Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020

Justin Madders Excerpts

Monday 25th January 2021 General Committees

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

It is a pleasure to serve under your chairmanship, Mr Pritchard —for, I think, the first time, as the Minister said. I declare an interest, in that my wife is a member of Cheshire West and Chester Council, one of the local authorities mentioned in the regulations; I do not think that requires any further expansion, but it needs to be stated for the record.

I thank the Minister for his introduction, and his acknowledgment of the issue to do with the timing of these regulations—a matter that we have debated on many occasions over the past 12 months. I echo his tribute to NHS and social care staff, and indeed all key workers, who continue to do this country proud and see us through this incredibly difficult time.

As we debate these regulations, we must recognise the scale of the challenge we still face. The situation is as serious as it has ever been. We have lost 98,000 people so far to the virus; as we know, the Office for National Statistics shows more than 110,000 excess deaths; and as of yesterday, there were 38,000 people in hospital, some 4,000 of them on ventilation. Those figures are significantly higher than those in the height of the first wave of the pandemic. The climbing, record death rate is a tragic reminder of how devastating the virus is, and behind every statistic is a grieving family. We must therefore leave no stone unturned in our efforts to prevent further loss.

We have come together to discuss these regulations, following their introduction on 30 December, even though, as the Minister says, they have largely been superseded by the national lockdown. As I have said many times, retrospectively approving legislation—in particular, regulations that have a dramatic impact on individual liberty, as well as an economic impact, which we have discussed many times—is no way to go about things.

I will not labour the point, because it has been made many times, but it is worth noting that on the day these regulations were introduced, the House was already debating a number of previous instruments, most of which were also significantly out of date. I know this is a rapidly changing situation, and in December things perhaps changed more quickly than at most other times, but is there any particular reason why these regulations could not have been dealt with at the same time as those others debated on 30 December?

As we heard, today’s instrument amends the “All Tiers” regulations for the fourth time—quite a record, given the latest tier system was in place for one month. Even though we are again in lockdown, as the Minister has said, we will be moving back to a tiered system as restrictions are eased, so it is important that we review the effectiveness of the tiered system when looking at this instrument. Given that the past two attempts at a tiered system ended in lockdowns within a matter of weeks, we need to be confident, and to hear from the Minister about his confidence, that the situation will not repeat itself.

Although whether the tiers proved effective is of fundamental concern, there is little evidence to date to suggest that, on the whole, most of them were working. Another problem with the regulations, and all the regulations that we have dealt with on this matter, is that we are presented with a list of places, which tells us who can do what and where they can do it, but does not tell us why. Of course, at a macro level, we know why, but what we are missing is why one area is in one tier and another area is in another.

We know what the Secretary of State told us about the criteria, which the Minister repeated today, and they are set out in the explanatory memorandum, but they have never been explicitly spelled out in the regulations. Nor, crucially, is there any detail on the point at which those criteria take us from one tier to another. No doubt the Minister will say that it is not as black and white as that, and I am sure that there is some merit in that answer, but there has to be some yardstick and some analysis of the data that matters; otherwise, the process would be entirely random, which it clearly is not.

Although most of that information is publicly available, it is disparate and often not released at the same time. What would make debates such as today’s rather more meaningful is if there were full disclosure of all the information at the time the decisions were made, and the debates took place at the time of those decisions, so that Members on both sides of the room could say to their constituents that there was clarity, and could say that the reason why one area was in one tier and another was in another was debated when the regulations were introduced.

That is particularly relevant to today’s regulations, as it seems that the primary reason for areas moving up tiers this time probably relates to only one of the criteria: NHS occupancy and projected occupancy. That is apparent to us all now, given the figures that we have alluded to, but it probably was not as clear to everyone at the time the regulations were introduced. Moving forward, I ask the Government to, as far as possible, set out in the regulations the data applicable to each area, so that we can objectively judge, when the regulations are introduced and debated, whether the Government have got it right. I think that is what all Members want.

I understand that the measures are presented on a “take it or leave it” basis, and that sometimes events mean that scrutiny lags behind the original decisions, but that should be a reason for more transparency and more debate—not for simply providing us with a list of councils that are moving tiers. The regulations are all concerned with moving areas up to higher tiers, rather than down, albeit for a matter of days before the next lockdown came in. We therefore need to ask, irrespective of whether there is a new variant, whether the tiers have ever been, or will be, effective.

We have asked time and again for the Government to provide us with evidence of what measures work. Some areas have been in a form of lockdown since last summer, as the Minister is well aware from his constituency. There has been plenty of time to gather data on the subject, even if it is to conclude that local restrictions are insufficient. As the Minister will know, last year the Secondary Legislation Scrutiny Committee also highlighted a need for that information to be public, reminding the Government that it is customary, when a scheme is changed after it has been operating for a while, to explain what has worked well and what has been amended because the performance has not always achieved the desired effect.

The Liverpool city region is often cited as an example of an area in the then highest tier—tier 3—where there was a successful attempt to reduce transmission. That was largely attributed to the mass testing regime undertaken there, but infection levels were dropping before that scheme was introduced, and it relied on significant input from the Army that I do not think it would be physically possible to replicate elsewhere. Is that the plan, moving forward, for the highest tiers? We need realistic and resourced plans for such areas because, the tier system having effectively collapsed over Christmas and the new year, people need confidence that any new tier system will work, and that infection rates will not spiral out of control again.

I am sure that the Minister agrees that this lockdown needs to be the last. The Government need to demonstrate that they finally have a grip on localised restrictions that not only enables areas to reduce transmission, but gives areas with low transmission rates the tools to keep them low. To date, that has palpably not been the case. We will not oppose today’s regulations, but we need assurances that when we return to another system of tiers once we exit the national lockdown, they will finally work. We must see, in real time and in full, the advice that the Secretary of State and the Government receive from the Scientific Advisory Group for Emergencies on the restrictions needed before we are asked to make judgments on those decisions.

Thus far, we have seen a tragic failure by the Government to learn from mistakes. That must now change. We must not repeat that with the roll-out of the vaccine. It is widely acknowledged that that is our only way out of this situation. The task is clear. The Government must deliver the vaccine quickly and as safely as possible. We want to see round-the-clock vaccine programmes, 24 hours a day, seven days a week, in every village, town, high street, GP surgery and pharmacy—everywhere possible that we can use to roll out the vaccine.

That goes hand in hand with measures to supress the virus. Not everyone can work at home or comfortably isolate themselves. The system still expects families to go hungry to stop spreading the infection. Again, I urge the Government to fix sick pay and ensure everyone is supported to self-isolate. The Health Secretary, as was mentioned many times, has admitted that he could not live on statutory sick pay, but that is what we still expect hundreds of thousands of people to do each week.

The Government have known for many months that rates of self-isolation compliance are low. That is the gaping hole in the system. I was disappointed that rumours at the end of last week that the Government were due to extend the scope of the £500 self-isolation payment were just that: rumours. I urge the Government to consider extending the payment to all low-income parents self-isolating with children, and to ensure that councils can give discretionary payments to all who need them. When even Baroness Harding recognises that this is a big flaw in the Government’s approach, we need to act.

We know how difficult this lockdown is for millions of families. We are being asked to stay at home for a third time, to help get the virus under control. In return, the Government must not only deliver the vaccine, but ensure that people can self-isolate when required to. The decisions made will be significantly influenced by how quickly people can be vaccinated. Of course, we want roll-out to proceed as soon as possible. Being the first country to approve the vaccine, we should be the first country to roll it out successfully.

I hope that in his closing remarks, the Minister will update us on how the Government plan to reach those communities that are hard to reach. We know that the crisis has had a disproportionate impact on black, Asian and ethnic minority communities, so it is important that the vaccine roll-out does not leave those communities behind. We need to understand how the roll-out relates to the implementation and continuation of the tier system. The Secretary of State has said of easing lockdown measures that there will need to be no more major new variants of covid-19, that hospitalisations must fall, that the daily death rates must fall, and that the vaccination programme should work.

On new variants, the need to secure our borders is clear. I suspect decisions of that nature are above the Minister’s pay grade, though maybe not for long; who knows? Perhaps one day. I hope he will convey our concerns about the daily scenes at our airports, and about the clear need for more robust systems. Lockdown, with the incredible sacrifice that it involves, is a decision that I know weighs heavily on every Member, but to ask our citizens to submit to that while, because of holes in our defences, people enter the country and potentially spread new, dangerous variants is unforgivable. That must be addressed as a matter of urgency.

Two of the criteria are the same as those in the tier system. I want to raise a few points about the vaccination process and how that will relate to the tier system. It seems, as a matter of logic, that if these criteria apply to the lockdown, they will also apply to the tier system. This is the one thing that the Government can control and direct, so it is important that we have transparency about how this will happen

We know how many people daily, by region, receive their first and second dose of vaccine. Those figures are now further broken down to those for each sustainability and transformation partnership footprint, but that does not give us the data that we need to identify whether progress is even, or how that will impact tier systems. For example, the latest data, up to 17 January 2021, tells us that 114,000 people over 80 have received the first dose of the vaccine in Cumbria and the north-east. That is undoubtedly good news, but we do not know the proportion of over-80s, or how those people are spread across the region. Are some parts of the region doing better than others?

I hope the Minister accepts that the public are getting only a partial picture. Moving forward, as we look to adjust the tiers, I suggest that that information needs to be disseminated at local authority level, consistent with the tiers contained within these regulations. For example, Cumbria County Council is described in the regulations as being in the north-west, but in terms of the vaccination process it is in the north-east. We also need to know what percentage of each vulnerable category has been vaccinated and, crucially, how much vaccine has been supplied to each local authority area, ideally expressed as a proportion of the total vulnerable categories.

To date, despite questioning on the subject, we have no specific information about how much vaccine has been supplied to each area. We are only getting information about when it has reached the arm of the patient. That is the most important data, but if one of the criteria used to allocate tiers is progress with the roll-out, we will need to know if there is equity in supply as well. I am sure the Minister will not want to end up in arguments about whether tiers are being decided on the basis of whether the vaccine has been fairly distributed. In the spirit of being helpful, I suggest to him that the best way to avoid getting into those arguments is through total transparency on the numbers and proportions distributed to each area.

Finally, there has been a lot of debate today about schools and the continuing uncertainty about when they may be able to reopen. I am sure we all share the same aim and we want them fully reopened as soon as possible. That begs the question about the possibility that education settings could be treated differently, depending on which tier they are in. Is that being looked at on an area by area basis? There was a spike in September when schools and universities returned. Can that be better contained by more localised decision making in the new tier system?

In conclusion, we believe that there is an awful lot more to be done to demonstrate that tiers are effective, that areas are placed in tiers on a transparent basis, that areas are given sufficient support to reduce transmission of the virus or to prevent it from increasing, and that there is sufficient support for business, recognising that each tier brings with it a different set of challenges, both trading within the tier or having to close the business altogether.

--- Later in debate ---

[Justin Madders]

I pay tribute to all those involved in the vaccine roll-out. I had the pleasure of visiting my local centre a couple of weeks ago, and it was very well organised. I was trying to gain some understanding from the Minister about whether the vaccine roll-out will be applied to tier decisions, or whether the national picture will be part of the decision. I do not expect him to say, “This number of people receiving a dose is going to mean x, y or z relaxations,” but will that be considered at national or local level?

[Edward Argar]

I am grateful to the shadow Minister for his clarification. If I am being honest, I think it is probably premature at this point for us to speculate about things at that level of detail, but he makes his point well and it is on the record. I will relay it to the Secretary of State as we look at when the time is right for us to start easing the national regulations and potentially move towards a tiering model again. At that point, those sorts of question are of course pertinent, and I will ensure that the Secretary of State is aware of the hon. Gentleman’s comments.

The hon. Gentleman’s final point was, in the context of vaccines, infection rates and hospital pressure, about the need for information to be as local and granular as we can get it. Vaccinations started in earnest in early to mid-December, and we have ramped up at a huge rate the number of people being vaccinated each day. In parallel with that, we have continued to try to increase the amount and granularity of information that we publish on gov.uk and on the dashboard about vaccinations by region, area and volume. In parallel with actually getting the vaccine in people’s arms, the team continues to look at what more they can do to be as transparent as possible about how that is going, so that people in a local area can understand a bit more about what it means for them.

I hope I have addressed if not all then as many as I can recall of the hon. Gentleman’s questions and points. I commend the regulations to the Committee.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020 (S.I. 2020, No. 1654).