Procurement of Evusheld

Catherine McKinnell Excerpts

Wednesday 12th October 2022 Westminster Hall

[Daisy Cooper]

I welcome that intervention and I do agree. I will outline all the scientific evidence that backs the decision to procure Evusheld and roll it out right now, this side of Christmas.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I congratulate the hon. Lady on securing this timely debate. I was contacted by a constituent ahead of it, who reiterated that as autumn and winter approach, we are even more vulnerable and isolated. Given what we face, I am sure the hon. Lady agrees that it is urgent for Ministers to listen to this debate and set out plans to support immunosuppressed patients and people during the difficult winter ahead.

Access to GP Services and NHS Dentistry

Catherine McKinnell Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with the point my hon. Friend makes. It is simply not good enough for the Minister to keep on talking about what the last Labour Government did. If she does not agree with the situation described by my hon. Friend, which is happening on her watch, why does she not legislate? If she is incapable of governing, she should make way for people who can govern.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I commend my hon. Friend for the tone of the speech that he is making, because it is vital that we stand up for our NHS, which the Government are failing to do. They seem happy to let everybody be angry with their GPs and about their inability to seek the medical help they need, but very unwilling to do something about it. Is this argument not really one to be had with the Government entirely? They should be making sure that we have sufficient GPs to treat the people in this country.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend; it is the trend with this Government to seek division, sow division, pass the buck, devolve the blame and not take responsibility for anything. What Opposition Members would not give for just one day of being able to govern in the interests of the people in this country! This Government want to give the appearance of being in office but not governing at all. That is what is happening on their watch. If that is not bad enough, against a difficult economic backdrop, with scarce resources, not only is the way in which they manage and govern bad for patients, but it is squandering taxpayers’ money.

Vaccination Strategy

Catherine McKinnell Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

I completely agree with my right hon. Friend that persuasion is the right way to go. That is why the uptake went up tremendously among care home staff and since we implemented the policy for the NHS the uptake among NHS staff has increased tremendously as well, which is really encouraging. We want it to be a positive choice, and we want people to understand that they are protecting not just themselves and their families but the patients they care for, ensuring that they are safe. Those one-on-one conversations are ongoing to ensure that people understand that, from the perspective of patient safety, this is the right choice to make.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

With rates of infection high among teenagers, many are simply unable to get double vaccinated yet as they were infected in the period when they would have been eligible and had to wait 12 weeks to get the jab. Unfortunately for families hoping to travel in half term, they cannot access a covid recovery certificate through the NHS app or through 119, despite contracting covid being the reason that they are not double vaccinated. Families are facing the prospect of cancelling their travel plans for half term, which will have an impact not only on our constituents but on the travel industry. I know that the Department is considering a solution, but will the Minister give some clarity that that will be achieved before half term, to give people the confidence to make travel plans?

[Maggie Throup]

The hon. Lady makes a very good point, and it is not the first time the issue has been raised with me. We had that situation in the run-up to Christmas, and we are obviously now in the run-up to half term and Easter as well. I assure her that measures are being considered to see how to resolve the situation.

Covid-19 Update

Catherine McKinnell Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to talk about the importance of increasing capacity. The pandemic has brought that acutely to the front of our minds. There has been significant investment since the pandemic started, particularly in certain types of capacity, such as intensive care units, PPE and oxygen, as well as personnel, with some 10,000 nurses and 3,000 doctors added over the last year. As a result of the omicron emergency, we are revisiting the issue of how we can further increase the temporary capacity.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

NHS data in November showed that 98% of the pregnant women in hospital with covid were unvaccinated. Pregnant women want to do the right thing to protect themselves and their babies, but there has been a lack of clarity and a lack of prioritisation for vaccines for this group of people. Will the Secretary of State set out what the Government will do to send the message loud and clear that vaccination uptake for pregnant women and their babies is a priority for the Government?

[Sajid Javid]

It absolutely is. Work on this is being led by Lucy Chappell, in particular, in my Department and the UKHSA. One of the central focuses of her work has been to encourage more pregnant women to come forward and take up the offer of the vaccine. As the hon. Lady says, sadly, when we look at the data on pregnant women who are going into hospital because of covid infections, we see that almost all of them are unvaccinated.

Giving Every Baby the Best Start in Life

Catherine McKinnell Excerpts

Tuesday 9th November 2021 Commons Chamber

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I thank the Backbench Business Committee for granting time to debate this incredibly important subject. I also commend my colleagues, the hon. Member for Richmond Park (Sarah Olney) and the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), for setting out so eloquently and passionately the case for focusing on this issue. I had hoped that, as co-sponsors of the debate and co-conspirators on this issue, we would not just repeat one another’s arguments, and I believe that, without co-ordinating in any way, we will not. We agree on the problem—we agree on the challenge and the importance of this issue—but today I want to focus on the enormous challenge presented by poverty in overcoming many of these issues.

We know from international evidence that so many important life outcomes, from health to wealth and wellbeing, have their origins in early childhood, but the reality is that not all childhoods are equal. If we truly want to give every child the best start in life, we must tackle poverty and economic disadvantage. There is substantial evidence demonstrating the damaging, stigmatising and often lifelong impact of experiencing poverty in childhood. It affects cognitive skills, social and emotional development, physical health, mental health, educational outcomes, employment prospects, the likelihood of being in poverty as an adult, and life expectancy.

Recent reports have highlighted starkly that the impact of poverty begins in very early childhood, or even pre-birth. For example, last month, MBRRACE-UK— Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK—reported that

“babies born to women living in the most deprived areas are twice as likely to be stillborn, and at a 73% excess risk of neonatal death compared to babies born to women living in the least deprived areas”.

Likewise, national child mortality database research published in May found a clear link between deprivation and child death. It concluded that around 700 fewer child deaths per year—a fifth of all child deaths—might be avoided if children living in the most deprived areas had the same mortality risk as those living in the least deprived. Poverty is literally killing children.

[Wera Hobhouse]

Is the hon. Member as concerned and shocked as I am about data showing that a mother from an ethnic minority background has a much higher likelihood of experiencing complications during pregnancy or birth that result in their baby being either stillborn or born with a disability? Does she agree that we need absolutely to focus on such discrimination and disadvantages?

[Catherine McKinnell]

Yes, I absolutely agree with the hon. Lady. As the Chair of the Petitions Committee, I can say we received petitions on that issue and debated it in Parliament. We have been given some assurances from the Government, but it is imperative that all of us in this House ensure an improvement in both the statistics and the reality for those who experience it.

It is well established in education research that on average the longer a child has been disadvantaged the worse their performance will be at school, particularly in key stage 4 assessments. Even where children from more deprived backgrounds do achieve the same results as their better-off peers, they are still likely to have lower lifetime earnings. How unbelievably disheartening is that?

Sadly, child poverty is getting worse. Government statistics on households below average income published this spring show just how many families were struggling before covid-19. In 2020, 200,000 more children were pushed into poverty compared to the previous year, using the measure of relative poverty after housing costs. That means 4.3 million children living in poverty: real children living in real hardship. I know the Government do not readily accept the concept of relative poverty, but Ministers should listen to the recommendation of the Work and Pensions Committee to end the sole focus on absolute poverty and look at broader measures. After all, if the Government are committed to levelling up, improving the position of a child in Newcastle relative to a child in Middlesex is surely more relevant to comparing a child in Newcastle today with a child in Newcastle 11 years ago.

Even if we use only the Government’s preferred absolute poverty measure, the proportion of children living in poverty rose by an average of four percentage points in every north-east local authority area between 2014-15 and 2019-20, while the number of children living in absolute poverty across the north-east rose by more than 21,000 during that period. The latter point is particularly concerning as absolute poverty is a measure that has always tended to naturally improve over time as living standards rise, but in the north-east it is going in the opposite direction. As troubling as the pre-pandemic figures are, none of that should come as a surprise given the direction of Government policy over the last 10 years. Indeed, the country went into the pandemic expecting to spend £36 billion less on social security because of Government welfare policy. That has to come from somewhere, and it is coming from the poorest pockets and the mouths of children.

Just as Government action can lead to increases in child poverty, it can bring them down too. We have seen it before, especially under the previous Labour Government. What we need is a cross-governmental strategy for tackling child poverty, something groups such as the North East Child Poverty Commission and the Child Poverty Action Group have consistently called for. It needs to go a lot further than anything we have heard from the Government to date. It should include a welfare system that prevents and reduces poverty, giving all families a dignified safety net when they are going through tough times. It should tackle unemployment and low-paid insecure work, the kind of work that means most children living in poverty are now in working families. We need concerted action to support families with the cost of major outgoings: energy, housing and childcare.

All those things were problems pre-pandemic and they still need to be addressed, but covid-19 and the lockdowns of the last year-and-a-half have brought additional challenges for parents and young children. For the past 18 months, the Petitions Committee, which I Chair, has investigated the pandemic’s impact on new parents and children, and expressed its deep concerns that it is being overlooked by the Government. Our first report in July 2020 highlighted the need for urgent catch-up investment to help new parents access support services disrupted by the pandemic, and to do more to ensure employers meet their health and safety duties towards pregnant women. Unfortunately, the Government rejected almost all our recommendations, saying that support was “sufficiently generous” for

“the vast majority of parents”.

That, however, did not match up with all the evidence we heard from new parents about their struggles. We heard that crucial support for children’s wellbeing and development was being missed, that there were concerns about employers not meeting their health and safety duties towards pregnant women, and about additional difficulties in accessing childcare. I fear that the Government know that the impacts of all of that are long term, and that by the time the impacts of their failure to invest will be seen, they may be well gone, or at least their failure forgotten.

This year the Committee decided to revisit those issues with a follow-up report, but unfortunately it is already clear that we are seeing the impact of the Government’s lack of action in this area, including: children coming into early years classes behind in their social development; increasing rates of poor mental health among new mothers; and childcare providers going out of business. The Committee found that new and expectant parents’ access to support has remained severely limited. Many have lost out entirely on the crucial window of support available in the early months of their child’s life, and issues around children’s development and parents’ mental health will have been missed. I have said repeatedly that there is a good reason why we wrap a blanket of support around new mums and their babies—and dads, too. It is needed at the time and the long-term impacts of not providing it are well known. Urgent investment is needed to provide catch-up mental health and health visiting support.

The Government have failed to deliver on stronger workplace discrimination protections for new and expectant mothers, and they have repeatedly promised to do that. That is especially concerning as the economic impact of the pandemic continues to be felt. I pressed the Prime Minister on that at the Liaison Committee, and I urge the Government to pass those protections into law as soon as possible. If mums are being discriminated against, it is bad for their children, too.

The pandemic has also exacerbated pre-existing problems in the early years sector. Government financial support has been welcome, but it has not prevented many early years providers seeing a significant impact on their finances, with low pay for staff, many of whom are mums too, and high costs for parents. The pandemic may well contribute to or even accelerate an ongoing erosion of provision. I therefore urge the Government to consider a review of early years funding to ensure it is affordable and meets the needs of new parents seeking to return to work. They could set out a clear vision for our children, our undervalued early years and childcare workforce, and ensure that no parent must choose between their child and their career.

Before I conclude, I want to ask the Minister some specific questions on the Government’s proposed family hubs. Given that there are 152 upper-tier councils in England and there will be 75 family hubs, it looks like just under half of local authorities will benefit from the programme. Have the Government already determined the criteria by which the funding will be allocated? We assume it will be based on some measure of deprivation, but will the Minister confirm that? May I urge the Government not to continue their approach of forcing overstretched local authorities to commit their scarce resources to making funding applications? We should not be pitting local authorities with high levels of deprivation and child poverty, such as those in the north-east, against each other to receive support. How does the Minister see family hubs working in large local authority areas, often with poor public transport links? For example, getting across Newcastle with young children to access services via public transport can be challenging, particularly for my constituents in the Outer West. Large rural areas like Durham and Northumberland face their own challenges. I hope when the Minster responds, she will confirm that services will be “within pram-pushing distance” of the families they are intended to help, as was the aim of the Sure Start programme.

In conclusion, the crushing pressure that poverty places on families and children is clear. It impacts our children’s lives directly when parents and carers do not have enough money to meet their children’s material, social and educational needs. It impacts on them indirectly by creating stress, insecurity and conflict at home.

These adverse childhood experiences inevitably influence children’s development and wellbeing, creating a vicious cycle. To escape that cycle, we need a coherent, cross-departmental anti-child poverty strategy, backed by proper investment. It is fair to say that we are pretty far from that at the moment when the Government often seem unsure about which Minister to send to respond to child poverty debates. Such pervasive child poverty is not inevitable. The last Labour Government reduced child poverty and the concerns about child welfare that it creates. We can do it again and truly give every child the best start in life. We just need the Government to care truly about achieving it.

Covid-19 Update

Catherine McKinnell Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to raise this and our guidelines on mask wearing will be very clear. If people are in retail spaces and they are crowded—as we know, most of them are enclosed—they should consider wearing a mask. They should be thinking not just about themselves but about the people around them and the people serving them.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab) [V]]

The Secretary of State will have seen the huge and rising number of covid infections in the north-east, and the decision to remove controls will clearly accelerate that and increase concerns about the short-term and long-term impacts of covid and the risk of vaccine-resistant variants. Regardless of the proposed covid passports, businesses in the north-east—especially in sectors such as hospitality, where large numbers of young unvaccinated people work—are already struggling to function with reduced staff and customers cancelling at the last minute to self-isolate. With the Government withdrawing economic support at the same time, does the right hon. Gentleman appreciate the concern that, for many hospitality businesses, the Government’s summer of high covid may be too much to survive?

[Sajid Javid]

The hon. Lady will know that there is still significant economic support in place, and of course it is the job of the Treasury to keep that under review. When it comes to self-isolation and the impact that it has on businesses, it is important, now that we have such a high level of vaccination, including in the north-east, that we can take a more proportionate and balanced approach, and that is exactly what we are doing.

Social Care Reform

Catherine McKinnell Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I thank my hon. Friend for his involvement on the Health and Social Care Committee, whose reports I find really helpful; they provide great insight and contribute to the conversation. He alludes to the different models for paying for social care, and clearly there are many different approaches. We have been considering them, but I am not able to go into detail here and now. I will have to ask him to wait until we publish our proposals for social care reform.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab) [V]]

This pandemic has starkly demonstrated the unequal footing of social care alongside the NHS in this country. The Prime Minister’s announcement back in 2019 that he had a social care plan ready to go has been clearly shown to be untrue, and according to Age UK, 1.5 million older people are going without the care they need. People living in areas with a low council tax base, such as Newcastle, have seen their local council tax precepts rise because the Government have shifted the burden of paying for social care on to those who can least afford it. I agree with the shadow Minister, my hon. Friend the Member for Leicester West (Liz Kendall), that the time for excuses is over, so what is the Minister doing to ensure that the Prime Minister and the Health Secretary stop making empty promises so that we can start building much-needed cross-party consensus on this issue without any further delay?

[Helen Whately]

We are working on our proposals for social care reform, and we are working across the sector. As I have said, I am already talking to and meeting those across the sector—care providers, representatives and, in fact, users of the care and carers themselves. This is complex. There are reasons why there have been discussions about this for many years without proposals for reform being brought forward. We are hugely ambitious, and we want to get it right. That is why I make no apologies that we are taking some time, but as we have said, we will be bringing forward our proposals for reform later this year.

Black Maternal Healthcare and Mortality

Catherine McKinnell Excerpts

Monday 19th April 2021 Westminster Hall

[Catherine McKinnell (Newcastle upon Tyne North) (Lab) [V]]

I beg to move,

That this House has considered e-petition 301079, relating to Black maternal healthcare and mortality.

It is an honour to speak under your chairmanship, Sir Gary. I am also honoured to open this debate on behalf of the Petitions Committee and the more than 187,000 people who signed the petition organised by campaigners Tinuke Awe and Clo Abe.

The petition highlights the shameful fact that in 21st-century Britain, the colour of a woman’s skin affects how safe she and her child are during pregnancy and birth. That is one of the starkest examples of racial health inequalities in this country. As Tinuke and Clo have pointed out, the latest data show that black women are more than four times more likely than white women to die during pregnancy or in the six weeks after giving birth. Women from Asian backgrounds are twice as likely as white women to die during pregnancy. To put that into context, I should state from the outset that the UK is one of the safest countries in the world to give birth. Deaths during pregnancy are very rare. I am sure the Minister will reiterate that in her response.

Around one in 10,000 pregnant women dies every year from causes related to their pregnancy. Every single one of those deaths is a tragedy, but they are a very small proportion of all pregnancies. The situation has also improved slightly over the last 10 years. Those figures mask the underlying, long-standing and shocking inequalities in maternal mortality, yet we do not have a base of research and evidence to fully explain their root causes and to point the way forward. There is still no Government target to eliminate the gap. That needs to be addressed urgently.

What do we know about women who die during or shortly after pregnancy? Pregnancy alters the way the body works. Two thirds of all pregnant women who die fall victim to complications such as heart disease or the care they receive while pregnant. Most do not die during childbirth itself. Dr Christine Ekechi, co-chair of the race equality taskforce at the Royal College of Obstetricians and Gynaecologists, points out that black women are more likely to have pre-existing health conditions that lead to greater risks during pregnancy. However, she also highlights that the obvious question to ask is why black non-transmissible health issues such as cardiac disease and high blood pressure are more prevalent in the first place. If it is a result of existing social and economic inequalities, that must be addressed.

Across all ethnicities, most pregnant women who die have complex medical needs, but leading maternal health researchers such as Professor Marian Knight have expressed concerns that our health and social care system is just not set up to deal with that complexity. Clinics are often based at different hospitals, requiring separate appointments. Communication between them does not seem to happen in the way it should. Women are often expected to juggle other childcare and work commitments while attending myriad appointments at a range of different institutions. Not all women have the same support and security at home and at work, and the system does not account for that.

Accounts have shown that the symptoms that pregnant women present with are too often dismissed and attributed to pregnancy itself, when they could be indicators of serious underlying medical complications. Pregnant women from all backgrounds report not being listened to despite the fact that that is crucial to the physical and mental wellbeing of both mother and child. Professor Knight points to what she calls the “constellation of biases” that black and Asian women are subject to. Those range from lack of listening, learning and nuance around women’s backgrounds and the most appropriate care, to micro-aggressions, all the way to completely unacceptable race-related perceptions such as the entirely unsubstantiated notion that black women have higher pain thresholds. If pregnant women are not being listened to and their symptoms are not taken seriously, or if they feel that they will not be, that is a recipe for tragedy.

It is important that public awareness of that issue has finally begun to increase, which is in no small part thanks to the work of such campaigners as Tinuke and Clo and the initiatives that they have launched, such as Black Women’s Maternal Health Awareness Week, which was first held last September, and the petition that we are debating. More women are now coming forward with their experiences, and five times more have shared their stories. One woman recounted:

“As soon as the second midwife was on shift she just seemed to have one goal in mind and that was delivering my baby as soon as possible, she didn’t seem to care about easing any part of my pain or reassuring me for the many worries I had at the time—she rushed my labour along and as a result almost cost me my sons life.”

Another said:

“I already seemed like that hyper-emotional black woman worried about nothing and I let that silence me. I really wish in this moment I expressed my concern or spoke up, because I honestly couldn’t have fathomed that what happened next would come.”

The reaction on social media to Channel 4’s recent “Dispatches” documentary was also very telling. One Twitter user said:

“For many Black women ‘The Black Maternity Scandal’ on Ch 4 is sadly not shocking or eye opening at all. Not being listened to in times of pain has become far too normal and it has to change.”

Another wrote:

“For many of us Black and Brown women, this felt like the first time our stories and traumatic, hurtful experiences got a small hearing on national TV.”

Pregnancy can be a special and exciting time, but it can also be exhausting and terrifying. For any woman to have to spend it not being listened to or not receiving the most appropriate care because of the colour of her skin is nothing short of appalling, so it is unsurprising that there is now an increasingly vocal consensus on the urgent need for more research and evidence, and for firm commitments from the Government and the NHS to end the scandal. We need to address the under-researching of health issues that black women face, and get a clear picture of the data on maternal deaths among different ethnic groups. Many different ethnicities are grouped together under broad categories, which risks missing cultural nuances, misrepresenting experiences and leading us to the wrong conclusions.

Maternal deaths are just the tip of the iceberg. For every woman who dies, many more will have severe pregnancy complications, and there is evidence of disparities between ethnic groups in that respect, too. However, the number of those cases and the impact on their families and lives is not recorded. Lack of research on those so-called near misses is a gap in the knowledge base that must be urgently and proactively corrected.

Tinuke and Clo are asking MPs to act by signing up to the Five X More black maternal health pledge, which I know many colleagues who have spoken today have already supported. One of the asks is that the Government implement the recommendations of the Joint Committee on Human Rights, including the introduction of a firm target to end the disparity in maternal deaths. I would be grateful if the Minister would tell us whether the Government agree with the Joint Committee on Human Rights, the chief midwifery officer and the petitioners that such a target must be put in place. It would also be useful to know whether the Government intend to address the data gap in medical research in the upcoming women’s health strategy.

I want to end by quoting what Tinuke said in an interview with The Guardian last year:

“In 1991 when my mum gave birth to me she was at greater risk of dying. In 2020 when I gave birth to my daughter that risk had increased and I was five times more likely to die…I’ll be damned if my daughter, whenever she decides to give birth, is 25 times more likely to die.”

That truly is a source of shame for this country, which is why today must mark the day that future generations start to look back and wonder how on earth this situation was ever tolerated for so long.

--- Later in debate ---

[Catherine McKinnell [V]]

Thank you, Sir Gary. I thank the Minister for her response, and everybody who has contributed to the debate, which has been very moving and powerful, and also very painful. I thank in particular my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing such a powerful personal story.

I hope that the debate has helped to raise awareness and understanding of why the issue must be urgently addressed, and I hope that we have done justice to the passionate and powerful campaigning of Clo and Tinuke. I know that they and we all want to see change, so I hope that the Government and NHS leaders have heard that call today. I urge the Minister to meet those who are affected, to continue to listen and to ensure that data continues to be collected and that changes are made to put an end to the five times more statistic for good.

Question put and agreed to.

Resolved,

That this House has considered e-petition 301079, relating to Black maternal healthcare and mortality.

UK Rare Diseases Framework

Catherine McKinnell Excerpts

Wednesday 24th March 2021 Westminster Hall

[Catherine McKinnell (Newcastle upon Tyne North) (Lab) [V]]

Thank you, Mrs Miller, for chairing this debate. I thank the Minister for allowing us to get in.

Whatever the rare disease, it cannot be right that families are spending their time and energy fighting for treatments when they should be spending precious time with their children. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing this debate, and I echo the concerns about Kuvan, particularly the recommendation for its use only by children. One of my constituents whose daughter is living with PKU raised very legitimate concerns with me about the detrimental impact this could have on the mental health of children and teenagers whose lives are transformed by this drug, but know the clock is ticking towards it being taken away from them as they turn 18.

One of the themes underpinning the UK Rare Diseases Framework is patient voice, which the Department for Health and Social Care says is essential to its implementation, and I could not agree more. However, we must understand that there is a long way to go before families coping with the impact of rare diseases truly feel valued by the system. Gail and Matthew Rich from my constituency fought a long campaign that I supported to access Brineura on the NHS for their daughters Nicole and Jessica, who have CLN2 Batten Disease. Ahead of this debate, Gail told me:

“Patients and parents are not included or listened to enough, and children are suffering as a result of following an antiquated system which seems all about number-crunching and balancing figures rather than what is essential and morally acceptable.”

Those affected by rare diseases too often feel that they are struggling alone, so as we move from publication of the UK Rare Diseases Framework to the development of action plans, I urge the Minister to ensure that patient voices are truly heard, and positive outcomes reflect patient needs, not just those of the healthcare system.

HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (SELF-ISOLATION) (ENGLAND) REGULATIONS 2020 HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NORTH OF ENGLAND, NORTH EAST AND NORTH WEST OF ENGLAND AND OBLIGATIONS OF UNDERTAKINGS (ENGLAND) ETC.) (AMENDMENT) REGULATIONS 2020

Catherine McKinnell Excerpts

Monday 19th October 2020 General Committees

[Helen Whately]

I thank my right hon. Friend for his question, and I will indeed cite the evidence that we have on the level of compliance with self-isolation later.

The regulations also recognise the importance of employers respecting self-isolation requirements. No employer should prevent an employee from self-isolating or encourage or put pressure on them not to do so. Where an employer is found to be in breach of that obligation, they face a fine. That is in line with fines for other employer covid-19 breaches. Employees who need to self-isolate must also inform their employers of their legal requirement to do so, and a fixed fine of £50 is set for employees who do not inform their employer. There is a clear reciprocal duty between employees and employers about self-isolation, which supports both the opportunity and motivation to comply.

We recognise that there may be exceptional circumstances in which an individual may need to break their self-isolation; for instance, if they are unsafe or if emergency assistance is needed. In those cases, the legal duty would not apply and individuals would not face a penalty. The regulations specify the circumstances in which breaking self-isolation would be permitted.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I am aware of situations where employees are very afraid of losing their job if they have to self-isolate. They are not necessarily able to access any sick pay or Government support. What messaging are the Government putting out to employers to make sure that they understand their obligations towards their employees? What can an employee do where they fear that they will lose their job if they do the right thing and self-isolate?

[Helen Whately]

The hon. Lady makes an important point about the role of employers as well as that of employees. Communications have been going out to make sure that people are aware of the importance of self-isolating. I may be able to offer something more specific about the communications to employers when I respond to the debate. There is financial support now in place because we found out from research that the financial impact of self-isolation was one reason that some people failed to do so.

[Helen Whately]

I know that that point has been raised throughout the pandemic, and there will be reasons why parents, for example, will have extra childcare responsibilities. We had that challenge during the full lockdown, when schools were closed other than for the children of key workers, and we know that employers did everything they could to be understanding and support their employees. I will take away the hon. Gentleman’s question about whether anything further can be done.

To set out the rationale behind the regulations we are discussing, the headline point is their importance in our overall strategy to combat covid-19. Clearly, the number of people testing positive has risen sharply and, indeed, is still increasing. That is not only among younger people; worryingly, we are seeing increasing rates among the over-60s, particularly in parts of the country that have higher rates overall. Hand in hand with the increasing number of cases, we are seeing a higher percentage of people testing positive and increasing rates of hospital admission, again particularly in areas where the case rates are highest.

Against that backdrop of increasing rates, we heard that, unfortunately, compliance with the restrictions has not been what it should be. To answer the question from my right hon. Friend the Member for Forest of Dean, general population surveys conducted between March and August showed that self-reported self-isolation compliance was relatively low. For instance, only around 20% of the population reported that they fully complied with self-isolation if they had symptoms or were identified as a contact. That is evidence of the challenge with self-isolation compliance at that time.

[Catherine McKinnell]

The Minister will recognise that there is a difficult balance to strike between encouraging compliance and discouraging engagement with the system —not being tested and not reporting symptoms in order to avoid the consequences of not being able to self-isolate. Have the Government analysed the potentially worrying consequence that increasing the penalties may disincentivise doing the right thing from a health perspective?

[Helen Whately]

The hon. Lady makes a really important point. We would not want to disincentivise anyone from coming forward to get tested or sharing their contacts, because that is such an important part of controlling this virus. On the other hand, if the data shows that compliance is low, which it does, then what actions can we take? First, we ensure that people really know what action they should be taking—that they should get tested, share their contacts and ensure that their contacts know that they should be isolating. Secondly, we provide people with more support to enable them to isolate. Thirdly, we make self-isolation a legal requirement, which communicates both the seriousness of isolating and the fact that if someone does not self-isolate when they test positive or are a contact, they could be putting other people’s lives at risk. Ultimately, if something is serious, there is a penalty associated with it. Those three things need to go together, particularly the understanding of the importance of taking the responsible course of action and self-isolating if necessary.

By making self-isolation a legal duty enforced through penalties for non-compliance, our aim is to ensure that people who have tested positive for covid-19 and those who have been directly exposed to the virus recognise the importance of self-isolating in order to reduce transmission and actually do isolate. SAGE has advised that ensuring infected individuals and their close contacts isolate is one of our most powerful tools for controlling the spread of the virus, so now is the time to introduce this measure and to combat the rising incidence.

The regulations were introduced using emergency powers so that we could respond quickly to the increasing threat to public health posed by covid-19. The urgency in this case arises from the increasing rate of diagnosed positive cases at the time of making the measures. The self-isolation SI came into force on 28 September 2020. It will be reviewed before the end of the six-month period and will expire 12 months after coming fully into force. The Secretary of State for Health and Social Care keeps their necessity under consideration between the formal review points, too.

The regulations demonstrate our willingness to take action where we need to. That said, we are committed to ensure that the measures are only in place for as long as necessary. I therefore commend the regulations to the Committee.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Ms Fovargue.

I thank the Minister for her opening remarks. As she noted, today we are debating two SIs. The first numerically, No.1045, came into force on 28 September, and strengthens the duties on those who are required to self-isolate and increases penalties for non-compliance. The second SI, No. 1057, makes changes to the restrictions on the protected areas throughout the north of England.

In common with the Minister, for the purposes of today’s debate I will largely focus on self-isolation issues. But, first, I must refer again to the timing of the introduction of multiple SIs, particularly No. 1057. The Minister will be aware that my colleagues and I have consistently raised concerns about the way in which regulations are introduced. It is the view of the Opposition and of Members on both sides of the House that the regulations are too important not to be debated before they become law, and that full parliamentary scrutiny should be required. It will not have escaped anyone’s notice that we saw some progress on that last week when the new regulations on medium, high and very high tiers of restriction were debated in the Chamber before they came into force. After arguing in this room and others along the Corridor week after week for such debate, it would be churlish not to acknowledge the improvement in such scrutiny.

The SIs before us today are back to the old ways and bad habits, I am afraid. Last week, when we debated multiple SIs that related to face covering regulations, I noted that the Secondary Legislation Scrutiny Committee had pointed out that it is not helpful to have the law scattered across so many different SIs. That is exactly the case with regulation No. 1057. Although it has now been superseded, it actually amended four different SIs. That practice adds to the confusion about what is or is not lawful under health protection regulations at any given time. When we are asking people to comply with measures that are needed to protect public health, it is really important that we make that process as helpful as possible.

Because, once again, we are debating regulations several weeks down the line, much of the legislation is already out of date. The accompanying explanatory memorandum is also out of date, having been written before the new three-tier approach was introduced. I found it of little value to my understanding of what is still relevant for the purposes of today’s debate. I think the Minister has put me out of my misery by confirming what part of the regulations are still live. Regulation 3, however, which relates to restrictions on indoor gatherings and exceptions to that, has been superseded by the tiered approach that was introduced last week. I believe that regulation 4 on obligations of venues when taking bookings is still a live requirement.

[Catherine McKinnell]

On the point about clarity, everybody appreciates that this is an unprecedented situation that is difficult to manage, but the Government have to do better at communicating the decisions and changes that affect people’s everyday lives, because that is the only way that people will know how to best combat this virus. For example, three different sets of regulations for the north-east have been announced to us in three weeks. I have such admiration for the people of the north-east; they are erring on the side of caution and doing what they think is best. However, it is difficult to understand exactly what the requirements are, because we have the national rule of six, then we had local restrictions and now we have the tiers. I do not want to add to the confusion, but the Government really need to do better if they are to get the best results from any measures put in place.

[Justin Madders]

I thank my hon. Friend for her intervention, which was made in the right spirit for this critical time. It is difficult to understand exactly what is and is not in force at any one time. Our businesses, in the main, want to comply with the law. In fact, they would be foolish not to, given the level of penalty applied for breaking some of these regulations. I talked to some local publicans over the weekend, and they are petrified of asking the wrong question or doing the wrong thing in terms of who they can and cannot let into their pubs and so on. We all have a responsibility to try to explain the rules as best we can, but at the moment we are not assisted by the often confusing manner in which they are set out.

I make one final point on SI No. 1057. Paragraph 6.6 of the explanatory memorandum says of regulation 2:

“There is no practical effect from these changes”.

Clearly this was written before it was superseded, but our debating a regulation that apparently has no actual effect makes me wonder whether this is the best use of our time, and whether there needs to be more attempts to try to regularise regulations before they come before us.

I do not make these points to try to catch the Government out, because as I said, we are in broad agreement with the measures being taken. However, I make the point again that, because there is such a bewildering array of regulations, we are not clear what is and is not legal, so how can we expect our constituents to be? This is particularly important given the severe financial penalties and the health issues that the regulations are trying to prevent?

[Catherine McKinnell]

Something occurred to me as my hon. Friend was speaking: it is the way that we are legislating and regulating these activities that results in such confusion. If we follow the normal procedure of announcing an intention and Parliament debating it, we will get that automatic feedback on how the regulations will work in practice, problems will be ironed out and it will be legislated for, and the country will have been briefed directly through Parliament, rather than through the papers. I think that would run much better. If the Government go back to the normal way of doing parliamentary democracy, it might help our response to the pandemic.

--- Later in debate ---

[Justin Madders]

My hon. Friend tempts me to go outside the scope of the regulations. His point about simplicity and clarity of message is vital. In the early days, when there was a clear, national lockdown, it was much easier to convey messages, but issues have become more complicated, and there are a whole range of areas where confusion and uncertainty arises, certainly about the self-isolation regulations. I will be taking the Committee through a number of examples of that.

The self-isolation regulations were laid before Parliament at 5 pm on a Sunday evening and came into force the following day. As we have already said, they contained significant requirements and penalties for individuals and employers alike. I do not think seven hours’ notice on a Sunday evening is the reasonable period of warning that we would want to see as the norm if we want people to understand and comply with the laws. It is not as if self-isolation is a recent development. The requirements have been in place for many months now, and with a little more thought and planning, we could have debated those regulations before they came into force. Nothing I have heard from the Minister today persuades me that there was an urgent need for the regulations to be enacted before debate in Committee.

As we heard from the Minister, the regulations strengthen the duties on those who are required to self-isolate, and increase the penalties for non-compliance. Regulation 2 states that adults who have been notified other than through the NHS app that they have tested positive for coronavirus, or have been in close contact with someone who has tested positive, must self-isolate in their home or another suitable place. Those who test positive are required to self-isolate for 10 days and those who live in the same household, or who have been in contact with someone who has tested positive, must self-isolate for 14 days. The regulation also makes it clear that they are responsible for ensuring that any child under the age of 18 in their household self-isolates.

Regulation 2 sets out the details of the people who are authorised to issue notifications regarding the duty to self-isolate, and states that notifications that are withdrawn are treated as never having been issued. It is not clear from the regulations what the process is following withdrawal, or in what circumstances such a withdrawal might take place. Could the Minister set out in more detail how a withdrawal or a proper notification might come about, and what the practical and legal consequences of such notification might be?

Regulation 3 sets out periods for self-isolation, which differ depending on whether a person has tested positive for coronavirus, lives in the same household as a person who has tested positive, or is a close contact of a person outside their household who has tested positive. As we have already said, clear communication is a key weapon in this fight. I will not recount the many confused and mixed messages we have had, but I will raise with the Minister a real and current concern I have with contradictory messages around self-isolation periods.

Regulation 3(3) states that the period of self-isolation begins on the day symptoms show and lasts for 10 days, but a number of my constituents, having had symptoms, have subsequently obtained a test, and have then been told by the Test and Trace system that their period of self-isolation of 10 days begins from the date on which they were contacted by Test and Trace. The official advice is clear, but this notification is causing confusion. Can the Minister take that away and investigate whether anything needs to change in the system and the messages it is putting out?

Can the Minister clarify the circumstances in which regulation 3(3)(a)(i) applies? Regulation 3(4) states:

“(4) The period ends with the final day of a period where regulation 2(1)(a)(ii) or (b)(ii) applies, of 14 days beginning—

(a) where P is living in the same household as the person (“C”) who tested positive for coronavirus—

(i) in a case where C, or R where C is a child, report to a person specified in regulation 2(4) of the date on which symptoms first developed, with whichever is the later of—

(aa) the date five days before the test pursuant to which notification referred to in regulation 2(1) was given”.

I quote that provision word for word because it highlights an issue to do with communicating what we are trying to do. I thought I was clear on when periods of self-isolation started, but the insertion of

“five days before the test”

in sub-paragraph (a)(i) makes me want to lie down with a hot towel over my forehead. I am trying to work out exactly what that means. People want to do the right thing, but this kind of language does not make it easy for them. When penalties are applied for not doing it, it is doubly important. We need to make it very clear exactly what the situation is in that part of the regulations.

Regulation 5 deals with the definition of “close contact”, which includes not only face-to-face contact within 1 metre, but

“spending more than 15 minutes within 2 metres of an individual”.

It is not expressly clear whether that applies regardless of whether face coverings are worn, but I would assume it does. I would be grateful if the Minister could confirm that when responding. It also includes

“travelling in a car or other small vehicle with an individual”,

which I presume is meant to exclude most forms of public transport such as buses, but may we have confirmation from the Minister of whether “small vehicle” is meant to cover all personal forms of travel or personal vehicles?

The bit in this regulation that I have more difficulty understanding is the exact remit of the phrase “close proximity” in regulation 5(c) regarding travel on an aeroplane. Is the Minister able to put “close proximity” into a measurable distance for the purposes of communicating this to our constituents?

Regulations 7 to 9 require a worker or agency worker to notify their employer of the requirement to self-isolate as soon as is reasonably possible. In addition, it prohibits employers or agencies from allowing them to work in any place except the place where they are self-isolating, and introduces fines for employers who knowingly breach the regulations. As my hon. Friend the Member for Newcastle upon Tyne North said, there are understandable concerns from individuals who are required to comply with the self-isolation regulations, because what is missing is any kind of extra protection for the employee or worker who might be on the receiving end of detrimental treatment from their employer for self-isolating.

Throughout our legislative landscape, there are protections for individuals in the workplace. There are protections for those raising concerns about breaches of the working time regulations or about health and safety in the workplace, and protections in whistleblowing legislation for those suffering detrimental treatment. However, we do not have any equivalent protection for the employee or worker who is required to self-isolate for any of the reasons set out in these regulations. I do not know whether that is a deliberate or an accidental omission, but it is concerning to me all the same, and it places the individual who is required to self-isolate in a very vulnerable position.

We need to make it as easy as possible for people to self-isolate, and not leave them exposed to detrimental treatment, such as refusal to pay sick pay, if they are entitled to it, or possibly even dismissal. There is nothing in these regulations to stop workers receiving punishment for self-isolating from a particularly unhelpful employer. I have heard concerns from constituents that their period of self-isolation would trigger a sickness absence review, or be used as part of an absence review process that is already under way.

It is quite possible that people will have to self-isolate on multiple occasions, because, say, other members of their household get symptoms or test positive, so I am sure we can all understand the genuine anxieties people have about telling their employer that they have to self-isolate for a second or third time. Why is there nothing in these regulations to give people workplace protections for doing the right thing?

The Government website advice page entitled, “Self-isolating after returning to the UK: your employment rights”—I accept that that is a slightly different situation from the period of self-isolation envisaged within these regulations, but it was the only advice page on the site that I could find on the issue of employment rights and self-isolation—talks about people working from home if they can. That is absolutely the right and obvious thing to do, but I am sure the Minister will appreciate that that option is not available to everyone.

The website goes on to suggest that as an alternative, annual leave could be taken. That raises the very interesting question of whether that advice would apply in this situation. I very much question whether we could call a period during which someone is legally required to remain at home annual leave. I would be grateful if the Minister could state for the record what advice has been given to employers on how they should classify a forced period of self-isolation.

I would like to make it clear that I am not at all comfortable with the idea of employers being able arbitrarily to designate a period of self-isolation as annual leave. There is a tension here with what the working time regulations allow; they state that in the absence of any other agreement, an employer can designate particular periods as annual leave. My question to the Minister is whether there is anything to stop an employer declaring to an employee that, as they will not be available because of self-isolation, they will be classed as being on annual leave.

That also raises the question of whether employers could put pressure on employees to take this period as annual leave, perhaps suggesting to them that if they do not, it will be classed as an unauthorised absence and will go on their employment record. It would be helpful if the Government stated clearly through guidance or regulations that a period of self-isolation should be classed as other leave, and cannot be classed as unauthorised leave, sickness absence, or annual leave that can be counted as part of any annual entitlement, and that it cannot be used in a disciplinary or capability process. If we are to improve compliance, it is important that we have that clearly set out.

[Catherine McKinnell]

There is another aspect. The economy faces a challenging period ahead, and businesses need to make savings. There will be employers who will not necessarily cite self-isolation as the reason why they are dismissing or penalising an employee. Although we cannot legislate for everything that an employer might decide to do, the Government could do a lot more to send the clear message that such behaviour is not acceptable and will be frowned on. It is socially unacceptable for any employer or business to treat any employee detrimentally for doing the right thing in relation to coronavirus. The Government could do much more to set a very clear tone on that front.

[Justin Madders]

My hon. Friend is absolutely right. When I practised employment law, I saw an amazing number of coincidences: when employees raised complaints about or concerns with their employers, other issues would suddenly be raised from out of nowhere, in a pushback against the employee; we are used to that. There is a role for the Government here. There is something we can do to give employees more confidence that they will not face adverse consequences for doing the right thing; that is what we are trying to achieve.

The intention of the regulations, as we know, is to increase compliance. The Minister referred to a study that the Department has undertaken. I presume it is the same one that I have read about in the media, which I believe has been analysed by members of the Scientific Advisory Group for Emergencies. Why did it take so long for that to come out, given that the study began in February? I will go into more detail on the findings of the study. It is reported that people were asked why they did not self-isolate for 14 days. Some of the reasons given included caring for a vulnerable person at 9.9%; going to work at 8.9%; and thinking that they had already had coronavirus and were immune at 10.4%. I hope that with greater public information and engagement, we will see a reduction in those giving the latter reason. The second reason will hopefully be dealt with by the self-isolation payment, but there is nothing I can see in the exceptions in regulation 2(3)(b) that covers the first of those situations.

I note that under the regulations someone can take their parrot to the vet when they are self-isolating, but they cannot provide care for their elderly grandparent. I am not for one minute suggesting that those who are self-isolating should do that. We do not want to risk those who are already vulnerable coming into contact with someone who has to self-isolate, but it is estimated that around one in eight adults, or 6.5 million people, is a carer. Some of those people will be asked to self-isolate, and will be unable to provide care as they would normally. Hopefully they will be able to find others in the family, or friends, to step in, but of course many family members are in the same household, and they might be required to self-isolate as well. There will be some tension when people who are asked to self-isolate have caring responsibilities that cannot be fulfilled. Is a Government strategy being adopted to try to take the pressure away from people in such situations, so that we can make sure that someone can step in and provide the necessary care when a carer is asked to self-isolate?

Perhaps the most concerning finding of the survey was that only 18% of people with symptoms self-isolated. That went down to just 11% among those who were told to self-isolate by Test and Trace. I know those figures have not been peer-reviewed, but this is the best information that we have. Can the Minister confirm whether that is the basis on which the regulations were formed?

As we know, there are questions about entitlement to self-isolation payments being tied to the receipt of universal credit, working tax credit, income-based employment and support allowance, income-based jobseeker’s allowance, income support, housing benefit and/or pension credit. Although around 4 million people are potentially covered by that, it is not everyone, and there may be those who are not in receipt of any of those benefits who do not receive any contractual sick pay, and so would be left trying to claim statutory sick pay or employment and support allowance. That is frankly not good enough.

We know SSP is far below the rates set for the self-isolation payment, and the Secretary of State himself famously said that he could not live on that amount. I ask the Minister whether there will be any consideration of whether to relax the restrictions on eligibility for this payment. We are asking those who are not eligible at the moment to take a reduction of 70% or 80% to their pay every fortnight. We are already seeing constituents who are not eligible for any support in significant financial hardship.

As my hon. Friend the Member for Warwick and Leamington mentioned, there is an issue about school children as well. This issue most notably occurs when parents are having to self-isolate to look after children who have developed symptoms or have been sent home on the instructions of the school. I ask the Minister whether there are any plans to look at the dilemma of parents of children who have been sent home from school and are not eligible for any payment.

Regulation 10 deals with enforcement and gives powers to an authorised person, such as a police officer, or a person designated by the Secretary of State to act in support of enforcement. It would enable such a person to direct people to return to the place where they should be self-isolating, and in cases where an authorised person believes that a child is repeatedly failing to comply, they may also direct the person responsible for that child to ensure compliance as far as is possible. It also sets out that reasonable force may be used to enforce the regulation’s requirements if that is necessary, and an authorised person is allowed to exercise power under this regulation only if they have reasonable grounds for believing that it is necessary and proportionate to do so.

Regulation 11 deals with offences under these regulations that are punishable on conviction by fines. Fixed penalty notices are available as an alternative. I will not go through the full list of offences that are created or the level of fines, as other hon. Members wish to speak. Suffice it to say that there is a considerable number in there.

The explanatory memorandum states that these regulations have

“a key role to play in slowing or preventing a rise in the rate of reproduction (R) of Covid-19 and reducing the total number of infected people”.

That is the overarching intention behind most of the regulations that we have been debating in recent weeks. The Secondary Legislation Scrutiny Committee has expressed its surprise that the explanatory memorandum failed to mention that it had been reported that these stronger measures are required as a result of the study that we have discussed, which mentioned low levels of compliance.

The Committee also noted its surprise that the explanatory memorandum did not mention the figure on compliance, or give the Government’s estimate of the numbers breaching quarantine, in support of policy changes. As the independent Scientific Pandemic Insights Group on Behaviours reported on 16 September, the rate of self-isolation is very low—less than 20%, based on self-reporting. It is particularly low among the youngest and poorest. It was an oversight for the Government not to mention that in the explanatory memorandum, and not to explain that that was part of the motivation for this regulation, if indeed that is the case,.

The Secondary Legislation Scrutiny Committee raised a concern about the potential for discrimination. As we have heard, regulation 2 requires someone to self-isolate where their sample tests positive for coronavirus, or where they have been in close contact with such a person. The exception is when they are notified by the NHS covid-19 smartphone app. That app cost £4 million, was rolled out many months late, and does not operate on phones that are more than five years old—and does not actually require people legally to self-isolate; I am sure that will come as a surprise to the millions of people who have downloaded it. That is about as far away from world-beating as possible.

The Department has confirmed the app has explicitly been designed to protect the anonymity of users, and the legal duty and fines do not apply to people notified through it. Instead, it will just advise the individual to self-isolate. The Department says:

“there is no discriminatory effect: the legal duty to self-isolate applies equally to anyone identified as a contact through standard contact tracing processes, whether or not they also happen to be an app user.”

This does raise questions about inequalities among certain groups, such as the elderly or those on low incomes who may not have the necessary technology to use the app. Although 14 million people have downloaded it, far more have not.

We know that the app is only accessible to those people whose phones have modern software, thereby excluding people who have older phones or no phone at all. Those people are typically poorer and older members of society. These groups are therefore more likely to be required to self-isolate through track and trace than through the app and are subsequently more likely to be in receipt of fines than those with the latest smartphones. The Committee pointed out that this raises concerns regarding the potential for avoidance.

The Government cannot track those who have been informed by the NHS app, creating a potential loophole for those informed by the app to avoid being fined for failing to self-isolate. If the Government do not know people are being contacted through the app, how can they be contacted? Again, there is a flaw in these regulations that there has been no impact assessment or consultation prior to their publication.

Returning to enforcement, the fines are substantial—an enormous sum of money to most people—but they are, of course, dependent on contact tracing working effectively. The most recent statistics show that only two thirds of people who tested positive were even transferred to the contact tracing system, and of those only 68.6% of close contacts were reached. That is a very low figure, almost as poor as when we first started, and it is lower for cases handled either online or by call centres. The overall proportion of people reached has decreased for each of the last three weeks and is similar now to when we first started. If we cannot actually get hold of people, how can we ask them to self-isolate? SAGE has warned that unless the system grows at the same rate as the epidemic and support is given to people to enable them to adhere to self-isolation, the impact of testing, tracing and isolating is likely to decline in future rather than improve, which is very worrying.

It is expected that around 4 million people will qualify for the payment, but as I say, significant numbers will not qualify. On 28 September, I tabled a written question some time ago asking how many applications and approvals have been granted for the self-isolation payment in the first week of its operation. That was a named day question due for response 11 days ago, but I have not had a response yet. Is the Minister able to update us on the uptake of self-isolation payments?

It is not just about the compliance, of course, it is about enforcement. We know that the police have expressed concerns about their ability to enforce all the regulations that have been introduced. I understand that over the weekend a memorandum of understanding was signed with police forces to enable them to access Test and Trace data. I would be grateful if the Minister clarified two points in that respect. Is it the case that until this date the police forces were not able to access the data? Will she comment on the point made by many in the medical profession, that the involvement of police may dissuade people from getting a test in the first place? The Minister said in her opening remarks that it is important not to discourage people from taking part in the system. Could measures be put in place to mitigate those concerns? Police forces have made it clear in relation to the recent introduction of fines for other offences that officers do not have the resources or capacity to enforce these fines. If the Minister is able to give us a realistic assessment of the resourcing for enforcement of these regulations, I would be most grateful.

I return briefly to authorised persons under regulation 12(12)(c), which gives the Secretary of State broad powers to designate officers for the purposes of these regulations. As I have already mentioned, these officers have the ability to use reasonable force to ensure compliance with the regulations. It is, I think, quite a worrying development that we have unspecified officers able to use reasonable force. Could the Minister set out who, if anyone, has been given that designation by the Secretary of State to carry out these functions, and, if so, what skills, experience, and training do they have in the use of reasonable force?

I would also like some clarity regarding the liability of parents where children fail to comply with the self-isolation regulations. It is set out that the authorised person may direct the person responsible for the child to ensure compliance as far as that is possible, but there is some indication that parents will be found liable, in terms of fixed penalty notices, for the actions of their children. How realistic is it to expect a parent to make a burly 16-year-old stay in the house for two weeks?

With regard to the fines issued so far, new data last week showed that this is a bit of a postcode lottery, with police forces issuing wildly different levels of fines. Some have issued more than 1,000, and others fewer than 100—this is across the spectrum of regulations to deal with coronavirus. Will the Minister comment on what appears to be a postcode lottery when it comes to enforcement of regulations and say whether any steps will be taken to ensure that there is no disparity in their application? I have asked on a number of previous occasions what additional resources will be given to the police to ensure compliance with regulations. Is the disparity partly to do with resources or other priorities, and what can the Government do to address that concern?

--- Later in debate ---

[Mr Harper]

Point taken.

It is welcome that the regulations create an offence of falsely giving contact information, meaning that someone needlessly has to isolate at some considerable cost to themselves. Self-isolation is the equivalent of house arrest, which under the criminal justice system requires a high bar of evidence.

Under the regulations, if Test and Trace tells someone to self-isolate they must do so, but what procedures are available to challenge that? Some people will not have travelled on public transport or have met the criterion of having been closer to someone than 2 metres for 15 minutes. If they receive a message that they must self-isolate but know they have not been in contact with anyone, is there a mechanism whereby they can challenge that? I suspect the answer is that there is not because of the need of the person who has tested positive to be anonymous, but if that has been considered by Ministers I would like them to say so and accept that it is unfortunate but that there is nothing that can be done about it.

I am concerned about it because for those in this room self-isolation is not a massive burden: we are still paid and can do quite a lot of our job at home. But for some people self-isolation is a real problem, and if it is not necessary in order to keep the community safe I do not want people to have to do it and I do not want anything to damage their confidence in the regulations.

Regulation 2(3)(a)(i) states that somebody must self-isolate in their home or in the home of a friend or family member. When we were debating where university students had to self-isolate, I asked whether, if a university student or anyone else who potentially has more than one home tests positive, they have to self-isolate in their university accommodation. Clearly, they must not do what a Member of this House did and get on public transport to go to another place and put other people at risk. However, if they were able to travel from one location to another in a private car, for example, where they were not going to come into contact with anyone else, and the person they were staying with was perfectly happy for them to do so, is there anything in these regulations that prohibits them from doing that?

The reason I ask is that the Department for Education is putting quite a lot of effort into thinking about what changes might have to take place in the period running up to Christmas to enable students to go home. When I read these regulations, I could not quite see on the face of it any reason why even a student who had tested positive, if they could travel safely, with the agreement of their family and where there was nobody at particular risk, could not just go home anyway and have their period of self-isolation at home, while obviously taking appropriate precautions. I would be grateful if the Minister could clarify that.

The final point I will raise—I think I am perhaps a bit firmer on this than the Labour party—is that I have a particular reason to be unhappy with the enforcement powers in the regulations, particularly giving the power to use “reasonable force” to officers of the state. Let me tell the Committee briefly why I am very concerned about this, to the extent that I have already made it clear on the Floor of the House that I am not satisfied by the Minister’s answers I will seek to vote against these regulations even though I am completely in favour of people’s having to self-isolate.

I became a Minister in the Home Office shortly after some individuals who are being deported had sadly lost their lives as a result of poor restraint procedures on aircraft. We carried out a significant independent inquiry into that and into how to use force, if required, on somebody in a way that kept them safe. I have no problem with powers being given to police constables; they already have the power to use reasonable force and their use of reasonable force is governed not only by a number of pieces of primary legislation, but by common law. A new police officer has a five-day training course specifically on using reasonable force and has to attend a two-day refresher course every year. There is a national decision-making framework that officers are familiar with, which they use to make those decisions, and in all their safety training that they are assessed to ensure they understand how to use reasonable force and what their legal requirements are. They also have to state the length of time since their personal training and refresher course when they use force, and any use of force by a police officer is reviewed by an independent panel.

That part of it I am fine with, but I have a real problem with the other three groups of people being given that power. People may not be aware that police community support officers do not have the power to use reasonable force except to detain someone until a police officer arrives. They do not have the power to use force any more than a member of the public does, and they do not go through all those training procedures that I have just talked about. I have no idea what sorts of people the,

“person designated by the Secretary of State”,

will be, but I want to know who we are thinking of and what training they have undertaken to ensure that this is safe.

The final group is officers designated by the local authority. I do not want local authority employees having the power to use reasonable force. I do not think the Ministry of Housing, Communities and Local Government does either, because if we look at the regulations that the House approved last week on tiers, there are powers to use reasonable force in those, and although they still include the powers to use reasonable force for police community support officers, the powers available to local government employees have been constrained to a specific part of the regulations. They have been narrowed—I am still not happy with them, but they have been narrowed.

The reason why that is important is that we are talking here about using force on people with coronavirus. In itself, that is a risk. Giving the power to use reasonable force to agents of the state is a big deal. We do not generally give state employees the power to use reasonable force to detain and move people. That is a limited power. Because of all the regulatory requirements, where we give that power to police officers, there is a huge number of controls around it, quite properly. Unless the Minister can give me a very good reason why the powers are here, and say what the thinking is behind them and what steps the Government have taken to make sure they will be exercised in a safe manner, I cannot support these regulations.

Not everyone will feel the same way as me, but I have been a Minister with this responsibility, and have seen what happens when powers like these are used inappropriately: they lead to deaths. I do not think they should be here. Frankly, we should take these regulations away and strip those powers out. They should be given only to police officers—people trained to use them, and who know how to use them when all the appropriate safeguards in place. This is incredibly serious. I conclude there, to give the Minister time to answer our questions in the remaining 20 minutes.

[Catherine McKinnell]

rose—

[The Chair]

Before I call Catherine McKinnell, I remind people that the Minister has been given a number of questions to answer.

[Catherine McKinnell]

Yes, the Minister has a huge number of questions to answer, and I would like to hear the responses, because I share many of the concerns raised. The Minister will have discerned the flavour of my concerns about this legislation. We are not opposing it, but it is right that it be properly scrutinised. It is right also to acknowledge the other side of these restrictions, measures and enforcement powers that are being put in place, namely the ability of people to comply with what is being asked of them in this pandemic.

I agree with the points made by the right hon. Member for Forest of Dean (Mr Harper) about local directors of public health, and I want to put on record my gratitude and admiration for the local director of public health in Newcastle, and also for the city council. They have not only worked tirelessly to deal with the virus, but done everything they can to mitigate its impact on people in Newcastle and across the north-east.

Newcastle’s response to the university outbreak was a clear example of how the knowledge, intelligence and capacity of local public health departments can really made a difference. If there had been a data lag, and if data had been sent to students’ home addresses, rather than being recorded locally, we would be in a different position, but we have connections and networks, and the knowledge, insight and ability to reach into local communities and understand what is really underneath the data. Newcastle and the north-east have been making headlines for the worrying rising infection figures, but some measures appear to be working. It is early days, and this will come down to the ability of local people to comply with measures. We are all doing everything we can to reiterate the messages on how that can be achieved. There does appear to be a positive response to the measures put in place.

It is worth noting that there is generally a two to three week-lag in the response to restrictions; it does not happen overnight. We are seeing now the response to the restrictions that the local authorities asked for. The lesson to be learned is that there should be a collaborative approach in which local authorities work closely with communities. If we get to the point of imposing measures and use many of the powers in the regulations, we are losing the battle against the virus—and the argument. We are certainly losing local communities and their ability to respond. There are huge concerns that the restrictions being put in place across large swathes of the country are not backed up with the economic support necessary to ensure that people can comply with them. That is not a party political argument; the reality is that people will not comply if they unable to do so.

Many parts of the country are facing a double whammy of local lockdowns and the withdrawal of financial support. The people who were more economically vulnerable going into this crisis are the ones most affected by it, by the restrictions that are coming into place, and by the withdrawal of the full furlough scheme, which is closing at the end of this month. When it comes to the impact of the withdrawal of that economic support, we ain’t seen nothing yet.

I cannot fail to take this opportunity to plead with the Government to heed what is being said about economic support for the areas in the north most affected by the virus. Giving that economic support is not only the right thing to do, morally, for those communities; it is the right thing to do to defeat the virus.