Public Health Debate

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Department: Cabinet Office
Tuesday 1st December 2020

(3 years, 4 months ago)

Commons Chamber
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Adam Afriyie Portrait Adam Afriyie (Windsor) (Con)
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I commend the Government, because I know that the motivations behind the measures they are trying to adopt are worthy. They believe that these measures represent the best way forward and I respect that point of view. They have done a great job on PPE, the acceleration of vaccine development and the rolling out of mass testing, as my right hon. Friend the Member for Tunbridge Wells (Greg Clark) just observed.

I thank the Prime Minister, his office and the Government for interacting with Back Benchers in an open and co-operative way. It is our duty as Members of Parliament to make informed decisions on behalf of our constituents and our country—to be able to say that we have chosen the best measures to save lives and jobs and to make sure that we have tax revenue for the future. It seems to me that this is not a zero-sum game: there is not just one option—the Government’s option—or no option at all. That is certainly not the case; there are all sorts of alternatives.

We could take a targeted approach, as in Germany; a borough-based approach, as my right hon. Friend the Member for Tunbridge Wells just mentioned; or even a targeted approach based on the individual premises where there may be an outbreak. We could decide to use a strategy in which we trust people more, offering more guidance and allowing people to make up their own minds about what they are going to do. We need to look at the evidence around that kind of approach.

We could continue to conduct intensive research into whether or not hospitality does spread the virus, along with all sorts of other areas. We could look at triage at hospitals to see whether the bar should be lowered slightly or raised slightly depending on the demand for hospital beds. We could also accelerate and refine test and trace. There are plenty of alternatives.

It seems to me that we have to focus on the harms versus the benefits. Whenever any one of us makes a decision in our own daily lives—about an investment or buying a house, for example—we think about the long-lasting consequences: the costs and the benefits. When it comes to personal healthcare, we go to see a consultant, who makes it clear that there are alternative treatments and sets out the relative benefits and harms of those various treatments. When it comes to business, if one is going to make an investment, one will always do a cost-benefit analysis in the long-term. In this place, we virtually always see an economic analysis, an impact assessment or an analysis based on quality-of-life indicators.

When it comes to this decision, however, we do not have a cost-benefit analysis, we do not have an economic impact assessment, and we do not have a health and harms analysis based on QOLIs, so it is with deep regret that I find it incredibly hard to back the Government today. However, I hope that in the future we will see proper health and economic impact assessments for proposed actions, as we will have a lot more actions to consider around vaccines and testing. It is our duty to make an informed choice, but I do not feel that we are in a position to make that choice. The Government will probably have their way today, but I hope that in a few weeks’ time we will assess this more carefully and perhaps make a different judgment.

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Adam Afriyie Portrait Adam Afriyie
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Apologies for the interruption, but I saw the so-called impact assessment and I have to say that it would not pass through the boardroom of a small business. It really was not up to it. Does my hon. Friend share that view?

Steve Baker Portrait Mr Baker
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I do agree with my hon. Friend, who is well qualified to say that.

The hospital capacity projection from the SPI-M-O medium-term modelling, which was leaked, says that it “takes three weeks for non-pharmaceutical interventions to have any impact on hospital admissions, therefore the window to act is now”—in bold and underlined. The trouble is that drawing a vertical line on it through 21 days after 5 November, we find that three hospital trusts should have been exceeding surge capacity, including the Nightingales, and it just did not happen.

We now need to start having a serious look at modelling. I provided a paper to the Government on how to reform modelling. We also need to have a serious look at how we deal with expert advice in this complex, contested field. I have provided a paper to the Government on how to do that. I believe that we need a new public health Act that can allow us better to balance the need—the absolute need—to infringe people’s civil liberties with people’s fears that they are being infringed too much, again to show proportionality.

Again, I have reached out to a judicial expert in the field, and he provided us with a one-pager, which I have given to the Government, on what should be done. I have also, by working with independent scientists, come up with that more liberal plan that stands between where the Government are and moving in the direction towards a freer system. Again, that has been provided to the Government. No one can say that I or anyone working with me have not done our duty, but here we stand in a profoundly dangerous moment, heading into infringements on our liberties and on vaccination and testing that we would never normally tolerate. Therefore, I find, with huge reluctance, that I am going to have to vote no tonight, to send a message to the Government.