I disagree with some of those points. As a liberal, I believe fundamentally in giving people the most personal freedom they can have up to the point at which it interferes with the personal freedom of others. We hear a lot in this House about personal freedom, particularly from those on the Conservative Benches, but there is very little discussion about our broader responsibilities to others. That is the challenge that we as legislators have in this House: it is about getting the balance right. I do not think this is about putting restrictions on businesses because of the failures of our health service. GPs in particular are struggling with their workloads and with the abuse resulting from campaigns against them that are being led by national newspapers. If we had a stronger workforce to deal with these issues, and if the NHS had not been run into the ground, we would have more frontline health workers to deal with these problems right now. However, I am mindful of the Deputy Speaker’s entreaty to stick to the regulations, to which I now want to return.
As I said at the start, we will support these regulations. I agree with other Members that it is vital we have full scrutiny of any decision to repeal, extend or renew the regulations in any shape or form in the coming weeks. I implore the Government to take action and consider these restrictions in the light not only of this new variant but of the overall pressures across our NHS, whether on GPs, ambulance services or elsewhere.
Does the hon. Gentleman not accept that the major incentive for people to be vaccinated is to reduce their own chances of hospitalisation and death, not just so they can go to the local pub, shop or anywhere else?
My hon. Friend has been a Member of this House far longer than I have. Is there a mechanism where that could be clarified before today’s vote?
Yesterday, I intervened on the Secretary of State and during his statement he repeated to me:
“we will not keep measures in place for a day longer than necessary.”—[Official Report, 29 November 2021; Vol. 704, c. 679.]
With that assurance in mind, I thought I would come to listen to this debate and speak on behalf of the transport sector, which relates to my Select Committee, willing to support these measures as proportionate measures in circumstances where we do not know whether the new variant will have an impact on transmissibility and on our vaccine effectiveness. On regulations 1340, on face coverings, I can get there in that regard because they expire on 20 December and they are well set out. I have concerns about the way the transport sector is somewhat singled out, albeit with retail, as perhaps being an unsafe setting, whereas hospitality is marked differently. If we put £10 billion into the rail network alone just to keep it going, sending out a message that it is a less safe setting than a pub or restaurant will not be the way to give people confidence to get back on to that network which we need to survive.
I also have concerns about what happens on the buses, given what I witnessed today. That may well have been because people had not tuned into this debate and did not realise that these regulations had already come into force. People are still getting on board without a face covering. Despite the powers given to drivers to ensure that they do not do so, there is no questioning and on they go. Not only does that wind people up, but it leaves others thinking, “What’s the point in bothering? If not everyone is wearing a mask, what’s the purpose of anyone wearing one?” However, I can get there on those regulations because of the unknowns that we need to deal with.
One of the wonderful things about coming into this Chamber is to be educated. I might make the point that my hon. Friend the Member for Winchester (Steve Brine) has made: perhaps more of us can come here and be educated. I have grave concerns about the issues around regulation 1338, on self-isolation. If the aim is for us to be covered for no longer than is necessary, why do they have no end date and default to 24 March? The impact of these regulations is even greater than our having to wear a face covering for longer periods because, as has been mentioned, we could well be back to “pingdemic” territory.
I emphasise that the regulations mean that, regardless of a vaccination having been given, one has to self-isolate for a period of time if there is a suspicion that one has been in contact with someone who has the omicron variant. Right now, and perhaps for the period up to 20 December, I can understand that the suspicion would perhaps be linked, as the transmission rates are slower to build—one would hope that would be so for the next few weeks—to whether one had been in contact with someone who had been in South Africa, or something on those lines. If, however, we move to 24 March and the variant has spread fast but, as we hope, it has not had a negative impact on the vaccine, we could see the default option being, “I have come into contact with somebody who has covid. I did not know whether they had omicron or not, because that does not tell me that. Therefore, I must be cautious, as we are always told to be. Therefore, I must self-isolate.” Then we could see the whole country being pinged again, as it has been before.
The situation could even be worse than that. If it turns out, as is currently being discussed in South Africa, that although the strain may transmit quickly it may not have the same impact as even the delta variant, stopping people being out and about may make things worse, because they will not get the antibodies that we want them to get. Surely those on our Front Bench are aware of that. The beta variant was a variant of concern, and the amber-plus regulations were brought in, as there was a concern that beta would have been worse against the vaccine than delta. It turned out that one dose of AstraZeneca was more effective against the beta strain than two doses of it were against delta. So variants of concern can quickly turn out not to be a concern at all.
That is why we must make sure that our legislation stops and is flexible and nimble, yet these regulations will roll on until 24 March. That is what our job in this place is about; I can agree in principle that there is a need to take measures, but I cannot vote for legislation that does not actually do what I believe the Government intended it to do. There are options, and they can be used right now. The Minister could stand at the Dispatch Box and find a way to reassure those of us who have the same concern. Alternatively, the default option for me is to vote against this legislation, not because I disagree with the principle, but because I disagree with voting for legislation that I know to be poor, badly drafted and not to meet the intention. Surely we should not be stubborn and pig-headed when legislation does not work; we should fix it or we should vote against it.
I have one last point to make in relation to a motion that I thought would be before us but is not—one that deals with the restrictions on travel and the introduction of PCR testing. Yesterday, the Secretary of State also reassured me that PCR testing would not be expensive and that we would not be at the mercy of unscrupulous providers, as we saw happen during the summer. A wise person just told me about an incidence of a three-hour PCR test, which many will need to take in order not to have to self-isolate—that is good for the economy—costing more than £200. Why are these regulations being laid under the negative procedure? We need to be discussing that legislation and finding the pitfalls, as we have with the regulations before us—I applaud my colleagues for doing so this afternoon—yet they are not even being brought forward.
I want to ensure that all the support that is needed for our vaccination programme is there, across England. The hon. Lady rightly asked what we were doing to reach out to those who, for whatever reason, have so far been a bit hesitant. We have been working actively for months with many community leaders. We have added many more venues and ways in which to receive the vaccine, so access has been improved. Significant work is also being done on communications and ensuring that the right messages are there, and that people, including clinicians, are available to answer questions. However, the hon. Lady was right to point to the importance of this issue, and I am pleased to hear that she will be getting boosted this weekend.
My hon. Friend has made an important point. One reason for the difference between dealing with this pandemic today and dealing with it even a year ago is that we already have more treatments, and my hon. Friend has just mentioned another potential new treatment. I am afraid that I cannot give him any exact date for when we think the trials will be over, but I am pleased that they are taking place. He is right to point to the potential of that treatment, but I can reassure him that whether the UK’s engagement is with ivermectin or with other potential new treatments, it could not be more engaged.
My hon. Friend is making a very strong case. Does he agree that we do not want to send a message from this House that vaccines are a bad thing? Vaccines are right and we should be vaccinated. Equally, on the rare occasion when it goes wrong, is it not right that compensation is made available—on those very rare occasions?
Fridays are a wonderful thing in this place. The hon. Member calls for a judge-led inquiry. I quite understand the importance of the issue, but many believe there should be a judge-led inquiry into many aspects of what has happened on covid and will wonder why this issue should get preference over others. Will he give his thoughts on how he would explain to care workers in care homes, for instance, why their concerns should not be considered at the same time as these important concerns?
My hon. Friend is being generous with his time. I have been listening intently to what he has to say, but I am conscious of the narrative. How do we ensure that, on the one hand, people who suffer severe disablement as a result of the vaccines get that support and payment, but on the other hand, we do not create a culture of hesitancy where people do not uptake vaccines or, equally, do not produce vaccines because of the fear that they might cause mass severe side effects? I am conscious of hearing his views on that.
I am eating into the time for my own Bill, but I wonder if the hon. Gentleman would agree that his Bill would not be required if his own Government agreed a date for an investigation into the Government’s handling of the pandemic, just as the Government in Scotland have agreed to do?
My hon. Friend is talking about the independent review that he wants actioned and the timescale for that. Does he not agree that over that period of time, the evidence that we need actually to ascertain vaccine damage will probably be found and that those payments will be made?
I beg to move,
That the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021, which were laid before this House on 22 June, be approved.
As we head towards a winter where care homes may have to battle with covid and flu, the question we should ask ourselves is this: what more can we do? Over the last year and a half, covid-19 has sadly taken many thousands of lives, particularly the lives of older people and those with underlying health conditions, and particularly the lives of those who need the kind of care received in a care home. There have been more than 40,000 deaths among care home residents. They were mothers and fathers, grans and grandads, brothers and sisters, sons and daughters. Sadly, we have lost some of our dedicated care workers, too: despite all the efforts that have been made by care homes and their staff, local authorities and by us in Government to keep covid out, despite personal protective equipment, despite testing, despite isolation. Throughout the second wave, care homes used 26 million tests and—
I may well answer many of my hon. Friends’ questions as I proceed, so I ask my right hon. Friend to let me make a little progress and I assure him I will take interventions.
As I was saying, throughout the second wave care homes used 26 million tests and 1.2 billion items of personal protective equipment, yet still we saw outbreaks in many care homes during the winter and 14,000 deaths from covid among care home residents. But there is one thing now making a huge and crucial difference, a major advance that is unequivocally saving the lives of care home residents and staff from this cruel and pernicious virus, and that is vaccination. I have spoken to residents who were in tears of joy and relief as they were vaccinated, as they at last had their own defence against this virus. So far, the vaccine roll-out to residents and staff in care homes has been a big success story. The Joint Committee on Vaccination and Immunisation made residents and staff in older age care homes the highest priority as soon as vaccines were available, and the NHS hit its target of offering the first dose to all care homes by the end of January, which was a fantastic effort.
In one moment. Vaccination teams have made multiple visits to care homes since then and as a result 96% of those living in older age care homes have had their first dose and 93% have had their second dose. Some 92% of residents living in working age care homes have had their first dose and 87% have had their second dose. Take-up among staff has also been strong, with 86% of staff in older age care homes having had their first dose and 75% having had their second dose, and 83% of staff in working age care homes having had their first dose and 72% having had their second dose. Our vaccination teams have gone to great lengths to support and encourage those who have been worried about the vaccination, along with care home managers and care colleagues. I am sure that Members will join me in thanking everyone in the NHS, local authorities and care homes who have worked so hard together to achieve such levels of vaccination.
I will make some progress. As the Prime Minister and our chief medical officer have said, even when we are no longer in a pandemic, the virus will remain in some shape or form and we will have to learn to live with it. It will continue to circulate and potentially evolve into new variants, and there is a serious risk of a resurgence of flu and other seasonal infections. A combination of covid and flu may be unpleasant for many of us, but it will be life threatening for those who are most vulnerable.
This debate finishes at 7.19 pm and I need to bring the Minister in at the end. That means that if colleagues speak for between four and five minutes, everybody will get in. If colleagues do not speak for between four and five minutes, everybody will not get in.
I do not usually speak in the debates about statutory instruments on covid regulations as they apply only in England, but I feel I have to make a couple of points on the plan to make covid vaccination mandatory for all care home staff—the first mandatory vaccination legislation in the UK for well over a century.
As chair of the all-party parliamentary group on vaccinations for all, I totally support vaccination and I draw attention to our recent report, published in May, on how to improve the uptake of all vaccines. Virtually all our expert contributors highlighted the dangers of making vaccination legally mandatory because while it may force uptake among some, it tends to increase distrust and suspicion of vaccines and drive those who are hesitant to become vaccine refusers.
In Scotland, virtually 100% of care home staff are fully vaccinated with both doses, without mandating it. That has been achieved through three key policy approaches. First, as part of developing caring as a profession, care home staff in Scotland are now registered, which means we have information on who we are trying to reach. Secondly, when the Scottish Government became aware that care home staff were being deliberately targeted with disinformation on covid vaccines, they arranged expert webinars for staff with our chief medical officers and NHS director. Thirdly, as soon as the Pfizer vaccine became available in December, care home staff were vaccinated at the same visit as residents. That not only improved convenience, but created a strong sense of solidarity between colleagues and with the vulnerable people they care for.
The Scottish Government faced considerable criticism at the start of the year for spending so much time and effort on care homes rather than pushing ahead with mass vaccination centres, but it has paid off. We hear that in England, 86% of care home staff have received a first dose and 75% are fully vaccinated, although I understand that that hides a wide variation in uptake. While repeat visits have now been provided to care homes in England, that was not national policy at the start of the programme when many providers reported difficulty in accessing vaccine appointments for their staff.
The UK Government have never taken forward the principle of care staff registration and professionalisation in the care sector. As has been highlighted, staff in England are not even paid the real living wage. Care home staff have faced a very difficult time in the last 18 months and we all owe them a great debt of thanks. I still believe that locally targeted support, information and persuasion would be more successful in convincing care home staff than heavy-handed legislation, which threatens their jobs.
We all agree about the need to get the highest rate of vaccination possible to protect care home residents. The difference is in how to get there. Our APPG report makes it clear that the most important approach when dealing with communities with hesitancy is not to make assumptions about the cause but to listen to them and then act on what they are seeking.
Apart from my concerns about the principle of mandating vaccination, I call on the Minister to clarify that the legislation applies to England only. The Scottish Government do not accept the principle of making vaccines mandatory, nor do they see the need for such an approach after the fantastic uptake by our care home staff.
I thank the hon. Gentleman for his point of order. As I said earlier, it is a totally unsatisfactory situation, irrespective of whether anybody has been misled by the statement in one of the official documents. Those on the Treasury Bench will have heard the point of order and will make absolutely certain that it gets through to the Department. I will, as the hon. Gentleman has asked, raise it with Mr Speaker at the prayer meeting tomorrow morning.
I thank the hon. Gentleman for his point of order. I have been a Member of Parliament for 29 years and many times, at the end of a debate, Ministers have said they cannot deal with each point that has been raised. We were under time pressure today, as has been pointed out by a number of Members, and therefore a number of questions have gone unanswered. Again, those on the Treasury Bench will have heard the point of order and will bring it to the attention of the Minister in order that she is able to answer the questions that went unanswered in her summing up.
I believe my hon. Friend is referring to the measures that the Government have already announced around vaccinations and people who work in care homes. Ideally, I would like to make sure that the impact assessment is available. I do not know the full detail as to why it has not been completed, but at the same time, I think it is important to get on with this part of building our vaccine wall. We will have more to say about it tomorrow.
Further to that point of order, Madam Deputy Speaker. In intending to be helpful to those on the Treasury Bench, I have noticed, looking at the said regulations, that they do not actually come into force until 16 weeks after they are approved by the House. It seems to me that in four months there is plenty of time for the Government to produce the relevant information for the House and for the House to take a decision, with no detriment at all to the health and safety of anyone in our care homes.
I thank both hon. and right hon. Gentlemen for their points of order. I am sure the House is well aware that it is not a matter for the Chair. I will not spring it on the Secretary of State for him to give an answer on this operational matter, but Mr Speaker usually observes that it is helpful to the House for Members to have as much information as possible before them when a matter of importance is to be considered.
Once again, the hon. Gentleman knows that I cannot answer that question, because what is said by Ministers and their Departments is not a matter for the Chair. However, if it were to be the case that a spokesman for a Minister had suggested that something had happened that had not happened, and on which Members were trying to rely and could not rely, Mr Speaker would take a very dim view of that. It is better if Ministers make sure that their Departments give as much information as possible to Members ahead of discussions.
Yes, the data on the impact of the vaccine—including side effects from the vaccine and the rare occasions when, sadly, people die after having had the vaccine—are published by the Medicines and Healthcare products Regulatory Agency. If there are any data in this area that are not published but my hon. Friend would like to be published, he can write to me and I would be very happy to look into publishing them. Essentially, we take an attitude of being as transparent as possible, because there are side effects to the vaccine as there are to all pharmaceutical drugs and we want to be completely open and transparent about those side effects—essentially to reassure people that the risks are extremely low.
This data has been collated recently; it is in the so-called SIREN study from Public Health England. I am very happy to look into exactly the data that my hon. Friends are looking for and, if we have it, to publish it. I think we have what has been asked for, but let us try to do this by correspondence to ensure that we get exactly what is being looked for. On the face of it, my hon. Friend is absolutely right; it is exactly the sort of thing that we are looking at, but I want to make sure that we get the details right.
As I was just saying, each step of the road map is guided by the data and the progress against the four tests. We were able to take the first step on 8 March, when we allowed the return of face-to-face education in schools, relaxed the rules on two people gathering outside for recreation and allowed care home residents to nominate a single regular visitor, supported by regular testing and personal protective equipment.
The regulations before the House today ease restrictions further—again, in a careful and controlled way. First, they allow us to put in place the remaining measures of step 1, which will come into force on Monday. That means that the “stay at home” rule will end and six people or two households will be able to meet outdoors, and outdoor sports can resume. The regulations also commit the remaining steps of our road map into law, so that we can gradually ease restrictions at the right time before eventually removing them all together, which we hope to be able to do on 21 June.
I am grateful for the opportunity to speak in this debate, and delighted to follow the wise words of the right hon. Member for Orkney and Shetland (Mr Carmichael). I am the 31st Member to speak in this debate. I have been here throughout, and I think I am right in saying that only two Members have given their unqualified support to what the Government propose. The Government would be wise to reflect on that, considering the gap that is opening up between our rulers—the Executive and the Government—and those of us who represent the liberties of the British people. I am particularly pleased to be the fourth Greater Manchester Member to speak against what is being proposed, because we come from a city with a fine and long history of standing up for liberty, and I am glad that is continuing.
The danger in what is being proposed is that we risk normalising an extreme policy response. It was put in place during the emergency a year ago with very little thought or debate, and draconian powers were given to the Government, who initially expected a three-week lockdown, which then became a three-month lockdown. My constituents, like those of my hon. Friend the Member for Bolton West (Chris Green), were released for three weeks, and then they were again put under heavy new restrictions.
I have asked before in this Chamber a question about whose rights we are dealing with. Do the Government have the right to tell people whether they can see their children or grandchildren, or whether they can start a relationship with someone? My answer is an emphatic “no”. Even those who are less certain should reflect on whether extreme control over people’s right to family life, intimate relationships, and freedom of association should be introduced just briefly by the Government in an emergency, or for more than a year.
On 6 January—the last time we had an opportunity to assert some control on the Government exercising these powers—the Prime Minister told me, when I intervened on him, that it would be very surprising if the House did not get a vote to get rid of any of these restrictions before the end of March. Well, okay, it is 25 March, so perhaps we should prepare to be surprised. I stand with Members in all parts of the House who have said we should expect that, if the Government are given these extreme powers and allowed them for longer, they will retain them and are likely to seek to extend them. That is why the House should say no to extending the Coronavirus Act—it would have been in force for a year and a half at least.
The danger is that Government start to believe that these fundamental civil liberties belong to Ministers to grant to us or withhold. They do not—they belong, as of right, to British citizens. It is this habit of control that leads to coercive laws that have no sense. Government have, for example, a legitimate interest in people who entered the United Kingdom from high-risk countries, but there is no public health argument for fining people £5,000 for leaving the country, and the Government should think again about that. This habit of coercion and control has gone too far, and it has gone on for too long. It is time for this House to trust the British people and return their rights to them.
With this it will be convenient to discuss amendment 2, in clause 6, page 3, line 38, leave out from “force” to end of subsection and insert “on 1 October 2021”.
This amendment will incorporate into the Bill the guidance for policy makers issued in August 2010 that there should be two common commencement dates each year, one of which is 1st October, for the introduction of changes to regulations affecting businesses.
I am very grateful to have reached this point today. This is an important Bill that will protect young people. We are short on time, so I will cover the substance of the amendments quickly. On amendment 1, consequential provisions are essential to ensure consistency with other legislation. On amendment 2, six months will enable the necessary changes to be made to the human medicines regulations under the consequential provisions that were just discussed.
I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on the outstanding work that she has done in introducing the Bill, and I reiterate the Government’s support for the legislation. I believe that everyone has the right to make informed decisions about their bodies, but our role in Government is to support young people in making safe, informed choices where necessary to protect them from the potential harm that cosmetic procedures can do to their health. The increasing popularity of cosmetic procedures and the pressures on our young people to achieve this aesthetic ideal are well documented, and I believe that the Bill is an important step in putting those necessary safeguards in place.
I acknowledge the intentions behind the amendment tabled in the Public Bill Committee by the hon. Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) to introduce a medical necessity test on the face of the Bill, and I hope that they have taken assurances from the explanation by my hon. Friend the Member for Sevenoaks of the work that she has done to explore this. The standards set by the General Medical Council already require doctors to consider the best interests of the patient to cover the ethical treatment of under-18s.
It has been an absolute pleasure to work with my hon. Friend to take this step towards greater regulation of the cosmetic procedure industry. I look forward to the Bill’s successful passage through the Lords.
As discussed, time is short, so I will keep my remarks to a minimum. I thank everyone who has been involved in this Bill. I pay tribute to my hon. Friend the Member for South Leicestershire (Alberto Costa), the hon. Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins), and the right hon. Member for North Durham (Mr Jones), all of whom have raised the profile of this very important issue over a number of years. I also pay tribute to the work of Save Face, a campaigning organisation that has done brilliant work to safeguard many, many young people over many years. Lastly, I also thank the Minister, whose support throughout this has been absolute, and I am very grateful.
I add my congratulations to the hon. Member for Sevenoaks (Laura Trott). I know that this has been no mean feat, especially during the current challenging times, and there has had to be a lot of patience, but it has been rewarded today. It is important that we act to protect our young people, especially with the pressures that they face. This is one of those great bits of legislation where I think if we stopped our constituents in the street and asked them about it, they would think it was already like this. This is a common-sense, practical and proportionate way to protect our young people, and we give it our full support.
We obviously had a tiered system over the autumn and one of the challenges we found was of people travelling from a part of the country where rates are higher to those where rates are lower. Therefore, while we do not rule out a localised approach to outbreaks, we will move down the road map as a nation across England.
I do not have those specific figures to hand, but the MHRA—the regulator—regularly publishes what are called adverse events when somebody still has a problem with coronavirus having had the vaccine or has a response to the vaccine, and I will ensure that the appropriate body, whether it is MHRA or Public Health England, publishes both the number and the percentage.
I hear my hon. Friend’s point, and I share his view that throughout this pandemic the vast majority of people have behaved with great responsibility. I know that people in tiers other than tier 4 thought very hard about whether they should gather with relatives, even within the easing that was allowed during the Christmas period, and rightly so. We must all play our part in controlling the virus and stopping its spread.
I will make some progress.
At the time of these provisions we were seeing an exponential rise in cases in London, Kent, and some other parts of the south-east, and it was clear that the tier 3 restrictions were not sufficient. We identified the existence of a new variant in those areas, and further analysis showed us that the new variant was driving the steep trajectory of infections. The new and emerging respiratory virus threats advisory group—NERVTAG—tells us that the new variant demonstrates a substantial increase in transmissibility, compared with other variants, and that the R value appears to be significantly higher, with initial estimates suggesting an increase of between 0.4 and 0.9.
There is no evidence to suggest that the new variant of the virus is more likely to cause more serious disease, but increased infections lead to increased hospital admissions and, sadly, increased loss of life. These winter months already pose great challenges for our NHS. That is why we had to take the action that we took before Christmas, and the further steps announced today to control the relentless spread of the virus. However, it is not all bad news.
I am making some progress and I am mindful that many Members want to speak this evening.
The roll-out of the Pfizer vaccine is happening at pace, with more than 600,000 people receiving it between 8 and 20 December. Vaccinations in care homes started on 16 December, and the NHS has already been getting the vaccine to those who are most vulnerable, and the care workers who look after them. Now, the Oxford-AstraZeneca vaccine has been approved, and it is much easier to get out to people and into arms. There is every reason for optimism, but we are not there yet. We must suppress the virus now and in the weeks ahead.
On the specific measures in these regulations, in response to the greatly increased risk, the addition of tier 4 stay-at-home measures will be familiar to people from the November national restrictions. Tier 4 involves minor changes to those national restrictions. As of November, people in tier 4 areas must stay at home and not travel out of tier 4. They may only leave for a limited number of reasons such as work, education, or caring purposes. We are advising that clinically extremely vulnerable people in tier 4 areas should do as they did in November and stay at home as much as possible, except to go outdoors for exercise or to attend health appointments. The regulations contain the same exemptions as other tiers for childcare and support bubbles. We advise that people elsewhere avoid travelling into a tier 4 area, unless they need to do so for work, education or health purposes.
One thing that I will do when I have finished speaking is see whether I can look up the specific data for the hon. Member’s constituency. In general, however, the announcements made today, just as with previous announcements, are based on the data that we are seeing, which includes rapidly rising rates of infection in certain areas, the level of new infections, the trajectory and hospital pressures.
The tier 4 regulations require all non-essential retail, indoor entertainment, hairdressers and other personal care services to close. International travel is also restricted to business trips only. However, we have listened to hon. Members and the public about what is most important to people in their daily lives so, unlike in the November restrictions, communal worship and a wider range of outdoor recreation are still permitted. We also recognise the restrictions’ impact on businesses and continue to provide them with ongoing support to help get through the crisis.
We know that these measures are hard. We know that they keep families and friends apart, yet we also know that they are necessary for us to get through this situation and to prevent the loss of lives as we do so. This virus thrives on the things that make life worth living, such as social contact, but that means we can all play our part in stopping the spread—as I said, if not for ourselves, then for others. The end is in sight, but for now it is our duty here in Parliament to put in place these restrictions—onerous though they are—to control this virus. I commend the regulations to the House.
This House legislated explicitly for specific arrangements to govern the celebration of Christmas, and no sooner than the House had risen itself for Christmas, the Government, by ministerial fiat, changed those arrangements. We are asked this evening to give retrospective legislative approval to the changes that they made. We are in the absurd position of being asked to vote for the ghost of Christmas past.
Sometimes in a democracy, process has an importance. I am constantly—daily— confronted by individuals and businesses facing ruin, notwithstanding the huge investment that they made in covid-secure premises and procedures. What we have never had, and what we have always been asking for, is the cost-benefit analysis that the Government made on each of the restrictive measures that make up the menu of their tier system. I do not for one moment question the motives of Ministers. I do, however, question their ability, in exactly the way that I question my own ability.
When the House rose, the lobby of Government scientific advisers—a lobby, we should remember, that had already publicly expressed their frustration that their earlier strictures on how Christmas should be celebrated had not been fully taken on board by the Government—announced that they had discovered a new strain of the disease so much more transmissible than the earlier one. They bounced the Government. I have to accept, of course, the possibility that they may be absolutely right, but I know this: were I presented by such a lobby of eminent scientists—eminent people leading in their field—and told that they had discovered this new emergency, and that so many more people were going to die, and unless I did what they said, I would be responsible for their deaths, I would find great difficulty in having the wherewithal to identify and ask the right questions to be sure that they were on the money, or 100 miles from it.
What I would certainly want, and what I believe the Government need, is an alternative source of expertise—a competitive source of expertise—particularly statisticians leading in their fields, who would be able to furnish me, to arm me, to arm Ministers, with the right questions to ask about the validity of the modelling and the data. It can only improve the decision-making process. But what is really galling in all this is then to hear on the airwaves Professor Ferguson being interviewed, giving his wisdom to the nation once again, to all intents and purposes as if he were still a key Government adviser. I do hope that the Minister winding up the debate will be able to assure us that that is most certainly not the case.
I was always rather jealous of Poole, Christchurch and Bournemouth, because our infection rate in the New Forest was substantially lower than theirs, but they turned out to be in tier 2 and we were in tier 3. Now we are all together in tier 4.
It is a pleasure to serve under your chairmanship, Sir Christopher, and a great pleasure to be speaking in a debate secured by my very old, wise and aged colleague, my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom)—the high priestess of early years. As she said, I speak as the chair of the all-party parliamentary group on the first 1,001 days. I also recently stood down as chair of the Parent-Infant Foundation, the charity that she founded and that is having such an important effect on the whole movement for 1,001 days. I have been very proud to chair that charity for the past six years.
It is great to see this subject coming into the mainstream. We have had a number of Westminster Hall debates, including on the impact of covid on maternity, families and children in lockdown. Before the general election, I held a debate on health visitors. Since “The 1001 Critical Days” manifesto, the important document produced about eight years ago by my right hon. Friend, we have had various reports, including “Babies in Lockdown”, “Rare Jewels” by the Parent-Infant Foundation, “Building Great Britons”, and several Select Committee reports, including by the Health and Social Care Committee and the Science and Technology Committee, all of which were serious, heavyweight studies of the first 1,001 days.
This is, at last, not a new subject. I come to this debate much in the mode of Elizabeth Taylor’s sixth husband: knowing what was expected of him, but struggling to make it new and fresh. But we will give it a go.
Children, particularly very young children, have been the forgotten element in the whole pandemic lockdown; so too have parents of very young children. The lockdown, the regulations, and the alienation from or unavailability of family member support networks—which many of us, as early parents, took for granted—have had mental health impacts on new parents and single parents in particular. We should not underestimate that. It will be a long time before we can get back to a degree of normality and start to see the impact that missing out on those important contacts and support mechanisms in those crucial early months has had and will have for many years to come.
Early years has for too long been forgotten when it comes to Government spending. Many of us have been going on about that for a long time, and it is worth repeating. Work done a few years ago estimated that the cost of perinatal mental illness is £8.1 billion each and every year. The cost of child neglect in this country is £15 billion each and every year. That means that we are spending more than £23 billion on getting it wrong for parents and very young children in those crucial early years. If we were to spend a fraction of that amount on greater preventative intervention measures for those who most need it in those crucial early years from conception to age two, that bill would be reduced significantly and it is a false economy not to be doing that.
It was disappointing to see just £300 million in additional funds being given to the social care sector—that is, the adult and children’s social care sector—in the spending review, even though there is a shortfall of some £3 billion in local authority children’s social care alone, not to mention all the problems with public health and the shrinking numbers of health visitors, which I will come back to in a moment.
Why is that important? My right hon. Friend the Member for South Northamptonshire has given us some of the figures. Up to 20% of women experience mental health problems in pregnancy or the first 12 months after birth, and 50% of all maltreatment is related to children under the age of one. It has been estimated that 122,000 babies under the age of one live with a parent who has a mental health problem. One third of domestic violence begins during pregnancy—a figure I could not believe when I first came across it. The Government are doing good work with domestic abuse legislation, but we need to be addressing the problem at source. If domestic violence is happening in a household, what sort of physical and psychological message is that sending to the newborn child? The same applies to even before it is born as well: there are signs that communication within the womb itself is a factor. Suicide is one of the leading causes of death during the period of pregnancy to one year after the birth of a child. That is a deeply tragic figure, but it preventable if proper systems and checks are in in place.
About 40% of children in the UK have an insecure attachment to a parent or carer by the age of 12 months. The figure that I have always used—this is, I think, the killer point—is that for a child at the age of 15 or 16 who is suffering from some form of depression or low-level mental illness while at school, there is a 99% likelihood that his or her mother suffered from some form of depression or mental illness during or after pregnancy. It is as direct a correlation as that. If we do not do something within those first 1,001 days, we will reap the consequences, as will children, not just during childhood but into adulthood as well.
Child obesity rates are all connected to what happens in the first 1,001 days. Last year we also had worrying figures—this is particularly topical now—about the dwindling vaccination rates in England. In particular, only 86.5% of children had received the full dose of the measles, mumps and rubella vaccine. We have effectively lost our immunity status, because the World Health Organisation target to protect a population from a disease is 95%. One hopes that parents in particular will take up the covid vaccination as it is rolled out, because we have seen the effects on the children’s population of not having vaccinations in recent years.
The Children’s Commissioner estimates that 2.3 million children are living with risk because of a vulnerable family background and that more than one third within that group are invisible—they are not known to services and are therefore not getting any support. That is why it is crucial, particularly before those children present at school and come on the radar, that health professionals at various levels are having contact with those children and families to ensure that everything is all right. They can give that help and support and that tender affection and empathy, but they are also an early warning system for when things are going wrong, right up to safeguarding issues. The one thing that all those ailments have in common—there are a lot more that I have not mentioned—is that they come under the remit of the health visitor to a varying extent. I will come back to the importance of health visitors.
The impact of covid is great, as I have said, and I will not go over that again, but more families with babies and young children under five have been tipped into vulnerability due to the secondary impacts of the lockdown. At a time when families, and particularly families from deprived communities and single-parent families, need face-to-face contact with people like health visitors the most—I also refer to health visitors as the trusted uniform services who are usually welcomed over the threshold, whereas with social workers and others a barrier goes up instantly—more than 70% of health visitors have been repurposed to other aspects of the health service to deal with covid. That really is a false economy.
I pay tribute to Cheryll Adams, the chief executive of the Institute of Health Visiting, who is standing down from the outstanding role she has played for the cause of health visitors and their importance in the first 1,001 days. She will be greatly missed, but I am sure she will not quit the scene altogether, because of her dedication to the cause. Her report showed that 82% of health visitors reported an increase in domestic violence and abuse; 81% an increase in perinatal mental illness and poverty; 76% an increase in the use of food banks and speech and communication delay among children; 61% an increase in neglect; and 45% an increase in substance abuse. Finally, 65% of health visitors have a case load of more than 300 children under the age of five.
Is that sustainable? My worry is that even in the good times without a pandemic, health visiting was greatly stretched. One of the great achievements of the coalition Government was the delivery of a promise to institute 4,200 additional health visitors, based on the Kraamzorg system in Holland, which we visited and saw. It was a huge achievement—I think we were just a few dozen short of 4,200 by the time we got to 2015—and yet I fear that those numbers have dwindled back almost to the level that was inherited. That is such a false economy. Health visitors are a critical part of a universal offer to all families in the first 1,001 days. The report by the First 1001 Days Movement says:
“It is essential that governments invest in the delivery of the Healthy Child Programme and that this programme supports babies’ emotional wellbeing and development. We believe that all families should be able to access care from a named health visitor who offers them a high-quality service that is proportionate to their needs.”
I wholeheartedly concur.
What should be done? Many suggestions have been made. The LGA recently brought out a report saying that the Government should
“properly resource councils to enable investment in preventative universal and early help services to ensure that children, young people and their families receive the practical, emotional, education and mental health support they need”.
That is absolutely right. The Parent-Infant Foundation, in its “Babies in Lockdown” report, recommended funding for a
“Baby Boost to enable local services to support families who have had a baby during or close to lockdown.”
As my right hon. Friend said, more than half a million babies were born in that period. The report also said we should have a
“new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.”
I obviously agree with that.
Finally, I will go back to the “Building Great Britons” report, which was produced back in 2015 and made nine main recommendations: that a 1,001 critical days policy should be a mainstream undertaking by central Government; that all local authorities should be required to produce and implement a 1,001 days strategy within the next five years; that national Government must establish a 1,001 days strategy blueprint; that local health and wellbeing boards should demonstrate delivery of a sound primary prevention approach; that the early help recommendations from the Munro review, which I commissioned back in 2010, should be picked up and carried; that we should have a Minister for families, either close to or at Cabinet level, to carry the banner for the importance of the early years and family contexts, which are so important to the social policy of any Government; that we should have more inter-agency training on the importance of the early years; that children’s centres should be repurposed to be these family hubs, which this Government have committed to and which should be a Piccadilly Circus of these services available to all families; and that we should have the research evidence to go with all of that.
In short, we need a full “team around the family” approach; we need to invest in health visitors and other health professionals, including GPs and mental health specialists, particularly around attachment issues. We need them to work with all of those in the early years setting, alongside social workers and others with safeguarding responsibilities—supporting, not supplanting parents, but signposting them to the most appropriate services and ensuring that they are accessible when needed. We need a national roll-out, national guidance and national scrutiny to ensure that it is being delivered, but it should be implemented locally and governed by local circumstances. To not do that is a false economy, and children in future generations will pay the price.
Thank you, Sir Christopher. I thank the right hon. Lady for South Northamptonshire (Andrea Leadsom) for setting the scene so well, and to all those hon. Members who have made contributions.
As the grandfather of five grandchildren, this is an issue that is close to my heart. There is little that brings me as much joy as seeing my grandchildren—though that has not happened as often over the past few weeks because of the lockdown—and knowing that they are healthy and happy. Katie, Mia, Austin, Rhea, and Max, who is just eight weeks old, are bright and happy and in these dark days. That brings so much joy and I thank God daily for them.
I thank the Duchess of Cambridge, to whom the right the hon. Lady referred in her introduction, for the wonderful work she has done. She came to my constituency but unfortunately I was unable to be there. She visited the Ark Open Farm in Newtownards, and the results of what was done that day are clear.
Early years matter a great deal and the overarching response to the questionnaire undertaken is that more support must be given to young mums and families. Over the pandemic, many of us have realised how much we underestimated the support and help provided by the mums and toddlers groups in the local church or community centre. We had not understood that talking to another mum about their horrific day with their wee toddler—even if it was never really all that horrific—and exchanging viewpoints about how they felt made coping that little bit better. We have learned, more than ever, that it takes a village to raise a child, and so it does. It is little wonder that dedication and christening services highlight that a mum and dad cannot and should not do it alone.
When my parliamentary aide was pregnant with her daughter, one of the first signs I noticed was that her 10 cups of coffee per day were reduced to zero. She had read that caffeine would make her baby’s heart beat up to six times as fast; she loved her coffee, but she loved that unborn child even more. Mothers all through this nation make changes before a baby arrives, including eating more healthily, taking vitamins, stopping drinking. There are no laws that say they must do these things, but the mother knows to do it. Prenatal support for mum at this time is essential, and I believe that we need to give more advice, more listening ears and more communication for those who worry at this stage.
Together for Short Lives contacted me and asked me to briefly highlight a number of issues, as not all pregnancies end in the dream photo-op at the end of labour. Some have a much sadder story to tell—that is a fact of life. The majority of child death occurs in the first 28 days of life—the neonatal period. Every year, over 100,000 babies are admitted to neonatal intensive care in the UK. While many of these babies will only need to receive treatment for a few days or weeks before being discharged home, a minority will need more intensive care. The “Make Every Child Count” study, published this year, found that the prevalence of life-limiting conditions is highest in the under-one-year age group, at 226.5 per 10,000. That is the point that the right hon. Member for South Northamptonshire is making, and the very point of this debate. On average, there are 1,267 neonatal deaths each year from causes likely to require palliative care.
With this in mind, Together for Short Lives has highlighted the importance of the specific challenges faced by babies and children with life-limiting conditions and their families; they are not forgotten. The NHS England children’s hospice grant will increase to £25 million per year by 2023-24. It will be reallocated equitably to children’s hospices and there will be £7 million funding for children’s palliative care.
In conclusion, Sir Christopher, I briefly highlight the phenomenal work done by the WAVE Trust and Alex Williamson, and their 70/30 Campaign, which is about reducing the number of children who experience maltreatment by at least 70% by 2030. It is difficult to argue against their proposals or those of Together for Short Lives.
I look to the Minister, as I always do, to confirm that pregnancy and early years matter; if we want to see a generation of well-adjusted and happy youth it must be not simply because their parents have invested time and love. It has to be more than that. Our Government have to understand that funding for early years is not a grant of money, but an investment in our future—one certain to return a great yield. As the good book says, as you diligently sow, so you will reap. We must sow good for our children to get good from them as adults, and that must begin today.
I agree that is arguably one of the opportunities of a more cashless society. If people are making a payment, the gift aid opportunities are potentially easier to access than with putting money in a box.
I appreciate that healthcare is a devolved matter, but I am still looking forward to hearing the Minister’s response because I am sure these challenges exist throughout the UK. Indeed, that is why the hon. Member for Strangford is the person who has secured this debate. We can also achieve much by pooling our healthcare expertise across the four nations. We should be making sure that in Scotland, Wales, Northern Ireland and England that we are following the best possible practice, which means raising awareness of symptoms, enabling swift diagnosis and ensuring that children, young people and their families are properly supported.
It is, as always, a pleasure to see you in the chair, Sir Christopher. I very much miss serving on the Procedure Committee with you all those years ago, but it is a pleasure none the less to see you this morning.
I congratulate the hon. Member for Strangford (Jim Shannon) on securing and opening the debate, and to see him back in his place after his period of self-isolation last week. He was very much missed last week in the debate that he had secured on the persecution of religious minorities. It is good to see him back in that seat—which I am sure he has probably got title deeds for now given that he is there so often.
This has been a very short but very enjoyable debate. The hon. Member for Strangford opened with a very passionate speech, as we would always expect from him, but in particular he spoke about that very poignant testimony from Alex. The hon. Member for Wakefield (Imran Ahmad Khan) spoke about young Daniel and that relationship that was struck by his father in hospital. I think hearing about three-year-old Ellis really moved us all. I cannot begin to imagine how difficult it must be for Ellis’s family as they work through losing a loved one. The hon. Gentleman has spoken very eloquently on behalf of his constituents and they should be incredibly proud to have him in here to be raising those issues, as he sits alongside the Minister.
Finally, the hon. Member for North East Fife (Wendy Chamberlain) talked about Toby’s Magical Journey in Cupar. I, too, pay tribute to Richie, Alison and Toby for that remarkable figure of raising £50,000 pounds, and it was great to hear that Toby got the all-clear in 2018. She raised an important point about the impact that the transition to a cashless society will have on charities. I hope that is something that we can tease out in the debate in Westminster Hall on Thursday afternoon about transitioning to a cashless society, particularly in the light of the covid pandemic.
On that point, covid-19 has dominated so many aspects of our lives. Much of the discussion around public health shows that it is still so vital to look after other aspects of our health and wellbeing during this time. That very much includes checking for symptoms and signs of cancer.
With your forbearance, Sir Christopher, I want to pay tribute to my colleague and my hon. Friend the Member for East Dunbartonshire (Amy Callaghan), who has been a tireless campaigner on the subject of cancer and young people. She is not just one of my colleagues in this place and my constituency; she is one of my closest friends. I congratulate her on her election as chair of the all-party parliamentary group on children, teenagers and young adults with cancer. I also pay tribute to this young woman who has survived cancer twice. As has been well documented this year, she has also been through other health challenges. This House is stronger for having the experience of people like her. I look forward to her coming back and, arguably, making a much better speech than I could ever do. I hope to do this justice on her behalf.
I also want to pay tribute more broadly to the work of the APPG. It has done fantastic work in raising awareness of the issues affecting young people with cancer and their families. The 2018 report published by the APPG, “Listen Up! What Matters to Young Cancer Patients”, looked into cancer patient experience for children and young people across the UK. That report found that 64% of respondents did not think enough was being done to create a positive experience for children, teenagers and young adults with cancer. It also discovered that 82% of young people and parents responding to the survey did not think that Government listened enough to the experiences of young people with cancer and their families.
The report offered several recommendations for helping teenagers and young people understand the symptoms of cancer, as well as for those facing cancer treatment. Those include compulsory lessons in secondary school on spotting the signs of cancer; designated hospital parking for children and young people with cancer; an agreement by the Government to meet yearly with young cancer patients to discuss their experiences; and offering access to free fertility treatment to survivors of childhood cancer, who are not offered fertility preservation before receiving cancer treatment. That report highlights that not enough has been done to support young people and their families through a challenging diagnosis.
It is important that young people know the signs and symptoms of cancer, although they may differ from person to person. The common symptoms are lumps, unexplained tiredness, mole changes, pain and significant weight change. For more information about the different symptoms and where to seek help, I advise people to go the NHS website, the CLIC Sargent website and that of the Teenage Cancer Trust.
A lot of young people have expressed worry that they are wasting doctors’ and nurses’ time, particularly during the coronavirus pandemic. I get incredibly frustrated, as a constituency MP, when people say, “I don’t want to bother the NHS or go to my GP, because they are really busy.” One of our privileges in this place is to have the voice to get this message out to our constituents: “If you are experiencing any of those symptoms, please do not worry about bothering your GP or the health service, but go and get it checked out.”
I want to reassure young people that if they have any of those symptoms or if they are worried about their health, they will be listened to and taken seriously. The NHS, in whatever part of the United Kingdom, is and always will be there for everyone. That is something we have certainly learned during the course of the pandemic. Despite the pandemic, the NHS continues actively to encourage people to contact their GP if they are worried about possible cancer symptoms. If the symptoms lead to a diagnosis, early diagnosis and treatment are really important and can improve the outcome for many young people.
I want to highlight the fantastic work of CLIC Sargent and the Teenage Cancer Trust, both of whom act jointly as the APPG’s secretariat. Understandably, for many families, when a young person receives a cancer diagnosis, it can be a very scary and confusing time. From doctor’s appointments to new treatments, the process can be overwhelming for young people. Those organisations offer advice to help young people and families to adjust to the cancer diagnosis and the treatment that follows. The Teenage Cancer Trust offers people advice on how to speak to doctors if they are feeling nervous, details of the different symptoms and case studies of teenagers and young people who have experienced treatment during the pandemic. CLIC Sargent is also a great resource, providing guidance for navigating clinical care, granting financial support and helping young people with the emotional impact of illness. Both organisations have new information around how to manage cancer during the covid-19 pandemic. Clearly, the public health crisis creates new challenges for patients, but there is still support available to help young people through this challenging time.
This year, the covid-19 pandemic has thrown unprecedented challenges at us all. From facing the virus itself to the huge financial insecurity that many people have experienced, to the restrictions and lockdowns taking us away from our loved ones, it has undoubtedly been a tough year for many of us. I say that after my grandfather was cremated yesterday. One of the hardest things that I have experienced during this pandemic was limiting the number of people at his funeral to 20. It has been incredibly, incredibly cruel from a public health point of view, and I think we would all agree that this has been such a difficult year for us.
This debate has highlighted that the teenagers and young people facing a cancer diagnosis and treatment during this time are facing even more challenges, but support is out there. Whether it be from the APPG, the NHS, CLIC Sargent or the Teenage Cancer Trust, there are people out there to offer information and guidance. It is vital that all young people check for the signs and symptoms of cancer. To reiterate, they are: lumps, unexplained tiredness, mole changes, pain and significant weight change. If a young person is experiencing these symptoms, I urge them to contact their GP. An early diagnosis will lead to the best outcome. Facing cancer as a young person can be incredibly scary and overwhelming and I pay tribute, above all, to all the young people undergoing treatment for cancer diagnoses. I thank their families, their carers and the NHS, who are working so hard to support them.
Parliamentary questions are a key element of Parliament’s ability to scrutinise Government on behalf of the people of the United Kingdom. As the House would expect, we take them very seriously, and as you, Mr Speaker, and hon. Members will know, I take seriously all aspects of my and the Government’s accountability to this House. Prior to the pandemic, my Department had an exemplary record of providing accurate and timely answers. In the last full parliamentary Session, despite receiving more PQs than any other Department, we had the highest response rate in Whitehall. However, as hon. Members will be aware, DHSC, its Ministers and officials have been at the forefront of responding to this pandemic, with the attendant additional workload that has brought.
As such, it is a matter of regret that we have been unable to sustain previous PQ performance, for which I rightly apologise to you and the House. However, it is explicable in the face of a trio of concurrent challenges. The first is volume: between March and October this year, we received over 8,000 written parliamentary questions across both Houses. This compares with 4,000 for the equivalent period last year. The second challenge is timeliness: we have met a rapidly, almost daily, changing situation, and answers drafted by officials are sometimes out of date shortly after they are drafted. We have been prioritising accuracy of response to Members over speed, but this can mean that responses have to be redrafted, with attendant delays.
The third challenge is policy input: despite increasing the administrative resources to respond to parliamentary questions, it remains the same policy officials who are responding to the pandemic operationally and drafting regulations and are the only people with the requisite policy expertise to input into parliamentary questions and responses.
That said, Mr Speaker, although we continue to field exceptional volumes of parliamentary questions, I want to reassure you and the House that we are not making excuses in providing these explanations, and are taking every possible step to recover our performance. We have instituted a parliamentary questions performance recovery plan and are delivering against it by increasing resource where we can and clearing the backlog, focusing on the oldest parliamentary questions first.
More broadly, throughout this challenging time the Secretary of State and Ministers have sought to make themselves regularly available in the House to be questioned and held to account. Between March and October, the Secretary of State made 18 statements and answered seven urgent questions. We have also seen seven general debates on covid since March, and that is not including junior Ministers’ appearances in the Chamber. This is not an alternative to written parliamentary questions, but it is an important reflection of our accountability to this House.
To conclude, written parliamentary questions will continue to be a top priority on which I am briefed weekly. I thank you, Mr Speaker, and hon. Members for your and their patience and recognition of the exceptional circumstances of recent months. In the weeks and months ahead, we will work hard to restore our leading performance, which hon. Members have a right to expect.
I am grateful to my hon. Friend. As he will be aware, other Departments, while they have heavy workloads, are not leading the response to the pandemic. In response to his final point, he will not be surprised that I do not characterise it in that way. Instead, I would characterise it as the Department of Health being in the lead in saving lives and protecting the NHS in this country.
My hon. Friend asked two other substantive questions. I think his language was a little intemperate in respect of the serious efforts that officials undertake every day to try to provide accurate and timely answers. There is no suggestion that they seek to stonewall or to avoid responding. They do their best, but it is difficult and the situation changes day by day. Where answers are deemed to be inadequate, hon. Members often revert to me directly or table their questions again, and we endeavour to fulfil our obligation to provide accurate answers.
On my hon. Friend’s question about recovery, we have set a trajectory for each month in order to recover performance over the coming months. Of course, that depends to a degree on the workload of officials in responding to the pandemic, as well as in providing answers, but I do not see it as an either/or; we intend to recover performance in parallel with tackling the pandemic.
I am delighted to start my contribution to this debate by paying tribute to the key workers on the frontline of this pandemic. Their commitment to public service and their selflessness in the face of the most severe of circumstances set an example to us all.
I am deeply concerned by the dangerous polarisation on public health measures that have been implemented to save lives, and that is what I want to focus on. I am sure that Members across this House have been inundated with correspondence from constituents sharing very legitimate concerns about restrictions that have been imposed in order to protect the NHS, keeping us agile enough to deal with covid, while thousands of elective care patients have had procedures and treatments delayed. This suffering is real. The diversity of the issues raised is phenomenal, spanning mental ill-health, business support, attendance at funerals, redundancies, access to universal credit, and care home closures. We also receive correspondence from constituents reasonably seeking to clarify the rules in respect of their own actions.
On the other side of the coin, we have all received correspondence from angry constituents—on occasion aggressive, even abusive—about the restrictions that this Parliament has collectively implemented, under great duress and with an increasingly heavy heart. Aggression and abuse are never acceptable, but the anger is justified, and it is not taken lightly; neither is it dismissed by anyone in this place, especially coming from those many constituents who have fallen on hard times.
However, I want to shine a spotlight on some of the more sinister and fringe drivers of that anger. A cause for growing apprehension is the misinformation, the fake news and the dismissal of science in the post-truth world that a small number of hardened minds occupy. Assertions are made, social media lies are repeated, and distrust in our institutions, our scientists and our elected representatives is sown in reference to their motives. That translates into real-world consequences. This ugly underbelly has seen a small number of aggressions against those in Liverpool waiting patiently in line to be tested. There have been megaphones outside school gates screaming at parents and pupils about testing, confrontation sometimes of those wearing masks, and the outright dismissal of the growing prospect of a vaccine—a prospect that is giving so much hope to a beleaguered population who yearn to return to some normality.
It is apparent that much responsibility for such behaviour lies with social media platforms: most people receive their information through that medium. People currently have many insecurities, both health and economic, and the misinformation plays into these deeply held fears and is easily shared at the click of a button. My colleagues on the Front Bench are right: the producers of such material should be denied a stage to peddle these lies and myths that have no basis in truth. Ahead of the delivery of a vaccine, we cannot let the naysayers spread further mistrust when so much is at stake for all our people.
The hon. Gentleman, as ever, makes a valid point. That is why I have been calling for additional support, whether signposting or helplines. We actually need a cross-Government strategy on mental health going forward.
On those who have been excluded from financial support, as the Chancellor remains intransigent on that point, I urge the Minister first to speak to her Treasury colleagues and ask them yet again to think again. Will she also step up mental health support for those who have been excluded? The mental health impacts will cost us a lot down the line.
The other very important group is the more than 9 million unpaid carers who are the forgotten heroes in our society. I hope the Minister agrees when I say that our health and care systems would be overwhelmed if it were not for the work of unpaid carers in our society. The Exchequer saves billions thanks to their work. Four out of five unpaid carers have taken on more caring responsibilities during lockdown, and almost two thirds have seen their mental health worsen during the pandemic. Many have lost their access to respite care, which has affected their ability to earn money. She will be aware that carer’s allowance is pitifully low at £67 a week.
One thing that would help respite care and day care centres to reopen—Homelink in my constituency is taking all sorts of safety measures and is desperate to reopen—is access to regular testing. I raised that in the Chamber with the Secretary of State for Health on 7 July. He told me that a plan was in place and he would write to me about it. He never wrote to me, but I did not chase him about it because I heard that testing had been made available to day centres—briefly; I have now heard that it is no longer available. My council has spoken to colleagues in the Department of Health and Social Care, who say that they cannot offer tests to respite care day centres. Those officials say that they are following SAGE priorities, and that suggests to me that there never was a plan. I would be grateful if the Minister could clarify that point. This is an issue for the Department, and I urge her to address it urgently, because respite care is a lifeline to so many unpaid carers. I also ask the Minister to speak to her colleagues in the Department for Work and Pensions about addressing the woeful level of carer’s allowance. How can anyone be expected to survive on the equivalent of £1.91 an hour?
The Chancellor previously said to the public,
“you will not face this alone”.
Can we say, hand on heart, that unpaid carers and those whom the Chancellor has excluded from financial support have not been left alone? They feel abandoned and their mental health is suffering, so I urge the Minister to address these injustices.
I draw Members’ attention to my membership of trade unions and to donations from Unite the union, as outlined in my entry in the Register of Members’ Financial Interests.
I welcome this debate on covid-19. Stockport and Greater Manchester have been hard hit by this pandemic. I pay tribute to the leader of Stockport Council, Elise Wilson, and to the Mayor of Greater Manchester, Andy Burnham, for all they have done. Stockport Council has much to be proud of in its response to date. The transfer of many council functions to home working has gone well, which is a credit to all the staff involved. Stockport was one of the most effective authorities in Greater Manchester in distributing covid grants to local businesses. Our council workers do a very important job in difficult circumstances, and I speak on behalf of my constituents when I thank them from the bottom of my heart.
I believe that Members on both sides of this House will agree that the hospitality sector has been particularly hard hit in recent times. My trade union Unite has published a hospitality and tourism rescue plan this week. The hospitality and tourism sector is the third-largest employer in the UK and Northern Ireland, creating one in six of all jobs and employing 6 million people, 3.2 million directly. The hospitality industry has lagged behind many other sectors in terms of good working practices, with average pay of just £8.84 per hour and more workers employed on zero-hours contracts than in any other sector. I urge all Members to look up Unite’s hospitality and tourism rescue plan, as it is an important document. The recommendations include extending the sector-specific job retention scheme for six months, adequate sick pay and routine testing for hospitality workers, and a call for the Government to work with Unite’s proposed hospitality commission to retrain workers who lose their jobs.
The Test and Trace system has been a national disgrace. The Labour party’s analysis shows that the Government’s contact tracing is going backwards across England, with just over half of contacts—57.7%— reached last week. In my region of the north-west, more than 26,000 people were not contacted. I urge the Government to give local communities additional resources to carry out door-to-door testing and contact tracing and to check in on people to ensure that they are able to self-isolate in areas such as mine that face additional restrictions.
In the absence of any form of effective test and trace, frontline staff, including all key workers at hospitals, schools and local authorities, must be provided with access to personal protective equipment. I used to work as an industrial organiser for Unison North West and often went into hospitals and care homes to recruit union members. Sadly, care home residents and staff have suffered badly due to the mismanagement by the Department of Health and Social Care. Weekly testing of care home residents and staff is critical to saving lives, yet there have been repeated delays to the rolling out of testing, and care homes have waited days for their results. There are also serious concerns about vacancies in the care sector during the months ahead.
The Government must provide an immediate plan to better support care workers in all settings, including the 9 million unpaid carers across our country. That includes covid-19 test centres, which is why I have recently highlighted concerns that my constituents have raised about the lack of PPE at Tiviot Dale church test centre in my constituency. I have received a letter from a secondary school teacher, who informed me that the only protective measures in place were disposable face masks for staff and visitors, and that the manager had informed them that they did not need them. This is deeply concerning, given that a large number of staff were from an ethnic minority, who, as we know from the first wave of the pandemic, suffered disproportionately. Our test centres should be the first step towards controlling this disease, not hotbeds for its spread. I have written directly to the Health and Social Care Secretary on this issue, but I have yet to receive a response. It is simply not good enough, with Stockport and Greater Manchester facing sharp spikes in infection rates and cases rapidly spiralling out of control.
We are reaching a crisis point with the virus, and we badly need the Test and Trace system fixed and adequate support for all workers and businesses.
Possibly; the hon. Gentleman is in a very difficult position now. I say well done to him for taking apart the Great Barrington declaration. I will now not go into it, as he did an excellent job.
Turning to herd immunity, without a vaccine how do we attain herd immunity? With no knowledge of immunity from coronavirus, how do we obtain herd immunity? I will share with the House that I was diagnosed with coronavirus on 7 March, I had a severe dose and my antibodies had disappeared 12 weeks later. I am no longer immune to coronavirus. That is not just my story; it is the story of many, many people. Many people who were donating their plasma post-coronavirus for convalescent therapy were told quite quickly, “We no longer need your plasma because you do not have any antibodies left.” Work is going on into immunity, and we have not reached a conclusive position yet, but I can speak from my own experience and from the experiences that we are hearing about, and if people do not have long-term antibodies and we have no vaccine, there is no such thing as herd immunity. I say that again because it is the truth.
On the comments about the measures we are putting in place, how restrictive they are and social distancing, all I can say—and this relates to the number of deaths in hospitals—is that back in March no one was wearing face coverings and no social distancing was being complied with by the public, and the rate of infection was doubling every three to four days. Now, it is doubling every seven to 14 days, because the public are wearing masks, they are hand washing and they are socially distancing, and that means that when someone contracts coronavirus, they contract a smaller viral load, which is enabling doctors to treat those patients once they reach an intensive care unit. In ICUs, people are now living, not dying, but we still need the ICUs and we still need the ICU beds in which to treat those people in order that they can live. The fundamental purpose of every measure we take is to protect the NHS and to keep those beds in ICUs, so that they are there to treat people and to keep people alive.
I described this to someone today who argued with me that face masks and coverings are unnecessary. If people are in the space of someone with no facemask—I will use a scale of one to 100—they will breathe in 100 droplets and a full viral load, but when someone has a mask on it is much less. This is not a scientific experiment; it is my own analogy, but the figure is probably 10. The hon. Member for Tooting (Dr Allin-Khan) knows this much better than I do, and can confirm or deny it. Therefore, with a mask, people’s viral load is lower and it is far easier to treat them once they arrive in hospital at A&E and are transferred to an ICU, and there is a huge chance of success. That is what we are seeing in action now in our hospitals. If we all abandon our face coverings, stop social distancing and stop hand washing, we will be back to where we were in March, when the virus was doubling every three to four days.
My hon. Friend the Member for Christchurch (Sir Christopher Chope) mentioned Sweden, but an article in The BMJ—a research study—concluded that Sweden and the US are the only two countries that are failing to reduce their numbers of deaths. In fact, it is far more accurate to compare Sweden with its Nordic neighbours. Sweden has 586 deaths per 1 million people, while its neighbour Norway has 279, so I am not quite sure why Sweden would be cited as a country of success.
No, there is no time—I am sorry—because I want to go on to what other Members have said.
I want to talk about mental health and just correct a few points, particularly on frontline workers. On the evidence we have at the moment, the two groups of people who are suffering with their mental health as a result of this pandemic are those people who had pre-existing mental health conditions and frontline workers who are suffering from post-traumatic stress disorder. For those frontline workers, a package was put in place straightaway by the NHS, which provided each frontline worker with three counselling sessions, numerous apps and the ability to have a contact and to receive immediate counselling, as well as a website where they could go through the tools used to work through their feelings. Almost every trust manager put in place a support package for frontline workers in their hospitals, and yesterday the NHS announced a further £15 million to support the mental health of frontline workers.
For those with pre-existing mental health conditions—and I would like to pay tribute to Claire Murdoch, who is responsible for mental health delivery in the NHS—trusts across the UK put in place 24-hour mental health crisis helplines in a matter of weeks, and they have had a huge impact. The Government have committed the £2.4 billion; we have accelerated the long-term plan; we have accelerated the trailblazer schemes in schools; we have introduced the wellbeing package in schools for children returning to school, and we have supported the third sector financially to deliver additional mental healthcare to almost every sector of society, including on eating disorders. I always say that is one of the worst mental health conditions because it has a high rate of morbidity, and it too has received additional funding. We have put a huge amount of work into mental health, and I know that Claire Murdoch and others are proud of what the NHS has done in terms of the mental health services that it has delivered.
I cannot answer anybody else, but I will write to people. This has been an important debate in the middle of one the greatest public health emergencies that this country has faced, and I would like to end by again thanking everyone across the country for playing their part to reduce the rate of transmission and to protect their loved ones and our local communities.
Question put and agreed to.
That this House has considered covid-19.
Just yesterday the Prime Minister and the Government unleashed a new package of restrictions and tiers in order to tackle the transmission of the coronavirus. Yesterday afternoon, in a meeting with west midlands MPs, the Secretary of State for Health and Social Care told the MPs present that all bar two areas—Dudley and Coventry—will be placed on tier 2 restrictions. When I asked him whether he could let me know the scientific basis for Coventry and Dudley being on tier 1 restrictions, and what could trigger a move to tier 2, my question was ignored and unanswered. When I asked how soon after a governmental decision has been made to move a constituency from one tier to another Members and community leaders would be alerted, I received no answer.
This is utterly unacceptable. My constituents in Coventry North West deserve better. They are doing everything they can to hold up their end of the bargain to ensure that transmission is low and stays that way. They deserve more clarity on the evidence behind the Government’s decisions. Clarity ensures adherence. Without it we are flailing in the wind, and people are suffering. Right now, the Government risk losing confidence in their ability to see us through this crisis. They have wasted months of precious time and millions of pounds of taxpayers’ money, and are still not getting it right. Will the Minister let us know just how much notice each local area will be given if a change in its restriction level occurs, and how local communities and local leaders will be told of these decisions?
To borrow a phrase that we are all too familiar with, winter is coming. It is imperative for the Government to be better prepared to tackle the virus, and equip our hospitals and care sectors with the resources they need to handle the second wave. I fear that the Government have not learnt lessons from spring, and that our care sector will be under-protected. I fear that our hospitals will be ill prepared to cope, and that non-covid patients will once again be relegated to the back burner, because the right precautions and planning are not in place to deal with what may come.
Will the Minister let the House know what the Government are doing to prepare for the pressures on our NHS that winter will bring, in particular for cancer patients? What plans will be in place clearly to address sprawling waiting lists for cancer services, and what additional support have the Government given to the many thousands of people who have had their cancer treatment disrupted over the course of the pandemic? These are pertinent question that we have asked the Government time and again, but yet again they are providing us with little clarity and no answer—on the back foot, as usual.
This is an opportunity for the Government to do better, and, in the interests of the country, I really hope they do.
Clearly, if we are going to live with this virus, which we obviously will at least until—if ever—a vaccine is found, we need to influence individuals to behave in a way that not only keeps them safe, but makes them discharge their responsibility to keep safe other people in society and in their families. There are many tools that Governments can use to do this. They include rules, regulations and restrictions on activity. They also include messaging. We must give positive incentives to do these things, as well as negative consequences if the rules are not followed. However, I have to say to the Government that more rules will just mean that the compliant, who are not engaging in risky behaviour, will continue to comply, but that those who are reckless will find ways round the rules.
There is no better example of that than the curfew. We know that there is no scientific basis for doing it to protect people’s wellbeing. We have penalised restaurants, which now have to close at 10 pm and cannot do two sittings in an evening, although they have made massive investments to make their premises covid-secure. We are punishing the compliant. Meanwhile, publicans in the high street can comply with the rules and close at 10, but they are offering take-outs at 9.45 to the massive crowds of people spilling out of the pubs. That is reckless behaviour, and I really think the Government need to take stock. It is clear that this is not a good measure to influence behaviour in any positive way. There are much better ways of doing it. Considering the powers that the Government have already taken, I think we should look at more enforcement of fewer rules and regulations, rather than creating new ones when there are issues.
In the time I have left, I want to pay tribute to my community and to the local authority officials and health officials in Thurrock for the fantastic effort they have made in tackling this virus. We are currently 134th out of 149 local authorities in terms of cases. We have a local contact tracing capability that has kept rates down, and we have had no deaths since July, so it has come as some surprise that Public Health England has been lobbying my local authority to move from tier 1 to tier 2. That makes an absolute nonsense of this tiering policy, because we should be asking for additional restrictions only where there will be a material benefit to public health. My director of public health advises me that further restrictions will actually jeopardise public health, and that there will be no benefits from them. We must not be complacent, given the current rise in cases, but please will the Minister resist any attempt to put Thurrock into tier 2?
Mr Deputy Speaker, you may well think that over 37 years, you have heard enough from me, so let me read out a letter that happened to arrive this morning from a constituent. It says:
“I am 67 years old and for the first time in a long time I am scared. Not of the virus, which, let’s be honest, is proving to be no more deadly than the flu”—
that is his opinion; I do not necessarily share it.
“I am scared of the damage being deliberately caused to the economy and our freedoms by this Government in the name of covid-19. It isn’t the virus closing businesses and causing job losses, it’s the actions of the Government. It isn’t the virus stopping people getting treatment and operations, it’s the actions of the Government. It isn’t the virus preventing pupils and students getting the education they are entitled to, it’s the actions of the Government.”
So speaks my constituent in a letter that arrived this morning.
Another letter arrived this morning from a constituent telling me that they were having doorstep services very successfully over recent months attended by six to 16 people in place of going to church if that was not possible. That, of course, now breaks the rule of six, so they have had to stop.
I follow my hon. Friend the Member for Christchurch (Sir Christopher Chope) in posing some serious questions to Government that have to be answered. On positive test results—I ask the Government to write back to me if they cannot answer in the winding-up speech—what percentage do they estimate are false positives? Of covid hospitalisations, what is the breakdown between those in hospital who happen to have tested positive and those who are in hospital because of their covid symptoms? Given the disparity between the number of cases and the number of deaths, are we not wrong to react to the rate of infection, rather than hospitalisations and deaths? There are many, many other questions that need answering.
Following my hon. Friend, what is the evidence that we are saving lives by throwing people out of pubs at 10 o’clock into the street? They can go and buy lager in the shops. They can go back to their student digs.
My hon. Friend makes his point. We are a Parliament and we are entitled to express our opinion and hold the Government to account, and that is what we are trying to do this afternoon.
The trouble with the Health Secretary’s arguments is that he is always raising up Aunt Sallies and pretending that some of us want to let this thing rip. We are simply trying to ask questions of the Government and hold them to account. No Member of Parliament wants to let this thing rip, but what we do say is that the real danger of the disease is to people over 80. The average age of death is 82, and the vast number of them are over 80. It is up to the older population and those who care for them to take self-responsibility—masked by all means, taking great care and shielding even in places of multiple occupation. We have to shield elderly people—they are the people at risk—but we have to get the country back to work. We simply cannot go on bailing out businesses. We are going bankrupt, as I said to the Chief Secretary to the Treasury earlier this afternoon.
With the economy, we are hoping to pull ourselves up by the hair. We cannot do it. We have to allow people to work, and therefore the whole approach needs to change. We need to emphasise the need to shield the elderly population and those who care for them and we need people to take back control of their own lives. I repeat—I will say it again and again—that if we go on cancelling cancer operations and heart operations, if we drive people into mental health difficulties and if we close down businesses, we are paying a terrible price, and there has to be a balance.
I feel I have taken quite a number of interventions, so it is time that I moved on, if that is all right.
Let me talk through some further changes that have come into effect since the regulations were made. On 21 September, following the advice of the four chief medical officers, the UK’s covid alert level was raised from 3 to 4, which is the second most serious stage, meaning that transmission is high or rising exponentially. The Prime Minister outlined to Parliament on 22 September that we were at a “perilous turning point”, and needed to act to save lives, protect the NHS and the most vulnerable, and shelter the economy from far sterner and more costly measures that would inevitably become necessary.
As a result, further restrictions came into effect from 24 September. These included: rules on the closure of certain businesses selling food or drink between 10 pm and 5 am; measures to require hospitality venues to provide food and drink for consumption on the premises by table service only; the doubling of initial fines for individual breaches of the above measures; and new fines for businesses that do not adhere to the new requirements, starting at £1,000, up to a maximum of £10,000 for repeated breaches. The rules also change the exemptions to the six-person gathering limit to restrict attendance at wedding ceremonies, receptions and support groups to 15, and remove the exemption for stand-alone religious or belief-based lifecycle ceremonies and adult indoor sports apart from indoor disabled sports. We are working through the normal channels to schedule debates for these regulations as soon as possible.
I recognise that people have had to make significant sacrifices to suppress the first wave, and these restrictions are not measures that any Government would want to introduce, but the threat of the virus very much remains. With winter approaching, we must do whatever it takes to keep it under control and protect the NHS so that it can, in turn, look after us.
I certainly do not think my constituents are stupid, and I hope that the right hon. Gentleman does not either. A very important point has already been made about children, and I will return to that later. We have not yet had a convincing explanation why they are included in the six.
Even with the best of intentions, concerns and questions remain, not least about the way in which these regulations were introduced, how effective they are, how the Government communicated them and how they will be enforced. The timeline of these regulations is the perfect demonstration of the lack of transparency, strategy and accountably, which has been the hallmark of this Government. Following media briefings the night before, the Prime Minister made an announcement about the rule of six on 9 September, not to this place, as it should have been, even though he was in the House that day to answer Prime Minister’s questions. I call that a discourtesy to this place, and I hope we see and end of that. It shows not only a lack of respect to all Members and our constituents but a lack of confidence in what is being proposed and a lack of commitment to scrutiny. Most of all, the way that these regulations were introduced shows a lack of thought about the practicalities of enforcing them.
How can we expect anyone to adhere to the minutiae of these regulations if they appear for the first time only a quarter of an hour before they become law—at quarter to midnight on a Sunday evening? How were the police meant to enforce that? Are they supposed to google the regulations as they walk around on their beat? Brian Booth, the chair of the West Yorkshire Police Federation, said:
“Everybody is in the dark, it shouldn’t be like that…If the government says they’re going to infringe on people’s lives, they have to tell them how.”
Once again, there is no impact assessment for these regulations. Surely some thought was given to the practicalities, so what discussions did the Minister have with her counterparts in the Home Office and with police forces around the country prior to the introduction of these regulations?
The way that regulations are introduced matters. They are too important not to be debated and given full and timely parliamentary scrutiny before they become law. Since March, more than 70 health protection statutory instruments have been introduced in this way, with no debate and no vote before they come into force. We recognise that, in the early stages, there was a need to act quickly under the emergency procedures, and we acknowledge that that may still be the case at times, but more and more of the regulations that are being introduced do not meet the test of urgency. The Government have slipped into bad habits. They treat this place as an afterthought—an inconvenience, an optional extra—and not as the cornerstone of the democratic process that it should be. Surely they can do better than that. Do they not realise that scrutiny, debate and challenge in the making of our laws means that, in the long run, laws are more robust, more effective and have greater public acceptance?
I repeat once again and for the record our offer to meet at short notice to debate and vote on regulations before they become law. I appreciate that that might be inconvenient for some, but, to be frank, we are in a pandemic so a bit of inconvenience should be the least that we have to put up with to ensure that democracy still functions.
Regrettably, I am not one of the business managers of the House, so I cannot advise on that, although I expect that we will have an answer during the business statement on Thursday. I note what Members have said about national regulations being debated on the Floor of the House before they become law, if possible—obviously, that will still be after the event, but we really need to start doing a lot better in that area.
There is rightly a concern across the House and among the population that we do not have control of the virus. A central part of regaining control is ensuring that there is robust scrutiny of the regulations and their effectiveness. The Government need to stop reacting to situations too late—that is how the virus has run out of control. They need to look ahead, plan, prepare and act now to get a grip on test and trace, to have a clear and consistent message on what the public need to do and to ensure that there is widespread compliance with the rules. The latter two go hand in hand and are very much connected to the regulations that we are debating today.
As we heard from the Minister, the regulations amend the Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations for the fourth time. The regulations restrict social gatherings to six people, unless an exemption applies. We have heard a little about some of those exemptions, so I will not list them all, but they are where the good intentions behind the regulations depart from the clear and consistent messaging that we need. For example, there is an exemption in the regulations for gatherings of up to 30 persons for a marriage or civil partnership; as Members will already be aware, that has been reduced to 15. Yet again, as with a whole host of other restrictions, we are debating regulations that are, in part at least, out of date.
The wedding industry has been decimated this year; I do not know what repeatedly inviting and uninviting people to a wedding does for family relations—maybe people could ask everyone to wear tweed to the wedding and combine it with a grouse shoot so that they could keep numbers at 30. However, this is a health debate, so I will focus on the health aspects. To that end, I would like the Minister to spell out very clearly the rationale for this decision. The limit of 30 at a wedding lasted for just two weeks before it was reduced to 15. Either a specific piece of evidence emerged during that fortnight that required the limit to be reduced for weddings but not for funerals, or the limit should never have been 30 in the first place. Which one is it?
The regulations also provide that the restrictions in private dwellings in the regional lockdown regulations remain in place; it is notable that the rules for the rule of six vary across the devolved nations, as we have already heard. Far from us having an easy-to-remember set of rules that apply to everyone, it seems that the rule of six is the baseline for around only half the UK.
In Wales, as we have heard, primary-age children are not counted in the six. The Welsh Assembly took that decision based on the evidence that it has, which shows that children are far less likely to have the most serious symptoms and are less likely to pass on the virus. The question, which has already been put today, is about how the Government have come to a different conclusion on that point. Why are younger children included in the rule of six in England, but not in Wales—or in Scotland, for that matter?
There are eight people on the call list, and I will get everyone in if it kills me. To do so, I am introducing a rule of six. It is not an arbitrary figure; I have divided the time left by how many people want to speak. The rule of six could become the rule of five or the rule of four if there are a lot of interventions.
I am sure the Minister really appreciated that warm welcome from her colleagues—so different from those horrid breakfast-time interviews that she is occasionally trapped in.
I would like to make three very quick points. I want to ask, first, about this rule of six. If it is a purely arbitrary figure and it has no scientific basis at all, does the Minister accept that she is being quite unfair to those with larger extended families, and how does she justify that?
Secondly, we need clarity on the question about police powers of entry. It is quite ridiculous for the Minister to come to the Dispatch Box and tell us that the police can level fines and that they can do this or that enforcement, only for us to discover that, if they are standing outside a property where there is a party of 40, 50 or 60 going wild, they have no room to enter. It would be useful, if we are being asked to renew these powers, to know what powers the police have.
Finally, is there a numerical point of reference—an R number, say, or a number of cases—for when these restrictions will be revised in either direction? If that is the case, surely we should know, and surely the public should know.
I have only three minutes left, so I am keen to cover a few more points that have been made in the debate.
Colleagues have spoken about children and the rule of six. As I have said, I am acutely mindful of this point as I have a family of five. I am well aware that Wales and Scotland, where health is devolved, have made their own decisions, including a slightly different decision on this issue. Of course, we will learn from the other parts of the United Kingdom. There are regular conversations between the devolved authorities and the UK Government.
On the matter of extended families and larger households, there is an exemption for larger households—clearly, they can gather—but in some areas there has been a particularly rapid spread when larger households of extended families come together. That can be a particular source of the spread, so it is much harder for larger households wanting to socialise. This is a difficult balance to strike, but we want to ensure that we are suppressing the virus because it is such a cruel thing.
Let me turn to policing. The police approach is one of engage, explain, encourage and enforce. I can confirm that they do not have power of entry, but my understanding of the feedback that we have received from the police is that they feel that they do not need further powers to enforce these measures.
I would like to reiterate the Government’s commitment to working with Parliament and to debating regulations such as these and others. I should say that we absolutely recognise the impact of these restrictions on people’s lives, and that it is with great reluctance that we bring them in. None the less, as I have said, the alternative is not suppressing the rate of the virus, and, as I have mentioned, it is not always a mild illness. We are seeing cases of long covid. There is also a health impact on our hospitals: if they become too full treating people with covid, they will struggle to treat people with other illnesses. That has its own health implications, and cannot be the right strategy. The strategy has to be to control this virus and to suppress it with the rule of six and all the other things that we as individuals can do, including our own compliance with the social distancing measures. We must take this approach, and I thank everybody for all that they are doing. I know that the public face the implications of these restrictions day in, day out, as we do ourselves, but we must do it, because it is the way that we get back to normal as soon as possible.
I have to admit that I have had to rewrite my speech in the light of the events that have occurred today in my area, Cleveland, with respect to covid-19.
I thank and pay tribute to all the NHS workers, care workers and key workers who keep the people of my constituency, Hartlepool, safe, well, protected and fed. I also pay tribute to all the local volunteers who have been relentless in their efforts to keep our communities going, to keep them together and to keep our citizens supported. I am very pleased—so pleased—that one of the national vaccine trials is taking place at our very own University Hospital of Hartlepool, which deserves much more Government investment to protect operational services. It is playing its part in this national crisis and I am proud of the people who work there.
I have changed my speech because of the Secretary of State’s announcement from the Dispatch Box of local restrictions for the Cleveland and Tees Valley area. On the letter written by the hon. Member for Middlesbrough South and East Cleveland (Mr Clarke), who is not present to hear this speech, and his fellow Conservative MPs in the area—they are known as the Cleveland Conservative collective of MPs—to all local authorities in the Tees Valley area to say that they feel the authorities should not proceed with voluntary local restrictions, it would have been much better for them to have spoken to all Tees Valley MPs, rather than construct what is little more than a local, party political and divisive missive at a time when we should all be working together for the greater good in the Tees Valley. I am sorry that the hon. Gentleman is not present to hear me say that.
Local restrictions are the last thing we want—they hurt business and keep families and loved ones apart—but where the R rate is so high, protective measures and local restrictions are put in place to protect people and stop the spread of virus, as we have seen in other areas. I have often disagreed with my local council—for example, it has a bizarre plan to stop traffic going up and down a local high street known as the York Road but it cannot explain why; it just says that it is because of covid-19 reasons. I will disagree with bizarre local plans like that and be vocal about them, but I have spoken to the council today about local restrictions and I have listened to our local public health authorities, and I understand why they feel that more resources and more support is needed to get Hartlepool through this crisis.
Until now, Hartlepool has been given only ad hoc provision, yet we persistently sat at the bottom of the fatalities league in the north-east—something we should rightfully be proud of. Even so, we had been in the red zone—the watch zone—for more than two weeks before routine testing materialised. I am no apologist for my council, which is a Conservative-backed collective, but in order to get a grip of this virus, and with a distinct lack of direction and leadership from the other side, on balance taking local control appears to be the way forward. People in Hartlepool—or anywhere else, for that matter—should not be made to drive miles just to get a test. It is absolutely ridiculous and my constituents rightly feel outraged by it. We need Government leadership and positive direction from the Government; unless we get that, the local option is the better option.
Coronavirus presents a very real threat to the health of our constituents and must be controlled, but we must also recognise that measures to control its spread are having a huge impact on our constituents’ lives and those impacts are not evenly felt. They have a disproportionate impact on particular groups, particular places and particular sectors. There is only a short time available, so I intend to restrict my remarks to three matters.
The first is the system for test and trace. If this is not working effectively, there is a likelihood of further restrictions, which none of us wants to see, yet we know that, over the last few weeks, many of our constituents who are unwell and who suspect they have contracted the virus have faced huge problems in accessing a test. When they do get a test, results are too slow. Last week, fewer than one in three people tested in person got their results back within 24 hours, and that proportion was lower last week than the week before. Once positive cases were identified, only around three quarters of those they were in close contact with were asked to self-isolate—again, a smaller proportion than in previous weeks.
The Prime Minister might say that testing and tracing has “nothing to do” with the spread of the disease, but everybody else understands that rapid testing, effective contact tracing and self-isolation are absolutely vital to identifying and containing any outbreak. The Government must acknowledge that there are problems, identify the source of those problems and then take swift action to fix them. Please can we get the Department of Health and Social Care to start working with others that can help? Numerous universities, including the University of Nottingham, are undertaking asymptomatic testing to control outbreaks on university campuses and protect the wider community. Those universities are now working together to share information, but the Government have gone AWOL. Where is the strategy?
That brings me to the second issue I want to raise—the need for Government support for universities and their students. The Government of course have had to act fast on some issues, but when it comes to universities, their action has been glacial. I asked for a statement from the Universities Minister on 9 July, and we still have not had one. Tomorrow, I understand, we are going to have an urgent question, but only because there are serious problems. Young people who are starting university this autumn were promised a mixture of online and face-to-face learning, but an increasing number of students want or need to study remotely, and to do so they need access to the right equipment and connectivity. We know that students from disadvantaged backgrounds already face a digital divide, so what are the Government doing to bridge that divide and ensure that every student can access high-quality education, whether they are on campus or at home in self isolation?
Having seen some of the very worrying reports this weekend, what are the Government doing to ensure that students are properly supported at university, particularly if they are required to self-isolate? Many young people already experience anxiety and poor mental health. What are the Government doing, alongside universities, to ensure that young people—many away from home for the first time and now experiencing extra pressures as a result of restrictions—can access mental health support, and can the Minister assure us that there are systems in place to ensure their well-being? Will she also assure us that students will not be forced to remain in student accommodation, away from their families, when it comes to the end of term?
Thirdly, Nottingham does not just benefit from having two universities—it is a regional centre with a rich and diverse cultural sector and a thriving night-time economy, sectors that are vital to the city’s economy and provide employment for thousands of people. I am deeply concerned that the Chancellor’s economic plan simply ignores the disproportionate impact on these sectors. Pubs, bars and nightclubs are either still shut down or operating at reduced capacity, and the 10 pm curfew has made things even more difficult. Our theatres, arts venues and cinemas are reopening, but at far reduced capacities.
These businesses and the people who work in them need and deserve Government support, but the job support scheme simply does not provide it. If a business remains closed, it is impossible to access. For businesses that can access the scheme, it is cheaper to have a fewer number of full-time staff than to keep more people on in part-time work. My Labour colleagues have repeatedly called for a more targeted approach for a job recovery scheme that incentivises bringing more staff back part time and includes a training component. Of course it is welcome that the Chancellor has finally accepted the need to move away from the furlough cliff edge, but he is still letting down those sectors and those workers who most need support. Without a further change of direction, we can only see further job losses hitting my city hard.
I rise to do three things. The first is to praise the Government for everything they have achieved on PPE, on testing and on the track and trace app. In my libertarian soul, and in my instinct, my heart and my reason, I consider the Government’s track and trace app to be the very apotheosis of my worst fears. Yet over the weekend I studied what the Government have done. They have moved away from the first version, to the Apple and Google-distributed model, with all the private data remaining on the user’s phone. They have released a source code, both for the server side and for the client, which I very much welcome as a software engineer, although I doubt I shall be grinding through it. Against all my instincts—and in the knowledge that I am not the Member of Parliament for dogmatic libertarians across the country, with whom I generally agree, but in fact the MP for Wycombe—I have done the right thing: I have, against my expectations, installed the contact tracing app. I ran out of excuses, I have installed it, and I am allowing it to run even as we speak. I hope that will be of some reassurance, even to those libertarians who might condemn me for it.
Secondly, I want to say something about the science. I am not going to engage in amateur epidemiology, much as I have been enjoying picking it up, but I will praise my constituent and friend, Dr Raghib Ali, who is an epidemiologist. Unusually, he is an academic epidemiologist and also an acute medicine consultant who works in Oxford, so he is perhaps uniquely positioned to comment on the disease. He has been tweeting and writing about the disease. He is a very reasonable man. He has really helped me to keep my feet on the ground. I say to all Members who, like me, really hate and despise these restrictions on our freedom to look at what Dr Raghib Ali is writing. He has helped to keep me anchored in the truth that this is a very dangerous disease for people who are older and people who have pre-existing conditions, and we have just got to deal with it.
On the science, I wish my right hon. Friend the Secretary of State were present. As he framed the problem between either suppression or letting it rip, I thought that our friend Mr Osborne was back framing the issue in terms of what I think is a false dichotomy. I think we need to take another look at the scientific advice. There are professors out there telling us that this is an optimisation problem—we need to maximise the lives saved and minimise harm. There is, I think, going to turn out to be a third way that enables us to minimise harm. The Department’s own figures have shown, as reported in The Daily Telegraph, that the cost of lockdown in quality adjusted life years, adjusted for comorbidities, was greater than the cost of the disease thus far. So if we wish to maximise human flourishing and save lives, we have to look extremely carefully at the science.
I am working with my friend Professor Roger Koppl, from Syracuse University and author of a book titled, perhaps unfortunately, “Expert Failure”, looking at what actually happens with expertise. I wrote a brief for the Prime Minister, which I have also tweeted. My covering letter points out:
“Pandemic policy making has been asking the impossible of scientists, economists and politicians. There are solutions and they are fundamental to the success of a free society in an era of accelerating complexity and change.
There is a structural problem rooted in the division of labour which, when combined with bad incentives, causes inevitable failures of expert advice. The problems are acute, delicate, dangerous and long-standing. They do not arise from faulty expertise or bad actors.”
I am not going to call for anyone to be sacked.
So I hope people will look at the brief I have put out, which includes concrete suggestions. I will put on the record the Harold Macmillan quote with which the brief leads:
“We have not overthrown the divine right of kings to fall down for the divine right of experts”,
however brilliant they may be.
I do not know the facts about meningitis, but I am grateful to my hon. Friend for his point. I particularly welcomed the debate between scientists on this Sunday’s Ridge programme. We have seen that the science actually involves a great deal of uncertainty and debate, as brilliant people, well versed in their lifetime’s work, try to make their way through uncertain knowledge, to predict the future. We must all proceed with great care if we are to be concerned for our constituents’ wellbeing.
In a sense, what I am saying to the Government today is that we need to fix two parts of this process. We need to change the structure within which expert advice is provided. I have provided a brief to the Minister. I have tweeted it out and would happily give it to the Minister. We also need to deal with the problem that has been the subject of so much news this week. We need to deal with the issue of this House voting on restrictions of the people’s liberty before it is taken away. That is surely the fundamental point about democracy. I can say, hand on heart, that all Members of this House appreciate that, in an emergency, it is necessary for Ministers to use the powers they have to protect life, liberty and property and I do not condemn anyone, but we are now into a different phase of the disease. It really is time to reach an agreement—I am happy to say that we have just had a constructive meeting with the Secretary of State, the Chief Whip and the Leader of the House—and to reach a constructive way forward. I know it is inconvenient for Ministers to come to the House before they take away people’s liberties, but I say to Ministers: it is supposed to be. It is what keeps us a free people.
I say happy birthday to my hon. Friend and pass on the best wishes, no doubt, of the whole House. The question he raises is a difficult one, because in many cases, the best place for somebody is not in a hospital. Indeed, people can catch diseases in hospital, so it needs to be done on a clinical basis. That is why we have put in place the testing, isolation procedures and infection control of people who are leaving hospital to go into care homes.
One of the five tests that we have set out before the restrictions are eased is that the number of deaths should be falling consistently. Indeed, the Scottish Government’s document includes a similar proposal, and we are working to ensure that the UK is as aligned as possible.