and guidance, employers of people still suffering from long Covid.

More than 1.3 million vulnerable people are eligible for Covid-19 treatments, such as antivirals. Can the Minister indicate whether they will be eligible for free tests? What about their families, friends and close contacts? Will there be a limit on how many tests eligible people can receive? It would be helpful to have clarification from the Minister to give people the reassurance they need.

The potential confusion in public health messaging has been referred to. On the one hand, there is guidance telling people to self-isolate if positive, yet on the other there are still pressures—financial from employers, or from elsewhere—that force people to go to work. This suggest that the message that people will take is that Covid-19 is no longer a threat, but we know that the pandemic is not yet over. The British Medical Association has argued that asking individuals to take greater responsibility for their actions while taking away free testing is likely to cause more uncertainty and anxiety.

Finally, I shall raise the matter of sick pay with the Minister. What is the reasoning behind the Government’s decision to scale it back? Those who are sick with coronavirus will now have to wait until the fourth day of their sickness before claiming statutory sick pay. We are highly concerned that when people cannot afford to stay at home they will be forced to bring their infection into work. To put this into some perspective, after April some 7 million workers will have to survive on just £38 per week if they find themselves suffering from Covid. Covid is not going anywhere, and it is right that we learn to live with it, but proper provision needs to be in place to help people make the right choices in what is, I hope, a late stage of this pandemic. I hope the Minister will be able to give assurances to your Lordships’ House today.

Health and Care Bill

Debate between Lord Sentamu and Baroness Merron

Committee stage
Friday 4th February 2022 Lords Chamber

[Lord Sentamu (CB)]

My Lords, I support this amendment. I will tell a true story of a teetotal preacher who harangued his congregation that nobody should be drinking because it is dangerous, damages our health and damages everything else. “Alcohol should be banned,” he said, “and the best thing to do is go and drown it in the river.” Unwittingly, he then said, “Our final hymn is ‘Shall We Gather at the River?’ The beautiful, the beautiful river.” He did not see the contradiction in what he said. This amendment is full of clarity, clarifying areas that need to be put fairly clearly. The obligation that it puts on the Secretary of State and, incidentally, all of us is very clear. Because of the real danger in what overdrinking does to a lot of people, I say: no, we shall not gather at that river, that beautiful, beautiful river.

[Baroness Merron (Lab)]

My Lords, it is a pleasure to follow the noble and right reverend Lord, who reminds us of our obligations to assist with alcohol-related ill health. I thank the noble Baroness, Lady Finlay, and the noble Lord, Lord Shipley, for putting these amendments before your Lordships’ House today. The first is a probing amendment about the need to report on the consultation on alcohol labelling. It is absolutely right to raise this: consumers have a right to know what is in their drinks, to make informed choices about what and how much they drink. Currently there are no legal requirements for alcohol products to include health warnings, drinking guidelines, calorie information or even ingredients. Research by the Alcohol Health Alliance found that over 70% of products did not include the low-risk drinking guidelines, and only 7% displayed full nutritional information including calories. I certainly add my voice to welcoming the forthcoming consultation on alcohol calorie labelling. When can we expect to see this, and what is the reason for the amount of time that it has taken to bring it forward?

Amendment 296 requires the Secretary of State to make a five-yearly statement on the cost efficacy of alcohol services. As we know, rigorous impact evaluation is absolutely key to good policy-making and improving the lives of those who use alcohol services. At present, the Government cannot say that they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right places. Perhaps the Minister will tell your Lordships’ House what evaluation measures are already in place.

Of course, the background to all this is that, since 2012, there have been real-terms funding cuts to alcohol services of over £100 million. Pre pandemic, only one in five dependent drinkers was believed to be in treatment, leaving a shocking four out of five without help. The pandemic has only worsened the situation. I hope that the Minister will agree that there is a need to do better to ensure that we know how policies and services help or hinder the treatment of problem drinking, in order that efforts and resources can be targeted to where they work best.

[Earl Howe (Con)]

My Lords, I pay tribute to the noble Baroness, Lady Finlay, for her work as chair of the Commission on Alcohol Harm. I thank her for this opportunity to set out the current state of play on the Government’s alcohol policy. I am the first to acknowledge the seriousness of the harms caused by the consumption of alcohol, which she pointed out.

Effective alcohol labelling is an important part of the Government’s overall work on reducing alcohol harm. I am pleased to tell the noble Baroness that the legal powers available to the Government are already sufficient to enable us to consult and report on alcohol labelling. The kind of power proposed in her probing amendment is highly prescriptive, and, from a purely practical point of view, would not allow for sufficient flexibility in the consultation process, which could make the process less effective.

As she knows, as part of the Government’s Tackling Obesity strategy, published in July 2020, the Government committed to consult on whether mandatory calorie labelling should be introduced on all pre-packed alcohol as well as alcoholic drinks sold in the out-of-home sector. I repeat that commitment today, and, as part of our public consultation, we will also seek views on whether provision of the UK Chief Medical Officers’ Low Risk Drinking Guidelines, which includes a warning on drinking during pregnancy, should be mandatory or continue on a voluntary basis. The noble Baroness, Lady Merron, asked when we might expect that consultation to be forthcoming. I am afraid I can say no more than “in due course” at this stage, which I realise is not wholly enlightening, but it is as far as I can go at the moment.

Turning to Amendment 296, which proposes additional reporting and government statements, we do not think a new reporting requirement is necessary. The Office for Health Improvement and Disparities already publishes annual data on estimated numbers of alcohol-dependent adults within local authorities in England. Health commissioners can use this data to estimate local need and appropriately plan their alcohol treatment services. Outcomes for local authority-funded alcohol treatment services are already published at local and national level via the national drug treatment monitoring system. The Office for Health Improvement and Disparities also provides a number of data tools to enable local areas to compare their performance against other areas and nationally, including the public health outcomes framework, local alcohol profiles for England and the spend and outcomes tool.

On funding, local authorities are currently required to report on their spend on alcohol services annually to the Department for Levelling Up, Housing and Communities. Through the “why invest?” online guidance, the Office for Health Improvement and Disparities already produces data and information on the return on investment for alcohol and drug treatment. The guidance includes cost savings data on treatment interventions in primary and secondary care and on specialist and young people’s treatment services. There is a strong programme under way to address alcohol-related health harms and their impact on life chances, and to reduce the associated inequalities which the noble Baroness emphasised, including an ambitious programme to establish specialist alcohol care teams in hospitals and to support children of alcohol-dependent parents.

Throughout the Covid-19 outbreak, drug and alcohol treatment providers continued to support and treat people misusing drugs and alcohol. OHID supports local authorities in this work by providing advice, guidance and data. OHID is developing comprehensive UK guidelines for the clinical management of harmful drinking and alcohol dependence. These aim to develop a clear consensus on good practice and to improve the quality of service provision. The work is expected to be completed later this year.

Finally, we are currently developing a new commissioning standard for drug and alcohol treatment which aims to increase the transparency and accountability of local authorities on how funding is spent. It will include requirements to commission services—