Public Health

Alex Norris Excerpts

Wednesday 30th December 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I hope you had a good Christmas, Madam Deputy Speaker, and I wish you and all colleagues a happy new year. I take this moment to express our gratitude for the work of you and the staff to ensure that we could sit today. I also associate myself with the Minister’s comments regarding this country’s outstanding health and social care workforce, who have made Herculean efforts over Christmas and new year. They are greatly appreciated.

There is something very 2020 about discussing covid regulations three hours after a subsequent set of regulations were introduced, but it is nevertheless important that we do so. I will cover each of them, perhaps making some cross-cutting points as I do so.

With regard to SI No. 1611, we discuss these regulations today because we are obliged to do so following their introduction on 20 December. However, we are compelled to do so because the failures of the restrictions announced on 2 December. At some point in the next few parliamentary days, we will debate the restrictions announced from the Dispatch Box earlier, and we are compelled to do that because of the failure of restrictions that we talk about today. This episode is a perfect encapsulation of the failings of the Government’s handling of the pandemic: slow and always falling short.

The Government have now had three goes at a tier system. The first two have failed, and today’s announcement marks the final attempt to salvage a third go. We must hear from the Minister today a clear commitment that, based on the best scientific guidance available, the Government firmly believe that these restrictions will halt the rise in the infection rate and, indeed, start to reduce it. We must have that commitment today, because otherwise we will be back here time and again. When the Minister hopefully makes that commitment, there ought also to be a commitment to publish the guidance that the judgments are based on, so that we might begin to repair damaged trust.

The stakes are high. We cannot afford failure. Our national health service is experiencing dire pressures. A major incident was declared in Essex this afternoon. Elsewhere, exasperated doctors are taking to social media to report that oxygen is running out. An internal incident has been declared at the Queen Elizabeth Hospital in Woolwich. London hospitals are asking their counterparts in Yorkshire for support. Rates of sickness in our care facilities are increasing. Right hon. and hon. Members had a call this afternoon with Stephen Powis from NHS England, and it was clear not only that the pressures are significant, but that we can expect multiple weeks of growing demand. If the Government dither and delay again today, the price will be significant indeed.

We are considering a bundle of five different regulations. I do not intend to labour too much on SI No. 1533 or SI No. 1572, as they exclusively deal with moving specific geographies into specific tiers and are now significantly out of date, as was elegantly demonstrated by the hon. Member for Christchurch (Sir Christopher Chope).

SI No. 1611 creates tier 4, something that nearly 80% of us will now need to get used to. I shall cover that shortly, but it also deals with Christmas. Although that is of course now in the past, it is worth reflecting on briefly. The change was announced on 19 December, turning the nation’s plans upside down at a stroke. Of course, some allowance must be made for the changing nature of the virus; I accept that. We are in very fast moving times. However, it was clear many days before the announcements were made that the initial Christmas plans would not be sustainable. That was regrettable, but it was clear. On 16 December, the Leader of the Opposition asked the Prime Minister from this Dispatch Box to look at it again, and the Prime Minister replied characteristically with bluster and bluff. Later that day, he said that it would be an “inhuman” thing to do, but of course he had to. He delayed, he dithered and, eventually, he had to do it anyway. Again, these things matter because they chip away at public confidence bit by bit to create a sense that the Government do not really have a handle on the crisis.

We will all have been cheered—the Minister majored on this in her speech—to wake up this morning to the news of the approval by the Medicines and Healthcare Products Regulatory Agency of the Oxford-AstraZeneca vaccine. This is an extraordinary scientific success and a vindication of the Government’s backing of multiple vaccine candidates. We should be exceptionally proud of Britain’s role in this vaccine and others. It is a great success story for our country and our place in the world after such a significant day today.

The Health Secretary said today that the vaccine is the way out of the pandemic, so for us today the vaccine must be the way to end the regulations. That is nearly right, because actually it is a vaccination programme that is the way out of this. Of course, a vaccine is the most vital component of such a programme, but now that we have that it ceases to be so much a question of science and becomes a much more rudimentary and basic exercise in logistics.

The Government have faced two such major logistics challenges in this pandemic. The first was the effective and urgent procurement and distribution of personal protective equipment and the second was the roll-out of the test, trace and isolate system. Both have been significant failures. The PPE roll-out was a farce for at least the first two months, and the test and trace system has not delivered, even on the Government’s own metrics, since its introduction. At the root of both these failures has been the same slowness that has characterised the Government’s response to the pandemic. They have been slow to respond and slow to grasp the scale of the challenge—this cannot happen again with the vaccine.

I have an awful lot more confidence in a programme that will be delivered by the NHS than in one delivered by one of the companies that the Government seem to default to even though they do not tend to deliver for them. There are still some questions, however. NHS staff are in category 2 of the initial prioritisation, but we are still hearing that there has not yet been a full roll-out. Can the Minister let us know when she anticipates that all of our NHS heroes will have had their jab? Of course, that is the least they deserve, but we have heard today from the British Medical Association that NHS staff absence is at 10%, so it is a pragmatic necessity that, as we deal with increasing demand, we have a resilient workforce to do that.

We saw a significant change of direction in the administration of the vaccine this morning. Previously, we were administering it in pairs about a month apart, and that was seen as the best way of delivering it effectively. Now, the Government have made the judgment that they will go to a first shot, with a second shot to come three months or so later. I assume that this reflects the best advice of the Joint Committee on Vaccination and Immunisation, and if so we will support it, but will the Minister publish that advice and, crucially, the roll-out plan?

We know now that we have enough vaccines for everyone who wishes to take the offer up. We know that we have a national health service and different ways of dispensing it through our GPs and our hospitals. We know all the components, but we now need to know the timetable. That is important so that it can be scrutinised and perhaps improved, but also so that we can build public confidence in this crucial plan. People are rightly looking at this with great hope, and it is right that they know that there is a proper process behind it. In the meantime, however, the way out of the tiers as constituted in SI Nos. 1611 and 1646 remains to reduce the five metrics on which the Government say the tiering decisions are based.

As a constituency MP, I have to say that this is a Kafkaesque process. Like you, I suspect, Madam Deputy Speaker, I have met Ministers, Government scientists and NHS leaders, both national and regional, and I still do not believe that there is a particular criterion for going up and down tiers. It is more that you kind of know it when you see it. To an extent, that is understandable. This is a complicated mix of infection rates, healthcare capacity and their associated trajectories and direction of travel, and then you kind of cook them all up altogether, so it is never going to be one number at one time at one moment. However, it is a significant issue for us as local leaders that we cannot build confidence in regulations by answering the basic question from constituents. I have had this multiple times, as will other hon. and right hon. colleagues. Constituents are saying, “I accept that we are in the tier that we are in, and it is important that we are. I wish that we were in a lower one, so that I could do more of the things that I enjoy doing. What do we need to do in order to achieve that?” Frankly, as a local leader, I cannot answer that question and I doubt that anybody, including the Minister, could answer that question either.

What we did not hear from the Health Secretary from the Dispatch Box earlier, and what we did not hear from the Care Minister in her contribution just now, is that the reality is that you are in your tiers now, especially in tier 4, until the vaccine is rolled out. However, we have heard from the Prime Minister on that, hints on that from Robert Peston and hints on that in a reply after the Downing Street briefing. If that is the case, it is time for the Government to be honest about it. The one thing that we know after the year that we have had is that the British people can take it. They can take that level of honesty. What they hate is when plans are changed at the last minute. What they hate is being told that, if they push down the infection rate in their community, they will be able to get back to doing the things that they love doing, and then finding out that it is no longer that but the percentage of positive tests. We have been through that in Nottingham; it is horrible and it is chipping away at confidence. It is time for a bit more honesty.

We support the introduction of these tiers. We withheld our support from the three-tier system. We did not believe that it would work and it did not. This goes further, so we are willing to support it, but two things need to be resolved with regulations that flow from today’s announcements, but also relate to the regulations we are discussing today. First, on the support for business, the £1,000 for wet pubs was an insult—£30 a day for the busiest time of year. Tiers 3 and 4 mean a shuttered hospitality sector. Viable businesses, jobs and livelihoods that are closed for very good reason must be better supported.

Similarly, tier 4 restrictions were introduced 10 days ago. We have worked throughout this pandemic on the principle that as restrictions increase, so does support for businesses, jobs and communities, but we have heard nothing since then. Where is the Chancellor? His slow and shorthanded response in his winter economic plan meant that, in the end, he had to have four different versions of it. Frankly, we might need another one because, otherwise, these restrictions will mean significant damage to our economy and to lives. This means action, finally, for those who have fallen between the various schemes on offer. We could dispute all day how many have been excluded, but we cannot deny their existence. I would give the Government significant latitude in understanding that, as you make up a furlough scheme and a self-employed scheme out of nowhere for the first time, there will be gaps between those schemes. It is entirely obvious that that will happen. However, what we must do is do something about it and close those gaps. It has been months and months, and now the Government really have to do it.

Secondly, a fundamental gap remains the test, trace and isolate system, which is fundamental to breaking the chains of transmission. The Prime Minister promised 100% of results within 24 hours nearly six months ago. At the moment, that figure is 19%. If we allow for next day, rather than 24 hours—because it is still the Christmas season—that figure rises to 37%, which is pathetic. On tracing, things have got better, with the greater improvement of local authority teams. However, the one way the Government have made significant inroads in their testing statistics is by defaulting to the canniest tactic in the book; they have changed the way this is counted. Generally, that is not a good sign about how things are going. Again, progress here has been pathetic.

Crucially, we come to isolation payments. All colleagues will have heard stories of constituents making that impossible choice between feeding their families and doing the right thing for the national effort. The £500 payment was too slow to come forward and does not adequately replace lost income. The scheme is still so full of holes and very much depends on how the system picks you up. Self-isolation should be automatic and we have failed communities by not creating conditions for it to be so. Ministers will want to blame the new strain for covid’s continued spread, but the reality is that they did not have control of the virus prior to this and they still do not have an adequate test and trace system to subdue and control it anyway. In the course of such a defective system, we have managed to spend £22 billion—dearie, dearie me.

Finally, on regulation No. 1518, we are happy to support the reduction of the self-isolation period from 14 to 10 days, assuming, again, that it is based on the best scientific evidence. Will the Minister commit to publishing this?

To conclude, we are at a crucial point in this pandemic. Today, with profound sadness, we hear of the passing of a further 981 of our fellow countrymen and women. The total directly who have lost their lives from covid alone is over 70,000 but, in reality, it will be many, many more. Those are big numbers but behind every one of them is a life, a person missed, a grieving family. Today, we have heard that the way out of this is in sight. However, we have also heard that things are poised to get much, much worse before they get better. In recognising this, the Government’s response is another system of tiers. These have failed every time so far. They must not fail now and we must hear from them why they believe they will work. We must also hear more clearly what they are going to do to deliver on other crucial aspects—on the vaccine and on test and trace. Failure to do otherwise will cause extraordinary harm.

--- Later in debate ---

[Alex Norris]

This has been an excellent debate. We have heard lots of different views and perspectives about how to wrestle with this knotty crisis—the great national question of the day—but I do not mistake the disagreement and points of difference for a lack of faith or a lack of love of community or country. All hon. Members and right hon. Members have attacked the question with a commitment to wanting the best for our country, even if sometimes we disagree on the conclusions.

That is particularly important today. Today has been a momentous day and the past 12 hours and five minutes of parliamentary business will be remembered—perhaps that is one for your book, Mr Deputy Speaker, and please be kind if I do anything to earn a place in there. Who knows how I could do that? There will be some for whom today is a day of great joy, and there will be some for whom today is a day of pain. Whatever people feel about what has happened here today, we have to come together. We have had four years—longer, really—of significant disagreement and division and what we have seen in the pandemic is that the UK is at its best when it is united and comes together. I hope that we will move forward from today in that spirit, and tackling the virus reminds us why we ought to do that.

Let me reflect on the contributions from colleagues. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) made the point about ensuring that NHS staff are vaccinated. As I said in my opening speech, that is important because it is the right thing to do and because of the sacrifices they make and the risks they run on our behalf, but also because of the need for a resilient workforce.

My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) made a very important point: when the right support is not in place, whether that is for the individual to self-isolate or for businesses to shut their doors in challenging times, it undermines people’s confidence and faith in the overall process. That is why the Government’s economic support package needs to move hand in hand with increased regulation to protect public health.

My hon. Friends the Members for Hackney South and Shoreditch (Meg Hillier) and for Birmingham, Selly Oak (Steve McCabe) both referenced an important theme about honesty. I will reiterate what I said to the Minister—the British people are ready for candour. If we are in tier 4 from now until the vaccine, now is definitely the time to tell us.

I am not going to itemise all the Government Back-Bench colleagues who spoke—there were too many. We really ought to do something about that at the next election; at least I can commit to that. I particularly want to mention the speech made by the right hon. Member for South West Wiltshire (Dr Murrison), because he referred directly to my speech and suggested that when I talked about SI No. 1646 I was a bit churlish. I do not think I was; I was a bit saddened by that. I shadowed the right hon. Gentleman when he was a Minister for international development and I was never churlish then, and I was not churlish now. My point about SI No. 1646 was that we were concerned—and said so at the time—that the three-tier restrictions would not go far enough, but in that SI in particular it is not clear how to get out of a tier. I have not heard anything in the subsequent speeches, and I doubt we will hear anything from the Minister, that gives a clear set of criteria even around the five metrics for exiting tiers. That remains a significant problem for public confidence in the process.

I wanted to pull out two quick themes from Government Back-Bench contributions. The first is about tiers. In the contributions from the right hon. Member for New Forest West (Sir Desmond Swayne) and the hon. Members for Bolton West (Chris Green), for Thirsk and Malton (Kevin Hollinrake) and for Buckingham (Greg Smith), they all put admirable scrutiny and pressure on their Minister, as I have heard them do before, and I know that she will be keen to respond. I would be keen to enlist that support for matters beyond tiers. Tiers are a symptom, not a cause, of the challenges of the restrictions of liberty we are making today. Tiers are put in place when we lose control of the virus. Some of that can be accounted for by the mutant strain, which is 56% more potent, but the issues existed before then. We needed tiers before that, and tiers that constantly increased in strength, because we do not have the fundamentals right, particularly on test and trace. I implore those Members to apply that level of scrutiny and pressure on their Ministers on that, too, because it would make a real difference.

The second theme was vaccines. Many colleagues, including the right hon. Member for Forest of Dean (Mr Harper) and the hon. Members for Mid Derbyshire (Mrs Latham), for Runnymede and Weybridge (Dr Spencer), for Dudley South (Mike Wood), for Aylesbury (Rob Butler), for South Cambridgeshire (Anthony Browne) and for Newcastle-under-Lyme (Aaron Bell)—everyone, in fact, but particularly those Members—expressed joy about the plan. The right hon. Member for Forest of Dean made a particularly detailed and powerful case for the levels he felt that the Government should be aspiring to. I hope the Minister will engage with that directly and say whether it is realistic. If it is not, can she say why not and what a more realistic level is?

I want to reiterate the point on schools that was made by a number of colleagues. Not that Members would ever look at social media during a colleague’s contribution, but if they did, they will have seen that there is significant anxiety as a result of the announcement by the Secretary of State for Education this afternoon. It just will not do to say that some schools will be open and that some schools will not be open and then not to publish the list, and then when the list is eventually published, it is incomplete. This has caused a significant amount of anxiety. We must not forget that we are—what—five days away from those schools opening. Parents need to know. Schools need to know. It really will not do and I hope the Minister might be able to give some clarity on that and, if not, a sense of when the Government will return to finish off that job.

I just want to finish by reiterating three key questions to the Minister. I know that she will have an awful lot to cover, so I wanted to make sure that I left her the lion’s share of the winding-up time—whether she will thank me for that I do not know. First, we do need to hear the Government say with both clarity and commitment that, based on the best scientific evidence available, they believe that the tier system is sufficient to control the spread of the virus. This is their third go at a tier system. The first two failed and we are here today because the third one is not working either. We need to hear that explicitly, because otherwise we will have to take more significant action later. We might as well be honest about that now.

Secondly, when will we see the roll-out plan for the vaccine so that we can help to build confidence and perhaps to improve it through parliamentary scrutiny? The plan should include NHS staff as a priority, but, in general, it needs to ensure that we get through the entire population. It is a wonderful and joyous moment to know that we will have access to enough vaccines for everyone who wants one. It is a wonderful moment. Now our responsibility is to demonstrate that we can get them out for people in the quickest and safest possible manner.

Finally, there should be no extra health regulations without extra support for business. Where is that support package? When will we see it? When asked that question earlier—I think by a Back-Bench colleague of mine—the Secretary of State for Health said, “Well, I’m not a Treasury Minister, I am a Health Minister.” Nobody thinks that that is how it works here. We cannot afford for it to work in that way. The two need to move in lockstep, so can we have clarity about when we will see that support package? I will sit down now, Mr Deputy Speaker. It has been a very good debate, but I hope that the Minister can now give clarity on the points that I have raised.