Covid-19 Update

Baroness Barker Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Baroness Thornton (Lab)]

I thank the Minister for taking questions on this Statement today. It was noticeable yesterday, and on Monday, that at no point was there any attempt to reveal any scientific basis or evidence for the impact on the spread of the virus of either a 10 pm curfew or going back to working from home if you can. A few weeks ago, we were all being urged to go to the office or workplace if we could. We have certainly not been told what SAGE’s modelling shows as the impact a ban on mixing households indoors would have.

The Government are lacking a clear Covid-management approach. We recognise that the pandemic, and its impact, are complex. The response can be no better than the best compromise, and that should be admitted. Timely policies to rejuvenate the economy will fail if policies to contain the infection fail; we recognise that. In the absence of a vaccine, testing, tracing and isolation is the only response that matters now. Covid infection data should be published, to make it clear to the public where the risks are. The Prime Minister said that more information would be made available. I would like to know that it will and when that might happen.

This leads back to testing, tracing and, importantly, isolating, as every conversation about the containment of Covid-19 does at the moment. Looking back over the last few weeks of growing disquiet, and then serious concern, about not being able to get tests, does the Minister agree that part of the problem—leaving aside the seeming failure of the noble Baroness, Lady Harding, and her operation—is the clear lack of communication about testing? I plead with the Minister not to treat the House to the mantra about the record number of tests and so on. It is completely clear, from MP’s postbags and the media, that “them out there” were under the impression that tests were more widely accessible than they in fact are. Lecturing us on how simple all this is both misses the point and is dangerous.

As far as schools are concerned, I asked a headmaster how things were going. He said: “If they ran a school the way they are running the country, what Ofsted grade would they put on their self-evaluation form?” I thought that was quite a good question. The tone of the Secretary of State and the Prime Minister in their Statements rather gave the impression that the Government were blaming people for breaking the rules and allowing the virus to grow. The reality is that people have done everything that they were asked to do. They have missed birthday celebrations, weddings and funerals; they have, quite rightly, sent their children back to school; they have gone back to their workplace. They have done what they were asked to do. In return, Ministers were supposed to fix test, trace and isolate so that we could return to something like normality.

The mayor of Tower Hamlets, John Biggs, said:

“With cases rising the government is right to bring in stricter restrictions to prevent the transmission of COVID-19. In Tower Hamlets we need to keep each other safe by following these new rules”.


He added:

“Government also needs to ensure adequate testing is available and that there’s continued support for those losing out financially due to these restrictions. The next few months will continue to be challenging—as a community we’ll remain resilient and together can get through this”.


He puts the case extremely well.

The Cabinet Office Minister, Michael Gove, said the 10 pm curfew on pubs in England has been brought in after evidence from places such as Bolton, where the curfew has already been in place for two weeks, suggested it will drive down coronavirus infection rates. However, according to the latest figures released by Public Health England, the infection rate in Bolton has risen again. Does the Minister share my concern that the new regulations may be based on poor evidence? Will the Government review this decision and immediately publish the evidence to allow it to be scrutinised in peer review?

Why is that 10 pm curfew not on all sales of alcohol? For example, you get thrown out of the pub at 10 pm with five of your mates; you go to the off-licence, buy whatever you want and go to somebody’s home. I cannot see the evidence that this will make any difference. I would really like to know.

Returning to tests, can the Minister confirm that only half of all tests have been received in less than 24 hours and will he publish the Pillar 2 data which breaks down how many people asking for those tests were symptomatic and how many were asymptomatic? Many parents report going to walk-in centres with their sick children, when they had no symptoms, and being given a test. Was that a national policy? Has it been abandoned? This is further evidence of confusion.

I welcome what the Minister said about prioritising NHS staff, care workers and teachers, but can he clarify why he has issued guidance to hospital trusts placing restrictions on the number of tests they can carry out? Also, how he will protect care homes? In a previous exchange this afternoon between the Leader of the House and the Leader of the Opposition, my noble friend asked the noble Baroness about domiciliary care. I think she maybe did not understand what was being said—it might have been after a question from the Back Benches. Will people in domiciliary care, going from one home to another doing social care, be given PPE and will the tests available in care homes be available to them? I am trying to put it as simply as I can because it is a very important question.

Will the Minister ensure that no one is discharged into a care home without a Covid test? Given where the virus is, what is his advice to the shielding community? What protections is he putting in place for those from black, Asian and minority-ethnic communities, given that there are disproportionate numbers from those communities in intensive care units even today?

None of us wants to see another lockdown or circuit-break. We will understand if one becomes necessary, but test, trace and isolate should be fixed. The failure of that has left us vulnerable and exposed. It seems to me we must now act with speed to save lives and minimise harm.

[Baroness Barker (LD)]

My Lords, three months ago the Secretary of State said that test and trace was the single most important thing that had to be done to conquer the virus. Yesterday the Prime Minister said it had “little or nothing” to do with the transmission of the virus. These two things cannot both be right. For six months, the problem has been that we have had confused messages, careless use of statistics and a persistent refusal to work with and listen to people who run local public services and know what needs to be communicated to whom and how.

All those are the fundamental reasons we find ourselves in this situation. We still lack an effective and timely track, test and isolate system. In its place and without any evidence base behind them, we have come up with messages which, quite frankly, do not make sense to the general public. The rule of six does not make any practical sense at all, as was very well evidenced today by my noble friend Lord Newby in an earlier interaction with the Leader of the House.

Yesterday, the Prime Minister said the Government now had granular data that enabled them to understand the transmission of the virus. When will that evidence be released? And when will it be released to Members of this House and the other place, who, next week, are going to be asked to renew emergency powers the like of which have never been seen before to this Government? If the Government cannot come up with that evidence—and, I have to say, over the last six months, they have persistently failed to answer any kind of detailed question from Opposition Benches in this House—why on earth should they be trusted to have those powers renewed? When are we going to get the evidence base?

It is helpful, looking at the Secretary of State’s Statement, to see that finally, after repeated questions from these Benches and the Labour Benches, we have got a clearer statement on who is being prioritised for testing and in which area. But, as the noble Baroness, Lady Thornton, said, it is remarkable that there is nothing about black and minority ethnic communities, which we know are at greater risk, and nothing about the important people who work, for example, in domiciliary care, or who work in hospitals but are not medics.

I would like to ask one final question. When will they start listening to local authorities, who are persistently asking, in helpful ways, what they can do to expand the capacity for testing and to make sure that testing is better tied into the rest of the services? We are about to have an app launched, and local authorities are already telling us that there is soft intelligence that people who think they have symptoms but are unable to get a test just give up, and that people whose children are ill give up. It is all well and good for the noble Lord to say, as he did the other day, that they are going to completely redo NHS 111 to make it a more streamlined portal into the NHS, but if people have given up looking for tests long before they should, we are never going to get the data we need to get on top of this.

So I ask, as I did the other day: when they are revamping NHS 111, will they talk to the Royal College of Paediatrics and Child Health about the NHS 111 protocols? I agree with the noble Baroness, Lady Thornton; I think the public are desperate to do the right thing. They have been extraordinarily patient and have listened throughout, giving the Government the benefit of the doubt. But they will not go on doing that indefinitely while the Government continually fail to come up with a decent evidence base for their actions.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, I am extremely grateful to the noble Baroness, Lady Thornton, for correctly characterising our response to the epidemic as “the best compromise possible”. It is a compromise. We have competing demands on our strategy: we have to protect lives and the NHS, but we also have to be conscious of the economy and the livelihoods of people, and we have to look after our students and pupils. The package of measures being put forward by the Government is the best compromise we can make for this moment, and we are unashamed of that compromise.

But the noble Baroness is wrong when she says we do not have a strategy. The strategy is really clear; it is to suppress the virus and protect the economy and education until the vaccine and mass testing are ready. It may not feel like it now, but there are glimpses of sunlight in the distance. The vaccine and mass testing provide a strong opportunity for us to suppress the virus. The strategy that we have put in place, as the Prime Minister rightly described in his address to the nation, is a way to “get through the months” until we have those arms at our disposal.

Both the noble Baroness, Lady Thornton, and the noble Baroness, Lady Barker, talked about the publication of data. I must confess that I have a genuine sense of confusion about that point, because we publish so much data. If there is one thing that this Government have got wrong, it is that we have published too much data too early. Too much has not been audited; too much has been put out as early as possible in our efforts to be transparent. Tomorrow, we will have a REACT survey; we will have an ONS survey; we will have test-and-trace data. There are SAGE minutes; there is NIHR; there is literally data coming out of every organisation of government. It is a fantastically huge amount of data. It is, I confess, extremely difficult to process all of that data all at once. The story it tells does chop and change at an amazingly fast rate—much faster than any experience I have ever had in my life. It is a rollercoaster that the Government have to ride.

I make no apology, however, for the fact that this Government have sought to act swiftly and to bring in measures quickly when the evidence has changed. In the last few weeks we have seen the latest example of that, where the infection rates have clearly lifted quickly in a way that was not expected, and we have had a discussion about that point in previous sessions in the Chamber. We have moved promptly to address the challenge that those worrying and concerning figures have presented to us.

The noble Baroness, Lady Thornton, raised the question of testing. I completely and utterly acknowledge the frustration of anyone who has not been able to get a test for themselves, for their child or for a loved one. It is true that we have more people wanting tests today than we have supply. However, I cannot avoid pointing out that—boy oh boy—we have come a long way since February, when we were doing 2,000 tests a day, to today, when we are doing 240,000 tests a day, and we are well on the way to doing 500,000 tests a day by October. Our aspiration is to do many times that within the near future.

That is not in any way to avoid the fact that I wish that we had more tests today. I want to convey to the House that this Government are 1,000% committed to answering the needs of this country for testing and have put every resource—human, technological, administrative and financial—behind the testing programme in order to deliver that promise.

The noble Baroness, Lady Thornton, raised the question of tone. I completely accept her point that the people of Britain have made a terrific sacrifice. There is no question at all of blaming the people of Britain, but we have to acknowledge that the spread of the virus indicates as a fact within itself that some people are not respecting the principles of social distance, hygiene and isolation, and we have to move in order to shore up the basic principles of this country and, by the way, of any country that is effectively fighting the virus—because, if we do not, the virus will sweep through the country.

I thought that the Prime Minister put that challenge very well, and in a way that a large majority of this Chamber would support. He said that the choice was before us: we could ask those who are vulnerable and older and shielded to simply lock the door and we could turn our backs on them. That is not the choice that this Government have made. They have made a choice to fight the virus at every level, because we love the people whom we care about; and it is a pragmatic choice, because if we find the virus growing in one part of our society, whether that is young people, health workers or the very young, then sure as night follows day, it will sweep through the rest of society.

I turn to the evidence on the curfew. This is a moment where I do not have the science at my fingertips. However, I have been in pubs and clubs after 10 o’clock enough times to know about the proximity and intimacy of late-night drinking, and I know that what happens then is not conducive to social distancing. This is a moment when plain common sense can tell you that a curfew will help to break the chain of transmission among young people. It is, unashamedly, a signal that we cannot go on like this and, in particular, that young people have to change their behaviours because the signs of infection are crystal clear. The prevalence among young people is too high, and we have to turn that corner.

The noble Baroness, Lady Thornton, asked about symptomatic and asymptomatic testing. The honest truth is that it is very difficult to tell; if someone is standing in a testing queue, we do not turn them away. By the way, in order to get a test, people do have to fill in a form, on which they are asked if they are symptomatic. What we do know from closer analysis and questionnaires is that a proportion of testees—between 20% and 25% at current rates—do not meet the strict criteria of our testing. I am grateful to the British public for beginning to show respect for the fact that every test counts, and for helping us direct them at the most needy.

The noble Baroness, Lady Thornton, asked about domiciliary care, an issue that has been raised in this Chamber a few times. I reassure all those in the Chamber, including the noble Baroness, in answer to her specific questions: yes to PPE, yes to testing and, by the way, yes to new guidelines that help minimise contact and the number of patients seen by each itinerant domiciliary worker; and yes to substantial extra funds for the social care system, specifically to help social care avoid relying on people travelling from patient to patient.

The noble Baroness, Lady Barker, asked about our relationships with local authorities and the local teams. I reassure her that we have moved a very, very long way in the last six months and that the picture she paints is understandable but out of date. We have come a huge way to share all of our insight, data, analysis and systems with local authorities, local directors of public health and local infection teams. Decisions on lockdowns now have a protocol whereby they are led by local teams after engagement with local civic groups and brought to the Secretary of State after they have been agreed at a local level.

Substantial sums—billions of pounds—have been given to local authorities to help them afford the kinds of local intervention that they choose to make in order to support the most vulnerable and disadvantaged during the epidemic. Money is given to local authorities for PPE for the people that they decide need it. Community health is being supported within the NHS in order for communities to be given the support they need. Engagement with local civic groups and business leaders is at a level I have never seen in government before.

I will give one example in relation to contact tracing, which the noble Baroness, Lady Barker, specifically asked about. In Leicester, money has been given to the local council for it to commission its own contact tracing, because we recognise that the local authority may well have the insights, cultural connections and sensitivities, and contacts needed for this kind of work. Therefore, we have provided financial and logistical support, and professional advice on how it can fill the gaps. We recognise that a national system cannot do everything, and that we have to be both national and local at the same time.

The noble Baroness, Lady Barker, ended by talking about the public mood and her concerns that people are reaching a state of despair. I completely recognise the exhaustion that many people feel about the state of the epidemic. I particularly recognise the morale within the NHS and social care, where people have worked incredibly hard, often in circumstances and doing tasks that they did not originally sign up for, and the sacrifice that many people have made, whether they work in the healthcare system, are supporting people they love, cannot do the things they want or are isolated and on their own. Of course, lots of people have made massive sacrifices, but I do not recognise the world she describes.

I think the public largely support the steps taken by this Government to suppress the transmission of this virus. After all, it is the virus that is the enemy. In many respects, we have an incredibly united country in fighting that enemy. The way in which the British public have supported the regulations and guidelines, which have had a tough effect on many people’s lives, demonstrates a huge amount of support. No Government —and certainly not this Government—will stretch that beyond what is tolerable. I posit to the Chamber that, to date, that support is still in place, and I remain extremely grateful for it.