Public Health

Andrew Murrison Excerpts

Tuesday 30th November 2021 Commons Chamber

[Maggie Throup]

Today, we are debating some travel restrictions about self-isolation, but the other restrictions are covered by different legislation and therefore they are not relevant to this debate.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The Minister mentioned hand hygiene. Is she aware of a study published in The BMJ on 20 November that showed that hand hygiene was as effective as mask wearing? Does she agree that anything we do here needs to be firmly evidence-based? Can she say why we have focused on mask wearing in the regulations and not, for example, if our aim is to improve public health, mandating for alcohol gels in hospitality venues?

[Maggie Throup]

My right hon. Friend, with his medical background, makes a good point that I will take away and look into further.

I will return to my speech. Accordingly, our scientists are investigating omicron to determine, among other things, how quickly it is likely to spread and what the impact may be on the immunity that many of us have acquired through vaccination.

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[Daisy Cooper]

rose—

[Dr Murrison]

rose—

[Maggie Throup]

I give way to the hon. Lady, who has been trying to intervene.

[Maggie Throup]

As I said earlier, we are mandating the use of face coverings. I think we are in a different situation now with regards to that.

[Dr Murrison]

Will the Minister give way?

[Maggie Throup]

I will allow one more intervention and then I will move on.

[Dr Murrison]

The Minister is really being most generous and I thank her very much indeed. Our right hon. Friend the Member for Forest of Dean (Mr Harper) is absolutely right and I fear that, inadvertently, she has not given the fullest answer that she might have done to this. The fact is that motion 3 on the Order Paper expires on 20 December, yet motion 4 expires on 24 March 2022. Can she explain the logicality of that? I also observe that, given the extraordinary restriction on liberty that this potentially offers, most Members of this House would be more than delighted to return after the House rises for the Christmas recess in order to reaffirm our support for the measures that she has put before the House today.

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[Alex Norris]

The hon. Member goes slightly further than I did in saying that ventilation should be rolled out immediately across all schools. Of course, that would have significant financial implications. It would also, of course, be very good for British business. We are saying that, as has been clear throughout the pandemic, better ventilation in public buildings should be a significant part of building regulations in general. What I seek from the Minister is a sense that any of that, never mind all of it, has been done at all.

[Dr Murrison]

Can the shadow Minister cast his mind back to the debates we had on smoking in public places? If he is suggesting properly engineered extraction ventilation, we dismissed that during those debates—although many of us would have liked to have seen it as an alternative to an outright ban—because of the sheer engineering cost of doing it. Or is he proposing simply opening windows? What exactly is he proposing when he says we need to improve ventilation? At one extreme it is going to be murderously expensive and virtually impossible, and at the other it is simply opening the window.

[Alex Norris]

I cannot cast my mind back to that debate—I believe I had just started secondary school when it took place—but I can foresee the issues that were raised. I would not do down the idea of opening windows; that would be a good thing to do in and of itself, and I would support that. What I am saying is that there are certain places where that will work less effectively, and we ought to have some sense, certainly building by building, of what might be an effective measure. As I said, I do not think this is something that we can just click our fingers and do easily, but I would like to get a sense that we have tried to do any of it at all, and I have yet to get that. I hope the Minister will disabuse me of that.

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[Sir Graham Brady]

Absolutely. As a former Chief Whip, my right hon. Friend knows very well that there is always parliamentary time available when the Government want to do something; it is only when they are reluctant to do something that parliamentary time becomes elusive.

There is a further question as to why only one of the instruments before us has an expiry date in the regulations. Surely it would have been better to put an expiry date in place, which would have required some positive action to renew or extend the regulations if that was deemed necessary.

There are also serious concerns about the efficacy of what is proposed. We know enough about covid by now that we can see which interventions are ineffective. We can see that even full lockdowns possibly delay the spread of covid but do not eliminate it. In this instance, I am intrigued to know from the Minister exactly what action the Government propose if their research finds that this new variant is effective in evading the vaccines. Surely they do not propose to return to a full lockdown, knowing that that would simply defer the problem for a period of days, weeks or months.

[Dr Murrison]

If my hon. Friend recalls, the reason for lockdown was to reduce a potential impact on the national health service. Does he agree with me and everyone who has opined on the subject that there is no conceivable way in which our NHS is going to be overwhelmed by this? That would be a remarkable thing, since 90% of us have antibodies right now. Therefore, a justification for a lockdown falls away completely.

[Sir Graham Brady]

I am grateful to my medically qualified right hon. Friend for that intervention. He is of course right that that is unlikely. There would have to be some evidence of a very different kind of variant of covid for it to pose any kind of threat of that sort. He is also right to point out that when we first went into a lockdown, it was intended to protect the NHS for long enough for us to increase capacity in the service for a three-week period. The first lockdown then spread into three months. That is the most important thing the House should be guarding against: the mission creep that allows Governments simply to introduce restrictions and further restrictions, and then extend them, getting into the habit of regulating what we do. That is my most important concern of all.

In the summer of 2020, the Prime Minister said that it was time to move on and time to start to trust people to make decisions for themselves. I rejoiced at that and thought what a wonderful thing it was that we were moving to a point where we would advise people, inform people and make sure they had the best evidence to make decisions in their own lives. Now, however, we see the first instinct of the Government when we do not even have any evidence that the omicron variant is worse in its effects. There is some suggestion from South Africa that it might be less severe, but the Government’s first instinct is to introduce further compulsory measures and regulations relating to self-isolation and to face coverings in some settings but only until 20 December, plus measures that affect the travel industry, particularly the move back to PCR tests on day two.

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[Daisy Cooper]

I take that point. We know that many of these measures often result in a lose-lose situation. A real problem over the past 18 months has been the way in which people have tried to frame this as public health versus the economy, because for me, having a strong and healthy workforce and a strong and healthy economy are two sides of the same coin. Notwithstanding that, I am encouraging the Government to ask people to work from home where they can, in order to strike the right balance that would reduce levels of transmission. I am not suggesting a blanket mandate for everybody to stay at home; I am suggesting encouraging people to work at home where they can, in a balanced way.

[Dr Murrison]

I am listening carefully to what the hon. Member has to say. Does she agree that the group in society that has really borne the brunt in the past 18 months is young people? They have been particularly affected by so-called work from home, and their mental health in particular—which I know her party takes a close interest in—has in many cases been devastated. I commend to her the best available evidence as published last week. As the hon. Member for Central Ayrshire (Dr Whitford) pointed out, that evidence suggests that two interventions—that is to say, mask wearing and cleaning our hands properly—may well have some impact, but to be honest the evidence for social distancing is pretty thin. Would the hon. Member for St Albans (Daisy Cooper) perhaps like to reconsider the sort of swingeing measures that she appears to be recommending?

[Daisy Cooper]

I thank the right hon. Member for his intervention, but I respectfully disagree with him. What we have learned over the past few months, from public health directors in particular, is that the more measures we take, the better protection we have. It is not an either/or. If we wear a mask, wash our hands and limit the amount of time spent in close proximity to someone else, we limit our overall chances of either catching covid or passing it on. The more measures we can take, the better. Notwithstanding that, when I was talking about working from home, I was not referring to children studying at home. I was talking about the working population. I recognise that there have been enormous impacts—

[Dr Murrison]

I was talking about university students.

[Daisy Cooper]

Ah, okay. I thought the right hon. Gentleman was talking about schools and young people. Of course there have been major issues for young people, but when I was talking about working from home, I was talking about the working population. On the question of students at universities, of course there needs to be a balance. Many universities got it wrong during the pandemic, and I said so at the time. I was utterly appalled when some universities put railings around the student accommodation. We need to strike a balance. This is about reducing our contacts to reduce transmission. There is nothing to prevent university students from going in to study, if that is the point that the right hon. Gentleman was trying to make.

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[Dr Murrison]

How on earth does the hon. Lady think that we can mandate or suggest that people work from home but then expect students to tip up? University is about being taught, and being taught requires people to go to work. Or have I missed something?

[Daisy Cooper]

Something appears to have been lost in translation here. I am not entirely sure whether the right hon. Member is referring to students or to the academics who teach them. I am talking about encouraging people to work from home where they can. There are of course examples where people will need to go into work, and they can change the ways in which they work, but working from home has been proven to reduce levels of transmission.

I am concerned that we are talking solely about the new variant, and that the mantra around putting in place restrictions to protect the NHS appears to have stopped. I worry that the Government appear to have lost their tongue. Ambulance services across the whole of England are at their highest alert level: level 4, or code black. That means that there are people in the back of ambulances who cannot get into hospitals. The NHS 111 line has had more than 1 million calls abandoned after 30 seconds this year, when they should be answered within 20 seconds. We have GPs who are reducing their hours or resigning because of the workload and the abuse. Some of them are really worried and saying that they will not to take on the contracts to deliver the booster jabs because of the expectation that they will still have to do the same amount of work seeing their patients and that if they are required to do the booster jabs as well, that will mean longer waits for other appointments. They are not getting the support they need in that regard, and I hope that the Minister will respond to this point. We have record backlogs—

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[Dr Andrew Murrison (South West Wiltshire) (Con)]

I record my interest as a practising doctor. I agree with my hon. Friend the Member for Isle of Wight (Bob Seely) that there appears to be a problem with the availability of slots for vaccinations, and that was before the Government announced this week that we were to expedite the booster programme. I am concerned about that, and I hope the Minister, who has commented briefly on that already, can confirm she has a cunning plan to ensure that people who need to be vaccinated are vaccinated and in particular that those vaccines reach the elderly and the vulnerable. At the moment, I have severe concerns about the availability of those slots, if not the vaccines themselves.

I will be supporting SI No. 1340 today on face coverings. I am mindful that we have to rely on the best available evidence. The evidence for a lot of these non-pharmaceutical interventions is more common-sense than actual. It seems to me to be a minor imposition to ask people to wear a face mask, particularly given the evidence published by The BMJ last week on this matter, which we have referred to already. The hon. Member for Central Ayrshire (Dr Whitford) in particular spoke about it.

I am more concerned about SI No. 1338 for two reasons. While SI No. 1340 expires on 20 December—or, at least, Ministers can decide whether to continue it on that date—there is no such luxury contained within SI No. 1338. That seems to be illogical. When pressed earlier, I regret to say that the Minister, who was very good at taking interventions from hon. and right hon. Members, did not address that point. She needs to explain to my satisfaction, and that of other Members, why 20 December stands in SI No. 1340, but it is 24 March for SI No. 1338. It seems that there is an appetite in the House to return here, if necessary, to reconfirm or refute the need for these measures to continue into the new year. I hope that the Minister has heard that loud and clear.

I for one would be more than happy to be here well past the time at which we rise, and right up to Christmas if necessary, and the reason for that is this: the things we have been discussing today touch heavily on the liberties and livelihoods of our constituents. These things are not trivial; they are of vital importance, and all actions have consequences. I am worried about things like this because of the messaging it gives off. It will be very difficult for businesses deciding whether to invest. They will look at SI No. 1338 and think, “Good gracious me, this will go on and on and on.” While they have been happy to go along with some of the impositions that we have had over the past 18 months, they are now coming to the point where they are thinking, “This could basically be the new normal. This will go on and on, and on what basis will we continue to invest in our businesses if every few months we have these kinds of things and goodness knows what else that may follow?” I am worried about that.

I am also deeply worried, as other hon. and right hon. Members have pointed out, about this “suspected of” bit. That seems to me to be rather clumsy and I am not comfortable with it. Presumably, anybody showing any coronavirus symptoms could be “suspected of” having the omicron variant.

The World Health Organisation touched on a potential solution to that at the weekend, which is the Thermo Fisher PCR test. I assume that it relies on the detection of the S-gene dropout that has been referred to, which could expedite the diagnosis of omicron as opposed to straightforward coronavirus. I wonder whether the Minister could reflect on that and say whether her understanding is that such a test would be the basis on which we would decide whether somebody was suspected of having it, because that could shorten the length of time that people are required to be out of action and might make No. 1338 slightly more palatable for those of us who have concerns about it.

I disagree with some hon. Members about what will change in three weeks’ time, because I think a great deal will change, as a number of international authorities have made clear. Indeed, the doctor who first found the variant, Angelique Coetzee, seemed to be of that view in her upbeat assessment of how it is affecting her patients, as is Dr Anthony Fauci, the adviser to the President of the United States. Many international authorities are saying that in two weeks’ time, we should be a lot further along the journey of understanding how the variant behaves.

That makes sense because, in two weeks’ time, if the variant is a problem, we will presumably see an uptick in hospitalisation at least among the vulnerable population. It is wrong to suggest that everybody in South Africa is young and vibrant; of course it has its fair share of elderly, vulnerable and frail people and of people with comorbidities. In two weeks, I expect there will be at least some indication of whether it will be a problem. We should also keep in mind that it might be part of the salvation, rather than the problem, because we do not know how the virus will behave. Some viruses mutate downwards and others mutate upwards. We must hope for the former not the latter, but at the moment we simply do not know, which is the basis of my support for No. 1340.

There is an assumption that perhaps southern Africa is not sophisticated in healthcare terms, but I gently make the point that the Republic of South Africa certainly is sophisticated. It has been the victim of its own generosity in having invested heavily in sequencing. It is a bit like the UK in relation the Kent variant: if we look, we will find. We need to be careful about suggesting that other healthcare economies are not up to spec, because I do not think that is necessarily the case for South Africa.

I also observe that yesterday, 25 deaths were attributed to covid-19 in South Africa and the seven day average is 35 deaths. Many of us are captivated by the covid graphs; I check them daily. I confess that I do not generally obsess about South Africa, but recent events have made one focus on its graph, which is bumping along the bottom. We are in no way seeing a wave as yet, although we may yet do so, but we need to be careful about suggesting it will be a major problem, as Angelique Coetzee and others have been.

The Government are right to be cautious—of course they are—but we also need a sense of proportion. We need to understand that everything we do in this place with regard to regulation has a consequence for liberty and livelihoods, for the economy in general and for young people in particular. I made that point in connection with the apparent suggestion of the hon. Member for St Albans (Daisy Cooper) that it was a no-cost measure. We need to be careful about the impact that it all has on young people and especially on mental health.

[Bob Seely]

Does my right hon. Friend share my frustration that we have all these charts about covid, but we have never had them in context—how many people are born, how many people die, how many people die of flu, how many people die of other illnesses—so we have become fixated by something when there are many other causes of death in this country that, frankly, claim many more people, and by taking this out of context we create unnecessary fear?

[Dr Murrison]

Yes, I absolutely agree with my hon. Friend. The point about that is of course that the national health service at the moment is running very fast to catch up because for the past 18 months, necessarily, it has not been doing a lot of the elective work in particular that it would have wanted to do. That is actually going to be a problem, I think, for years to come. What I would say is that there seems to me to be very little likelihood of our NHS being overwhelmed this winter. There are always pressures at this time of the year, and an overwhelmed NHS was the absolute cornerstone of Government policy towards this particular public health emergency at the start. Those things are not there now, and I think that we just need to contextualise a lot of what is going on.

Of course we need to reduce the number of admissions to the NHS, particularly to ITUs, for covid-19. It is a huge burden for the NHS, and it prevents us from doing other things, but we are certainly not in the position now that we were in this time last year. So while I will certainly be supporting No. 1340, I am afraid that I will not be able to support the Government in respect of No. 1338, because of the lack of a sunset provision similar to that enjoyed by No. 1340 and also because I am very concerned about “suspected of” and what that might mean in terms of a chilling effect on schooling, the economy, liberty and livelihood.