Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020

Baroness Watkins of Tavistock Excerpts

Tuesday 1st December 2020 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I appreciate that the issue of reducing the spread of the Covid-19 virus is essential for the health of our population. However, while I broadly support the regulations before us today, I am extremely concerned that people in England are finding difficulty in understanding the correlation between the R rate in their local community and the tier in which those communities are being placed. Can the Minister explain why London should be in tier 2 when some parts of the north and the Midlands that have been placed in tier 3 seem to have similar R rates per 100,000 people in the population? We have been told that in many situations this is because of the pressure on hospitals. Is it the case, therefore, that there are sufficient empty ITU and vacant hospital beds to allow for an increase in the R rate that may occur associated with the social mixing allowed under tier 2 regulations in London compared to hospital bed availability in other parts of the country?

It is reported in the media that Ministers believe the adoption of the new tier system will enable a re-evaluation of tier allocation, depending, presumably, on the R rate, in as little as a fortnight. Members of the public might be in tier 3 from tomorrow, might move to tier 2 restrictions rapidly and might then enter the national relaxation in restrictions over the Christmas holidays. This concept suggests that if people adhere to the rules in tier 3, a rapid move to tier 2 is likely. Can the Minister confirm that, in the event of the R rate increasing in tier 2 areas over the next fortnight, these communities will be moved into tier 3 level restrictions prior to moving to the rules that are associated with the Christmas period?

We are told that these tiers are necessary to protect the NHS. In fact, the NHS is not just acute hospitals. Rather, the NHS involves public health, primary care and the long-term support of people with chronic health problems, in their own homes and in residential care settings, where there is inevitably close liaison with social care. Will the Minister inform the House what estimates have been made of the pressures on community mental health and learning disability services as a result of the pandemic, and what further interventions are being planned to support community-based services in tier 3 areas? Unless we intervene to tackle the effects of the pandemic on the most vulnerable in our society who do not require hospitalisation, we are in danger of doing more harm to the health of the population than we realise. The BBC “News at Ten” last night focused on the isolation and poverty that has been exacerbated as a result of the pandemic. It was a harsh reminder to anybody who watched it of the wider effect of the virus.

Finally, I remain concerned that, as the amendment to this Motion tabled by the noble Baroness, Lady Neville-Rolfe, states, “the restrictions being introduced” are not sufficiently

“informed by a wide and detailed analysis”

of other factors. The UK continues to reduce inbound travel restrictions from a range of countries using a methodology endorsed by the four CNOs in the UK. It states:

“As UK infection rates rise, the relative risk to public health from imported cases decreases”.


The latest changes were agreed at the sixth statutory review on 16 November when incidence was high in the UK. As the Minister has said, UK rates are now already reducing. How long will it be before we review again the travel restrictions? I ask this question because the methodology also states that:

“The rationale for this is that the impact of travel restrictions is expected to be greatest when UK infection rates are relatively low.”


Therefore, if we succeed in reducing the rates before Christmas, is the Department of Health and Social Care confident that the transmission of Covid-19 within the UK from people arriving in this country with asymptomatic disease is highly unlikely?

As a healthcare worker myself, I remain concerned that we have to face high levels of restrictions on social interaction to contain the disease and protect healthcare workers. The public do not wish to comply with our community’s restrictions only to have their own investment in disease reduction wasted as a result of people travelling from other parts of the world and unwittingly increasing infection rates in the UK again over the Christmas period.