Covid-19 Update

Baroness Brinton Excerpts

Tuesday 8th June 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, first, I thank the Minister for this update today and congratulate him on yet another long stint at the Dispatch Box.

We face some uncertainty, as we often have throughout the past 15 months, but we know the delta variant is now the dominant variant in the UK; we know that 73% of delta cases are in unvaccinated people; we know that one dose offers less protection against this variant; and we know that, although hospitalisations are low, an increase in hospitalisations will put significant pressures on the NHS as it tries to deal with the care backlog. We also know, of course, that long Covid is significant and debilitating for so many people. As the Statement makes clear, this is a race between the vaccine and the new variant. I therefore invite the Minister to narrow the timeframe between the first and second dose, given that we know that one dose is not as protective as we would like. We have seen that Wales will be vaccinating everyone who is over 18 from next week. Could the Minister tell us when England will follow?

We all know about the outbreaks among schoolchildren and young people. We know that children can transmit the virus and that children can be at risk of long Covid. In that context, why is mask wearing no longer mandatory in secondary schools? It is good that the JCVI will be looking at vaccination for children. Could we please know the timeframe for when the JCVI will report?

I turn to Nepal. UK Ministers justified the decision to move Portugal from green to amber in the travel list owing to the threat of the new Nepal Covid variant—a mutation of the delta variant—which experts believe may have the potential to make vaccines less effective. Some 23 cases of the Nepal variant have been detected in the UK, up to 3 June. Can the Minister confirm whether these cases are all associated with travel, particularly from Portugal?

In this, Carers Week, from these Benches we join the Minister in paying tribute and are grateful to the 6.5 million people who are carers. Making caring visible and valued is the aim, and this year of all years we need to support them in doing so. Our carers across the country have faced huge challenges during the pandemic; three-quarters of them confess to being exhausted, and a third confess to feeling unable to manage their caring responsibilities.

I am sure the Minister has already read the report produced by the Commons Health and Social Care Committee which addresses the issue of NHS and care staff in England being so burned out that it has become an emergency that risks the future of the health service. This is a highly critical report which said that workers are exhausted and overstretched because of staff shortages. It said that the problems existed before the pandemic, although coronavirus has made the pressures worse. It reports that one of the main problems is that there was no accurate forecast of how many staff the NHS needed for the next five to 10 years—something that we know as “workforce planning.” NHS workers, traumatised and exhausted, need to know there is a solution on its way to fix staff shortages. When will there be an NHS and social care workforce plan? How will the Government respond to the urgent situation that this report reveals? How will the NHS stop the haemorrhaging of its staff, which is already happening?

Combined with all this is the fact that we know that the NHS estate is in urgent need of attention and investment, and so Labour is today calling for a new rescue plan. Data also reveals the scale of the pressure on hospitals before the pandemic and how much worse it is now. Freedom of information requests show that the pressure on A&E was already very serious, with waits in ambulances jumping by 44% in the year preceding the pandemic. We know that the underfunding of the NHS, and the unpreparedness of the UK for a pandemic, has been paid for by people’s lives and by the exhaustion of our NHS. Surely these things call for a long-term NHS rescue plan, with the staff, equipment and modern hospital facilities that we deserve.

I turn briefly to the issue of data again. I record that I welcome the delay in proceeding with this proposal from the Government, but I think the Minister and the Government need to address the transparency that is vital around two things. The first is that somebody should be able to retrieve their data if they want to and pull it back; and the second is that, if their data is being used by a third party, they need to know who that party is, what the data might be used for and who benefits from that. My contention has been, for many years from this side of the House, that NHS data is a gigantic asset that we have that can be used to benefit the world, but we need to make sure that it is the NHS that benefits from the sale of our data—not private sector companies or individuals but our NHS.

Finally, I recently visited the Covid memorial wall myself. I would like to ask the Minister whether he has visited the wall of red hearts that we have opposite Parliament. The Covid memorial wall is immensely moving and a poignant reminder of the scale of loss that we as a country have experienced. Does the Minister believe that the wall should become a permanent memorial? If not, what should be a permanent memorial of the loss that we have sustained?

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as a vice-president of the Local Government Association. I also want to thank the Minister for his long stint at the Dispatch Box, yet again.

I want to start with the issue about consultation on NHS Digital patient data, which the noble Baroness, Lady Thornton, just alluded to. In 2013, the Government wrote to every household to explain the care.data project. This new scheme has had no such communication with the public. As people hear about it, they are increasingly concerned about the breadth of data that will be captured. Will the Minister agree to use the delay to ensure that every adult in England is written to as a matter of urgency, including an opt-out form they can use if they so choose?

I also want to pay tribute to our health workers and carers—paid carers and especially the unpaid carers—who have gone not just the extra mile over the last 14 months but a whole marathon. Can the Minister say what steps the Government are taking to help the exhausted staff and carers who know that there are many miles still to go before we are through this? Help is needed right now for them in an emergency plan that does not just focus on getting back to work as normal.

The Minister is right to say in the Statement that there is no room yet for complacency. The delta variant will not be the last variant trying to wriggle between those who are protected and those who are not. We are concerned that there is not a focus on communicating to the public about how we need to find a way to live with Covid circulating, as my noble friend Lord Scriven said yesterday. We have moved into Covid being endemic, and the public will want and need to know what they should do over the next few months.

Communication about the vaccine figures is cheering to hear, but still too many Ministers talk about the one-dose level, not the two. The Minister in the Lords, to his credit, usually make that point, but the Prime Minister and many other Cabinet Ministers do not make it clear that we need 90%-plus of adults to have had two doses before we are anywhere near safe, and that social distancing, mask wearing and hand washing will still need to happen.

I thank the Minister for giving more information yesterday on the isolation support pilots. He said:

“In Blackburn and Bolton, this will include trialling broadening eligibility during surge testing, so that all those who are required to self-isolate, who cannot work from home and earn under £26,000, receive a £500 payment.”—[Official Report, 7/6/21; col. GC 202.]


That is still only £50 a day if you are expected to self-isolate. If you are told to isolate on a Monday, and usually work nine to five, this works out at £7.81 per working hour—less than the minimum wage. If the minimum wage is the very minimum that the Government believe an individual can live on, why are they paying less than this to people for doing the great public good of self-isolating? What about people who work in risky occupations and have been told to isolate multiple times over the last year? For them, it is not just one period of 10 days.

From these Benches, we believe that the Government need to pay people’s wages. Now that fewer people should be required to self-isolate, as community cases are lower, we should be diverting resources to really get right what the Government have been getting wrong all along. We must stop Covid in its tracks. Examples from other countries show that paying wages has a strong and demonstrable effect.

On international travel, the red terminal at Heathrow is an improvement, but there are still issues with those arriving from amber countries, who are asked to jump on public transport to get home and need to travel in various ways before they are tested, once in this country.

Given the increase in cases of the delta variant among primary-age pupils, would the Minister outline what measures are being taken to prevent transmission in schools? When will the JCVI report on vaccines for 12 to 17 year-olds? Are any plans beginning to consider whether vaccination should happen for the under 12s? We strongly echo the comments of the noble Baroness, Lady Thornton, about mask wearing in schools. Is this really the right time to stop that happening?

Finally, I note that the consultation on vaccine and testing certificates has closed. Will the Minister say when the Government will publish their plans following that consultation? What type of legislation will be brought in on this, and will Parliament be able to see and comment on any regulation prior to it being enacted?

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

My Lords, I am thankful, as ever, to both noble Baronesses, Lady Thornton and Lady Brinton, for thoughtful and challenging questions. I will try to deal with as many as I can.

The noble Baroness, Lady Thornton, asked about the narrowing of doses. May I remind her that for those classed as vulnerable and those aged over 50, the dose period has been narrowed from 12 weeks to eight weeks. We are giving some latitude in the areas of special enforcement for the narrowing of the doses. I completely endorse her points on that and reassure her that plans are afoot. As for moving the age group to those aged over 18, our instincts are that the JCVI prioritisation process has worked extremely well. It is clear, it is fair and it has been effective. In conversation with those at the G7, I received a huge amount of admiration from other countries for how well that prioritisation process has gone. Therefore, we are reluctant, at this very late stage, to jump the gun on that, but I take her point that particularly those in areas where the infection rate is ticking up may benefit from early vaccination. Therefore, we constantly look at and review that point.

As for vaccination of children in schools, raised by the noble Baronesses, Lady Brinton and Lady Thornton, as they know, the MHRA has given its approval. The ball is now in the JCVI court. We are going to wait for it to pronounce. The state of our vaccine supplies means that we do not have a supply for children at hand right now, so there is scope for a really thoughtful conversation on that. When the JCVI has pronounced, the Government will engage on its recommendations, but I do hear, loud and clear, the obvious support that it has in this House.

As for the Nepal variant, I cannot say exactly how much of it came from Portugal, but it is true that it was present in the UK before Portugal was green-listed, so I think it is fair to say that not all of it came from there.

Moving on to NHS staff, I completely pay tribute to the contribution of NHS staff and those who work to support the NHS, social care and public health. I recognise completely the picture painted by the noble Baroness: many feel exhausted and burned out. Our focus is therefore on recruitment and the recruitment of more GPs and nurses is going extremely well. I would be happy to share updated statistics on that if it would be helpful. The work plan—the NHS People Plan—has within it a clear outline of the kind of workforce planning that we have in place. That is something that the recruitment programme has fully embraced.

I agree that the pressures on A&E, and on acute late-stage interventions from the NHS, have been rising for years—for decades. This is an unsustainable model in the long run, which is why this Government are fully committed to the prevention agenda. We have put in place plans for the Office for Health Promotion. That will be the device for using data to support our prevention agenda, and we will be working particularly with local authorities, and increasingly through the NHS, to ensure that we are putting in place measures that improve the nation’s health and that we do not just focus on those who are already extremely ill.

Moving on to data, I thank the noble Baroness for her kind comments. I completely agree that transparency is absolutely right. We want to be as transparent as possible, with both the professions and the public. These are complex issues. I accept that we could do better to improve our communications. We will be using this two-month hiatus as energetically as we can to engage the public and the professions in the changes that we are bringing about. They are changes that are absolutely essential for any modern use of data to promote resource allocation—when it comes to the workforce, as the noble Baroness rightly pointed out—and for research. I really would encourage all noble Lords who are interested in this to look at the minutes of IGARD. Noble Lords will see exactly which data uses are being sanctioned, and will be amazed by the extremely high-level, science-led research programmes that the GP data is contributing to. It will reassure noble Lords that this is an extremely well guarded and thoughtful process, and a massive asset to the nation. I agree with the noble Baroness that our data is a huge national asset; it is there to benefit patients and is mainly used for clinical trials and for planning within the NHS. That is right and I can reassure her that that is the way we intend to continue.

The noble Baroness, Lady Brinton, asked about mental health support for care workers and NHS staff. I reassure her that we have put in a huge amount of support for NHS staff: 10,300 calls have been made to the helpline, there have been 4,600 conversations on the national line and 200,000 downloads of the app, and 500,000 have engaged through the web page. The provision of mental health support for NHS staff has been extremely helpful for those stressed by the last few months, but we continue to invest in that area.

I remind the noble Baroness, Lady Brinton, that those receiving isolation payments are still eligible for their benefits. They will get support from housing benefit and other benefits if they qualify.

The noble Baroness asked about schools. The use of testing to protect schools has been one of the phenomenal success stories of this pandemic. There have been 65 million tests deployed since January, and a million tests were deployed on Sunday alone. That is both to break any chains of transmission within schools and to protect the opening of schools, which every parent in the country knows is an essential objective of our pandemic response.

On certification, we are making an enormous amount of progress. That is a Cabinet Office lead. When the plans have been crystallised, they will be published, and I am extremely hopeful that we will be able to make progress.

Lastly, the noble Baroness, Lady Thornton, mentioned the memorial wall. I am aware of it and have seen very moving pictures. I have not yet visited the wall, but I will take this prompt to go. While I am not across the future plans for the wall, I am grateful for the suggestion and will take it up.