Public Health

Daisy Cooper Excerpts

Tuesday 30th November 2021 Commons Chamber

[Maggie Throup]

I find it quite intriguing that the Labour party has been calling for this measure for some time and, now we are introducing it, it is unhappy about it.

[Daisy Cooper (St Albans) (LD)]

Will the Minister give way?

[Maggie Throup]

I must make some progress.

In July, when we lifted most of the remaining restrictions at step 4 across England, we made it clear that our response to the pandemic was not over. The vaccination programme continues to be a huge success and vaccines remain the most important weapon in our fight against the virus. However, as we enter this uncertain time, we must do more and we must do it quickly.

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[Maggie Throup]

My right hon. Friend makes a very good point. I would like to reassure him that we will continue to update the House over the next few weeks, that we will not continue to have these regulations in place for any longer than is necessary, and that—[Interruption.] If I may just finish. The type of regulations he is referring to are reviewed under legislation every four weeks and are more likely to be reviewed every three weeks. I understand his point and I do take it very seriously. I wish we were not in a situation where we have this conflict, but I reassure him that I take his point very seriously and these measures will not be in place for any longer than is absolutely necessary.

[Daisy Cooper]

rose—

[Dr Murrison]

rose—

[Maggie Throup]

I give way to the hon. Lady, who has been trying to intervene.

[Daisy Cooper]

I am grateful to the Minister for giving way. The hon. Member for Sheffield South East (Mr Betts) raised a question about the enforcement of mask wearing. One of the major problems being faced by GPs in my constituency of St Albans is that some people are refusing to wear masks because, “The Prime Minister didn’t have to when he went to a hospital”, so could I ask the Minister how she intends to lead by example when half of her own colleagues are still refusing to wear masks on the Benches opposite?

[Maggie Throup]

As I said earlier, we are mandating the use of face coverings. I think we are in a different situation now with regards to that.

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[Daisy Cooper (St Albans) (LD)]

The Liberal Democrats will support the regulations, but we have grave concerns about whether the Government are doing enough to protect people, to protect the NHS, and to buy scientists the time that they need in order to learn more about the new variant.

We know that masks are effective. We know that they reduce transmission, and they are a small price to pay for the guaranteeing of all our other freedoms. They also allow the clinically extremely vulnerable to leave their homes, which many of them have not done for a very long time. They continue to shield, cut off from society, because they do not have the confidence even to enter a shop or board a bus. I am worried by the Secretary of State’s pledge to abandon masks in a few weeks’ time if omicron proves to be no more dangerous than the delta variant, because the delta variant is still dangerous, and the NHS is already on its knees before we go into the worst of the winter.

I wish there were more support for those in self-isolation. For too long, the support has been too stingy and too hard to access. We must create a sense among people that it is their civic duty to self-isolate if they are asked to do so, and if the Government ask people to self-isolate, they must step up and provide proper financial support. I would also like to see the reintroduction of the encouragement to “work from home if you can” from the Government. The colleagues have also mentioned ventilation, on which the Government have been far too slow to act. In schools right across England, people have been crying out for ventilation for months and months, but the Government have been dragging their heels.

[Alec Shelbrooke]

I want to pick up on the hon. Lady’s comment about working from home. I say gently to her that a great many of my constituents have businesses that thrive on footfall in the city centre of Leeds, and that the working from home encouragement had a devastating impact on their ability to earn a living. When people say, “Let’s just work from home again”, they must recognise that there would be a very large economic impact on a great number of my constituents if that were to happen.

[Daisy Cooper]

I take that point. We know that many of these measures often result in a lose-lose situation. A real problem over the past 18 months has been the way in which people have tried to frame this as public health versus the economy, because for me, having a strong and healthy workforce and a strong and healthy economy are two sides of the same coin. Notwithstanding that, I am encouraging the Government to ask people to work from home where they can, in order to strike the right balance that would reduce levels of transmission. I am not suggesting a blanket mandate for everybody to stay at home; I am suggesting encouraging people to work at home where they can, in a balanced way.

[Dr Murrison]

I am listening carefully to what the hon. Member has to say. Does she agree that the group in society that has really borne the brunt in the past 18 months is young people? They have been particularly affected by so-called work from home, and their mental health in particular—which I know her party takes a close interest in—has in many cases been devastated. I commend to her the best available evidence as published last week. As the hon. Member for Central Ayrshire (Dr Whitford) pointed out, that evidence suggests that two interventions—that is to say, mask wearing and cleaning our hands properly—may well have some impact, but to be honest the evidence for social distancing is pretty thin. Would the hon. Member for St Albans (Daisy Cooper) perhaps like to reconsider the sort of swingeing measures that she appears to be recommending?

[Daisy Cooper]

I thank the right hon. Member for his intervention, but I respectfully disagree with him. What we have learned over the past few months, from public health directors in particular, is that the more measures we take, the better protection we have. It is not an either/or. If we wear a mask, wash our hands and limit the amount of time spent in close proximity to someone else, we limit our overall chances of either catching covid or passing it on. The more measures we can take, the better. Notwithstanding that, when I was talking about working from home, I was not referring to children studying at home. I was talking about the working population. I recognise that there have been enormous impacts—

[Dr Murrison]

I was talking about university students.

[Daisy Cooper]

Ah, okay. I thought the right hon. Gentleman was talking about schools and young people. Of course there have been major issues for young people, but when I was talking about working from home, I was talking about the working population. On the question of students at universities, of course there needs to be a balance. Many universities got it wrong during the pandemic, and I said so at the time. I was utterly appalled when some universities put railings around the student accommodation. We need to strike a balance. This is about reducing our contacts to reduce transmission. There is nothing to prevent university students from going in to study, if that is the point that the right hon. Gentleman was trying to make.

[Dr Murrison]

How on earth does the hon. Lady think that we can mandate or suggest that people work from home but then expect students to tip up? University is about being taught, and being taught requires people to go to work. Or have I missed something?

[Daisy Cooper]

Something appears to have been lost in translation here. I am not entirely sure whether the right hon. Member is referring to students or to the academics who teach them. I am talking about encouraging people to work from home where they can. There are of course examples where people will need to go into work, and they can change the ways in which they work, but working from home has been proven to reduce levels of transmission.

I am concerned that we are talking solely about the new variant, and that the mantra around putting in place restrictions to protect the NHS appears to have stopped. I worry that the Government appear to have lost their tongue. Ambulance services across the whole of England are at their highest alert level: level 4, or code black. That means that there are people in the back of ambulances who cannot get into hospitals. The NHS 111 line has had more than 1 million calls abandoned after 30 seconds this year, when they should be answered within 20 seconds. We have GPs who are reducing their hours or resigning because of the workload and the abuse. Some of them are really worried and saying that they will not to take on the contracts to deliver the booster jabs because of the expectation that they will still have to do the same amount of work seeing their patients and that if they are required to do the booster jabs as well, that will mean longer waits for other appointments. They are not getting the support they need in that regard, and I hope that the Minister will respond to this point. We have record backlogs—

[Simon Hoare (North Dorset) (Con)]

I very much agree with the hon. Lady’s comments, and I wish that she had amplified them more in regard to the ambulance service. I represent a large rural constituency, as many colleagues do, and if people are waiting for ambulances because people are queueing at the acute sector because others cannot be discharged, that is going to lead to huge problems during the winter months. Does she agree that that is something we should all keep at the forefront of our minds?

[Daisy Cooper]

I am incredibly grateful to the hon. Gentleman for raising that point. I have tried to raise that issue as often as I can through various means, and that is probably all I can say on the matter. Back in October, I tabled a written question to the Government to ask how many ambulance services were at level 4, and it took a couple of attempts at chasing that up before I got a response. I believe that hon. Members would benefit from having time to debate the issue in this House. In my own constituency of St Albans, there have been some incredibly tragic cases. A woman lost her baby because she was stuck in the back of an ambulance for many hours without being able to get into the local hospital. Another constituent lost their partner because they were stuck in the back of an ambulance for 12 hours and then died a week later because they had not been able to get that emergency treatment—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Important though this matter is, the hon. Lady does appear to be straying. Could she please get back to the regulations that we are discussing?

[Daisy Cooper]

The point that I am trying to make is that the Government are framing the introduction of these specific restrictions in terms of whether or not there is extra transmissibility from the new variant. My concern is that they are not talking about whether we need these restrictions, and perhaps others in the future, because of the pressures on the NHS in its broadest sense.

[Sammy Wilson]

The hon. Lady is making an important and relevant point. Would she not accept, however, that these restrictions place a burden on businesses, on people’s individual freedom and on the operation of the education system, all to deal with a problem that is not going to go away as long as we have patients going to accident and emergency because their GPs are not seeing them, and as long as we have patients taking up beds in hospitals because they are not going into care? This will not be solved simply by introducing more regulations that put the burden on private industry because of the failures of the health service.

[Daisy Cooper]

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.

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[Daisy Cooper]

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?

[Sir Christopher Chope]

I hope the hon. Lady accepts that people should be free to make their own decision on whether they wish to be vaccinated. I am therefore extremely nervous about backdoor proposals to require vaccine passports. I do not believe people’s freedom should be conditional on taking compulsory medication, which is why I am against the provisions in the Health and Care Bill on compulsory fluoridation. To that extent, I am probably on the same side of the argument as she is.

A mood of increasing intolerance is being engendered towards those who have a reasonable excuse for not wearing a face covering. Paragraph 7.8 of the explanatory memorandum makes it clear

“people do not need to show proof of this reasonable excuse”

but that is not being promoted by the Government. Regulation 5 says:

“For the purposes of regulations 3(1) and 4(1), the circumstances in which a person (“P”) has a reasonable excuse include”—

this is the important point—

“those where P cannot put on, wear or remove a face covering because of any physical or mental illness or impairment, or disability…or without severe distress”.

That is one reasonable excuse, but there are many others. The Government seem to be rather conflicted or muddled, because paragraph 7.8 of the explanatory memorandum says:

“Nobody who has a reasonable excuse and is therefore not wearing a face covering should be prevented from visiting any setting because of the requirements in these Regulations. Furthermore, people do not need to show proof of this reasonable excuse under the Regulations.”

In other words, people do not have to show a face covering exemption certificate, such as this one from Hidden Disabilities. I see quite a lot of people wearing these certificates but, as soon as people have to wear them, they are asked questions, “Well, what are your disabilities?” Most of my disabilities are well hidden, and I intend to keep them hidden. It is unreasonable that we should be creating an environment in which people are being challenged, and being encouraged to be challenged, on their personal and private health.

That brings me to the conflicting content of paragraph 12.3 of the explanatory memorandum. It may just be a misprint, but it says:

“The Department has also included a range of exemptions to ensure that this policy does not unfairly discriminate against those with protected characteristics. Furthermore, the policy will be supported by a communications campaign that will make clear that some people are exempt from these regulations and people should be challenged by members of the public for not wearing a face covering.”

Surely it should say “should not be challenged”. I do not understand it, because paragraph 15.3 says:

“Maggie Throup, the Parliamentary under Secretary of State”—

she is sitting on the Front Bench—

“can confirm that this Explanatory Memorandum meets the required standard.”

If it was indeed a misprint, the explanatory memorandum does not meet the required standard. If it is not a misprint, it is a serious contradiction within the explanatory memorandum and seriously undermines people’s freedom to go about their business without having impertinent remarks and questions put to them by busybodies acting on behalf of enforcement authorities.

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[Mr Mark Harper (Forest of Dean) (Con)]

I shall endeavour to be mindful of that, Mr Deputy Speaker, and shall try to put some of those questions on the record for the Minister.

As many Members have said, and the chief scientific adviser agrees, covid is going to be with us forever and variants are going to be with us forever. This is the first test that we—the Government, the House and society—face in respect of how we deal with covid in a post-vaccine world, where we have vaccines and have vaccinated most of our population. It is important that we do not mess this up and fail that test. It seems to me that we need to respond calmly and proportionately, so I give the Government credit for resisting the calls for the economically damaging measures in plan B. Working from home, for example, does have significant economic consequences, as we saw from the Treasury’s own analysis. Vaccine passports are both illiberal and, as we have seen from the evidence—or lack of evidence—from Scotland, ineffective, so they are the worst of all worlds. They are an ineffective and illiberal policy, and we certainly do not want them introduced here.

Before I deal with the measures, I want to pick up on the point about the NHS made by the hon. Member for St Albans (Daisy Cooper), the deputy leader of the Liberal Democrats. She is absolutely right that the NHS is facing significant pressure, but it is not facing pressure from the number of patients in hospital because of covid, which is around 6% of total bed capacity. The NHS is under enormous pressure dealing with the significant number of patients who were both unable to be treated and scared away from the national health service during the pandemic. We must be careful not to repeat the mistake and scare away a whole new set of patients, as it will take the NHS another very significant period of time to deal with them. There is nothing about the measures that she suggested that will deal with those pressures; they will just make them worse.

[Daisy Cooper]

Although I recognise the right hon. Gentleman’s assertion that covid accounts for 6% of patients in hospitals, I urge him to think about the impact that covid in-patients have in the hospital setting. We know, for example, that for every one patient being treated, an entire ward can be taken out, because it has to be cleaned and if a staff member catches covid, they have to take time off work. I have asked the Government to produce an assessment and provide this House with the details of the impact of covid patients on the availability of beds, staff and elective procedures. Will he support me in asking the Government again to provide that assessment so that we can take an informed decision in this House as to whether these restrictions are necessary and how they may or may not help?

[Mr Harper]

I support the hon. Lady’s general call for transparency, but my point about the numbers is not an assertion; it is about looking at the data and seeing how many patients are in hospital because of covid. That information is published. It is not an assertion, but a fact. Secondly, if hospital trusts do what my trust does, they put covid patients together in hospital. My trust currently has one ward full of patients. It clearly has an impact, but it is not the thing that is causing the biggest problem. The biggest problem in my trust is that it has at least three or four times the number of patients who are not able to be discharged because of inadequate social care. That is the point that I have made several times in the House.

Mindful of your admonition to be relatively brief, Mr Deputy Speaker, let me touch on the regulations in front of us. On the face-covering regulations, they are relatively not damaging economically. I listened carefully to the speech of my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), and I agree that it is disappointing that we have moved away from a model where the Government lay out the evidence and the arguments and allow people to make their own decisions. That was a big choice that the Government made last year, and I am very disappointed that they have moved away from it. Weighing against that—this was set out very clearly by the Chairman of the Transport Committee, my hon. Friend the Member for Bexhill and Battle (Huw Merriman), and my hon. Friend the Member for Winchester (Steve Brine), a distinguished former public health Minister—is that at least those regulations have quite a tight expiry date, and they will expire in three weeks’ time. Although I do not like the move back to mandating, I am prepared on this occasion—balancing up the pressures, and because there is an expiry date—not to oppose the regulations, but I will not support them either.

On the self-isolation regulations, I am afraid to say that I am much more concerned, as was my hon. Friend the Member for Winchester, for two reasons. First, while Ministers have been clear that the regulations will be reviewed in three weeks—I will press the Minister on what we might learn in those three weeks—the regulations are not time limited; they amend another set of regulations that do not have an expiry date until March next year. Although the Minister tells me that they will not be enforced for a day longer than necessary, she must recognise that, given the events of the past few weeks and how Ministers handled, among other things, the standards measures, there has been a diminution in trust between Back Benchers and Ministers. Ministers must work hard to rebuild that trust. Having open-ended statutory instruments that do not expire for many months—when they are telling us that the measures only need to be in place for a few weeks—is not, I say respectfully to the Minister, how to build that trust.

Secondly, there is the point that my hon. Friend made. Let us remember that we are making the law, which should always be clear, precise and specific so that people know what their legal responsibilities are and what they are not. I am afraid that reference in the regulations to people who are “suspected” or “confirmed” as having the omicron variant, with no detail about what that is, is simply not good enough. I was trying to be genuinely helpful to the Minister when I intervened on her. I wanted to give her the opportunity to set out in her opening remarks—and I hope she will do so in her closing remarks—how the Government determine whether someone has the suspected omicron variant and what measures have been taken in terms of the scripts that are used by NHS Test and Trace, the information provided to people whom it contacts, the training that staff undergo, and, indeed, whether the app is to be changed to deal with the new regulatory approach. I am afraid that nothing in the regulations that I have seen gives me any confidence that those matters have been properly thought through. Despite what the Minister may or may not say at the Dispatch Box, the law should be clear in the regulations, and it simply is not. On that basis—how the regulations are drafted—I will oppose them.

Mindful of your instructions, Mr Deputy Speaker, I have only a couple more points. When I said that I was worried that the regulations would trigger a new pingdemic, it was picked up in a number of publications. Politico’s London Playbook, which is much read in the Westminster village, said that a Government insider, trying to allay concerns about a pingdemic, had argued that, because people no longer check into restaurants or pubs, they will not be contacted by NHS Test and Trace. They said that contact tracers are really only interested in catching contacts of cases coming into the country on planes. If that is true, I would suggest that the £30,000 million-odd we spend on Test and Trace is not terribly useful. I would be grateful if the Minister confirmed at the Dispatch Box whether what that Government insider has said is Government policy.

It has also been reported in the Financial Times that officials in the Department of Health and Social Care are drawing up contingency plans to require masks in many indoor settings, with a possible work-from-home order over Christmas. Apparently, these plans are being worked on by officials. Will the Minister confirm whether officials are working on such contingency plans? If they are not working on them under instructions from Ministers, can she, as a Minister, instruct them to stop working on such contingency plans and focus on the Government’s actual policies?

My final point is the one that I made yesterday. Ministers have said that they will review the measures in three weeks’ time, as of yesterday. That would be 20 December, when the House will have risen for the Christmas recess—I touched on this in my intervention on the Opposition spokesman. If any of the measures are to be extended, or if further measures are to be brought in, it would be unacceptable for Ministers to do it by decree, which is effectively what the Minister at the Dispatch Box did with these two orders. They should be brought forward to this House for a debate in advance of their coming in. If we have to sit in the days running up to Christmas, so be it. Many people in this country work over the Christmas period in many industries serving the public. We are better paid than most of those people, so if we have to come here and do our jobs, working on behalf of the public, to scrutinise the laws that affect their lives, then I for one am very happy to do so. It would be a failure of the responsibilities that Ministers have if they do not seek to keep the House sitting or recall it if they wish to take those powers. Ministers are accountable to the House and to our constituents through us, and they would be wise never to forget it.