Coronavirus Bill

Lord Tyrie Excerpts

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Wednesday 25th March 2020 Lords Chamber

[Lord Tyrie (Non-Afl)]

I agree with everything I have just heard in support of these amendments. I hope your Lordships will allow me to say some of the things I would have said yesterday had I not been giving evidence to a Select Committee during the opening hour or two of the debate.

The UK is in lockdown. Of course, the pressure on the Government to act has been immense, but we are in very uncharted waters and tight sunset clauses are clearly appropriate. People are understandably fearful for their lives and their well-being, and the Government are right in response to that to try to flatten the peak to enable the NHS to cope and to address the fear that has grown in the wider public. The question now is not whether the lockdown was the right decision but for how long it can sustained. These amendments bear directly on that question.

I have two proposals that I think the Government might want to consider. They have a bearing on whether the sunset clauses might find themselves exercisable. We need to be clear why we have arrived in this position. The epidemiological evidence on which the lockdown decision was taken was very well summarised in the Imperial College paper, which shows that it is needed to prevent an 80% infection rate and between 250,000 and 500,000 impending deaths. What the paper does not contain is an analysis based on wider health outcomes or on wider economic and ethical considerations, as it readily acknowledges. In other words, the full health economics of this huge decision have not been developed or set out at all by the Government.

If, as is widely held, maintaining such a policy indefinitely is unsustainable socially and economically, it must follow, in the absence of an early vaccine or treatment, that an alternative policy will have to be put together very quickly. In order to establish that sustainable policy, we first need a wider analysis of the effects of the lockdown than we currently have in front of us on the basis of health economics, and in particular of the effect on morbidity and mortality that will come as a consequence of the disruption to economic life. Extensive research on earlier sharp interventions suggests that these effects could be very large, and this may be true for both the full and the partial lockdowns discussed in the Imperial paper.

A second piece of analysis that needs to be undertaken—

[Lord Falconer of Thoroton]

I very much apologise for interrupting the noble Lord, who is making an incredibly valuable speech, but after my amendment there is one more amendment, which was put down by the noble Baroness, Lady Ludford. We must get to it and debate it by 2.30 pm, which is jolly unfair, in a way. Can we get to that amendment and then perhaps have the Second Reading speech?

[Lord Tyrie]

I gladly agree to what has been proposed from the Labour Front Bench.

[Viscount Hanworth (Lab)]

My Lords, my colleague and noble and learned friend Lord Falconer has provided a cue that enables me to talk briefly about Schedule 8 to the Bill, which would allow a patient to be detained in hospital—or sectioned, as the phrase is—under the provisions of the Mental Health Act, on the say-so of a single doctor. The Bill would also provide for a period of extension to be extended, if I understand correctly, by the decision of a single person.

To put these matters in context, we might look back to the late Victorian era, when a problematic member of a family could be incarcerated in an asylum at the insistence of that family. They could be left there for a lifetime, and forgotten by the family, who could thereby avoid the stigma of having mental illness in their midst.

That stigma has been alleviated, but it still exists. The sufferer of mental ill-health may be a fragile young person, whose aberrant behaviour has been in response to some dysfunctional family dynamics. To avoid the hazard of inappropriately sectioning a patient in such circumstances, it is now understood that a careful assessment is required, which must involve more than one expert and judgment. This is not a fail-safe procedure, and I have been told of its failure in some tragic circumstances. Sectioning a person under the Mental Health Act can injure a person for a lifetime. Therefore, I wish to sound a note of caution, if not alarm, at the provisions in Schedule 8 to the Bill.

This is one of only many hazards present in the Bill, and I wish to make a more general comment about such legislation. Some speakers in yesterday’s debate expressed astonishment and admiration at the speed with which the Bill has been assembled to meet an unexpected crisis. However, it must surely have been sitting on the shelf for a considerable length of time. It is the product of the kind of contingency planning that we can expect of any competent system of public administration. There is no lesser need for contingency planning to cope with the public health crisis than there is for detailed military planning. However, whereas military planning is bound to remain largely secret, there is no need for such secrecy in the plans to address a public health crisis. The contingency planning that underlines this Bill ought to be permanently in the public domain, and its clauses ought to have been considered in detail, in the absence of any need to invoke them.

[Baroness Bennett of Manor Castle]

My Lords, the Green group supports all the amendments in this group. I have two brief points to make.

Collectively, these amendments make this whole profoundly undemocratic, rushed but essential process that we have undertaken a little more democratic. Statistics show that in epidemics, death rates are lower in democracies than they are in autocracies. Those figures have been worked out over a range of epidemics. Democracy is an effective medicine. Your Lordships’ House has heard me comment often on what I see as the weaknesses of our democracy, both here and in the other place, but this is the best thing we have got. Let us not handicap it further: let us adopt these amendments and acknowledge that they bring the opportunity for more scrutiny and better decision-making through the involvement of more people.

I want to address particularly Amendment 7, about three-month reviews, and the timeframe for this. It was actually about three months ago, it is believed, that the coronavirus crossed the species barrier. This whole thing biologically started three months ago, somewhere in China—probably Wuhan. Two months ago, diplomats were just being flown out of Wuhan. Think about how fast things have moved. Just last night, we had a report from Oxford University—an epidemiological study that basically blew through and potentially redrew our entire understanding of what is happening right now.

Where we will be in three months’ time is utterly unknowable and may be massively different from where we are today. We need a proper, full debate in three months’ time. With regard to the other amendment and the ability of the other place to amend this legislation, we need a debate there so that it can put in and take out parts of it if they are not working. We cannot leave this for six months. That is more than double the time this entire situation has existed from its first biological moment. Six months is too long.

[Lord Tyrie]

I agree with those remarks too. Is it your Lordships’ will that I make my second point, or have people heard enough from me? I will do my best to be as brief as I can.

I said that there was one crucial piece of work to be done on wider health economics. A second piece of work that needs to be undertaken derives directly from the Imperial paper; we know that this is a very dangerous disease for the elderly but that it appears to have a very low casualty rate among young people without underlying respiratory conditions. There is no immediate prospect of effective treatment—reinforcing by implication the unsustainability of the lockdown—and no early prospect of a vaccine. It seems to me that it must be worth considering any means we can to get towards more normal economic life, and therefore not needing these amendments, by permitting young people, who are sharply less vulnerable to severe outcomes, to return to their workplaces.

Those who did this—it would have to be on a voluntary basis—would need to accept that a very high proportion of them might become infected and therefore have herd immunity develop among them. In an indefinite lockdown, massive direct financial support for the elderly would need to be maintained.

Understandably, the Government have not had time to assemble or publish elementary data for such an approach, but I do not think it would be appropriate to maintain this legislation without these sunset clauses or demonstrating an attempt to develop such approaches. The weakness of the data, in any case, is not an argument against developing such policies, any more than it is an argument against the suppression policy. Much of the data on which the current policy is based is very uncertain.

[Lord Parkinson of Whitley Bay]

If the noble Lord has made his second point, might he draw his remarks to a conclusion?