Covid-19: Vaccinations for School Pupils

Baroness Brinton Excerpts

Monday 17th January 2022 Lords Chamber

[Earl Howe (Con)]

My Lords, the noble Baroness, Lady Brinton, has indicated her wish to speak virtually, and I think this is a convenient point for me to call her.

[Baroness Brinton (LD) [V]]

My Lords, many parents are still saying that they have not heard when their clinically extremely vulnerable five to 11 year-olds will get their vaccinations, despite the JCVI saying that they should. Last week’s update to the GP green book now includes severely CEV children as eligible for the third primary dose, which is progress. However, there is no news for CEV young children not classed as severe, so can the Minister please say what he will do to ensure that GPs will call all these children for their vaccinations as soon as possible?

[Lord Kamall (Con)]

As the noble Baroness says, the JCVI advised on 22 December that children aged five to 11 in a clinical risk group, or who are a household contact of someone who is immunosuppressed, should be vaccinated. GPs and hospital consultants are now urgently identifying the children eligible, and we expect rollout to have started by the end of this month, with children and parents starting to be called up for appointments by the NHS locally. The message here is that there is no need for parents to contact the NHS; the NHS will make contact with the parents or carers of those eligible. Just to further reassure parents, we will be using a paediatric Pfizer vaccine authorised by the MHRA for use in this age group.

Vaccination Strategy

Baroness Brinton Excerpts

Thursday 13th January 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, I too echo the gratitude that this House and this country shows to Jonathan Van-Tam. Four months on, there are still severely clinically extremely vulnerable people eligible for a third primary dose and then a booster who cannot book their booster because the data system still cannot record this. Many CEV young children with underlying conditions are still waiting for their vaccines, as well as for guidance on how they, their families and their schools can keep them safe from Covid. This is important because there are now more children in hospital with Covid in the last three weeks than in the nine months of the first wave. Please can the Minister say how these people, who the Government say need the vaccines right now to keep them safe, can get them?

[Lord Kamall (Con)]

I thank the noble Baroness for making me aware of the issues. She will recall that we had a meeting on how we can address the concerns of the clinically extremely vulnerable, and I had hoped that a number of action points had flowed from that. If those have not been acted upon, I hope she will write to me and I can chase up the department and the NHS. I had assumed that that meeting, where we gave them some action points, was effective. I am sure she remembers that we requested a letter with action points, but if those have not been followed up, I will endeavour to chase that up.

Ambulance Queues: Health Outcomes

Baroness Brinton Excerpts

Thursday 13th January 2022 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, the noble Baroness, Lady Brinton, wishes to speak virtually. I think this is a convenient point for me to call her.

[Baroness Brinton (LD) [V]]

My Lords, yesterday NHS England data showed that trolley waits of more than 12 hours in A&E rose in December to just under 11,000, which is three times higher than in December 2020. One hospital reported that it had a dozen patients waiting on a trolley for a bed for over 24 hours. The Minister has talked about extra money, but without staff and bed capacity in both hospitals and care homes, the crisis remains. Can he say what the Government are doing right now to help alleviate the current crisis?

[Lord Kamall (Con)]

I thank the noble Baroness for giving me the opportunity to say what the Government are doing right now. We are working closely with ambulance services, NHS England and the Association of Ambulance Chief Executives to reduce the handover delays. The 10-point plan I referred to earlier goes into detail about how we handle this, both in handling calls at call centres—some calls are not emergencies, for example, and patients are directed elsewhere—and in making sure that the wider system is available to make sure that patients are unloaded within the 15-minute target and that ambulances are turned around as quickly as possible. Where we have spotted disproportionate pressures in the system, as in the 29 hospital trusts across 35 sites, we have focused more resources there.

Respiratory Viruses

Baroness Brinton Excerpts

Tuesday 11th January 2022 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, the noble Baroness, Lady Brinton, wishes to speak virtually. We have her on screen. This is a convenient point to call her.

[Baroness Brinton (LD) [V]]

My Lords, government data show that more children have been admitted to hospital with Covid in the last three weeks than in the whole of the nine months of the first wave. Many clinically extremely vulnerable children are still expected to go to school, even though they still await their vaccines and guidance on how to manage the risks they face, including RSV and influenza. Can the Minister say when these children and their families will get the vaccines and guidance they need? If he cannot, will he please write to me with the answer?

[Lord Kamall (Con)]

The Government have put in place a range of measures to protect children from RSV this winter, including expanding the passive immunisation programme for all at-risk infants, ensuring that the NHS has surge plans in place to respond to any increasing cases, raising awareness among parents and at schools of the symptoms of RSV and when to seek medical help, and increasing our out-of-season surveillance capacity.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Baroness Brinton Excerpts

Wednesday 15th December 2021 Lords Chamber

[The Deputy Speaker (Baroness Garden of Frognal) (LD)]

My Lords, I am getting indications from the Chief Whip that we should move to the winding Front-Benchers. The noble Baroness, Lady Brinton, will be speaking remotely. I invite her to speak for the Liberal Democrats.

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as a chair of the All-Party Group on Coronavirus. I thank the Minister for his speech on the three SIs before your Lordships’ House today.

Plan B was published four months ago. It was absolutely evident, first from the Secretary of State for Health’s announcement on Friday and then from the Prime Minister’s speech on Sunday, that no real planning has been going on behind the scenes in the department. Before we get into the practical consequences of these regulations, from these Benches we want once again to join in the strongest objection to the slack way in which the regulations and the Explanatory Memoranda are written.

The right reverend Prelate was right to say that we accept that late legislation may need to be written at pace, but this is communication at its worst and, of course, it cannot go through the usual scrutiny from the Secondary Legislation Scrutiny Committee and others. This goes hand in hand with Ministers’ messaging to the wider public, from the Prime Minister down. All because he is worried about certain parts of his party, he has once again announced mitigations too late, which inevitably result in further restrictions and in omicron being allowed to move really fast through our society.

The noble Lord, Lord Hannan, said that he worries this will be the case with every new variant we go through. That has not been the reality so far. What is different about omicron is how quickly transmission has doubled, which, by the way, without mitigations, will have an effect on the economy, because businesses are already seeing staff go off sick. If we have 2 million people with omicron by the end of the year, and that continues to increase at the same doubling rate every two days, we will find that the economy, schools, societies, our GP surgeries, ambulances and hospitals struggle even more than they are now. On Tuesday, at the All-Party Group on Coronavirus, one GP said to us that, on the previous day, every single doctor in her practice had tested positive. That meant that there were no doctors available to work, other than by Zoom.

We are learning about omicron because it is very new to us. The evidence of its exponential growth so far is concerning. The noble Baroness, Lady Foster, said that not one patient in South Africa has had oxygen. This is not true. It is true that there are fewer people in hospital, but some have severe disease. The number of omicron critical care beds is going up. At the end of November, 291 people in hospital were on oxygen. Two weeks later, it is nearly 900. The numbers in ICU have also doubled. These figures are from the Covid dashboard on the Spectator website.

From all Benches, we have heard agreement with the Prime Minister’s confused lines in the sand—for example, face masks must be worn in shops, but not in pubs and restaurants. Even if omicron is less dangerous—by which I think the noble Lord, Lord Robathan, means that there are fewer people with severe disease—its key elements are higher transmission and the doubling of cases. If there are fewer hospital admissions per 100,000, the already beleaguered NHS will have to find many more hospital beds than were needed in January 2021. This is what the doctors are advising us.

The noble Lord, Lord Robathan, constantly repeats his mantra that the only deaths from Covid are in the over-80s or among those with underlying conditions. In a recent debate, he asked if anyone knew anyone under the age of 80 who had died. Last week, a dear friend died of Covid after just four days in hospital. She was much younger than I am. Another friend in his 40s, who had a lung transplant earlier this year, is back in ICU with Covid. He does not know where he caught it because he has been very careful. Is the noble Lord really saying that there should be no mitigations to keep the vulnerable safe? This is the consequence of removing all these mitigations.

My noble friend Lord Thomas of Gresford spoke movingly about his compromised immune system. I too am in this position, though for a different reason. My medical advice is not to come out at the moment.

The 800,000 clinically extremely vulnerable have not had one word of guidance in the last week. It is not good enough to say that shielding ended in July. This group is at high risk and needs advice. When will this be evidenced? I think that even the noble Lord, Lord Robathan, would recognise that some people are at high risk. Shame on the Government for not getting in touch with them at all.

Other noble Lords have spoken about those with long Covid, including children. On schools, we have been asking since last year for air filtration units in classrooms. This has only just happened in the last week. Until now, the Government have been talking about CO₂ monitors, but the public health need in our schools is for air filtration units.

The first regulation is about self-isolation and moving to a daily lateral flow test. If it is negative, you can leave your isolation. We say that test and trace must remain the key defence in fighting Covid—particularly omicron—not least because of the somewhat reduced vaccine efficacy with this variant. The level of transmission of omicron is so high that this is a public health precaution. We disagree, therefore, with the fatal amendment laid by the noble Lord, Lord Robathan, which would remove this vital, basic, public health rule of self-isolation and testing.

The second SI on entry to venues and events creates a broader Covid pass, vaccine or test result, than the previously proposed vaccine pass. We have consistently opposed vaccine passports—first, for public health reasons. Importantly, vaccine passes give people a false sense of security, especially as it is possible to catch Covid and pass it on, even if you are double-jabbed. People cannot tell if their vaccine immunity is waning. We just do not like the reliance on that. We also do not want vaccine passports creeping in by the back door, as the noble Baroness, Lady Bennett, outlined. Our principal concern with this SI is about public health. This hotch-potch Covid pass is a muddle.

We agree with the use of lateral flow tests. They are highly accurate. Researchers from University College London found that they are more than 80% effective at detecting any level of Covid-19 infection. They are likely to be more than 90% effective at detecting who is most infectious when they use the test. None of us wants lockdown, particularly the noble Lord, Lord Robathan, and his colleagues, but I struggle to understand why those who do not want lockdown will not accept lateral flow tests as a mechanism to help reduce transmission.

We cannot support the noble Lord’s fatal amendment on the issue of flow tests, but we are deeply unhappy that the Government are relying on the vaccine element of the Covid pass at a time when we need to reduce transmission by the tried and tested test, trace and isolate system. So, if a vote is called, we will not support the Government’s proposals for Covid passes—although for very different reasons from those of the noble Lord, Lord Robathan.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021

Baroness Brinton Excerpts

Tuesday 14th December 2021 Lords Chamber

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, there will be one winder taking part remotely, the noble Baroness, Lady Brinton. I hope we can go to her now.

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as vice-chair of the All-Party Parliamentary Group on Coronavirus and a vice-chair of the All-Party Parliamentary Group on Adult Social Care. The Minister started and ended his contribution to the House by saying this was a statement. I suspect the Minister is in no doubt now that this is actually a statutory instrument. I thank the noble Baroness, Lady Thornton, and also the noble Baroness, Lady Noakes, for her Motion, given the clear failings of the presentation of this statutory instrument. The Minister needs to hear the concern from every part of your Lordships’ House this afternoon, and it very gracious of the noble Baroness, Lady Noakes, to say that she will not press her fatal Motion, for all the reasons cited by the noble Lord, Lord Hunt.

The 21st report of the Secondary Legislation Scrutiny Committee states at paragraph 10:

“An EM … should be a freestanding, comprehensive explanation, and it should not be necessary to conduct extensive research into other documents in order to achieve an understanding of what an instrument does: we regard this EM as an example of poor practice.”


From these Benches we thank the Secondary Legislation Scrutiny Committee, including the noble Lord, Lord Cunningham, whose presence will be missed when he leaves it, for going further and collating as much other information as it could for your Lordships’ House. The committee is excoriating about the failures of the legislation, the Explanatory Memorandum and the guidance, including unclear definitions in law.

For example, what does “vaccinated to a complete course” mean? At what point does the booster jab become compulsory? Will whoever is checking check that the severely clinically extremely vulnerable have had their four doses instead of three? That would require access to very personal staff health information. There is no definition and there are no practical suggestions. The use of the term “registered person” is set out in the Health and Social Care Act 2008, but there is no explanation of who, in reality, in a hospital, has responsibility for checking that staff have had their vaccines.

This SI speaks of people with face-to-face clinical and non-clinical ancillary contact with patients and those who are directly involved in patient care having to have the vaccination. The guidance, however, is still not published to define what is and is not in scope. Does it include clerks on the wards? What about catering staff bringing meals? Does “not being vaccinated” mean that you have to stay a certain number of feet away from patients?

The Secondary Legislation Committee report also points out that non-face-to-face staff are exempt—but they can still mix with front-line staff at other times. Does the Minister think that Covid can tell the difference and that the virus will not transmit from an exempted co-worker to a front-line member of staff in the cafeteria? We know that omicron is bypassing the vaccinated, even if it is bringing possibly less serious disease—although we are waiting to see the evidence.

The government consultation document published on 10 December on vaccination says that more than 1.2 million social care workers in England have now taken up the vaccination. As of 19 August, vaccination take-up was around 87% of staff in younger-adult care homes; 81% of domiciliary care staff; and 75% of staff in other settings. In London, obviously, this is lower, as we all know. This data, however, directly contradicts the Explanatory Memorandum, which says that only 65% of care homes are meeting the 80% staff rate; so they are not even co-ordinating on their own data. The Government’s own data has shown that there has been a 3% reduction in social care staff since March. Some—not all—will have left because of compulsory vaccines. They are not just leaving the care home; they are leaving the profession. They are going into retail or hospitality, and we know that people, having left, often do not return.

I entirely agree with my noble friends Lady Tyler and Lady Walmsley that targeted help and support has worked with a large number of social care staff, as the Government’s own figures in the 10 December document demonstrate. The evidence is that the most effective way of changing the minds of vaccine-hesitant people is to give them a chance to sit down with a local doctor and their own community leaders, ask questions in their own time and listen to people that they trust. The problem with compulsion, especially short-notice compulsion, is that it removes the opportunity to take that time to listen, think, discuss and be reassured. Worse, as we are moving into another wave of the pandemic, doctors will not have the time to do this, whether it is with other NHS workers or with more social care staff.

Even more than that, the Government undermine their own arguments for urgency. At paragraphs 25 and 26, the Secondary Legislation Committee report points out that, in discussing making the flu vaccine compulsory, the department said that

“the government has considered the concerns raised in relation to introducing flu vaccination requirements. The flu programme runs between October and March, with most flu vaccinations happening October through January. Due to the need to balance this with the time necessary for health and social care to implement the regulations, the government has decided not to introduce vaccination requirements for flu at this time. The government will keep this under review following this winter and ahead of winter 2022-23.”

It seems extraordinary that, while this precedent has been set to delay one type of compulsory vaccination due to the time of year and the extreme pressures on the healthcare and social systems, the Government are insisting on doing it for another. The left hand does not know what the right hand is doing.

Covid-19: PCR and Lateral Flow Test Providers

Baroness Brinton Excerpts

Monday 13th December 2021 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, the noble Baroness, Lady Brinton, wishes to speak virtually. I think this is a convenient point for me to call her.

[Baroness Brinton (LD) [V]]

My Lords, the Minister has just had trouble responding to the Question from noble Lord, Lord Scriven, and from the noble Baroness, Lady Thornton, about the process used to review performance of the Government-approved travel PCR testing companies. Can I give him a specific example? TestnGo has a 76% “poor” rating on Trustpilot, with thousands of people not receiving their PCR tests and others not getting the results in two days. As the noble Lord, Lord Scriven, has said, many have reported this to test and trace, so why is it still on the Government’s list of approved suppliers?

Covid-19 Update

Baroness Brinton Excerpts

Wednesday 8th December 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for reading the Statement tonight. On this side of the House, we have always put public health first at every point during this pandemic, so I repeat the words of my honourable friend Wes Streeting, shadow Secretary of State for Health and Social Care, in the Commons an hour ago, when he said

“I want to be clear with the House and the country that Labour will support these measures in the national interest.”

Of course, we know that this decision is not taken lightly. Restrictions impact on people’s lives, livelihoods and liberties and we do not take those for granted on this side of the House.

Everyone wants to be able to enjoy Christmas safely this year, given the trauma of last winter. But the omicron variant is a clear threat, as the Minister has explained, and clearly swift action is needed to limit its spread. I want to ask the Minister a question I have not asked for some time in your Lordships’ House: what is the R number today and what is it predicted to be in two weeks’ time?

On these Benches, we have said that scrapping the guidance on mask wearing was a mistake and have consistently called for masks to be worn in indoor hospitality settings too. We welcome the Government’s reintroduction of that measure, if that is what the Minister said. I seek some clarification on what is actually going to happen; I am not sure I understand the difference between an attraction and hospitality, so could the Minister go into some detail about what will happen in our pubs and restaurants—or will they continue as they are?

The House may remember that we have said that people should have the flexibility to work from home, so we welcome the updated guidance on that. On vaccine passports, I am glad that the Government have listened and responded following their previously abandoned plans to require vaccination status only, and that presenting a negative test will be an option. Can I ask for clarification about whether vaccine passports will be required for access to essential services?

The Minister is correct to say that the greatest tool against the pandemic remains vaccination. How do the Government plan to speed up the booster rollout, which is certainly not hitting the target of 500,000 vaccines a day and is not on track to get everybody boosted by the end of January?

Public health depends and relies on people’s willingness to comply with rules that affect their lives, livelihoods and liberties, and which, in return, relies on confidence in the people making those rules. The damage the Government have done to public compliance with the rules that have governed our lives during the pandemic is very serious indeed. We had the Cummings eye test—that seems like years ago—the former Health Secretary’s tryst with his special adviser, the former Education Secretary’s private party, the Prime Minister attempting to get out of having to isolate, and now the footage of his staff laughing on camera and joking about breaking the rules at a No. 10 Christmas party.

It is hard to overstate how this makes people feel when they have followed the rules and complied, sometimes at enormous personal cost—the businesses that were forced to close; the family weddings that were postponed; the chance to say goodbye to loved ones at funerals that we missed; and the NHS workers, educators and key workers who risked their own health to get us through the pandemic before vaccines and treatments arrived. The headline we saw today is why the laughter in the video from Downing Street is so stomach-turning; it feels as if they are laughing at us.

It is not just that they clearly feel that there is one rule for them and one for everyone else, infuriating though that is; it is the actions of the Prime Minister, which have undermined public trust and distracted from key public messaging at a critical time. This comes from the very top of our country. The problem is that we have a Prime Minister who does not believe the rules apply to him—his own conduct says that—and who also finds it almost impossible to own up, take responsibility and admit that he might have been wrong. The Minister needs to explain to the House how the Government will overcome that.

I was very pleased to hear the news that three doses of the Pfizer/BioNTech vaccine appear to neutralise the new omicron variant, according to preliminary studies; this is very good news indeed. However, it underlines that we have to get more jabs in arms if we are going to make that at all effective.

How will the Government support the people who cannot work from home and who need to continue to go to their workplace? As we know, millions of people who we depend on every day to keep our nation running have continued to go to work throughout the pandemic.

Will the Government set a deadline by which they expect all children to receive their first dose of the vaccine? Will they be able to get them vaccinated over the Christmas period? What are the Government doing to drive up vaccination in areas where there has been low take-up? Are they offering additional support ahead of the winter?

We have discussed in the Chamber before that many critically ill NHS Covid patients are unvaccinated pregnant women. Why is there only one mention of pregnant women in the Government’s COVID-19 Response: Autumn and Winter Plan 2021? In the Whittington Hospital, of which I am a non-executive director, we have set up a room for pregnant women to deal with the issues they may have about vaccination. The Minister might look at that as one of the ways of dealing with this.

Finally, do the Government accept that, if they have not done enough to drive down infection rates by improving ventilation in public buildings such as schools, they must institute a programme of investment in ventilation in schools? This pandemic is clearly a long way from being over and we need our children to be protected.

[Baroness Brinton (LD) [V]]

My Lords, I thank the Minister for repeating the Statement. The chaos to even get it heard in the Commons and the very late notice on whether we were having this or Monday’s Statement sum up the chaos that the Government find themselves in.

As the noble Baroness, Lady Thornton, outlined, the Government have once again lost the trust of the public. My first question is: how on earth will Ministers persuade people to follow these new, very important restrictions, with the chaos going on at the moment?

We understand that restrictions are disappointing but, from these Benches, we have always said we want people to remain safe. As for these proposals, we have said before and say again that we think the Government are once again late to move to plan B.

I note that the arrangements will remain until 5 January and that there is a sunset clause of 26 January. Please can we debate the regulations before they expire—preferably next week, before we rise for Christmas?

Today, there are 131 new cases of omicron, a rise of a third in one day, taking the UK to nearly 600 cases. This confirms that the doubling rate is between two and three days. Scientists are talking about an R rate of between 2 and 4 and it is also following the same rapid transmission trajectory seen in many other countries. Unfortunately, in the last 48 hours, we have seen that South Africa is now showing increasing hospital and critical care bed admissions, showing that, even if there is less likelihood of serious disease, there is still some serious disease.

Ministers are right to be concerned about superspreader events, which are being reported all over Europe. Assuming that doubling continues at this rate and with a million cases possibly by the end of the year, that is very worrying, as is the news of the lower immunity against omicron from the vaccine compared to delta.

Just this afternoon, Antonio Conte, head coach of Tottenham Hotspur, reported that eight of his first team members and five members of staff have tested positive ahead of a big European game. He said:

“The situation makes me very upset … It’s contagious and there is a big infection.”


He is right.

The Statement does not mention that there is a higher percentage of young children both contracting omicron and going into hospital in South Africa. What arrangements are being made to ensure that parents recognise that and understand the different symptoms that young children have?

From these Benches we have been urging the Government to move ahead with plan B since cases started rising steadily in September. Today, all cases—of whichever variant—still number over 51,000, with a further 161 deaths. It is vital that we make sure that those numbers do not go up.

Face masks are vital, especially with increased transmission. But do I understand the Minister to say that singing, which we already know is high risk for transmission, will be exempt? On what medical grounds is that sound? I understand that hospitality has exemptions too. Is this taking us back to when you could take your mask off if you were sitting at a table and eating, but had to wear one when you were moving around a pub, bar or restaurant?

Ventilation is vital. Can the Minister say how many schools have received the air filters they were promised a year ago?

I notice that we are moving now to lateral flow tests rather than isolation. Can the Minister say what the current percentage of false negatives is for lateral flow tests and how that is going to be managed?

It makes sense to follow both Scotland and Wales in asking people to work from home if they can. How is that likely to affect the working arrangements on the Parliamentary Estate, including your Lordships’ House? In particular, and as a minimum, should the House consider returning to remote voting to avoid noble Lords mixing together in large numbers? We know we have a large number of votes over the next few weeks.

There are also a large number of notable omissions from this Statement. The first is the difficult issue of social care and support for those in homes, or housebound, as well as the staff who look after them. I see that the Statement says that there will be information to follow.

The second is the lack of mention of the Covid app. Given that many people are saying that their third dose or booster dose information is still not being recorded properly, can the Minister say if these difficulties have been resolved? The consequences of having to have Covid certification will affect people from Friday.

Thirdly, there is not one word about the clinically extremely vulnerable: that is 3.7 million people, of whom 800,000 are severely clinically extremely vulnerable. Most of the larger group should have had their booster jabs by now, and should be reasonably protected, but can the Minister say yet if that is true of omicron, especially as no one will have had three doses of Pfizer?

I thank the Minister for arranging our meeting next week to discuss the problems that the severely clinically extremely vulnerable are facing. Doctors are already telling this group that they will have a less good and shorter-lived response—if any—to vaccines. Is there any data on vaccinations for this group and omicron?

Other problems remain, as the Minister will have seen from the responses to my tweet this morning. Many people are still finding that their GPs do not know they should have a third dose, because there is no register and their hospital consultants have not had time to write to every patient’s GP. The NHS app still is not recognising third doses. GPs are not sure if it should be eight weeks or 12 weeks between the third dose and the booster.

While the news about the antivirals and retrovirals is good, most CEV people do not want to catch Covid. So above all, following this Statement, where is the specific guidance to both groups who are alarmed by the high number of delta cases, the growing number of omicron cases, and the marked reluctance of people generally to follow mask guidance. This is not a “nice to have”. This is 5% of the population who risk severe disease or dying from Covid. Please can the Minister agree to advise this group in the same way that there will be advice for the social care sector?

[Lord Kamall (Con)]

I will try to answer as many of the noble Baronesses’ questions as I can. Regarding the more scientific data and evidence, I hope that Peers have received an invitation—if not, I will make sure that it is sent out—to a call with Dr Jenny Harries and me on Friday, during which we will be providing further details and data. It will be an all-Peers call, so noble Lords can discuss a lot of the scientific facts and evidence.

We are advising that you should work from home if you can. If you cannot, you should take lateral flow tests regularly when attending the workplace. We are requiring the wearing of face coverings in a wider range of settings. If noble Lords will forgive me, I will go into some detail here and, if appropriate, I will place these details in the Library.

Last week, we took the initial step of making face coverings mandatory again in England in shops, including contact services such as hairdressers, on public transport and on transport hubs. We are now going further, requiring the wearing of face coverings in a wider range of locations. Police and community support officers can take measures if members of the public do not comply with the law. Exemptions apply for children under the age of 11 and those unable to wear a mask covering due to health, age, equality or disability reasons.

From Friday, the settings requiring face coverings will be attractions and recreation venues—concert halls, exhibition halls et cetera—cinemas, theatres, museums and galleries. I have a longer list and I am happy to share that as appropriate with noble Lords. Other settings include bingo halls and casinos, snooker and pool halls, skating rinks, circuses, other business ventures such as public areas in hotels and hostels, play and soft play areas, sports stadia, other indoor public venues, places of worship, crematoria, chapels, community centres, public libraries and polling stations.

Places that already require face coverings, just to remind noble Lords, are shops and supermarkets, shopping centres, auction houses, post offices, banks and building societies et cetera, estate agents and letting agents, premises providing personal care, veterinary services, retail galleries, retail travel agents, takeaways without space for consumption, pharmacies, public transport and others.

So, face coverings have been reintroduced. We know that they are effective at reducing transmission indoors. I thank the noble Baroness for the support for these measures. We appreciate it on this side of the House.

It will not be a legal requirement to wear a face covering in hospitality settings, restaurants, cafés, canteens, bars, shisha bars and premises other than registered pharmacies providing medical or dental services, including services relating to mental health, and photography studios. The reasoning behind that, I am sure, will be covered in the call on Friday. I do not have all the details and the scientific evidence to hand, given the late notice of this, but I hope that Dr Jenny Harries can share much of that detail with noble Lords.

On the booster rollout, we have already seen nearly 21 million people take up their booster dose, with 1.9 million people coming forward last week. The NHS vaccine programme is to be extended today. People over 40, along with those in high-risk groups, can take their dose.

I was interested to hear from the noble Baroness, Lady Brinton, that people were still reporting that the booster was not on their app. I was not aware of that. In fact, a number of noble Lords had told me that it was on the app. I apologise for not recognising this—this is the first I had heard of it.

NHS: Elective and Cancer Care Backlog

Baroness Brinton Excerpts

Tuesday 7th December 2021 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, the noble Baroness, Lady Brinton, wishes to speak virtually. I think this is a convenient point for me to call her.

[Baroness Brinton (LD) [V]]

My Lords, this week the Royal College of Emergency Medicine reports that 40 hospitals have cancelled at least 13,000 operations over the last two months because of the surge in demand, as well as the high number of Covid patients in hospitals. The Government winter plan says that there will be extra beds and staff to help, but there are no beds or spare staff right now, so what are the Government proposing to do before many of these patients end up back in A&E because of their delayed surgery?

[Lord Kamall (Con)]

One thing that the Government are doing is looking at a number of different ways in which we can think outside the box and be multifaceted to make sure that, for example, instead of patients going directly to A&E they can be dealt with by 111 or other services. In addition, we are committed to delivering 50,000 more nurses, growing the workforce and making sure that we have a trained workforce not only in healthcare but in social care.

Health and Care Bill

Baroness Brinton Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as a vice-president of the Local Government Association. I welcome the noble Lord, Lord Stevens of Birmingham, to his place and look forward to hearing his maiden speech. I also offer my thanks to everyone who has briefed us. We, too, regret that the advisory speaking time is five minutes on a long and complex Bill, with many expert speakers whom I am sure the House will want to hear. We note that this time is advisory.

In principle, we have long argued for true integration of health and social care, and reforms are long overdue. The coalition Government created the better care fund, which has set a standard for integrated care in a number of places such as Torbay, but our social care system has needed reform for decades. The increasing workforce crisis and cuts to publicly funded patients, with private patients having to subsidise them, is scandalous. Covid, including the omicron variant as well as the severe winter crisis already with us, makes it much harder for substantial reforms to be in place for the end of March. I echo the comments of the noble Baroness, Lady Merron, about it being the wrong Bill at the wrong time.

The long-awaited adult social care reform White Paper, People at the Heart of Care, was essential for delivering true integration. Despite the Prime Minister’s promise on the steps of No. 10 Downing Street two and a half years ago, I am afraid that the White Paper is deeply disappointing, not least on how integration will work in practice. Perhaps it is not surprising that Ministers have already announced another social care integration White Paper for next year. We still need to see it before the passage of this Bill. I fear that we will not. We believe that these changes will not work without the reform of workforce planning, and we will seek to strengthen the long-term planning arrangements, especially for social care, where progressive career pathways and proper skilled rates of pay are long overdue.

We too regret the powers being given to the Secretary of State. The reforms under the coalition Government by the then Secretary of State, the noble Lord, Lord Lansley, to remove them from operational decisions was the right one. Despite some of Ministers’ words in briefings, we need to be convinced that this is the right move. Ministers tampering with reconfigurations, capital grants or even contracts have already led the Johnson Government into serious difficulties. Worse, giving powers to the Secretary of State to transfer or delegate powers or functions without a clear rubric about how sparsely this must be used, and in what circumstances, is also dangerous. Through some of these provisions, Parliament is once again excluded from scrutinising Ministers’ actions.

We are concerned about the membership of ICBs. With the increased commissioning duties on local authorities, it is important that they have a voice at the table. More than one local authority in an ICB area gives us a problem. The same is true for NGOs, charities and local enterprises that are involved in the delivery of local social care. Much of the reforms, for both ICPs and the levy, are based on older people’s social care. We think it is wrong that disabled younger adults and children who need social care have been squeezed into inappropriate arrangements once again. Unpaid carers are still evidently meant to pick up much of the burden of care, especially with the new emphasis on getting people home from hospital, sometimes before assessment. It is time that the Government truly recognised the commitment and the cost of these unpaid carers and rewarded them.

Part 2 sets out the new information and data requirements for health and social care, especially the latter. We seek assurances that patient and client data will not only be protected and anonymised but cannot be sold on to commercial parties. We are concerned about the power of the Secretary of State to decide what is and is not commercially confidential. We believe that the Health Services Safety Investigations Body is long overdue, but we will seek confirmation that it is to be truly independent from Ministers. In Part 5, we welcome the proposed ban on virginity testing but also seek a ban on hymenoplasty.

International healthcare arrangements in Part 6 must protect the NHS from this Government’s former aims to give countries the right to bid for NHS contracts as part of economic treaties in the Healthcare (International Arrangements) Bill of 2019. We will seek to ensure that nothing like this creeps in again.

A few weeks ago, the Government rushed the Health and Social Care Levy Act 2021 through Parliament in just a few days. It was clear to us then that the creation of a new tax mechanism deserved careful scrutiny, but this was denied to Parliament, not least because of the lack of detail in how it would work. The Minister said that the new cap arrangements are fair; they are not. They let down exactly the group of people that this Government claim they want to help: those who live outside the greater south-east, with property worth over £100,000.

There is irony in the Government saying in their document:

“It is important that the new reforms are clear and reduce complexity”


before setting out a complex structure of disregards and benefits and the bombshell that neither local authority contributions nor personal care, nor what are sometimes known as hotel costs will count towards the cap. We will oppose this.

My colleagues will cover the clauses on food and drink and the fluoridation of water supplies. We also regret the limited public health reforms to tackle inequalities.

We have argued for years that we need a comprehensive integrated health and social care system, alongside a modernised and effective NHS, managed by its leaders without ministerial interference. Our broken care system, where staff and providers have battled valiantly against all the odds, desperately needs real reform.

This Bill has some of the right ideas, but it is already clear that there are many worrying elements which will not deliver the reform or funding needed. Health and social care providers, all the wonderful staff across both sectors and the public who use and rely on our NHS and social care systems, need that reform. From these Benches, we will aim to persuade the Government to improve this Bill.