HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (SELF-ISOLATION) (ENGLAND) REGULATIONS 2020
HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NORTH OF ENGLAND, NORTH EAST AND NORTH WEST OF ENGLAND AND OBLIGATIONS OF UNDERTAKINGS (ENGLAND) ETC.) (AMENDMENT) REGULATIONS 2020
Helen Whately Excerpts(4 years, 2 months ago)
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The Minister for Care (Helen Whately)
I beg to move,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Self-isolation) (England) Regulations 2020 (S.I. 2020, No. 1045).
The Chair
With this it will be convenient to discuss the Health Protection (Coronavirus, Restrictions) (North of England, North East and North West of England and Obligations of Undertakings (England) Etc.) (Amendment) Regulations 2020 (S.I. 2020, No. 1057).
Helen Whately
I will briefly explain each statutory instrument in turn.
The regulations on self-isolation, SI 2020, No. 1045, came into force on 28 September 2020. They make it a legal requirement to self-isolate if an individual tests positive for coronavirus, or is contacted by NHS Test and Trace and told to self-isolate. Financial penalties have been introduced for non-compliance with the regulations.
The regulations on the protected areas in the north of England, the north-east and north-west of England, as well as obligations of undertakings, SI 2020, No. 1057, came into force on 22 September 2020. They originally delivered a number of amendments to regulations that have since been replaced by the local covid-19 alert level regulations. Now, only amendments to the Health Protection (Coronavirus, Restrictions) (Obligations of Undertakings) (England) Regulations 2020 still continue to apply. Those amendments include inserting a definition of “indoors” to the obligations of undertakings regulations. They also amend the obligations of undertakings regulations to add a requirement on certain businesses to take all reasonable measures not to take bookings that would not be in line with certain gathering limits. The new requirements were originally related to relevant premises in areas covered by the north-east and north-west of England regulations. Those regulations have been revoked and the amendments made by SI 2020, No. 1057 now apply in relation to relevant premises in areas covered by Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020.
It has been necessary to maintain the regulations to ensure that the requirements on businesses, as provided under the obligations of undertakings regulations, continue to support the covid-19 response. In particular, they align with and support the new local covid-19 alert level regulations.
Both sets of regulations have been introduced to mitigate the unprecedented impact of the covid-19 pandemic, and I urge the Committee to approve them so that we may continue to use those powers to save lives.
As the amended statutory instrument adds only a definition of “indoors” and a requirement on certain businesses to take all reasonable measures not to take bookings, I will now focus primarily on the regulations on self-isolation. The legal duty to self-isolate is one element of a three-part strategy to increase compliance with self-isolation after a person has been infected by, or exposed to, coronavirus. First, we aim to increase to public understanding of the importance of self-isolation to stopping the spread of the virus, and of the circumstances in which individuals must self-isolate. We have put in place a comprehensive media campaign to increase public awareness of NHS Test and Trace, explaining what it is, why it is important and what the public need to do.
Secondly, we are supporting people to comply by providing assistance to those who may have practical difficulties in self-isolating. NHS Test and Trace officials check in with individuals who have tested positive and who are contacts of cases through follow-up phone calls and text messages to reinforce the importance of self-isolation. They also provide advice and ensure that people have access to support that they need. Where a support need is identified, local authorities play a role in encouraging, educating and supporting compliance. In addition, a test and trace support payment has been introduced to help ensure that people on low incomes self-isolate when they test positive or identify as a contact, and to encourage more people to get tested.
Thirdly, we want to reinforce the seriousness of non-compliance. The regulations therefore introduce new legal duties, along with fixed penalty notices, for those who do not follow the rules. Where there is clear evidence that someone is not following the rules, the police will determine what follow-up action to take and, when necessary, issue fixed penalty notices. Fines start at £1,000 and may increase up to £10,000 for repeat offences. For more serious breaches, fines start at £4,000, increasing up to £10,000. Serious breaches may include where an individual comes into close contact with others and is reckless as to the consequences for the health of other people.
Mr Mark Harper (Forest of Dean) (Con)
I have listened carefully to what my hon. Friend has said about compliance. Does she have any evidence about how well people are actually complying with the self-isolation requirements? At a SAGE meeting in August, the SPI-B —scientific pandemic influenza group on behaviours—sub-committee was given an action to understand and improve adherence to self-isolation. It would be interesting to judge the regulations before us by understanding the extent to which people are or are not complying with the existing rules.
Helen Whately
I thank my right hon. Friend for his question, and I will indeed cite the evidence that we have on the level of compliance with self-isolation later.
The regulations also recognise the importance of employers respecting self-isolation requirements. No employer should prevent an employee from self-isolating or encourage or put pressure on them not to do so. Where an employer is found to be in breach of that obligation, they face a fine. That is in line with fines for other employer covid-19 breaches. Employees who need to self-isolate must also inform their employers of their legal requirement to do so, and a fixed fine of £50 is set for employees who do not inform their employer. There is a clear reciprocal duty between employees and employers about self-isolation, which supports both the opportunity and motivation to comply.
We recognise that there may be exceptional circumstances in which an individual may need to break their self-isolation; for instance, if they are unsafe or if emergency assistance is needed. In those cases, the legal duty would not apply and individuals would not face a penalty. The regulations specify the circumstances in which breaking self-isolation would be permitted.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
I am aware of situations where employees are very afraid of losing their job if they have to self-isolate. They are not necessarily able to access any sick pay or Government support. What messaging are the Government putting out to employers to make sure that they understand their obligations towards their employees? What can an employee do where they fear that they will lose their job if they do the right thing and self-isolate?
Helen Whately
The hon. Lady makes an important point about the role of employers as well as that of employees. Communications have been going out to make sure that people are aware of the importance of self-isolating. I may be able to offer something more specific about the communications to employers when I respond to the debate. There is financial support now in place because we found out from research that the financial impact of self-isolation was one reason that some people failed to do so.
Matt Western (Warwick and Leamington) (Lab)
I raised in Department for Work and Pensions Question Time just now my concern, which I am sure is shared by many Members, about schools that are forced to close at incredibly short notice. One large school in my constituency announced at 3 o’clock yesterday afternoon that it would be closed from 8.30 this morning. That means that many parents will have to stay at home and stay away from work. That impacts particularly heavily on mothers, sadly. They will not be entitled, currently, to the self-isolation payment. Is that something that the Minister is looking at or will support?
Helen Whately
I know that that point has been raised throughout the pandemic, and there will be reasons why parents, for example, will have extra childcare responsibilities. We had that challenge during the full lockdown, when schools were closed other than for the children of key workers, and we know that employers did everything they could to be understanding and support their employees. I will take away the hon. Gentleman’s question about whether anything further can be done.
To set out the rationale behind the regulations we are discussing, the headline point is their importance in our overall strategy to combat covid-19. Clearly, the number of people testing positive has risen sharply and, indeed, is still increasing. That is not only among younger people; worryingly, we are seeing increasing rates among the over-60s, particularly in parts of the country that have higher rates overall. Hand in hand with the increasing number of cases, we are seeing a higher percentage of people testing positive and increasing rates of hospital admission, again particularly in areas where the case rates are highest.
Against that backdrop of increasing rates, we heard that, unfortunately, compliance with the restrictions has not been what it should be. To answer the question from my right hon. Friend the Member for Forest of Dean, general population surveys conducted between March and August showed that self-reported self-isolation compliance was relatively low. For instance, only around 20% of the population reported that they fully complied with self-isolation if they had symptoms or were identified as a contact. That is evidence of the challenge with self-isolation compliance at that time.
Catherine McKinnell
The Minister will recognise that there is a difficult balance to strike between encouraging compliance and discouraging engagement with the system —not being tested and not reporting symptoms in order to avoid the consequences of not being able to self-isolate. Have the Government analysed the potentially worrying consequence that increasing the penalties may disincentivise doing the right thing from a health perspective?
Helen Whately
The hon. Lady makes a really important point. We would not want to disincentivise anyone from coming forward to get tested or sharing their contacts, because that is such an important part of controlling this virus. On the other hand, if the data shows that compliance is low, which it does, then what actions can we take? First, we ensure that people really know what action they should be taking—that they should get tested, share their contacts and ensure that their contacts know that they should be isolating. Secondly, we provide people with more support to enable them to isolate. Thirdly, we make self-isolation a legal requirement, which communicates both the seriousness of isolating and the fact that if someone does not self-isolate when they test positive or are a contact, they could be putting other people’s lives at risk. Ultimately, if something is serious, there is a penalty associated with it. Those three things need to go together, particularly the understanding of the importance of taking the responsible course of action and self-isolating if necessary.
By making self-isolation a legal duty enforced through penalties for non-compliance, our aim is to ensure that people who have tested positive for covid-19 and those who have been directly exposed to the virus recognise the importance of self-isolating in order to reduce transmission and actually do isolate. SAGE has advised that ensuring infected individuals and their close contacts isolate is one of our most powerful tools for controlling the spread of the virus, so now is the time to introduce this measure and to combat the rising incidence.
The regulations were introduced using emergency powers so that we could respond quickly to the increasing threat to public health posed by covid-19. The urgency in this case arises from the increasing rate of diagnosed positive cases at the time of making the measures. The self-isolation SI came into force on 28 September 2020. It will be reviewed before the end of the six-month period and will expire 12 months after coming fully into force. The Secretary of State for Health and Social Care keeps their necessity under consideration between the formal review points, too.
The regulations demonstrate our willingness to take action where we need to. That said, we are committed to ensure that the measures are only in place for as long as necessary. I therefore commend the regulations to the Committee.
Helen Whately
I thank colleagues for their contributions to the debate, and I will do my best to respond to as many as I can. I might not manage to get to them all, because I do not have much time.
I want to pick up on the comments made by the hon. Member for Ellesmere Port and Neston. I thank him for his overall tone, the approach that he takes to these debates, and the rigour with which he has gone through the regulations and asked totally reasonable questions. I will do my absolute best to respond to them. Like others, he had called for earlier scrutiny of regulations such as the ones we are debating, and I thank him for acknowledging that progress was made last week when we debated changes to regulations. Scrutiny is a valuable part of our democratic process.
The hon. Member for Newcastle upon Tyne North asked whether we could follow the normal processes for introducing and debating legislation, but she will know that we have the extraordinary challenge of the pandemic, which moves at a fast pace. With doubling times and exponential increases in case rates, there is a real trade-off between taking steps that will save lives and spending time debating them. We are constantly trying to get the balance right, so that we can move quickly and allow scrutiny, which, as I say, plays a valuable part in our legislative process.
The hon. Members for Ellesmere Port and Neston, and for Newcastle upon Tyne North, talked about some of the confusion about regulations, which I totally appreciate. We have been through a national lockdown in which the same rules applied to everybody. That was very simple, but it also had an enormous impact on the lives and livelihoods of the whole population. In response to that, the Government committed to trying to be more focused in our interventions, and to ensuring that interventions reflected what was going on locally where Test and Trace has given us information about how the virus is being transmitted. That led to local restrictions, and we worked closely with local authorities on what they felt would make the most difference in their area. That has led to different areas having different regulations. That can lead to confusion, in local authority border areas, about why the restrictions are different for people who live down the road.
We therefore introduced the tiering system—the local alert levels—to achieve more consistency while still allowing for local variation. That recognises that different areas have different infection rates, but it has led to people having to keep up with changes to rules. We are trying to strike the right balance between providing a local response to the virus and making the system as simple as possible. That is absolutely what the Government are trying to do, but it is clearly a difficult situation that we all find ourselves grappling with.
The hon. Member for Ellesmere Port and Neston expressed some confusion about the duration of self-isolation, and he asked about notifications. In general, self-isolation is for 14 days from the onset of symptoms. Clearly, that differs in some circumstances, depending, for instance, on whether we are talking about a member of a household or multiple members of a household, but I will look into the possibility that different things are being communication by Test and Trace, as it needs to be clear to everybody.
If I understood the question correctly, where a notification issued by a contact tracer is withdrawn because new evidence reveals that the person told to self-isolate was not actually a contact, these regulations would mean that the duty to self-isolate no longer applied. The hon. Member asked about close proximity. In general, that is being within 2 metres of somebody for more than 15 minutes, but further details can be found on gov.uk.
The hon. Member for Newcastle upon Tyne North asked about communications to employers. The Department for Business, Energy and Industrial Strategy has contacted major business representatives, such as the Confederation of British Industry and the Federation of Small Businesses, and there is also the ACAS helpline, so there are sources of information for business. I agree with what was said on the efforts that the hospitality sector has made to keep up to date with regulations, and its huge efforts to make premises covid-secure. We should absolutely appreciate what it is doing to keep us all safe.
On the important points made about the responsibilities of employers, it is unacceptable for any employer to discriminate against an employee because they are rightly self-isolating, either because they have tested positive or because they are a contact. The hon. Lady is absolutely right that that should be and is a clear message. It would be completely wrong for an employer to penalise somebody for doing the right thing. We all need to be responsible employers and citizens, supporting each other to do the right thing.
On the questions about annual leave, this is a choice for employees. If an employee faced being on statutory sick pay to self-isolate, but wanted to have full pay, they could choose to take annual leave instead, but that cannot be imposed on them by an employer. I am particularly alive to the financial challenges that this issue—and the pandemic in general—is imposing on people and, as hon. Members will know, the Treasury has made many announcements of support for people, but we are in difficult times.
Of relevance to this debate is the important introduction of that £500 support payment for those on lower incomes who are self-isolating; we know that is important in enabling self-isolation. This brings me directly to the question about research. The one reason why that payment was introduced was because research told us that one of the explanations people gave for not self-isolating was that they could not afford to.
The hon. Member for Ellesmere Port and Neston asked me about the source of the research; the figure I gave earlier of only around 20% of the population reporting compliance was based on the summary of results from around 21 nationally representative surveys. There is ongoing research on compliance, as that will be important in informing the ongoing response.
The hon. Member also spoke about the app; my right hon. Friend the Member for Forest of Dean (Mr Harper) made some of the arguments about its importance, why it is anonymous, and why, as a result, notifications received through the app are treated differently from notifications through the manual contact-tracing system. The hon. Member for Ellesmere Port and Neston also asked about the uptake of self-isolation payments; I can tell him that as of 13 October, 60 payments had been processed.
My right hon. Friend the Member for Forest of Dean talked about Test and Trace and its performance; it is absolutely an important part of our system. If I recall correctly, around 600,000 people have been contacted and asked to isolate as a result of the Test and Trace system, so it is having a material impact. Of course, we would like it to contact absolutely everybody.
Mr Harper
I will be brief—and it is mostly my questions that the Minister has not got to yet, so I am only affecting myself. She says Test and Trace is having a material effect, but that is not the view of SAGE, which was clear in its minutes of 21 September that it is not having a material effect. It said that if something does not happen, things are likely to get worse. That is SAGE’s view, not mine.
Helen Whately
We have been doing Test and Trace for some months now, and over a period of time, large numbers of people have been contacted through the system about the need to self-isolate.
I turn to the point made by my right hon. Friend and the hon. Member for Newcastle upon Tyne North about the role of local public health teams. Local public health teams are an incredibly important part of our response to the pandemic, both through their support of Test and Trace and—I see this in my work as care Minister—all the work they are doing with the social care sector in care homes. My right hon. Friend the Member for Forest of Dean is right that local authorities’ ability to knock on people’s doors, if we cannot get through to them by phone, is an important part of the response. I note his call for more resources to support that for areas, such as his, in tier 1.
My right hon. Friend asked me whether the MOU had been published. It has not been yet, but it will be. He also asked whether self-isolation can be challenged. An appeals process is being worked on to enable that. He also asked a number of questions about policing and reasonable force, on which I will have to get back to him, because I would not want to give anything other than the correct information. He also asked about the location in which students should self-isolate. In the regulations, as I am sure he is aware, there is a set of exemptions or reasonable excuses for why someone might not be able to self-isolate fully. Those excuses include, as I think was mentioned, taking an animal to the vet, seeking medical assistance, and avoiding risk of harm.
The purpose of the regulations is to make fully clear the importance of self-isolation, to educate people on their obligations, and to support people who are self-isolating; they then provide for enforcement, including fines, for those who knowingly and deliberately choose not to follow the rules. In addition, statutory instrument No. 1057 ensures that the requirements on businesses in the Health Protection (Coronavirus, Restrictions) (North of England, North East and North West of England and Obligations of Undertakings (England) etc.) (Amendment) Regulations 2020 continue to support our covid response, and are in alignment with the new local alert level regulations. We will review the regulations regularly, and continue to assess them in the light of the latest science and other data.
Question put and agreed to.
Resolved,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Self-isolation) (England) Regulations 2020 (S.I. 2020, No. 1045).
HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NORTH OF ENGLAND, NORTH EAST AND NORTH WEST OF ENGLAND AND OBLIGATIONS OF UNDERTAKINGS (ENGLAND) ETC.) (AMENDMENT) REGULATIONS 2020
Resolved,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (North of England, North East and North West of England and Obligations of Undertakings (England) Etc.) (Amendment) Regulations 2020 (S.I. 2020, No. 1057).—(Helen Whately.)
Public Health
Helen Whately Excerpts(4 years, 2 months ago)
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The Minister for Care (Helen Whately)
I beg to move,
That the Health Protection (Coronavirus, Restrictions) (North of England and North East and North West of England etc.) (Amendment) Regulations 2020 (S.I., 2020, No. 1074), dated 1 October 2020, a copy of which was laid before this House on 2 October, be approved.
These regulations came into force on Saturday 3 October. They were introduced, based on the latest epidemiological data and local insights. The data showed rapidly rising rates of covid-19 infections in Merseyside, Halton, Warrington, Hartlepool and Middlesbrough, indicating an urgent need for further steps to control the outbreak. The regulations also introduced an easing of restrictions for Bolton, based on the stabilisation situation compared with the rapid growth in case numbers a few weeks previously.
These regulations represent targeted measures designed to reduce transmission in areas where incidence rates are high. We do not want to, and will not, impose regulations where they are clearly unnecessary, but where we do, while public health is our priority, we are balancing the need to impose measures to tackle the transmission of the virus with protecting our economy and education.
Jacob Young (Redcar) (Con)
Does the Minister agree that it is also important to look at the number of hospitalisations in an area, which is why, at the moment, Redcar and Cleveland are staying out of local lockdown restrictions?
Helen Whately
My hon. Friend makes a really important point. In making these decisions, we look at multiple factors. We look at the incidence rate per 100,000, for instance. We look at the positivity rate—the percentage of tests that are positive—and we keep a close eye on hospital admissions. All those factors are important. The good thing about the data from our testing systems is that they give more leading indicators of things that may follow on. All of those are an important part of the information that goes into the decisions that are made.
Incidence rates across Merseyside, Halton and Warrington over the seven-day period 17 to 23 September 2020 range from 163.3 per 100,000 people in St Helens to 257.7 per 100,000 people in Liverpool. Test positivity was high too, ranging from 10.5% in the Wirral to 15.7% in Liverpool in the same period. With those levels of infection, including growing infection rates in people aged 60 and over, for whom we know the risks of complications are greater, action was clearly necessary. By contrast, in Bolton, which until the regulations were introduced was under greater restrictions and interventions than nearby areas, infection rates have stabilised, although they are still high, at 241.8 per 100,000 people, with a test positivity rate of 12.3%.
Many areas across the north of England have been subject to extra restrictions, in some cases, for weeks. I know that that is really hard for people, day in, day out, and for many businesses. The regulations do not introduce any new measures, but they amend existing legislation.
Mr Mark Harper (Forest of Dean) (Con)
Briefly, the Minister touched on the point that the regulations amend previous regulations that have been in force for some time. Something which, I suspect, Opposition Members will raise is the incidence rate, based on testing. As my hon. Friend the Member for Redcar (Jacob Young) said, there are other measures on hospitalisations and other things. Can the Minister set out some of the evidence that demonstrates that the measures that have been introduced in the Liverpool area are likely to have some prospect of working, because that will be important in reassuring our constituents that the Government have got a grip on the situation?
Helen Whately
I thank my right hon. Friend for his intervention. I will come on to the impact and detail of the rationale for the interventions.
Ms Angela Eagle (Wallasey) (Lab)
Does the Minister agree that as the virus is coming roaring back, particularly in areas such as my constituency, now is the wrong time to be getting rid of the furlough, and that if we are going to have extra restrictions, we also really need much greater extra support so that we can compensate and look after business owners and individuals that have to self-isolate or close?
Helen Whately
The hon. Lady makes an important point about the impact of restrictions on people’s livelihoods as well as their lives. However, she is asking me to stray beyond my brief as a Health Minister to talk about the financial support, although she will be aware that the furlough has supported huge numbers of people during the period of lockdown and since, and the Chancellor has introduced further measures to support people in the months ahead.
Helen Whately
I will make a little more progress and then I will take further interventions.
I will now run through each of the regulations that were amended. The first was the Health Protection (Coronavirus, Restrictions) (North of England) Regulations 2020—SI 2020/1057—which changed the geographic areas covered by the north of England regulations. Halton, Knowsley, Liverpool, Sefton, St Helens, Warrington and the Wirral were removed. These local authority areas were then added to the north-east and north-west regulations—SI 2020/1010. Two new areas were also added to the same protected area, Hartlepool and Middlesbrough. For each of these, this was the first time that local restrictions had been implemented. People living in these areas are prohibited from mixing with people from different households in each other’s homes and gardens, and in any indoor public venue.
Next, these regulations added Bolton to the geographic area covered by the north of England regulations, rejoining the other local authorities that make up Greater Manchester. This amendment meant that the takeaway-only restriction affecting hospitality was removed, so businesses in Bolton have been once again able to serve food and alcohol with table service. Due to Bolton being added to the north of England regulations, the Health Protection (Coronavirus, Restrictions) (Bolton) Regulations 2020—SI 2020/974—were revoked.
The final regulations amended by these regulations is the Health Protection (Coronavirus, Restrictions) (Obligations of Undertakings) (England) Regulations 2020—SI 2020/1008—which were incorrectly amended before. This amendment ensures that the right exemptions apply to the requirement on pub, café, restaurant or bar managers in the protected area of the north-east and north-west regs to take all reasonable measures to stop groups of six in areas where only national restrictions apply, or members of the same household in the north-east and north-west protected area from singing on the premises.
To come to the decisions behind these regulations in more detail, given the urgency of the situation and the rapidly increasing numbers of people testing positive for covid in Merseyside, Halton, Warrington, Hartlepool and Middlesbrough, we consulted local leaders last week on the potential next steps. Similarly, we consulted local leaders in Bolton.
Jacob Young
I thank my hon. Friend for her Department’s approach to the Teesside restrictions—for not including Teesside as one whole, homogenous bloc, as some people wanted, but viewing the individual parts, such as Middlesbrough, Hartlepool, Redcar and Cleveland, as separate entities.
Helen Whately
I thank my hon. Friend for his comment. We are trying to get the balance right between wanting to target restrictions and not impose them on areas where they might not be needed, while being mindful that if every area has its own local variant specifically, it does get more and more confusing, so there is a clear balance to strike in being targeted but also trying to keep things simple.
Helen Whately
Let me just come to Bolton. I was saying that we had consulted local leaders in Bolton and we used the emergency procedure to make the present set of regulations as soon as we could. Recognising the concern about the time that it can take for Parliament to debate these statutory instruments and given the pace of the pandemic, I hope that hon. Members acknowledge that we are debating today measures that came into force just this Saturday.
As I mentioned, for the implementation of these measures, existing legislation was amended rather than bringing in new Acts. We reviewed the impact of existing regulations and considered where they needed to be more robust or could be eased. We took into account the existing measures in place elsewhere and assessments of the impact that those measures were having. The complexity of local restrictions has been highlighted recently, so the decision was made to impose regulations already in place rather than to develop new ones.
There is extremely serious concern about the outbreak in the north of England, the north-east and the north-west, both at the point the decisions were made to introduce further restrictions and ongoing. Engagement with local public health teams and local leaders has been extensive. I would like to thank the local council leaders, local authorities more broadly and the local resilience forums, as well as Public Health England, the Joint Biosecurity Centre, and the local and regional directors of public health for all their engagement and all the work they are doing. All the local councils involved have engaged sensibly at chief executive and other levels, and I know they have also been doing a huge amount locally—for instance, working to increase compliance, supporting increased access to testing, working with care homes and supporting the most vulnerable. We will only succeed in suppressing this virus by working together at every level.
Steve Brine (Winchester) (Con)
I thank the Minister for setting this out so clearly and concisely because this is really difficult. The International Trade Secretary said on the radio this morning that we need to suppress this virus until the vaccine comes. The problem I have—today we are discussing these areas, but we could be discussing any area, including my area, next—is that, if the vaccine comes, when the vaccine comes, we then have all sorts of challenges around roll-out, efficacy and the long-term stay of that vaccine. Is the Government’s view that we need to suppress this virus until the vaccine comes and then science is going to ride to our rescue, or is there a bigger plan, a next plan, to think about how we live with this virus for the long term, which the Prime Minister and the Chancellor keep referring to?
Helen Whately
My hon. Friend invites me to stray somewhat from the subject of this SI and the updates to the regulations, but clearly from what he said, he is well aware of all the work that is going on for us to have a vaccine. He is also well aware that the priority at the moment is that we absolutely have to suppress this virus because the alternative does not bear thinking about.
Jake Berry
On the subject of this SI, what does the Minister think the impact was of the eat out to help out scheme in places such as Bolton? When it was introduced, the rate per 100,000 was more than 10 times that of central London. Does she believe it has had an impact, and if so, what?
Helen Whately
Again, my hon. Friend is asking me to stray beyond the scope of the SI, but what I will say is that, in the decisions that are made about interventions and policies more generally, clearly we are always looking at what is going on and what the transmission rate is. Something we saw during the period when there was eat out to help out was that that was a period when, in general, we had lower rates of infection. It gave great support to the hospitality sector, which had been clearly having a really difficult time. We are now very much seeing a second wave, particularly in much of the north of England, and therefore it is absolutely appropriate that there are, in general, greater restrictions. We absolutely must suppresses this virus and one place where we know that infection goes on is through hospitality, where there is social contact.
I will return to the job in hand, Madam Deputy Speaker. Guidance has been updated for people living in protected areas to make it clear what they can and cannot do under the restrictions. Again, I know local authorities are working hard on communications as these measures only work if people know about them, understand them and comply. These regulations, as with the other local regulations we have debated already, demonstrate that we will take action where we need to. In mirroring the restrictions that have been used in other parts of the country, we are drawing on and learning from experience. We will, of course, use continued experience of these measures to inform and help us develop our responses to ongoing local outbreaks.
I reiterate to the House that, for significant national measures with effect in the whole of England or UK-wide, we will consult Parliament and, wherever possible, we will hold votes before such regulations come into force, though of course responding to the virus means that the Government must act with speed when required, and we cannot hold up urgent regulations that are needed to control the virus and save lives. I am sure that no Member of this House would want to limit the Government’s ability to take emergency action in the national interest, as we did in March, but we will continue to involve the House in scrutinising our decisions in the way my right hon. Friend the Prime Minister set out last week. This will be through regular statements and debates, and providing opportunities for Members to question the Government’s scientific advisers more regularly. I am grateful to all Members for their continued engagement in this challenging process.
Helen Whately
I am just wrapping up, and I have taken many interventions. I am very sorry, but I am not going to take a further intervention at this point, as there are people waiting to speak.
I particularly thank people in the protected area in the north of England, who are restricting social contact and forgoing many of the things that make life worth living. In so doing, they are playing their part in supressing the virus and protecting those whose lives are at risk.
Madam Deputy Speaker (Dame Rosie Winterton)
Colleagues will be aware that this is an extremely short debate. To have any chance of getting everyone in—the Minister can come back at the end to respond to points that have been made—I will impose a three-minute time limit on Back-Bench speeches.
Helen Whately
I thank colleagues for the contributions that have been made today, which I have listened to very carefully. There have been some extremely heartfelt speeches on all sides of the House that clearly reflect the enormously difficult time we face right now in this country for all our constituencies and all our constituents. They are facing restrictions and things that affect their day-to-day life—their livelihoods, the businesses they may run or work in, or, for instance, visiting relatives in care homes; we want to do everything we can to make sure that can be done safely.
But this does all reflect that we are truly facing a global pandemic and, as I said yesterday, for those who were in the Chamber for the debate yesterday, the greatest crisis or the greatest challenge that our country has faced since the second world war. That means that, however we want things to be, at the moment there is no way they will be as we want them to be. I am sure hon. Members on all sides of the House recognise that everybody, whatever role they are in, is doing their very best to make things as least bad as they possibly can be.
The reality is that we are fighting this truly invisible, deadly enemy that is spreading through our communities—and we know, sadly, killing as it goes—and we must suppress it, but do so with this incredibly difficult balance. Colleagues have talked about the impact on businesses and the local economy in their constituencies. We must do so while doing our utmost to protect the economy and, of course, keep kids in school and support those in university and other forms of education. As has been said, if the pandemic spreads faster and further, that in its own right also has impacts on the economy—not just the restrictions, but the impact of the pandemic itself and more people getting covid.
As the Government have responded over the weeks that have passed, we have been constantly learning, listening, adapting—learning from those overseas, as well as from the data that we have built up ourselves—and working closely with those in local areas, because the only way we will win against this virus is, indeed, by working together, fighting together and defeating it together.
I now come to some of the comments from honourable colleagues. One thing that came up several times is: why are we seeing different action in different areas? What I will say is that numerous factors are looked at—the incidence rate, the positivity rate, hospitalisations, intensive care units and, of course, taking into account local views. That absolutely has been taken into account in the regulations that we are debating today. As for the impact—in fact, one colleague asked: are they still necessary?—some areas have come out of some restrictions and seen easements. We do know that it takes time for there to be an impact, but we need to continue to take the steps that are necessary because, as we know, the real exit from this is for us to see rates come down.
We are clearly working flat out for a vaccine, and we are continuing to build up the capacity of our test and trace system. I want to pick up one particular concern that there might have been some problem in that there was not the right data because of the technical problem last week. What I will say is that actually the data on which these decisions were made, or the data that did not feed through was too recent to affect these decisions, but it will feed into future decisions—very much so. What I will say, and ask colleagues to remember, is that we have built up the capacity of our testing system from testing 2,000 people a day to being able to test well over 200,000 people a day, which is not to be sniffed at, and working up to 500,000 day by the end this month.
Members have asked about local test and trace. Absolutely, the systems work together. The national system does work with local tracers and is working with local teams, although what I will say to those who want their local public health to be running the whole thing is that I am hearing from local public health teams that they are really maxed out with a huge number of responsibilities at the moment. We should continue to work together, because the local and national complement each other.
There are no easy answers. Some colleagues have said that they want restrictions that are easier to live with. Restrictions on our social contact will be hard to live with. I would like to say a huge thank you to all our constituents across the country who are playing their part in following these restrictions, as we must do ourselves. I commend these regulations to the House.
Question put and agreed to.
Resolved,
That the Health Protection (Coronavirus, Restrictions) (North of England and North East and North West of England etc.) (Amendment) Regulations 2020 (S.I., 2020, No. 1074), dated 1 October 2020, a copy of which was laid before this House on 2 October, be approved.
Oral Answers to Questions
Helen Whately Excerpts(4 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Rachael Maskell (York Central) (Lab/Co-op)
The Minister for Care (Helen Whately)
NHS Test and Trace launched in May. Four months later, more than 150,000 people who have tested positive for covid-19 have been contacted, and 450,000 of their contacts have been reached so that they can self-isolate. We have tested more than 7 million people at least once and many, such as care home workers, more than once. Rapid expansion brings with it challenges. Working with local authorities, we will continue to improve test and trace, as it is an important part of our armoury to defeat this virus.
Helen Hayes
As a co-chair of the all-party parliamentary group on adult social care, I meet weekly with a working group drawn from across the care sector. Providers on that group report that they are still experiencing delays in receiving weekly test results, still have no routine access to weekly testing for domiciliary care workers or staff working in supported living environments and urgently need regular testing for family members to alleviate the terrible isolation of care home residents from their loved ones. When will the care sector have all the access to testing that it needs on a reliable basis to stop the second wave of coronavirus delivering the utter tragedy and devastation of the first to the care sector?
Helen Whately
I thank the hon. Member for her question and for the work that she does with the APPG, which I joined recently for a very valuable conversation. Supporting care homes through the pandemic and in the months ahead is absolutely our, and my, priority. One part of that is ensuring that they have the testing that they need. We are getting regular repeat testing to care homes. I acknowledge that the turnaround times have not been what we would have liked them to be, but those turnaround times are coming down and we are seeing a rapid improvement in performance.
Mary Kelly Foy
This week, the president of the Association of Directors of Public Health said that the funding is just not there for local authorities to effectively run local contact tracing. Where it has been done, at a cost to the local authority, evidence shows that local teams were more likely to be successful in contacting people compared with the national tiers 2 and 3. Can the Minister tell me why the Government keep insisting that the current track and trace system is working when public health professionals are telling them the opposite?
Helen Whately
I thank the hon. Member for her question. I am sure she will know that local authorities received £400 million to support them with local outbreak management. It is really important to have this coming together of the national system and the local system, where local authorities are indeed playing an important part, using their local knowledge to follow up with contact tracing, particularly for some of the contacts that are proving harder to reach.
Karl Turner [V]
Schools in my constituency are having to close, disrupting children’s education and the work of their parents. Serco’s test and trace has been an unmitigated disaster. It is more than an extraordinary waste of public money; it is a public health crisis. To make matters worse, Ministers signed off on a wholly inappropriate Excel spreadsheet, blowing billions and leaving thousands of contacts untraced. When I asked the Secretary of State last week when he was going to take personal responsibility, he simply boasted that the system was working brilliantly. When does the Minister think her boss, the Secretary of State, will begin to take personal responsibility for this fiasco?
Helen Whately
There was quite a lot in that question. One thing I will say on schools is that enabling our children to continue to go to school is very much part of the whole strategy that we are using to tackle and suppress coronavirus, because education is so important. On the specific test and trace system to which the hon. Member refers, the Secretary of State spent an hour and a half in the Chamber yesterday answering colleagues’ questions about the performance of that system.
Rachael Maskell
In the light of the fact that infection levels in York have risen from 63.1 cases per 100,000 to 143.9 cases per 100,000 in just the past seven days, the local public health team is working with the university and local labs, and together they have put together a programme where they can test, process the testing and do contact tracing. This is a testing service that works for York, with test results the next day and tracers who understand local population flows. Will the Minister put the necessary resources in place to enable them to do their work and allow this to happen, because this is surely the game changer we need to beat this virus?
Helen Whately
Well, it is very good to hear of the set-up in York that the hon. Member describes, and what I can do is take away from here and follow up to ensure that there is joint working, which we know is a really effective way to bring together national resources with the local resources, expertise and knowledge that are so important in tackling this virus.
Dr Philippa Whitford (Central Ayrshire) (SNP) [V]
With covid, speed is of the essence, but people are struggling to get a test due to limited capacity at the Lighthouse labs. New labs were due to open in Newport in August and in Loughborough last month, but both are delayed. As NHS labs are having to take on more testing, can the Minister say what additional funding will be provided specifically to increase NHS lab capacity?
Helen Whately
The context is the huge increase in the testing capacity of our system that we have already seen, going from in the order of 2,000 tests a day back in March to well over 200,000 tests a day now and building up to 500,000 tests by the end of this month. I recognise also that there is both the Lighthouse labs—what is known as pillar 2 testing system—and the important part that NHS testing facilities play in the pandemic. And of course the hon. Member will know that a huge amount of money has been and is going into the NHS to support its response to covid.
Dr Whitford [V]
Scotland’s public health-based tracing service has reached over 95% of contacts, yet four months on, the Serco system in England has still only reached 61%. As finding contacts and getting them to isolate is critical to reducing covid spread, should not tracing in England now be based more on local public health teams?
Helen Whately
It may be helpful to say that, since the NHS Test and Trace system started, it has contacted 78.5% of those who have tested positive, and then 77% of their contacts have been reached. There is an important part of the system where the national contact tracers are handing over to local authority contact tracers who are able to access the same system and are supported in contact tracing but, critically, are also using their local knowledge of the local area to increase the success rate. It is really important that people are reached wherever possible and advised to self-isolate.
May I also say how much I appreciate and thank all those who are doing the right thing by self-isolating, both those with symptoms and those who have been contacted by contact tracers?
Justin Madders (Ellesmere Port and Neston) (Lab)
I am not going to ask about the current problems with test and trace, because it is clear from what we have heard already that the Government have no answers on that. Instead, I will ask about the so-called moonshot tests and Dido Harding’s comments that some people will have to pay for them. When the Prime Minister was given a chance in the Chamber, a fortnight ago, to deny that was on the table, he did not take it. We have real concerns about creating a two-tier system for tests where some people have to pay. It undermines a fundamental principle of the NHS and will do nothing to stop the spread of the virus. Will the Minister give us a definitive answer today? Are some people going to have to pay to access the moonshot tests, yes or no?
Helen Whately
I do not recognise the hon. Gentleman’s suggestion that there could be a two-tier system. What we have in place is a universal system where everybody who has symptoms is able to access a test. As he well knows, where we know there are particular risks, such as for those in care home settings, there are also tests for those who do not have symptoms so that we can pick up outbreaks early. A huge amount of resource and investment is going into developing new technologies for testing—easier testing, quicker tests and tests that can be done at greater scale—because this is all part of building up our testing capacity, so we can suppress this horrid virus.
Chris Loder (West Dorset) (Con)
The Minister for Care (Helen Whately)
Education, health and care plans identify the support needs of children and young people across those three areas. Local authorities and health bodies are required to jointly commission the services. The Government are currently undertaking a review of the special educational needs and disability system, and I am working on this with my ministerial counterpart in the Department for Education.
Chris Loder
I thank the Secretary of State and Ministers for their focus on Dorset County Hospital in the recent investment announcements, but in my West Dorset constituency, I have totally unacceptable waiting times of up to two years for EHCPs for children and their parents. That is totally unacceptable. They face the most difficult of situations and, I am afraid, are losing hope. Will the Minister help me in supporting these desperate children and parents who need to get their EHCPs done?
Helen Whately
My hon. Friend makes an important point about how we need to see children and young people getting in place, as soon as possible, the support that can help them and about how there are waiting times for these plans. There are two things I can say in response. First, in the context of covid, NHS England has made it clear to NHS organisations that they must restart and restore services that support children and young people with EHC plans and in the assessments for those plans. Secondly, in the review of the SEND system, we are indeed looking at how we can address some of the problems in the system and achieve better integration across health, care and education.
Kim Johnson (Liverpool, Riverside) (Lab)
Lilian Greenwood (Nottingham South) (Lab)
The Minister for Care (Helen Whately)
Universities have a duty of care to support students who are required to self-isolate. The Department for Education is working with universities to make sure that where an outbreak occurs, support is in place. That includes ensuring that students with cystic fibrosis and other long-term health conditions who are self-isolating have access to the food, medicine and medical care they may need.
Lilian Greenwood
Self-isolating students throughout the country, and their understandably worried parents, are reporting problems with accessing food, drinks, exercise and other support. That is completely unacceptable for any student, but for those with cystic fibrosis, who often need high calorie requirements to stay well, access to regular food supplies is absolutely essential for their health. What is the Minister doing to ensure that students with CF who are required to self-isolate at university and have previously shielded are able to access priority supermarket delivery slots? Many will have relied on their parents’ accounts when they were at home. What other action is she taking, in partnership with universities and the Department for Education, to ensure that every student with CF who finds themselves in lockdown is supported on their healthcare needs?
Helen Whately
The hon. Lady asks a really important question. Clearly, it is a difficult time for students starting university now, but particularly for those with long-term health conditions such as cystic fibrosis. Overall, as she knows, the context is that we are prioritising education. We do not want students to put their life on hold, but we do want them to be supported by their university, particularly if it is harder for them to self-isolate because of health conditions. I am in regular contact with the Minister for Universities and will take up with her the specific questions about support for students with cystic fibrosis and access to supermarket deliveries. If the hon. Lady would like to raise any specific case with me, she should let me know and I will take that up with the Minister for Universities to address the specific issues.
Gordon Henderson (Sittingbourne and Sheppey) (Con)
Danny Kruger (Devizes) (Con)
The Minister for Care (Helen Whately)
We have sweated blood and tears to support the sector through this pandemic. Last month, we launched the adult social care winter plan, with regular testing for care home staff and residents, free personal protective equipment and mandatory infection prevention and control measures for care providers, supported by £546 million of Government funding. I am enormously grateful to all those on the frontline in social care. I recognise the challenges that they have faced and how many feel daunted by the winter ahead. I say to care workers: “I cannot thank you enough for what you do and I am with you every step of the way.”
Miss Dines
I have been contacted by Ann Penrose, who is 91, in good health and in a care home in Ashbourne, Derbyshire Dales. She asked her family to contact Boris, but sadly she got me. Does the Minister agree that the time has come to look very carefully at what is happening in care homes to review the existing measures, routines and guidelines, bearing in mind that we are testing so much now? We need to have a bit more humanity. We are in danger of throwing the baby out with the bathwater. These people need their families, yes, in a safe environment, but they do need to have access to families and, at times, to their pets.
Helen Whately
My hon. Friend makes an important point about the importance of visiting both to the individuals living in care homes, and to their family and friends. Achieving the balance between protecting care home residents from the risk that covid might be brought into the care home, where it is so hard to control, and giving them access to visitors, has been one of the hardest areas to get right over the past few months. That is why in the summer we issued guidance on safe visiting and gave more freedom on the decisions about visiting to local authorities, with directors of public health working with care homes. I want us to continue to support and enable safe visiting for care homes.
Mr Speaker
Order. We have to get through this grouped set of questions, and it is going to take us well into topicals time; the Minister really does need to speed up on the answers.
Fiona Bruce
I thank the Minister for the social care winter plan announced two weeks ago. Can she tell me when this half a billion pound infection control fund will be released to councils covering constituencies such as mine in Congleton, in order to help protect residents and staff over the winter?
Helen Whately
The infection control fund is being distributed in two equal instalments, the first of which has already been paid to local authorities. My hon. Friend’s local authority, Cheshire East Council, will be receiving £4.7 million in total, so it should already have received £2.35 million to go towards the extra costs for care providers and others in infection prevention and control.
Scott Mann
As always, I commend the Department and the Secretary of State on their work during the pandemic. Although not every part of the response has been perfect—and we never expected that it would be—I am convinced that the Department has done its utmost to protect the public. I do have some concerns, however, about the transmission between care homes. What measures has the Department taken to prevent cross-contamination of covid between care homes, particularly from staff who work in multiple locations?
Helen Whately
I thank my hon. Friend for his comments, but most of the credit should go to those working in social care, who have been looking after some of the most vulnerable people in our society in such difficult circumstances. He is right that it is really important that we ensure that there is no transmission between one care home and another, which is why we are requiring care homes to make sure that their staff work in only one setting and are providing additional funding to enable them to do this.
Danny Kruger
Care homes are rightly the focus of our attention at the current time, but I know that the Minister is reviewing the future of social care. Does she agree that our focus in that regard should be on more community-based services, not solely on residential provision? Will she also set my mind at ease by ruling out the creation of a new national care service run from Whitehall?
Helen Whately
First, may I congratulate my hon. Friend on his recent report on levelling up our communities? As he said, care homes have indeed been the focus of our social care response to the pandemic, but I would not want anyone to think that that was the limit of our support for social care during the pandemic; the winter plan also includes support for domiciliary care, supported living and others. I agree with him that as we look to the future, we should support the aspiration that most people have to live independently, with their own front door, well into their old age. There are no plans to create a national care service run from Whitehall.
Liz Kendall (Leicester West) (Lab)
Families with loved ones in care homes are desperate to start visiting again, but are banned from doing so in swathes of the country with extra restrictions. The Government’s own carers advisory group says that visits are essential for residents’ health, and that, to make them safe, relatives should be treated like key workers—with regular testing. Will the Minister now please put that testing in place and lift the blanket ban on care home visits in lockdown areas, so that we can help to bring all families back together again?
Helen Whately
The hon. Member makes an important point, as did my hon. Friend the Member for Derbyshire Dales (Miss Dines) a moment ago, about the importance of visiting for those in care homes, and for their relatives and loved ones. We are striking the difficult balance between protecting those in care homes and ensuring that they have visits wherever possible, but these visits must be done safely. I have heard from the sector about the aspiration for some family members to be treated as care workers—for instance, if they visit the care home regularly. As we expand testing, I very much intend that we should test some visitors—and am making the case for doing so—but it is all part of how we expand and use our testing resources.
Tonia Antoniazzi (Gower) (Lab)
Public Health
Helen Whately Excerpts(4 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister for Care (Helen Whately)
I beg to move,
That the Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020 (S.I., 2020, No. 986), dated 13 September 2020, a copy of which was laid before this House on 14 September, be approved.
I will start with a short summary of the social distancing regulations, as context to this debate. The Health Protection (Coronavirus, Restrictions) (England) Regulations 2020—the major lockdown regulations—were introduced on March 26. Those regulations outlined restrictions on gathering and required a number of businesses to close. The regulations were amended four times as we opened up the economy and allowed for technical clarifications. They were then revoked and replaced by the Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020. Those regulations had been amended three times prior to 13 September to allow more businesses to reopen, as the transmission of the virus was falling or stabilising. Unfortunately, as winter approaches, the picture has changed and we now need to introduce tighter restrictions to control the virus, protect the NHS and save lives.
Mr Mark Harper (Forest of Dean) (Con)
The regulations were obviously made and brought into force ahead of the commitment that the Secretary of State made to the House last week. Given that the regulations that we are debating today cover the whole of England and are obviously of very great significance, will the Minister confirm that regulations of this nature would in future be covered by the Secretary of State’s commitment and would be brought for debate and decision in this House before they came into force? Would that also apply to, for example, the self-isolation regulations, which have not yet been debated by this House and which are also significant? I want to ensure that we are following through on the commitments that the Government made last week, and that this House will get to debate measures that cover the whole country and are of great significance.
Helen Whately
I thank my right hon. Friend for his point. Indeed, the Secretary of State has made a commitment that for future changes to restrictions that would have national effect, we will do our very best to bring them to the House to a vote, although obviously we have to bear in mind that there are circumstances in which we need to act very quickly, because, as we have seen, things can move very quickly with the infection rate and the consequences of the pandemic.
The regulations that we are debating today amend the Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020 so that people may not participate in social gatherings in groups of more than six unless they are members of the same household or support bubble, or exemptions apply. The regulations were made under the emergency procedure in order to respond quickly to the serious and imminent threat to public health posed by coronavirus.
Steve Brine (Winchester) (Con)
I think the Minister knows what I am going to ask. I asked it last Monday in the general debate and her colleague, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), chose not to respond in the wind-up, so I will ask it again: what is the rationale for including children under the age of those who have to wear masks in the rule of six? I am asking not about the fact that it is happening, but the rationale.
Helen Whately
If my hon. Friend allows me to make a little progress, I will pick up on that point during the course of what I will say.
I appreciate that these national regulations have caused real disruption to people’s lives, placing restrictions on who people can see and what they can do. However, the evidence indicated that the covid-19 infection rate was rising across the country. It was therefore vital that the Government took decisive action to limit and slow the spread, to protect public health and to reduce the likelihood of a further national lockdown of the type that was necessary earlier this year.
Madam Deputy Speaker, I am aware that you, Mr Speaker and a number of Members have raised concerns about parliamentary scrutiny. As the Secretary of State for Health and Social Care outlined to the House last week, for significant national measures with an effect on the whole of England or UK-wide, the Government will consult the House of Commons wherever possible and hold votes before such regulations come into force.
Mr Harper
I am grateful to my hon. Friend for indulging me a second time. The point of our arguing for that was insisting that Ministers had to set out their arguments and the evidence. I understand that one of the key ways of transmitting the virus is social contact, and that as the regulations have been in force for three weeks, they would lapse if this House did not debate and vote on them in the next four days, but what evidence is there that the measures are actually having an effect on reducing the rise in cases of the virus? Having looked at the data, I do not see any evidence that they are having any practical effect. We want to see action—yes—but we want the right action to be taken which will have the effect that we all wish to see.
Helen Whately
I will answer the question that my right hon. Friend asked in a moment, if he lets me continue.
As the Health Secretary set out in his statement to the House on 1 October, this virus spreads through social contact, so we are having to take difficult decisions to suppress the virus while allowing people to socialise safely. The regulations we are debating today brought previous guidance into law while tightening and simplifying it. The rule of six means that people can now gather only in groups of six both indoors and outdoors. There are exceptions to that rule for households or support bubbles that are larger than six, as well as for areas including work, schools, weddings and organised sports activities.
The regulations also gave the police the powers to enforce those legal limits, including issuing fines of £100, doubling for further breaches up to a maximum of £3,200. The vast majority of the general public will do the right things and follow the rules, but to protect public health, it is important that the police have appropriate powers to deal with those who flout the rules. As the Prime Minister announced, these measures were not a second national lockdown but are aimed at preventing the need for one.
Sir Desmond Swayne (New Forest West) (Con)
Do the police have powers of entry into a private dwelling to enforce these rules?
Helen Whately
I would not want to say anything incorrect at the Dispatch Box, so let me make sure that I get back to my right hon. Friend with a detailed answer to that question.
After a period of reducing or stabilising the transmission of the virus, we have been seeing daily case numbers rise rapidly across most parts of the country. That is why the Government chief medical officer and chief scientific adviser jointly agreed the changes that we announced. We know from the science of what has sadly happened in other countries that are experiencing a second wave that an increase in infections will lead to increases in hospitalisations and deaths until we take action.
In introducing the changes, we noted that clear and easily understood information about the virus and how it spreads was likely to increase adherence to public health advice. Although the majority of people report that they understand social distancing rules, feedback from the public and Members of this House indicate that people would value simpler messaging. That is why we have moved to the rule of six—one number for all settings—and have tightened the regulations so that they exactly reflect the guidance rather than there being one set of numbers in the guidance and another set of numbers in the legal framework. The rules were simplified and strengthened, so that they were easier to understand and so that the police could identify and disperse illegal gatherings.
We have acted to get the virus under control and, in doing that, we want in due course to be able to make changes and, clearly, to be able to lift the restrictions. My hon. Friend the Member for Winchester (Steve Brine) asked specifically about children. The position on this is, as I have said, the need for a clear steer. We needed the guidance to be simple and absolutely clear to everybody. We wanted, on the one hand, to enable a level of socialising for the sake of people’s quality of life, while on the other hand to take steps to control the virus. That is why we took the position that the rule of six achieved that balance. I appreciate that colleagues would like a different position to have been taken, but that is the position based on the—
Several hon. Members rose—
Helen Whately
At that specific moment, I was doing my very best to answer the point made by my hon. Friend the Member for Winchester. I think I should make some progress, but I am happy, of course, to come back to this point if colleagues feel that they have not had all the answers that they need.
As I was asked about this a moment ago, I wish to move on to the impact of these measures. I note that they have been in place for only just over three weeks. We know that, because of the incubation period of the virus, it takes at least a couple of weeks for us to see the measures take effect. When social distancing measures were first introduced, we saw high understanding, high awareness and lots of concern about covid and high adherence to the rules. What we have seen over time, with an easing of restrictions and perhaps lower levels of public concern, is that people’s social contacts have increased. Since the introduction of this rule, levels of socialising have begun to decrease again, including specifically socialising in larger gatherings—we know that, sometimes, larger gatherings have been a factor in some outbreaks. Clearly, we are keeping a close eye on infection rates and absolute case numbers across the country.
I will now briefly talk through some further changes that have come into effect since the regulations were made.
Mr Harper
I am grateful to the Minister for what she has said. What she seemed to be saying was that it is too soon to tell. It is very clear from the test and trace data that the primary location for infection is in people’s households and among visitors to households. Clearly, the rule of six may have an impact on visitors to households. May I ask her to make sure that the Government publish the data as they track it out each week?
The Minister also talked about compliance. The Government keep referring to how well people are complying with regulations—or not. They do not publish any data on that. Will the Government publish the compliance data to which they have access, so that we can all see the extent to which people are complying with the rules? There is no point making rules if no one is following them. That is an important matter for this House to be aware of when it is assenting to them.
Helen Whately
My right hon. Friend makes two important points. He will be aware that the Government are publishing a large amount of data and seeking to be as transparent as possible with colleagues and, clearly, with the public, and we will continue to publish what we can. I will take away his specific requests for even further publication.
Several hon. Members rose—
Helen Whately
I will just move on as I am conscious that I have taken quite a number of interventions—
Sir Graham Brady
I am very grateful to the Minister for giving way. We are three weeks in and we know that a different model is being applied in Scotland. At what point would she expect to be able to form a judgment as to whether the Scottish approach, excluding young children from the rule of six, is less effective, as effective, or more effective than that in England?
Helen Whately
I have a personal perspective, as I have a household of five and am therefore well aware that the rule of six can make socialising quite difficult for families. For instance, my own family now cannot get together either with both my parents or my husband’s parents. I very much appreciate the difficulty of this restriction, although the majority of households are slightly smaller and are not finding it as difficult as my own or other larger households. We are keeping this and all measures under review. The Government clearly do not want to introduce restrictions if we do not need to do so. What is crucial is that restrictions are effective, so we are looking at all the evidence, including where and how the virus is being transmitted—whether that is in households, in people’s own homes, through meeting up with other households or in hospitality settings—and we will continue to do so. But in answer to my hon. Friend’s question, I cannot give a date or a specific “This will be the moment at which it would happen.”
Helen Whately
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.
Helen Whately
I am sorry but I was closing my speech, not taking an intervention. That was the end of my speech. [Interruption.]
Madam Deputy Speaker (Dame Rosie Winterton)
Order. The Minister has completed her speech. She is due to come back at the end of the debate, although hon. and right hon. Members who wish to speak must bear that in mind if they wish her to speak again, because this is just a 90-minute debate.
Helen Whately
I thank all colleagues who have spoken in this debate, because I have been grateful for the thoughtful approach that many of them have taken. Just as I do in my role, Members have drawn on experiences from their own lives and of course from what they hear from constituents. The backdrop to this debate is the fact that the country is in the grip of a global pandemic. We are battling a highly infections and deadly disease, facing a challenge that this country has not faced since the second world war. As we have seen, this virus can spread through the population at an exponential rate, killing people as it goes. Only because of that have the Government brought in such restrictions to people’s lives, ones that clearly no Government would wish to bring in. The alternative—just allowing the virus to let rip—simply cannot be the right thing to do.
Mr Steve Baker
Nobody is suggesting that we let the virus rip; radical as I may be, I cited some supportive passages in my remarks. The Minister says that the virus is deadly. We all accept it is deadly for people who have prior risk factors, which raise the infection fatality rate, but is it not the truth that for a great many people who are younger and without prior conditions this is not an especially deadly disease? We knew that at the beginning; we know it today. It is deadly for a certain section of our society, and it is them we are looking after. Can we please be honest about that?
Helen Whately
I appreciate that my hon. Friend did not take the “let rip” position, but some have done so. The majority of those who have spoken this evening have absolutely supported the fact that we need to have restrictions in place, which is good to hear.
Helen Whately
May I just finish responding to my the point made by my hon. Friend the Member for Wycombe (Mr Baker)? He says that for the vast majority this is a mild illness and that the deaths have particularly been among those with underlying health conditions. It is true to say that the majority of those who have died were older and with underlying health conditions, but, sadly, some have died who did not have known underlying health conditions and were younger. I well remember reading about a nurse not far from my constituency, in Kent, who had three young children and was only slightly younger than me but who died early in the pandemic. So it is not true to say that this affects only older and unwell people, although we should also mourn the older people whose lives have been taken before their time, many of whom were in receipt of care.
The other point is that among those who have had mild illness we are seeing increasing evidence of the condition known as “long covid”, where, sadly, there are long-term health consequences of covid. We are learning about those all the time; they are making it materially difficult for people to lead their lives some weeks and even months after they had the illness, even if they had it mildly in the first place.
Several hon. Members rose—
Helen Whately
I will make progress, as colleagues made a large number of points during their speeches that I am keen to respond to. I will take further interventions if there is time.
Mr Harper
I just wanted to challenge the Minister on this let it rip point, as the Secretary of State has done that as well. I ask the Minister to take it from me that we all want the Government to be successful, but if every time somebody asks a question or posits a different strategy, we are accused of wanting to “let it rip” and kill tens of thousands of people, this debate will not remain good tempered. Please accept that we are all trying to get this right. We are all willing to be generous, because, as the hon. Member for Westmorland and Lonsdale (Tim Farron) said, this is difficult, but I ask the Minister please not to say that Members of this House who suggest a different strategy in order to be successful want to let the disease rip and kills tens of thousands of people. We do not, and we will not be pleased if that is what we are accused of doing.
Helen Whately
I absolutely hear my right hon. Friend’s point. I reiterate the response that I just gave, which is that I very much appreciate the support of colleagues in general for taking action to suppress the virus, and I think it is extremely valuable for us to be debating some of the measures, as we are this evening.
Helen Whately
If my hon. Friend would allow me, I would like to make a little bit of progress, otherwise I will have remarkably little time left.
We have a clear strategy, which is to control and suppress the virus while doing all we can to protect the economy, people’s work, schools and the NHS, so that it, in turn, can care for us.
Let me turn to some of the points made by hon. Members. Various reasons have been suggested for the rapid introduction of the regulations. In fact, the shadow Minister made some suggestions. The Government have had to act fast. When we see the rates of increase—particularly when we take away the average across the country, and look at specific areas and parts of the population where the doubling rate can be going up really quickly—it is clear that we need to act fast. The alternative is to act slowly—and if we did that for several days, it would be inaction. That just means that the virus would be left to spread further and faster.
Colleagues have asked for further information about the impact and effectiveness of measures. I get the sense that some Members would like to hear, “If you do x, you get y,” in a very mathematical way. We are dealing with a new disease that simply is not known to the level of “A leads to B exactly.” We look at a huge amount of evidence, including at what is happening overseas, the difference made by local lockdowns and evidence from the test and trace system. All that evidence informs the decisions that are made. We know that social contact is a particular cause of the spread, so we must reduce social contact.
Helen Whately
I am really sorry, but I have so little time.
We have seen reduced levels of socialising since introducing the rule of six, but that is against a backdrop of rates rising in particular parts of the country, which are now under further restrictions. We will continue to look at the evidence and ensure that we are putting in place effective interventions.
The measures that we are debating today are clearly coupled with the vital rules such as hands, face and space. We all have our part to play. We will continue to assess the effectiveness of the measures, but we need restrictions in place until covid rates come down.
Helen Whately
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.
Question put.
Adult Social Care Winter Plan
Helen Whately Excerpts(4 years, 3 months ago)
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The Minister for Care (Helen Whately)
I would like to update the House on the Government comprehensive adult social care covid-19 strategy and its publication of the “Adult Social Care Winter Plan”. A copy of the plan will be deposited in the Libraries of both Houses. The coronavirus pandemic has created unprecedented challenges in the United Kingdom and around the world.
This has resulted in an equally unprecedented, but not unexpected, response from the social care sector and its dedicated workforce of 1.5 million people, who alongside the 5.4 million plus women, men and young people who provide unpaid care, have made an invaluable contribution to the national effort and our gratitude to them all is immense.
Together, they have been working tirelessly to support people who need care, especially those who are older or already living with underlying health conditions making them more vulnerable to infection.
Alongside extensive efforts at local level, national Government have provided enhanced support to the sector, working with and through local leaders. This support was set out in the “Adult Social Care Action Plan” and “Care Home Support Plan”. It included £3.7 billion of emergency grant funding to local authorities to address the pressures on local services caused by the pandemic and a £600 million infection control fund to support providers to reduce the rate of transmission of covid-19.
Meanwhile, the adult social care covid-19 support taskforce, set up and chaired by David Pearson—social care covid-19 lead for the NHS and past president of the Association of Directors of Adult Social Services—formed part of the Government overall commitment to the sector.
It would be wise to assume that coronavirus, in addition to anticipated service demand, will place unique pressures on the health and care system this winter. Covid-19 will be co-circulating with seasonal flu and other viruses, and transmission may well increase over the winter period.
It is therefore essential that we—national Government and local partners—work closely together to make sure we are prepared for these additional pressures, particularly a resurgence of covid-19 cases. We must have robust plans in place to respond to challenging events and protect people who need care and the workforce supporting them.
The adult social care covid-19 support taskforce concluded at the end of August, and its recommendations have shaped our approach to tackling covid-19 in the adult social care sector and, in particular, the plans we have put in place for winter.
As we approach these colder months, the Government will play a key role in driving and supporting improved performance of the system, working with local authorities and the CQC to strengthen their monitoring and regulation role to ensure infection prevention and control procedures are taking place. The key elements of our plan for social care this winter are:
Providing an additional £546 million infection control fund to support infection control measures.
Continuing to engage with local authorities, care providers, people with care and support needs, and their families and carers to understand their needs and provide support.
Leading and co-ordinating the national response to covid-19 and providing support to local areas as set out in the contain framework.
Continuing to develop and publish guidance which is relevant and accessible, and update policies and guidance in line with the latest evidence. We will work to proactively communicate vital updates to our winter plan and other guidance.
Working relentlessly to ensure sufficient testing capacity and continuing to deliver and review the social care testing strategy in line with the latest evidence and scientific advice. We will also improve the flow of testing data to everyone who needs it.
Providing free PPE for covid-19 needs in line with current guidance to care home and domiciliary care providers via the PPE portal until March 2021.
Providing free PPE—for covid-19 needs—in line with current guidance to local resilience forums (LRFs) who wish to continue PPE distribution, and to local authorities in other areas, to distribute to social care providers ineligible for supply via the PPE portal until March 2021.
Making the flu vaccine available for free to all health and care staff, personal assistants, and unpaid carers.
Introducing tightened measures around visiting. We recognise that visits are important for the wellbeing of residents and loved ones, but with higher rates of covid-19 in the community, extra precautions will be needed. We have set these out in revised guidance. Infection control is paramount and in designated “areas of intervention” visiting will be stopped except in exceptional circumstances, such as end-of-life.
Stopping all but essential movement of staff between care settings to stop the virus spreading. We know that the majority of care homes have already done this—now we are taking this restriction further and will enforce this through regulation.
Working with the CQC to ensure that all places that receive people discharged from hospital are safe and have the highest levels of infection control measures in place.
Supporting providers to ensure that staff who are isolating in line with Government guidance receive their normal wages while doing do.
Publishing the new “Adult Social Care Dashboard”, bringing together data from the capacity tracker and other sources, meaning that critical data can be viewed in real time at national, regional and local level by national and local government.
Publishing information about effective local and regional protocols and operational procedures based on what we have learnt from so far, to support local outbreaks in the event of increased community transmission.
This does not diminish the need for a long-term plan for social care. Putting social care on a sustainable footing, where everyone is treated with dignity and respect, is one of the biggest challenges our society faces.
There are complex questions to address, to which we want to give our full consideration in light of current circumstances.
Successive Governments have failed to “fix” social care, but this Government have been clear that this must change. Right now, the Government No. 1 focus for adult social care is for everyone to receive the care they need throughout this pandemic.
This crisis, awful though it has been and continues to be, for so many people, may yet be the catalyst for a new kind of social care; services that reflect, adapt and future proof the health and wellbeing of all of us—now and for many generations to come.
[HCWS458]
Axial Spondyloarthritis
Helen Whately Excerpts(4 years, 3 months ago)
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The Minister for Care (Helen Whately)
I congratulate my hon. Friend the Member for Gedling (Tom Randall) on securing this debate and on bringing the House’s attention to the need for earlier diagnosis of axial spondyloarthritis. May I say how important it is that he has brought his personal experience to the debate? The House should appreciate the courage he has shown to speak up about his own condition—something that cannot be easy, but that is an example. I feel strongly that all of us bring our own experiences to our work. That is one of the reasons it is important to have a diverse House of Commons. He has brought his own extremely painful experience to bear. I am confident that simply by doing so, he will make a difference for many others who suffer from this painful condition or who may do so in the future.
My hon. Friend rightly highlighted how critical it is for those with axial spondyloarthritis to get the right diagnosis and get it quickly, and to have their symptoms taken seriously by all healthcare professionals. It is clearly incredibly important to ensure that people can access the right sort of care at the right time, as it can prevent the potentially devastating impact of the condition on quality of life. I very much appreciate from his account and from others I have read how the condition affects people and their loved ones. We must do all we can to reduce the impact on people’s physical and mental health, and I want to do so.
As my hon. Friend said, axial spondyloarthritis, which may also be referred to as axial SpA or AS, is a form of inflammatory arthritis that most commonly affects the spine. It is a painful long-term condition that currently has no cure. As well as affecting the joints in the spine, it can affect the chest, the pelvis and other joints, ligaments and tendons. Unfortunately, AS is often misdiagnosed as mechanical lower back pain or diagnosed late, leading to delays in access to effective treatments. It is estimated that approximately 220,000 people, or one in 200 of the adult population in the UK, have the condition.
As my hon. Friend said, the average age of onset is relatively young at 24, with patients having to wait on average eight and a half years before diagnosis at an average age of 32. That is clearly far too long to be waiting for a diagnosis, because left untreated the condition can lead to irreversible spinal fusion, causing severe disability. That makes a rapid referral to specialist care for those with any signs or symptoms crucial to treatment and to preventing those kinds of outcomes.
I recognise that AS can have a devastating effect on the quality of life of people who sadly go undiagnosed or misdiagnosed for far too long. This must get better. It is clear to me that early diagnosis and treatment are the key to preventing the development of other serious conditions further down the line and to improving the quality of life of those who suffer from this condition.
We recognise that one major reason for the delays in diagnosing axial SpA is a lack of awareness of the condition among healthcare professionals and the general public. That can take many forms: a lack of awareness of different types of arthritis; a lack of knowledge about the differences between inflammatory and mechanical back pain; or misunderstanding that AS affects similar numbers of men and women. Educational interventions to improve the level of awareness should lead to improvements in earlier diagnosis, and a range of materials are being produced to this effect. For example, an online training module on AS for GPs has been produced by the Royal College of General Practitioners.
In June this year, the National Institute for Health and Clinical Excellence published its managing spondyloarthritis in adults pathway, which has been well received by patient groups and charities. This set out recommendations for healthcare professionals in diagnosing and managing axial SpA in adults. It describes how to improve the quality of care being provided or commissioned in this area, both through guidance and via an associated quality standard. I completely agree that we would expect providers and commissioners to be following the guidance and recommendations in this area so that we can improve the overall rate of earlier diagnosis. It is not only important that we have this guidance but that it will be within the pathway that the APPG and my hon. Friend have argued should be put into place in practice.
Munira Wilson
While I welcome the guidance and the pathway, what does the Minister suggest can be done to tackle the clinical conservatism that we quite often find among specialists even once the diagnosis is made? In my husband’s case, the rheumatologists said to him, “You are far too young for us to move you on to the more advanced treatments”, so he was living with huge amounts of pain on just very mild painkillers and steroids. It was only because we happen to live in London that we got him re-referred to a world-leading specialist in the field who then put him on anti-TNFs. He is now able to be the primary carer of our two very young, active children, which he could not do otherwise. Not everybody has that luxury, especially if they live in a rural area.
Helen Whately
The hon. Member makes a really important point, again drawing from her own personal and family experience, about the importance of awareness of what is the best treatment for this condition. If she would like me to do so, I am happy to take away her specific point and look into how we can address the need for improvement in the treatment, as well as her general point about needing a better pathway. I am also happy to meet my hon. Friend the Member for Gedling, as he requested, to talk further about how we can make more progress on the right treatment for this condition, and awareness of it.
Coming back to the overall points about what we can do to improve the treatment, the NHS long-term plan set out our plans to improve healthcare for people with long-term conditions, including axial SpA. That includes making sure that everybody should have direct access to a musculoskeletal first-contact practitioner, expanding the number of physiotherapists working in primary care networks, and improving diagnosis by enabling people to access these services without first needing a GP referral—in fact, going directly to speak to somebody with particular expertise in the area of musculoskeletal conditions. The hon. Member for York Central (Rachael Maskell) intervened to make a point about the demands on physiotherapists. I have asked to be kept updated on progress on delivering the expansion of the number of physiotherapists in primary care networks and, more broadly, on the implementation of the NHS long-term plan. We do indeed need to make sure that we have sufficient physiotherapists to be able to deliver on that. I anticipate that that should have a positive impact on the problem of delayed diagnosis for a range of conditions, and particularly for this specific condition.
While better education and awareness of AS should improve the situation, there is clearly more that we can and must do to understand the condition. The National Institute for Health Research is funding a wide range of studies on musculoskeletal conditions, including AS specifically. That research covers both earlier diagnosis and treatment options for the condition, so that we continue to build our understanding of good practice and improve both the treatment and the outcomes for those who have the condition.
In conclusion, I want to pick up on my hon. Friend’s point about the importance of awareness and the call for an awareness campaign by the APPG, and I should of course commend the National Axial Spondyloarthritis Society for its work in this area. My hon. Friend mentioned that there is clearly a huge amount of public health messaging going out at the moment, but I hope the time will come when we can gain more airtime for this particular condition. However, the fact that we are having this conversation in the Chamber is in itself a step towards raising awareness of the condition, and so, too, is all the work that is going on; that is important as well, because along with having the policy and the pathway, we must make sure it is put into practice.
I congratulate my hon. Friend again on bringing this subject to the attention of the House and on the work he is doing and the effect that this will have. I truly want to support him and to do our best for all who suffer from this condition and may suffer from it in future, to ensure that we achieve much earlier diagnosis and treatment and better outcomes for those with the condition.
Madam Deputy Speaker (Dame Eleanor Laing)
I commend the hon. Member for Gedling (Tom Randall) on his courage in bringing such a personal and difficult matter before the House. Many people will not appreciate that that is a difficult thing to do, and I am sure that he will have made a difference to many by what he has done today. [Hon. Members: “Hear, hear.”] I am pleased that those in the Chamber are in agreement.
Question put and agreed to.
HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NO. 2) (ENGLAND) (AMENDMENT) (NO. 2) REGULATIONS 2020
Helen Whately Excerpts(4 years, 3 months ago)
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The Minister for Care (Helen Whately)
I beg to move,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No.788).
It is a pleasure to serve under your chairmanship, Ms Fovargue. I will start by summarising the changes to the regulations. The Health Protection (Coronavirus, Restrictions) (No.2) (England) Regulations 2020, which I will refer to as the national regulations, came into force on 4 July. There have been five changes to the national regulations, the first of which was debated in and approved by both Houses before recess. The focus of this debate is the second amendment to the regulations.
These amendments permitted from 25 July the reopening of the following businesses and venues: indoor swimming pools, including water parks; indoor fitness and dance studios; and indoor gyms, sports courts and facilities. Alongside those changes, the Government produced supporting guidance advising that the most high-risk activities within those businesses and venues, such as saunas and steam rooms, should not reopen. Those easings did not apply to the city of Leicester boundaries and the borough of Oadby and Wigston.
We have needed to use the emergency power to amend these regulations so that we can respond quickly to the serious and imminent threat to public health posed by coronavirus. I know that these national regulations have caused real disruption to people’s lives. They have placed restrictions on who people can see, what they can do and where they can work. Just as the Secretary of State has the legal obligation to protect public health, he is also obligated to ease restrictions as soon as it is safe to do so.
The first three changes to the regulations opened businesses and venues that had been required to close, and covid-secure guidance was developed with industry and medical advice to ensure that they opened safely. That means that now only nightclubs, dancehalls, discotheques, sexual entertainment venues and hostess bars are required to remain closed, as they are considered to pose a high risk of transmission because of the close proximity of members of staff and customers. That shows the Government’s commitment to ensuring that restrictions are in place only as long as necessary, and an evolution in our understanding and approach to tackling the virus.
Over the summer recess, we have combined the tightening of restrictions in areas where there are outbreaks with the easing of business restrictions nationally. We have given local authorities powers to act quickly in response to local outbreaks by closing specific premises, shutting public outdoor spaces and cancelling events. We asked all councils to develop dedicated local outbreak plans, and we gave them £300 million of new funding to support that. We published the contain framework, providing further guidance on managing local outbreaks.
Where regulations have been required, the Government have worked with local partners to develop tailored and proportionate restrictions based on the best scientific evidence available, in areas varying from a single factory to an entire region, such as the north of England. These interventions have been underpinned by scientific advice and local data provided by a combination of Public Heath England, the Joint Biosecurity Centre and NHS Test and Trace.
Colleagues will have seen that today the rule of six comes into effect. This change brought the gathering policy from guidance into regulation, mandating that people can only gather in groups of six, and it applies both indoors and outdoors. Single households or support bubbles of more than six are still able to gather together, and there are a small number of exemptions, such as for work, schools, weddings and organised sports activities. People should continue to follow social distancing rules with those outside their household or support bubble. As the Prime Minister announced last week, these measures are not a second national lockdown but are aimed at preventing the need for one.
It is thanks to the public and their continued effort that we have been able to slow the spread of the virus and have started cautiously to return to life as normal. Now, with winter approaching and covid rates rising again, we must keep doing whatever it takes to keep it under control, guided by our ever-increasing knowledge of how covid is spreading and what interventions are effective.
I am grateful to colleagues from across the House for their valuable contributions to these debates and for continuing to challenge us to do better in this vital area of public policy. I believe that we have met the bar set for us. These regulations are a proportionate and necessary use of the powers that Parliament has asked us to use, and I commend them to the Committee.
Helen Whately
I thank the hon. Member for Ellesmere Port and Neston for his response, some of which, as he mentioned, he has said before. I will address his comments head-on.
The hon. Gentleman said that he would like us to have debated these regulations sooner, and we absolutely recognise that timely scrutiny is important. There is substantial scrutiny of the Government’s decisions. For instance, there have been multiple oral statements, and numerous urgent questions have been responded to by Government Ministers. There is a great deal of challenge to decisions that are made.
However, throughout the pandemic and up to the present, we continue to need to act rapidly. We need to take rapid decisions to make restrictions to people’s normal way of living, unfortunately, when we see growing risks of the spread of the disease. We also want to be able to take rapid decisions to reduce those restrictions, recognising the difficulties that they cause for people going about their lives, whether in their family relationships, social relationships or livelihoods.
The hon. Gentleman has said that we are now at a different time, and things are different now. Yes, we have done a huge amount to bring the virus under control since the peak in the spring, and we now have a vast quantity of testing relative to the amount we had earlier on, although I fully recognise that its capacity is challenged at the moment because of the great deal of demand for it. However, we are continuing to learn all the time from the greater data we now have about how people are catching the virus—how it is spreading, but also how it is not spreading—so it is still the case that we need to be able to move quickly.
The hon. Gentleman asked about the scientific context for this, and whether because time has moved on, these easements are still the right thing to do. The restrictions are continuously reviewed, looking at what new restrictions may be appropriate and what easements might need to be introduced. As he has acknowledged, in some areas where there have been local outbreaks, restrictions have either not been lifted or have been reintroduced. We are able to do that because, thanks to the operation of Test and Trace and the Joint Biosecurity Centre, we have much more data about how the virus is spreading. For instance, we know that the virus is largely spreading through people’s social interactions. For the most part, it is not spreading in workplaces, and the risk for children in schools is very low, but we have a particular challenge with social contact. Therefore, we are, in general, able to maintain the easements that have been brought in, but are introducing the rule of six today to limit the social contact through which covid is spreading.
In some areas of the country where there are greater rates of covid, there are greater restrictions on household gatherings and even on the rule of six, because we have evidence that in some places, it is particularly spreading through households mingling in a home setting. The whole point is that having greater data and scientific insight, and following scientific advice, means that the restrictions we now have in place can be more tightly targeted, and can avoid restricting people’s lives in ways that are not essential while targeting the ways in which we know the virus is being spread. I assure the hon. Gentleman that we will continue to review the situation, including whether we need to impose further restrictions. Clearly, that would be done with great reluctance, but we cannot get to a situation that is the same as the one we were in earlier in the year. We must continue to be vigilant.
Justin Madders
I am grateful to the Minister for explaining in a little more detail some of the work that is taking place to understand how the virus is spreading. Is it the case that the relaxations we have talked about today are not contributing to an increase in transmission?
Helen Whately
As I said, the work that is carried out by the Joint Biosecurity Centre, drawing on the information from NHS Test and Trace and other sources of data, looks at the main sources of spread. We know that the main source of spread is through social contact, rather than in more controlled settings. In business settings, we are seeing, for the most part, businesses taking great care to ensure their setting is covid secure, for which they should be commended.
I feel that this is the moment to bring the debate to a conclusion, and I commend the regulations to the Committee.
Question put and agreed to.
Oral Answers to Questions
Helen Whately Excerpts(4 years, 3 months ago)
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Patrick Grady (Glasgow North) (SNP)
The Minister for Care (Helen Whately)
We recognise that there will be increased pressures on the NHS and social care during winter, and substantial preparations have been and are being made. The NHS has already published its winter plan, and we will shortly publish the winter plan for social care.
Patrick Grady
That is exactly why there is a need for significant additional funding to prepare for a surge this winter, and that has to include a fully funded pay rise for health and care staff. At the height of the crisis, the Secretary of State was saying, “Now is not the time to consider a pay rise.” When will the time be? Is it now or some time in the future?
Helen Whately
As I expect the hon. Gentleman knows, we have announced £3 billion of additional NHS funding for the winter and are continually looking at additional funding needs for social care.
Dr Rosena Allin-Khan (Tooting) (Lab)
There is a looming mental health crisis this winter, and as such it is vital to meet with experts. I know the Secretary of State believes that that is important, so I asked him several parliamentary questions wanting to know how many mental health trusts and organisations he had met during the first three months of lockdown. I was told that he “holds these meetings regularly”, but a freedom of information request revealed that he and the Mental Health Minister organised only two meetings with mental health trusts and organisations during that entire period. Can the Secretary of State confirm that he did not attend either of those two meetings? Does he think that is an acceptable track record?
Helen Whately
The Secretary of State has regular meetings with stakeholders about the future of mental health.
Sir David Amess (Southend West) (Con)
The Minister for Care (Helen Whately)
We know that those who receive social care are among the most vulnerable in our society. The Department of Health and Social Care has strived to support the sector throughout this pandemic, providing it with a sense of guidance, extra funding, and emergency supplies of personal protective equipment, and prioritising access to testing.
Mark Menzies
May I express my very sincere thanks for all the help that social care services have provided throughout this ongoing crisis, but can the Minister assure me that we have learned all the lessons from the shielding programme and that the social care sector is adequately prepared for the coming winter months?
Helen Whately
I join my hon. Friend in thanking all those who work in social care for their commitment and compassion since the start of the pandemic. We have indeed carried out work to understand the impact of shielding on people’s health and we will shortly be publishing our winter plan for adult social care, setting out our preparations for the winter and in the event of a second wave.
John Howell
Can my hon. Friend confirm that every care home in England has either received a coronavirus test or is about to receive one?
Helen Whately
Yes, I can confirm that. Every Care Quality Commission-registered care home in England has been offered testing. Care homes for those who are over 65 and with dementia have been offered repeat testing. We have now opened up repeat testing to care homes for working age adults.
Liz Kendall (Leicester West) (Lab)
Following on from that question, Ministers initially promised weekly testing for care home staff by 6 July. They then abandoned that pledge and said that routine tests would not happen until 7 September. With more than 15,000 deaths from covid-19 in care homes so far and with winter and the flu season fast approaching, regular weekly testing of care home staff is critical. Will the Minister now guarantee that every care home will have weekly testing for their staff by Monday to help all of our loved ones in residential care keep safe?
Helen Whately
We are indeed determined to support social care, and particularly the care homes, with repeat, regular testing. As the hon. Member knows, because we have spoken about it, there has been a delay with our repeat testing of care homes because of a particular issue with some of the test kits. That was communicated to her and to the sector. As I said in my previous answer, we have now been able to offer repeat testing to all care homes for older people, to open up the portal to those care homes with working age adults as residents, and to initiate our second round of repeat testing for the older sector.
Martin Vickers (Cleethorpes) (Con)
Angela Richardson (Guildford) (Con)
The Minister for Care (Helen Whately)
We will deliver 50,000 more nurses for our NHS. We are increasing the number of student nursing places on degree courses and improving the experience of working in the NHS so fewer nurses leave, and we will also add to our home-grown nurses through international recruitment. I am happy to report that we now have 13,840 more nurses in the NHS than a year ago.
Mrs Wheeler
I thank my hon. Friend for her answer. Does she agree that the changes made by Project 2000 in 1986 led to a large group of caring people being excluded from training to be nurses? If we are to recruit many more nurses, this approach should be rethought, with recruits once again being able to learn on the job, as they did prior to 1986. This would bring nurses’ education much more in line with the Government’s recognition that university is not for all children and fulfil our objective to have apprenticeships in all walks of life.
Helen Whately
My hon. Friend makes an extremely good point. We want all those with the capability and aspiration to become nurses to be able to do so. That is why we are supporting multiple routes to becoming a nurse. While the majority of new nurses take the university route, another option is the degree apprenticeship, which enables students to earn while they learn. Last month, we announced a £172 million funding package to double the number of nursing apprenticeships.
Angela Richardson
I am delighted to hear that we are successfully recruiting into the nursing profession. Does my hon. Friend agree that it is not just school leavers, but dedicated and caring people of all ages and diverse working backgrounds who have the transferable skills needed to start nursing qualifications? Will she outline what steps her Department is taking to engage with these individuals and encourage them to consider nursing as a vocation?
Helen Whately
I completely agree that nursing should be open to all men and women from diverse backgrounds. Our £5,000 grant to all nursing degree students, starting this autumn, will help students with the cost of that degree course. In addition to the apprenticeships route that I just mentioned, in January we are launching an online blended nursing degree to give another route into nursing.
Jim Shannon (Strangford) (DUP)
NHS Pay Review Body: Government Response
Helen Whately Excerpts(4 years, 5 months ago)
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The Minister for Care (Helen Whately)
I am responding on behalf of my right hon. Friend the Prime Minister to the 33rd report of the NHS Pay Review Body (NHSPRB). The report has been laid before Parliament today (Cm260). Copies of the report are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
As this is the third and final year of the three-year Agenda for Change pay and contract reform deal (2018-19 to 2020-21), the NHSPRB did not make any pay recommendations for 2020-21.
This multi-year deal has delivered year-on-year pay increases for our much valued NHS staff, and as part of this we have increased the starting salary for a newly qualified nurse by over 12% and increased the lowest starting salary within the NHS by over 16%.
The Government welcome the 33rd report of the NHSPRB and are grateful to the chair and members for all their work and helpful observations at what is a challenging time for our NHS. The report rightly recognises the hard work and dedication of our NHS staff in responding to the covid-19 pandemic, and makes helpful observations on effective workforce planning and how best to support the development of the NHS workforce.
The upcoming People Plan will seek to address many of the observations made by the NHSPRB, and the Government remain committed to delivering on their manifesto commitment to deliver 50,000 more nurses in the NHS by 2025.
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Doctors and Dentists Remuneration Body: Government Response
Helen Whately Excerpts(4 years, 5 months ago)
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The Minister for Care (Helen Whately)
I am responding on behalf of my right hon. Friend the Prime Minister to the 48th report of the Review Body on Doctors’ and Dentists’ Renumeration (DDRB). The report has been laid before Parliament today (Cm259). I am grateful to the chair and members of the DDRB for their report.
This report has been produced during what is an incredibly challenging time for our NHS and the DDRB report rightly recognises the tremendous effort of all of our clinical staff on the frontline of the covid-19 response. They have shown true resolve, professionalism and dedication throughout this challenging time for our NHS.
Thanks to the Government’s investment in the NHS and the certainty provided in the long-term funding settlement, the Government are pleased to accept the DDRB’s recommendations in full, providing a much deserved pay rise for our doctors and dentists working across the NHS.
The Government greatly value and appreciate the role public sector workers have in delivering essential public services, and we are delivering a real-terms pay increase to show that we mean it. The hard work and dedication of our public servants are something we do not take for granted.
We are conscious that public sector pay awards must deliver value for money for the taxpayer. Covid-19 is having a very significant impact on the economy and the fiscal position, and the Government will need to continue to take this into account in agreeing public sector pay awards. It is important that public sector pay is fair to both public sector workers and the taxpayer. Around a quarter of all public spending is spent on pay and we need to ensure that our public services remain affordable for the future.
Today’s pay award is worth on basic pay:
Between £2,200 and £3,000 for consultants
Between £1,100 and £2,100 for specialty doctors
Between £1,500 and £2,600 for associate specialists
This Government have invested heavily in our NHS and its workforce. We have backed the NHS by passing the NHS Funding Act which enshrines in law the largest cash settlement in NHS history as well as clearing billions of pounds worth of debt for NHS trusts. We also pledged that all public services would get whatever financial support they needed to deal with the covid-19 pandemic and we are working at pace to ensure the supply of vital funding and resources continues. We have also delivered on a manifesto commitment to address the tax issue in doctors’ pensions by listening closely to the concerns of senior clinicians. The Chancellor confirmed at Budget that both annual allowance taper thresholds will be increased by £90,000 from 6 April 2020, removing anyone with income below £200,000 from the scope of the tapered annual allowance. The incentive to take on extra NHS work is now restored, and clinicians can earn an additional £90,000 before reaching the new taper threshold. These measures will take up to 96% of GPs and 98% of NHS consultants outside the scope of the taper based on their NHS income.
The DDRB was asked not to make a pay recommendation for contractor general medical practitioners (GMPs) or doctors and dentists in training as both groups are moving into the second year of their respective multi-year deals. The significant investment in GMP core practice funding, as part of the five-year contract, provided greater certainty for GMPs to forward plan. The contract as agreed in 2019, and via further amendments in 2020, has also set out significant additional investment in a new state-backed indemnity scheme, the introduction of primary care networks and reimbursement for additional staff. For doctors and dentists in training the multi-year deal will mean all junior doctor pay scales will have increased by 8.2% by the end of the deal, and in addition circa £90 million is being invested to reform the contract, including to create a new, higher pay point to recognise the most experienced doctors in training.
Affordability has to be a consideration of Government when responding to the DDRB. Accepting the DDRB’s recommendations will require difficult trade-offs and reprioritisation of spending within the wider context of the original financial plan set out in the NHS long-term plan. However, the Government deem accepting the DDRB’s recommendations as important to reward and retain valued NHS staff.
In addition to retaining existing staff, the Government are committed to increasing workforce supply. That is why by September this year we will have opened five new medical schools in England so that we can continue to grow our domestic medical workforce. The new schools will help to deliver a 25% increase in the number of available places and by September we expect there will be an extra 1,500 medical students entering training each year, compared to 2017.
The Government’s response to the recommendations is as follows:
Accept the recommendation for a uniform 2.8% uplift in pay across the whole of the DDRB’s remit group with the exception of those already in multi-year deals. This includes uplifting the value of the GMP trainers grant, the GMP appraisers’ grant and the minimum and maximum of the pay range for salaried GMPs.
To accept the recommendation to freeze the value of national and local clinical excellence awards (CEAs), commitment awards, distinction awards and discretionary points.
Salaried GMPs
For salaried GMPs the minimum and maximum pay range will be uplifted. As self-employed contractors, it is largely up to GP practices how they distribute pay to their employees. Employers have the flexibility to offer enhanced terms and conditions—for example, to aid recruitment and retention.
Specialty doctors (new grade 2008) and associate specialists (closed grade)
For specialty doctors and associate specialists (SAS doctors) the Government take note of the DDRB’s comments on the need for improved recognition and career development. Negotiations on a multi-year pay agreement, incorporating contract reform, for this group of doctors are progressing and we hope to reach agreement in time for the next pay year.
Clinical excellence awards
The Government also acknowledge the DDRB’s comments on clinical excellence awards and its reasons for not recommending an increase in their value. With this in mind, we will progress our plans to reform these awards with a view to introducing new arrangements from 2022.
General dental practitioners
A 2.8% general uplift in the pay element of their contract backdated to April 2020.
The Government have also fully acknowledged the DDRB’s comments on the lack of progress on the dental contract reform and we appreciate the frustration with the pace of reform. NHS England and the Department of Health and Social Care need to be confident that the prototype contract, which has been tested, has proven that it has the ability to maintain or increase access, improve oral health, and is affordable for the NHS while also being sustainable for dental practices, before taking decisions on wider national implementation.
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