Public Health: Coronavirus Regulations

Debbie Abrahams Excerpts

Tuesday 13th October 2020 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I support these restrictions with a heavy heart. On balance, I will be supporting the Government this evening, but I want to make just a few quick points.

I would be very careful about subscribing to the Vallance/Whitty orthodoxy that informed these regulations, while not at all examining very carefully respectable bodies of medical opinion to the contrary. I would cite particularly the Heneghan/Sikora/Gupta line. It is important that the Secretary of State and his ministerial team address those things head-on and treat them with the respect that they deserve.

The Secretary of State has my utmost sympathy. When coming into office, he opened a box marked “public health” and found tools for doing all sorts of things, such as sorting out lifestyle problems—obesity, smoking, diet and all of that. I suspect that he found very few that were geared towards dealing with infectious diseases, particularly this infectious disease. He has done some good things to try to remedy that in a very short space of time. May I suggest to him, to sort out the shadow Secretary of State’s obsession with Serco, that he looks again at the Public Health Laboratory Service, which was in its second incarnation as the Health Protection Agency when it was abolished in 2012. He might find in such a thing the means to deal with infectious diseases of this sort in the future.

We need to be careful about groupthink, confirmation bias, a thin evidential basis and uncertainty masquerading as certainty. There is a huge margin of uncertainty with all this, and we all need to develop a level of humility in our attitudes towards dealing with this crisis. That is why I shall be supporting the Government this evening.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I cannot let the right hon. Gentleman get away with that. In 2016, Operation Cygnus was very clear about what needed to happen. It was a question not of if there was going to be a pandemic; it was when. The Government failed to introduce all the recommendations from that exercise. I will not let them get away with this.

[Dr Murrison]

The hon. Lady can do what she likes. The Secretary of State is dealing with the situation that he found at the time. Developing the National Institute for Health Protection in short order from the disaster that was Public Health England was, I think, a very good effort, but there is much more to be done, as I know he appreciates.

May I sound a cautionary note for the Secretary of State? We have gone to great measures to close down schools, and I appreciate the need for that. That was informed, of course, by the Imperial College model, which was a flu model, in essence, and was inadequate for this particular virus. He will know—I hope he does—of the work published in September by the University of Edinburgh group under Ackland, which suggests that that certainly did suppress admissions to ITU. It certainly protected the NHS, but probably over time, unless we get a vaccine, it will cause more deaths directly from covid, quite apart from the incidentals for other diseases, the loss of liberty and livelihood. The Secretary of State needs to understand that and that there is an alternative view. If we do not get a vaccine, I fear, paradoxically, that we will see more deaths, not fewer, as a result of some of the interventions that we have put in place. Of course, Ackland was unsighted on this latest set, but the logic would suggest that those measures too may, over time, if we get a third and fourth wave, cause more trouble than they solve. It is a respectable piece of work and the Secretary of State needs to take account of it.

In all this, we simply do not know and we are learning all the time. We have to accept, I think, the expertise of those advising Ministers and that we have experts for a reason, but there is an alternative view. Unless we get a vaccine—goodness me, I hope we do—I think we may find that the cure is worse than the disease in terms of lives lost directly to covid, incidental lives lost to other common diseases—stroke, heart attack and particularly cancer—loss of liberty, loss of livelihood and the compete trashing of our economy. That is what is at stake. I do not envy the Secretary of State in his work.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I would like to make the following points based on my 20 years’ experience as a former public health consultant.

Unfortunately, I do not believe that the new tier system and measures that were introduced yesterday are sufficient to contain the virus. The localised approach will not work because of seeding. The virus travels where people come from. I came down on the train yesterday—I talked to the hon. Member for Altrincham and Sale West (Sir Graham Brady) about this point—and there might have been people who were asymptomatic who unknowingly have spread the virus, unfortunately. There may also have been people who wanted to exercise their personal choice, who have the virus and knowingly exposed people to that risk. Unless the Government are prepared to set up roadblocks across the M1, M6, M62 and all other routes to and from the north, I am afraid that, just as happened in the first wave in Italy, the virus will spread.

To understand what we need to do now, we must understand how we got to this position. It is abundantly clear, as has already been said, that the national test and trace programme is not fit for purpose. In spite of clear WHO guidance, it was not fully operational in June when the first lockdown measures were eased, and as a consequence it has failed to cope with the predicted rise in infections ever since. On top of that there were, unfortunately, significant specific failures.

I support the calls of the CMO, SAGE and others for a short circuit break to help drive down infection rates, but that should be at the national level. Any circuit break period should be used to undertake the transfer of test and trace to local public health departments. That must be accompanied by full resource transfer. Currently, less than 10% of the money used by local authorities at a local level has been reimbursed by the Government. That is unjustifiable and unsustainable, and it must be resolved.

In addition, the circuit break should be used first to ensure that the NHS and social care are fully prepared. They must have adequate PPE. They must have flu vaccines. They must have regular testing regimes. We should identify vulnerable people for supportive shielding, and not via some algorithm. We need to define exactly how we are going to support people in a way that does not mean they will be detrimentally isolated. We must also make sure we have simple, coherent messaging with local community engagement, and I support what the Government are trying to do with the simplification. We must also make sure that we have monitoring and enforcement capacity.

All workers and businesses need to be fully supported during any circuit break. We are at war with the virus. The Treasury needs to recognise that and respond adequately. Finally, the Government must recognise that covid is a disease of poverty.