Draft Coronavirus Act 2020 (Early Expiry) Regulations 2021

Justin Madders Excerpts

Wednesday 7th July 2021 General Committees

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

It is a pleasure to see you in the Chair, Mr Robertson.

I thank the Minister for his introduction, and for his kinds words about local government. I say that because, for the record, my wife is a member of a local authority. I absolutely agree with the Minister that, in his words, the country has shown collective endeavour to do its best to fight the virus. That has been clear whether we are talking about the NHS, social care, local government or any of the other key industries that have contributed to the national effort over the past 15 months. As the Minister said, we all owe them a great deal for the efforts that they have put in.

As the Minister said, the matter was debated in the House in March. From reading the Hansard report, I think it is fair to say that a number of right hon. and hon. Members felt short-changed on account of the truncated nature of the debate, especially given that various other measures were discussed at the same time, and it was not possible to vote on amendments. It feels as though parliamentary procedure is operating in a manner that only gives us the thinnest veneer of accountability.

On a related point, I recognise the pressures on the Department of Health and Social Care, but I am not entirely clear why it has taken so long since March for the regulations to appear in Committee. Although that criticism is not as strong as it would have been were we debating the regulations merely to ratify them after their introduction, there is a pattern of delegated legislation procedures being followed weeks, indeed sometimes months, after the event. That has characterised the Government’s approach throughout the pandemic. We need an explanation of that behaviour. On a related point, I draw the Minister’s attention to the fact that although the legislation.gov.uk website shows the Statutory Instrument, it does not include the date on which it was made or will come into force. I appreciate that that website is outside of the Minister’s control, but we need to be clear about when regulations are made and come into force. I hope that he has a correct copy of the legislation to hand to clarify that for us.

I understand, of course, that the Government have had to move very quickly, and have had to make exceptional decisions throughout the pandemic. Time has moved on, however, and that pace of action has become less and less of an excuse and more and more of a habit. It is almost a default position adopted by the Government. I am sure that that is convenient, but that does not do any good at all to accountability.

The timing of today’s debate is apposite, given that the Government have decided that they no longer need emergency powers. Indeed, the Prime Minister’s announcement on Monday seemed to suggest all but the end of virtually all measures on 19 July. We have been told that the roadmap to unlocking would be driven by data not dates, but the Prime Minister has announced that we will basically no longer need any restrictions before he has seen any of the relevant information. Can the Minister tell us whether Government policy has changed from data not dates to “If not now, when?” to quote the Prime Minister? That is the polar opposite.

Regardless of the methodology used to reach the decision that virtually all measures to prevent the transmission of coronavirus are no longer needed, and regardless of the wisdom of that, which I recognise is outside the ambit of today’s regulations, that decision has a direct bearing on those regulations. As we have heard, the regulations remove a number of the emergency powers granted to Government under the Coronavirus Act 2020, but, as the Minister also correctly pointed out, many more powers still remain. I draw the Committee’s attention to the words of the former Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), who said of the powers in the 2020 Act

“we have always said that we will only retain powers as long as they are necessary. They are exceptional powers.”

Indeed, they are exceptional—they are unprecedented, and that means that they should not remain in force for a moment longer than necessary. The Minister said that there will be a review in September, and we know that those provisions are subject to a two-monthly review, but if the Government’s judgment is that we are so far past the worst of the crisis that we can remove all restrictions on people’s movements and interactions, including measures such as compulsory mask wearing that has been shown to protect the most vulnerable, why do the remaining powers need to stay on the statute book for a day longer than 19 July?

The two-monthly review justifies the continued use of emergency powers under the 2020 Act by claiming

“there is further work to do before returning to a more familiar version of normal life, and the ability to respond flexibly and cautiously still exists.”

Those words jar with the noise coming out of Government. Can the Minister confirm today that all remaining emergency powers will be repealed by 19 July? If not, why not? Clearly, we are no longer in the realms of responding cautiously to the virus, so why do those powers need to remain in force a day beyond 19 July?

Has any consideration been given to retaining some of the remaining powers, rather than all of them? It has been said that, shortly, we may expect 50,000 new cases every day. In that case, the powers relating to statutory sick pay may well be worth retaining. If powers have been enacted under emergency legislation, is there now a case for those powers to be permanently on the statute book? Frankly, I think that is how Parliament would want matters to proceed.

The Minister and I are likely to spend a great deal of time together in the coming months debating the Department’s latest effort to reorganise the NHS via the Health and Care Bill, which was published yesterday. The Minister will no doubt be disappointed that I have not yet read it in its entirety.

[Edward Argar]

There is plenty of time.

[Justin Madders]

Indeed. Would any of the emergency powers contained in the 2020 Act appear in that Bill at a later stage in parliamentary proceedings? I am thinking in particular about the powers in section 14, which I believe the Government have said they found useful. No doubt we can debate the merits of that in some detail at a later stage, but I would be grateful for a response from the Minister today.

The biggest concern raised in the March debate, and which still remains, relates to the powers in section 21 of the 2020 Act to detain potentially infectious persons. That power has been used in a number of prosecutions, and I understand that every one was found to be unlawful by the Crown Prosecution Service. The Joint Committee on Human Rights advised in its report of September last year

“In the absence of any clear evidence to support the retention of these powers”

section 21 powers “ought to be repealed”. It is not at all clear to me why the Government would wish to retain such a draconian, but ineffective, power. That seems at odds with yesterday’s announcement that those who have had both vaccinations will no longer be required to self-isolate. The power to detain under section 21, however, makes no distinction between those who are and are not vaccinated.

The Minister referred to the two-monthly review as being evidence of the Government’s commitment to transparency, but those who studied the latest review in May of section 21 powers raised concerns about the thoroughness of that exercise. The review states:

“Public Health Officers have used these powers a total of 10 times, but have not used them since October 2020…Police have not used these powers to date and they are only to be used after obtaining advice from a Public Health Officer.”

Big Brother Watch, which sends regular briefings to Members on the use of the Government emergency powers, has said that it has documented multiple unlawful use of section 21 by police forces in England to arrest and detain individuals. Members made various references to that in the March debate. It is a little disappointing, and indeed disconcerting, that whoever drew up the two-monthly review did not appear to make any further inquiries about the potential misuse of that power, and indeed its effectiveness.

The two-monthly reviews feel like a bit of a tick-box exercise to me. The Government have serious, unprecedented powers, and despite allegations that those powers are being used unlawfully, the Government review does not appear to be even aware that those powers have been used at all. That is the case before we even get to considering whether those powers are necessary.

The Minister must demonstrate that the Government are not falling into the trap of keeping emergency powers because that is convenient, rather than necessary. The Opposition will not oppose regulations, but I hope that the Minister will address the points I have raised. I hope that he can demonstrate that any emergency powers no longer needed for public health reasons will be revoked as soon as we reach that point.

[Edward Argar]

As ever, I thank the shadow Minister for his typically measured and sensible contribution and pertinent questions. The 2020 Act has formed a central plank of the Government’s approach to coronavirus and has in many ways often been misunderstood. As I said in the March debate, the vast majority of the measures have been undertaken by the Government under the Public Health (Control of Disease Act) 1984, but the 2020 Act none the less plays an important role. Like the shadow Minister, I and the Government have no desire to see the powers in place a day longer than they are absolutely needed. I have highlighted that the reviews will take place and that September is the next six-monthly review. I do not want to prejudge what will emerge, but I put on the record my view that the powers should not be in place a day longer than they can be justified as essential.

In that context, the hon. Gentleman made a number of points, which I will try to address in turn. He talked about whether some powers might be useful in the longer term—I think he referred to section 14 by way of example. I hope to give him the reassurance he seeks: notwithstanding the six-monthly way point or checkpoint in September, the powers in this Act automatically sunset next spring. There was a two-year sunset clause, and the Government are clear that any powers deemed to be useful in the longer term will be subject to the normal legislative process in this place, with hon. Members having the opportunity to scrutinise, challenge and debate in the usual way, if we wish to retain anything in the long term.

In the context of the legislation to which we gave First Reading yesterday, some aspects shade into this space, but do not explicitly replicate what is there. I suspect that the hon. Gentleman and I will spend many happy days in Committee, along with our hon. Friends the Whips sitting next to us on the Bench, so there will be opportunities to discuss and debate how that might be done.

The hon. Gentleman talked about the timing of the draft instrument after the debate on 25 March. My understanding of the timing is that immediately after that debate we went into recess, but that on our return in April, the statutory instrument was laid on 21 April, so relatively swiftly afterwards. The scheduling of debates on such instruments are a matter for the usual channels and the business managers.

My hon. Friends the Whips will have heard what the hon. Member for Ellesmere Port and Neston said, but I know that both Government and Opposition work hard, and have done throughout, to schedule debates in as timely a fashion as possible. We recognise the point he highlighted, that in the early stages the pandemic, that was extremely difficult to achieve, but I know that this House values timely debates on measures that come before it. The usual channels do everything they can to facilitate that for Members of the House.

On legislation.gov.uk, I will check the point the hon. Gentleman made. I cannot give him an answer off the top of my head, but I will endeavour to look into it. If anything is lacking, I will ensure that it is addressed. I suspect that, since the other place debated this on Monday and we are debating it today, with the dates and everything, the powers will be updated following our—I hope—approval. I take that approval slightly as read, given his kind words that he will not be opposing this piece of legislation.

The hon. Gentleman touched on a couple of other areas. Sections 21 and 22 were challenged by hon. Members, not necessarily saying no to them, but wanting to understand the reasons: were they proportionate, were they necessary and how would they operate? Section 21, he is right, has not been used since October 2020. The key aspect of section 21 is that the powers to do with infectious persons are most useful in the early stages of a pandemic, with small numbers.

[Justin Madders]

I think the Minister has misunderstood slightly what I said. The two-monthly review says that the power has not been used since October, but my point is that certain reports have it that it has been used, which raises the question of how thorough the review was.

Coronavirus

Justin Madders Excerpts

Wednesday 16th June 2021 Commons Chamber

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

May I start by associating myself with the many Members who have paid tribute to Jo Cox? As we have heard from the tributes, she transcended intake and party in bringing people together, and my thoughts are with her family at this time.

There have been many excellent speeches from both sides of the Chamber. People who will be voting different ways often made many similar points. I believe that shows the disappointment that we all feel that we are here once again, grappling with many overlapping and multiple considerations.

There were some particularly thought-provoking Opposition speeches, by my hon. Friends the Members for Blackley and Broughton (Graham Stringer), for City of Chester (Christian Matheson), for Luton North (Sarah Owen), for Leeds East (Richard Burgon) and for Stockport (Navendu Mishra). I particularly enjoyed the speech by my hon. Friend the Member for Luton North and her repeated use of the word hopeless—a word that I am sure is on many people’s lips at the moment. She was right that we have been here before—at Christmas, with the Prime Minister dangling the carrot of freedom before pulling it away at the last minute. It is the hallmark of a Prime Minister who struggles to deliver bad news to the public.



My hon. Friend the Member for Leeds East made the similar point that there is a pattern here of the Government making the same mistakes over and over again. He also rightly highlighted the continuing failure to provide adequate financial support for those who self-isolate—a point that was also made by my hon. Friend the Member for Stockport and is particularly apposite today, when a Government report has reached the news which states that the current self-isolation policy has “low to medium” effectiveness and that there are “barriers” to self-isolation. That is a point that we have been making since the start of the pandemic, so it is about time the Government listened to us and to their own advisers and fixed it.

It would be remiss of me not to highlight the fantastic contribution from my neighbour and hon. Friend the Member for City of Chester, who drew attention to how the announcement came out, once again, via the media. He also raised an important point about the enhanced measures that a number of areas, including our own county of Cheshire, have been put into this week. Unfortunately, we have seen a surge in cases, but there is apparently no prospect of our getting a rise in vaccines.

[Taiwo Owatemi (Coventry North West) (Lab)]

When I spoke to my fellow healthcare professionals in my local hospital vaccination centre weeks ago, many expressed their concerns about the delta variant and its possible impact on the local NHS and on delaying lockdown. Does my hon. Friend agree that the Government need to do more to prevent workplace burnout by providing more workplace support to our fellow healthcare professionals, who have spent the past 18 months supporting the Government through their incompetency?

[Justin Madders]

My hon. Friend is absolutely right. We owe a great debt to those in the NHS and to those who have worked on the frontline during the past 18 months. Last week, the Health and Social Care Committee released a very important report on burnout; I really hope that the Government address it, because without the workforce, the NHS is nothing.

To return to the issues in Cheshire, we have not had the increase in vaccines that the surge in cases requires and that the Government’s own scientific advisers say is the best way to deal with such an outbreak. Our constituents are being sent far and wide to get their first jabs. We have fantastic volunteers and NHS workers ready, willing and able to deliver those jabs, but we need the Government to match that ambition by increasing supply. That will be where we can make the most difference.

My hon. Friend the Member for City of Chester also made a very important point about how we are now in the worst of all worlds with the new guidance that was issued at the same time that the regulations came into force. We are now advised not to meet indoors: again, that diverts people away from the hospitality sector, which was just opening up again, but without a penny more in financial support for it. As he mentioned, other sectors have also been affected by the regulations and are still not getting any additional financial support in recognition of the change in policy.

On the issue of guidance and law, I hope that the Minister will look at last week’s report by the House of Lords Select Committee on the Constitution, which stated that the use of guidance had

“in some instances undermined legal certainty by laying claim to legal requirements that do not exist. The Government does not have, and must not assume, authority to mandate public behaviour other than as required by law. The consequence has been a lack of clarity on which rules are legally enforceable, posing challenges for the police and local government…and potentially undermining public compliance and confidence.”

If living with covid means living with guidance rather than laws, I really do urge the Government to read that report before they proceed down that road.

Will the Minister clarify whether the Government are still making decisions based on data rather than dates? As the shadow Secretary of State, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), pointed out, the Prime Minister was pretty clear that the 19 July was the “terminus date” for restrictions, yet paragraph 7.4 of the explanatory memorandum accompanying the regulations states that the delay is

“to gather more evidence that the…tests can be met”

under the road map in the light of the delta variant. There would be little point in gathering that data if it were not used to inform future decisions, so that rather implies that 19 July might not be the end date after all.

As the right hon. Member for Forest of Dean (Mr Harper) pointed out, there is no mention in the explanatory memorandum or the regulations of the two-week point at which things will be reconsidered. Of course, we all hope that 19 July is the end date, but we have been down the road of false promises many times in the past 18 months, and I do not think it unreasonable to be a little sceptical about what the Prime Minister says and what actually materialises, given his record to date. Any clarity that the Minister can shed on the precise reason for the delay would be much appreciated.

Of course, it did not have to be this way. The delays to our unlocking that we are debating were not inevitable; in fact, they were totally avoidable. The British public have been magnificent throughout the crisis—they have followed the rules and played their part. Yet when they see world leaders ignoring social distancing at a barbecue but are told that the rules cannot yet be relaxed for them, and when they see thousands of people attending football matches but are told that they cannot attend their own children’s school sports day, they grow frustrated at what they see as a lack of consistency from those who make the rules. That frustration grows into anger when they see a Prime Minister who has thrown it all away by keeping the borders open and letting the delta variant run wild through the country. As a result, the delta variant now makes up 96% of new infections. That did not happen by accident, and, as the chief medical officer said on Monday, we would be lifting restrictions now if it were not for the delta variant. All that good work and all the benefits of the vaccine have been blown because the Prime Minister was once again too slow, just as he was too slow with the first lockdown, the second lockdown and the third.

I know that the Government will say that they acted as soon as they could on the information that they had, but the explanation for why they did not act sooner on the delta variant has changed in the last few days. We were initially told on multiple occasions that the data did not support putting India on the red list earlier because the positivity rates of the new variant were three times higher for Pakistan, but now we are told that India was not put on earlier because the variant had not been identified as one of interest or concern.

Neither explanation stands up to scrutiny. The only published data on the Indian variant does not show a positivity rate three times as high for Pakistan, and the idea that action was taken shortly before it was designated as a variant of concern does not explain why Pakistan and Bangladesh were red listed weeks earlier. The only credible explanation I can therefore find for treating India differently is that the Prime Minister did not want to scupper his trade visit and photo opportunity with the Indian Prime Minister.

Instead of excuses, we should be getting an apology. It is beyond doubt that the Prime Minister’s incompetence, dithering and vanity have cost this country dear, and that is the only reason why the full unlocking of this country is not going ahead next week. Having heard today via WhatsApp from Dominic Cummings what the Prime Minister thinks of the Health Secretary, I wonder whether the Health Secretary has at any point in the last few weeks had similar feelings towards the Prime Minister. If he has, at least that is something we can both agree on.

Covid-Secure Borders

Justin Madders Excerpts

Tuesday 15th June 2021 Commons Chamber

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

Let us cast our mind back to January 2020, when we were first learning about the new virus. I remember the approach taken at the time to people coming in from parts of the world with a higher number of cases, because many of them were quarantined just down the road from me at Arrowe Park Hospital. No chances were taken then, but all that stopped very shortly afterwards: we carried on as normal, welcoming people—and the virus—from all over the world. We saw images from Spain of cases rising, yet Atlético Madrid fans were still allowed to enter the country for a champions league game in early March, contributing to an increase in cases and—according to one study—to an additional 41 deaths.

Perhaps some latitude can be given because at the time we were dealing with a new virus, but I find it hard to reconcile the actions that were taken with arrivals from Wuhan, where we knew that there was an outbreak, and from Madrid, where we also knew that there was an outbreak. Hardest to reconcile is the fact that, while the country was in lockdown from March last year onwards, thousands of people were still entering the country every day.

Turning to more recent events, there is absolutely no doubt in my mind that the reason that the full unlocking of the country is not going ahead is the decision to delay putting India on the red list, which has led to the delta variant rapidly pushing up case numbers. All that good work and all the benefits of the vaccine were blown because the Prime Minister was once again too slow, just as he was too slow with the first lockdown, the second and the third. His incompetence has cost this country dear.

I know that the Government will say that they acted as soon as they could on the information that they had, but I do not accept that. The only data that they have released on the Indian variant shows that they should have acted sooner. Indeed, the explanation for why they did not act sooner has shifted in the past few days, as we have heard again today, from the data not supporting action to the variant not having been identified as one of interest or concern. That is not the explanation that was advanced originally; nor does it explain why Pakistan and Bangladesh were treated differently.

The Health Secretary told the House on 19 May that when the Government decided to put Pakistan and Bangladesh on the red list two weeks before India, it was because positivity rates were higher. He said:

“The positivity rates…were 1.6% in India and 4.6% in Pakistan”.—[Official Report, 19 May 2021; Vol. 695, c. 732.]

That seems a fair enough reason—except that I cannot find those figures anywhere. Indeed, the Government’s own figures on the variant show that in the period from 25 March to 7 April—the closest period to when the decision was made—the positivity rate was 3.7% for Bangladesh, 5.1% for India, and 6.2% for Pakistan. Those are nowhere near the figures cited by the Secretary of State.

That is not the only data that contradicts the Government’s claims. Their own data on the number of variants that they detected from those countries in the period from 25 March to 7 April shows that they detected four from Pakistan, 12 from Bangladesh and 50 from India. Actually, we did not even need data to know what was going on—we could just turn on the TV to see what was happening in India.

The only credible explanation that I can find for treating India differently is that the Prime Minister did not want to scupper his trade visit and photo opportunity with the Indian Prime Minister. It is no wonder that he does not want to come here in person and explain to the House why his road map has been put on ice, because it is his own vanity and his own incompetence that has led us to where we are today.

Does the new traffic light system give us confidence that the Government finally have a system in place that manages risk? Well, not really, as we have had Ministers contradicting themselves on that as well, particularly on travel advice. This is what happened in just one day following the announcement on international travel reopening: the Secretary of State for Environment, Food and Rural Affairs said that people could fly to amber-list countries if they wanted to visit family and friends; the Health Minister in the other place said that nobody should travel outside Britain at all this year; and the Welsh Secretary said that some people might consider holidays abroad as essential. The following day, the Prime Minister set another definition. He said that people should travel only in extreme circumstances. That is four definitions in 24 hours, which is the nub of the problem. Everyone can have their own view on what is essential, which means that there is an ambivalence at the heart of Government policy that this virus can exploit.

For the past year, we have painstakingly legislated for every facet of our lives: when we can leave home; what time we have to leave the pub; and how many people can attend a funeral. On international travel, though, we seem to have a free-for-all.

Finally, I just want to say a few words about the absolute shambles that the Government have made of the day 2 and day 8 testing for those quarantining at home, with hundreds of people who book covid tests from firms that are listed under the Department’s own website complaining that they have either not received those tests, or that they have not received the results on time. These private companies, some of which did not exist at all last year and have zero experience in this area, are benefiting from an open-door policy from Government, because it seems that they can request to be added to the list of approved suppliers on the Government website simply by self-declaring that they meet the minimum standards required.

I find it absolutely astonishing that we are operating one of the most critical parts of our defence in such a reckless way. Fewer than 10% of those companies actually turned out to be accredited, so the Government really do need to do something to tighten that up as well.

Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) Regulations 2021

Justin Madders Excerpts

Monday 14th June 2021 General Committees

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

It is a pleasure to see you in the Chair this afternoon, Sir Edward. I thank the Minister for her introduction to the statutory instrument, which, as she pointed out, came into force on 17 May. I will return to that point in a little while. May I first repeat my thanks and gratitude to everyone who has played their part in fighting the spread of coronavirus, in the many different forms that that has taken over the past 12 to 15 months? We would have been in a much worse situation had we not all pulled together collectively in the way in which the Minister outlined.

As the Minister set out, these regulations amend the steps regulations to implement the easing of lockdown in line with the Government road map, moving all of England from step 2 to step 3, meaning that the restrictions set out in schedule 3 to the steps regulations now apply. For example, six people or two households can gather indoors, and up to 30 people outdoors, weddings and funerals are now permitted with up to 30 people in attendance, all remaining outdoor entertainment and indoor hospitality can now reopen, and the number of people who may attend support groups has been increased to 30. Significantly, regulation 8 revokes the prohibition on international travel and the requirement for individuals to declare their reason for travelling abroad. The Minister did not go into that point in any detail, but I will return to it a little later.

Finally, the instrument amends the Health Protection (Coronavirus, Restrictions) (Local Authority Enforcement Powers and Amendment) (England) Regulations 2021, the Health Protection (Coronavirus, Restrictions) (Obligations of Undertakings) (England) Regulations 2020, the Health Protection (Coronavirus, Wearing of Face Coverings on Public Transport) (England) Regulations 2020 and the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020. In particular, the regulations extend the expiry date of the face coverings on public transport regulations and the LAEP regulations to 20 June, which is this Sunday.

The regulations provide an exemption for wearing a face covering in community premises where the gathering is reasonably necessary for specified education and training purposes; provide that groups are permitted to gather; and increase the limit for the offence of organising or facilitating a gathering from 30 to 50 people. They also allow students undertaking a higher education course to form a vacation household, increase limits on the numbers permitted to attend parent and child groups from 15 to 30, remove the provision that support groups should only take place in person where it is reasonably necessary, and, importantly, remove the limits on the number of people who can attend a funeral.

We are not going to oppose the regulations because, like everyone, we want to see a return to some form of normality as quickly and safely as possible, but there are various areas where I would be grateful for some additional clarity from the Minister. Of course we want to see society open up and we welcome the steps that have been taken so far, but as we take further steps down the road—or not, as the case may be—the priority must be doing all we can to keep case numbers low and prevent further transmission, ensuring that we learn the lessons from the past year. Sadly, I do not think those lessons are being learned, as the same mistakes are being made time and again.

The Prime Minister promised us an “irreversible road map” to normality, but I am afraid to say that the rate at which the number of Indian or Delta variant cases is increasing puts that in some doubt. The Minister said that these regulations anticipated a rise in cases from the opening up of society, but I do not think for a minute that the rises we have seen in recent weeks can all be attributed to that—and I am sure that it is not what the Minister was anticipating. Cases have doubled in about 10 days, and although that has not yet led to an increase in hospitalisations, there has certainly been an increase in some parts of the country; I understand that hospitalisations in the north-west have increased by a third in the past week. It has to be hoped that the age profile of those catching the virus means that there will not be as many deaths as we have seen, because it is now mainly younger people who are catching the virus. However, people who are unfortunate enough to catch the virus may have long covid, which can have devastating consequences

While cases are on the rise, we need a national response to deal with the hotspots, particularly with surge vaccinations where cases are rising most steeply. We need to put retrospective and forward contact tracing in place. Critically, we need pay proper sick pay and provide financial support for those who have to self-isolate. At this critical stage, where it is really in the balance as to whether we can get back to some kind of normality this summer, it is important that we ensure that the steps the Government are taking are the right ones, which is why scrutiny and debating these regulations matter.

The Minister was gracious enough to acknowledge this point in her opening remarks; she will not be surprised to hear me say yet again that I have serious concerns about the way in which we are approving legislation retrospectively. I have debated many sets of these regulations with her, and she knows as well as I do that these rules have a profound impact on individuals’ liberty. Of course, there is also a huge economic impact that follows on from that. It is simply not good enough that we are once again debating these regulations well after the event. How can it be acceptable that the Government laid them through emergency procedures at 11 am on 17 May, the day they became law, when they had known for almost three months, by my count, that step 3 would be reached on that date?

Of course, we accept that in some instances emergency legislation has been needed, but it cannot be justified for each occasion, and certainly not for any legislation that I have seen come forward recently. The Prime Minister’s road map has been in place since February, so why are we debating step 3 only now, particularly given that the main topic across the country since we reached step 2 has been what would happen with step 3? It should not have come as a surprise to the Government that regulations would need to be laid and approved by 17 May if the road map were going to plan, as until very recently there was every indication that it was. The decision to proceed with step 3 was made only a week before entering that step, but there is absolutely no reason why the regulations could not have been published on that day and debated before they came into force, because their substance was set out well in advance back in February when the Government first highlighted the road map.

The fact that we are considering the regulations today of all days, when the eyes of the entire nation are fixed on a press conference that the Prime Minister will give in a couple of hours, makes a mockery of the role of parliamentary scrutiny. As colleagues across the House have said for the past year, the Government’s rationale for urgency just does not hold water any longer. The regulations once again contain a statement that

“by reason of urgency, it is necessary to make this instrument without a draft having been laid before, and approved by…Parliament.”

I wish to put it on the record that we do not accept that. Using urgency powers when they are not necessary has become a bad habit, and it is more than time that this contempt for parliamentary scrutiny came to an end.

Those comments apply not just to the road-map elements of the regulations, but to other changes such as the extension of the face-mask regulations. Again, that is not an urgent matter that can be dealt with only under emergency powers. The Government have known about the expiry of those regulations since they were introduced a year ago, so why are we dealing with it only now—is it arrogance, laziness, contempt or all those things? I know that the Minister is not personally responsible for the timetabling of our debates, but unfortunately she has to come here and defend this pattern of behaviour from the Government that has become all too familiar. The saying is that familiarity breeds contempt; the familiarity of this disregard for parliamentary scrutiny is beginning to feel like contempt.

Although we do not know the precise details of the Prime Minister’s announcement today regarding the next steps, it has been widely trailed that we will see a delay in the next stage, so will the Minister commit to ensuring that this House is provided the opportunity to see and debate any regulations that accompany whatever comes next, before they come into force? If, as anticipated, there will be a four-week delay, surely that is enough time to schedule proper parliamentary scrutiny.

What of the references to dates in the regulations? A number of measures are due to expire on 20 June. Will the Minister confirm whether, in the light of what we will hear later today, those dates still stand—or have they effectively been superseded? It is ludicrous that we are today debating the extension of the face-mask regulations for just six days, but it is even more absurd that it is likely that another set of regulations to extend them will be coming down the line in the next three or four weeks.

While we are talking about the lack of proper accountability in how the regulations have been introduced, I put on the record my concerns about the utter shambles of the contradictory Government guidance that was issued just after they came into force. As reported by the Secondary Legislation Scrutiny Committee, that guidance, which was published on 21 May,

“said that to combat ‘the Indian variant’ people living in Bedford, Blackburn with Darwen, Bolton, Burnley, Kirklees, Leicester, Hounslow and North Tyneside should meet outside wherever possible and travel in and out of those areas should be avoided.”

The Committee rightly points out what should have been obvious to the Government: that sneaking guidance out without publicising it

“caused considerable confusion.”

It further points out:

“All eight local health directors have since issued a joint statement contradicting it”—

the guidance—

“saying that there are no restrictions on travel in or out of their areas”.

Every affected local authority and its corresponding Members knew nothing about the new guidance until the evening of Monday 23 May. Although that may be the inadequate level of openness and transparency that we have come to expect from the Government, it runs completely contrary to the entire strategy that has been adopted throughout most of the pandemic in using law, not guidance, and crucially, ensuring that the public have clear messaging on what is expected of them.

As we have heard this afternoon, similar guidance will be issued in other areas including my own area of Cheshire West and Chester, alongside Cheshire East and Merseyside, which raises questions about what additional resources and messaging will be put out to public health teams in the affected areas. What is the plan to increase the vaccination rate in those areas? What support will be made available to businesses? How do the Government plan to communicate the guidance effectively?

I have not heard in Government announcements on additional measures for those areas a plan on surge vaccination. Last month, SPI-M-O said that surge vaccination could be successful in preventing an increase in cases in areas where there was a steep rise. It said:

“The extent to which surge vaccination would curb outbreaks of”—

the Delta variant—

“is unknown until evidence for the effectiveness of existing vaccines against it has been established. That does not preclude there being a strong case for prioritising delivering doses in areas where the variant is widespread.”

My question to the Minister is therefore what plan do the Government have to increase the supply of vaccines to affected areas? So far, I have not heard anything that gives me confidence that we will see such an increase. It is all well and good giving the first jab to people in lower age groups in areas of the country that do not have a rise in cases, but the advice is that we need to focus our efforts on those areas that have had the biggest increases in cases of the Delta variant.

The Secondary Legislation Scrutiny Committee concluded that the situation for those nine areas that were subject to enhanced measures last month was in part caused by continuing confusion over the status of Government guidance and in part by failures in how the advice was communicated. That sums up perfectly the shambles that we got ourselves into last month. The blurring of lines between guidance and law is at best unhelpful and at worst totally undermines confidence in public health messaging. The Government must be much clearer and must do better on this. If measures are necessary to restrict the transmission of the virus, they should not mess about with poorly publicised guidance. If measures are necessary, there should be laws, and they should be put into regulations. That way, everyone knows where they stand and adherence will be better. Parliament can then play its role in ensuring that those measures are necessary and proportionate. Critically, the Government have to articulate why such measures are necessary and what support they intend to put in place to ensure that businesses in the areas affected do not suffer any more from a loss of business due to covid.

Guidance means none of those things happen, and it may be the case that Ministers say that on balance they do not think introducing new laws is necessary, as guidance will do the job. I suspect that that last issue is the reason why we are lapsing back into guidance, rather than law. The Government do not feel they have to provide additional business support if they do not introduce formal restrictions. That is a cop-out, and businesses and individuals who will see a drop in trade as a result of new guidance deserve better support and clarity from Government.

Moving on to another area where a shift from regulation to guidance has caused absolute chaos, and which is also covered by the statutory instrument, I turn to what one of my colleagues in the other place recently referred to as the

“confused mess that is international travel”.

As we know, the regulations have removed the prohibition on international travel and the requirement for individuals to declare their reasons for travelling abroad. Of course, we are all keen to see international travel return as soon as possible, but safety must come first, which is why a strategic approach and clarity from Government are vital. Unfortunately, once again, that is not what we are seeing. There is mass confusion and chaos, with Ministers yet again giving wildly conflicting travel advice about what constitutes the amber list.

Following the announcement on international travel that accompanied the regulations last month, in just one day the Secretary of State for Environment, Food and Rural Affairs said that people could fly to amber-list countries if they wanted to visit family or friends; the Health and Social Care Minister in the other place said that nobody should travel outside Britain this year at all; and the Welsh Secretary said that some people might consider holidays abroad as essential. Three Ministers, three different interpretations in just one day. The following day, the Prime Minister came up with a fourth definition that people could travel in “extreme” circumstances. That in itself is open to interpretation, but it does at least set the bar a little higher, until we remember that the new rules make it easier for people to travel to amber-list countries.

I find it mind-boggling that, having spent the past year painstakingly legislating for every facet of our daily lives in order to suppress transmission of the virus, we find ourselves in a situation whereby one of the biggest threats to our future prosperity—variants—is subject to the Government inexplicably and recklessly letting people interpret the rules for themselves, having demonstrated through their Ministers that there are as many interpretations of the rules as there are people. The confusion over the amber list has led to reports of over 50,000 people travelling to the UK daily, with only a tiny percentage going into hotel quarantine, and a stream of flights entering the UK from amber-list countries. Moving Portugal on to the amber list last week was not the answer. The amber list should be scrapped, and Ministers should introduce a clear plan to manage the confusion that has led to people in Portugal not knowing whether they were coming or going. Does the Minister accept that the way this has been handled so far is gravely damaging for both consumer and business confidence? Does she accept that the system is leaving the door wide open to new strains of the virus and risks undermining the whole purpose of the regulations that we have been debating over the past 12 months?

At the moment, the situation is at risk of delivering the worst of both worlds. International travel is reduced, so the aviation sector and tourism industry are at dire risk without additional Government support, yet lax border controls and Government confusion mean that we are not successfully protecting our borders from emerging variants, as we have discussed with regards to the emergence of the Delta variant. The Government continue to make decisions that are detrimental to public health, with weak and dangerous border protections against covid that put our desire for freedom at risk. We know that the emergence of new variants of concern is the biggest single risk to the road map, so it is beyond frustrating that the Government do not seem to have learned from their previous mishandling of travel restrictions.

We have heard various efforts from Ministers to deny it, but the fact is that it took the Government eight days after banning travel from Bangladesh and Pakistan to introduce a similar restriction on flights from India to come into effect. During that time, travellers from India continued to enter the UK without the need to quarantine in a hotel, with the result that there were dozens of outbreaks around the country. The suggestion that the Prime Minister delayed adding India to the red list until he decided to cancel a scheduled trade visit to India means that his negligence has led to the announcement that he will be making today. There is now a terrible sense of déjà vu, as more variants enter the UK from Thailand, Brazil, South Africa and India.

The confusion around the ambiguity of the amber list must come to an end. We urgently need a comprehensive hotel quarantine system. In the meantime, Ministers should not turn their back on the aviation and travel sectors. As we have been calling for, they should bring forward a sectoral deal that supports the whole aviation industry, including securing jobs in the supply chain.

Last but not least, I will move on to a final element of the regulations in the SI. As we know, it amends the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020 to provide an exemption for gatherings for specified educational and training purposes in community premises, which brings the rules into line with those applied in schools. However, given that cases in many hotspot areas are now concentrated among school-age children and young adults who have not yet had the opportunity to receive either dose of their vaccine, and that a number of local public health authorities in the north-west have issued recommendations to secondary schools about using facemasks again owing to the rising covid transmission rates, mainly due to the Delta variant, is the Minister confident that the relaxation of the rules in this area is wise? Is she able to share with us the advice that informed the decision? Given the surge in infections since the SI was published, are there any plans to revisit the regulations on face coverings in educational settings? What is the most up-to-date advice on the risk of increased transmission as a result of the relaxation? I look forward to hearing the Minister’s response to those points.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I thank the hon. Member for Ellesmere Port and Neston for his contribution. I can begin by saying I agree that his focus needs to be on keeping people safe. However, we are here to discuss the regulations that were put through on the 17th, and once again we had quite a meander around the regulations that might underpin any future decisions. I will focus on the things that I believe I can inform him about, and I have noted and listened to the others, but I do not find them particularly relevant to what we are agreeing here today.

There is a need to take account of the latest data before we make the regulations. We said that the earliest date was going to be the 17th, but no earlier, and the same is true for the recommendations at each level of the road map. There was no promise that the date would be the 17th, and therefore the data that we look at and evaluate is very close to that point in time.

That leads me on to the question of why the statutory instrument is necessary. The Opposition cannot constantly ask for the data to be the most up-to-the-minute data, then not allow us to collect up-to-the-minute data, and refer back to the fact that it is problematic to make the timings fit. That is why we have ended up in this situation. I appreciate the hon. Gentleman’s concern that we are always discussing these things after the event, but we need to make sure that we are discussing what is relevant and what is there at the time, to make sure the decisions are as close to the data and as relevant to all of us as they can be.

[Justin Madders]

I am grateful to the Minister for giving way, but I think she has misunderstood the point I was making. I am not suggesting for a minute that these decisions should be made earlier: I absolutely agree that the most up-to-date data should be used. What I was saying was that we know what measures were envisaged on that date, because they were set out back in February, so it would have been perfectly possible to put those in regulations at the right time.

[Jo Churchill]

I agree with the hon. Gentleman that that was the indication of the road map, but there is always a need to look at whether we should flex all, some, or none of those things that were outlined in the road map. However, I put on record once again the fact that we appreciate and value the scrutiny role that Parliament plays, and we have tried to balance it with the dynamic nature of the pandemic. That is why we find ourselves on the Floor of the House, in Committee and so on going over these things, which are important.

I hope the hon. Gentleman appreciates that at all stages, I have tried very hard to be as open and transparent as I can. He has asked me to confirm points about the surge testing and things that are happening in parts of the country today, including his own, but I will gently say that we had a briefing on this earlier, and I do not feel it is relevant to these regulations that came into force on the 17th. As he knows, we had a full discussion with members of the medical profession, Public Health England and so on on that call. The hon. Gentleman is well aware that surge testing includes on-the-ground support from two local authorities; the use of the Army and mobile testing; surge testing and vaccination; supporting schools with their testing programme; and, as he said, PHE working with local schools and college leaders so that they can make the most appropriate decision for themselves and their environment, with reference to local data, rather than applying a blanket proposal.

On vaccination, as has always been the case, we are focusing on those in groups one to nine, making sure that we vaccinate the most vulnerable in a way that is based on age profiles. Our vaccination programme has followed the advice of the relevant committees and so on, and it has proven to be very successful: the way in which we have delivered it is now estimated to have saved some thousands of lives. We also, on any tests of positivity, have full genomic sequencing similar to that for water testing and so on, so I very much refute the idea that we are not making strong progress. Many other countries look towards us.

With respect to the hon. Gentleman’s comments about travel, the Government’s priority is still protecting public health. At the time that he alluded to, around the beginning of the Delta variant, positive rates were three times higher from Bangladesh than from India, but if the pandemic effort has shown us anything, it is that we are in an incredibly dynamic situation and that things can change very quickly. We cannot just ask for everything to be open; it has to be a steady progression towards opening up—hence the road map.

Step 4 is a cautious plan to ease restrictions. It sets out a “no earlier than” approach, so I ask the hon. Gentleman to be aware that there will be further statements later today; I, too, will be listening attentively when that information comes forward. However, the progress to step 3 of the road map, which we are considering today, represented a considerable achievement. It started a cautious approach to easing lockdown, guided by the data, with the specific aim of avoiding a surge in cases that would have put unsustainable pressure on the NHS and claimed more lives. Data from the Joint Biosecurity Centre, the Scientific Pandemic Influenza Group on Modelling, and Public Health England informed the assessment that all steps at that point were met. We continued to monitor the situation closely, informed by all current data and scientific evidence, and we will continue to work alongside experts to make sure that at each stage of the pandemic we are taking decisions driven by the evidence.

I recognise the impact that the restrictions have had, and their easing is hugely welcome, but there is not one of us in the House who has not been affected, with constituents, local businesses and members of our own family who have struggled over the past 15 months. Making sure that we can progress in a methodical way that does not allow us to slip back is of huge importance. We must all continue to be cautious, follow the rules and take up offers of vaccination as soon as they are made. I thank the hon. Member and take on board his comments.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) Regulations 2021 (S.I. 2021, No. 585).

Oral Answers to Questions

Justin Madders Excerpts

Tuesday 8th June 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

The Government have produced a four-step road map to ease restrictions across England. Before each step, an assessment is made against the four tests, including assessing the current risk posed by variants of concern. The move to step 3 on 17 May was based on the assessment that the risks were not fundamentally changed by those variants of concern. Step 4 is due no earlier than 21 June and the variants of concern will again be considered in advance.

[Justin Madders]

On Sky News, on Sunday, the Secretary of State was asked about figures that contradict his claim that India was not put on the red list at the same time as Bangladesh and Pakistan because positivity rates were three times higher in those countries. In response, he said that he did not recognise those figures, but he should have done, because they are his own figures from Test and Trace. Indeed, there are no published figures for the time the decision was made that support his claim. Given the allegation that the only reason there was a delay in putting India on the red list was to help secure a trade deal, and given that this delay is now having serious consequences, will the Minister agree to publish all the data and advice on which the decision was based, in the interests of transparency and accountability?

[Jo Churchill]

The positivity rates were three times higher from Pakistan than they were from India when we made that decision. As the hon. Gentleman knows, we keep these things under constant review and we would be equally lambasted if decisions were made before we had the correct information. Acting when we have the right information on variants of concern is an important thing; we will keep following the data.

Covid-19:International Travel

Justin Madders Excerpts

Monday 24th May 2021 Westminster Hall

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

It is a pleasure to see you in the Chair, Ms Fovargue. I start by thanking the hon. Member for Don Valley (Nick Fletcher) for introducing this important debate on international travel and covid-19, following the e-petition signed by more than 100,000 people. As he set out very clearly, all those people have particular personal circumstances—involving long-term relationships and parents and children—that mean that they are in a very difficult situation. Unfortunately, I think that, with the situation that we have seen with the Indian variant, things are not going to get any easier anytime soon.

I also thank the hon. Gentleman for raising the very important issue of the effect on the travel industry. Like him, I have local independent travel agents in my constituency. It seems at the moment that they are in the worst of all worlds: they have the workload from having to deal with cancellations and rebookings, but they do not have the ability to access additional support funds, and of course they cannot furlough all their staff, so I think that there is an argument for greater long-term support for that particular industry. The hon. Gentleman also raised a very important question about the cost of tests for people re-entering the country—a topic that we will come back to later.

There were a number of very good contributions today. My right hon. Friend the Member for Exeter (Mr Bradshaw) set out several important issues, including the economic impact of this situation on the travel industry and the hundreds of thousands of jobs that rely on it. His most important point was that many countries are allowing in those who are vaccinated without additional checks. At the moment, in the terms of our policy on letting people into this country, no distinction seems to be made between those who are vaccinated and the unvaccinated. It would be useful to hear from the Minister why that is the case.

Most hon. Members talked about the importance of the economics as well as the personal situations. My hon. Friend the Member for Ealing, Southall (Mr Sharma) has a particular interest, given all the employees of Heathrow in his constituency. I think he said that what they really need is clarity and certainty; indeed, a lot of Members referred to that.

As we have heard, the petition calls on the Government to class in-person interaction with family members and unmarried partners as a reason to travel. I am sure that, on a human level, we can all understand that—many of us have not been able to see our loved ones as we would have liked during the lockdowns—especially when we consider that in 2019 more than 20 million trips were made by air out of the UK for the purpose of visiting family and friends. The current situation means new parents not being able to see their families, and grandparents not being able to meet up with grandchildren—actually, many people have not met their new family member for the first time.

The timing of this debate is apposite, given last Monday’s announcement that holidays abroad are no longer illegal, but there are of course, as we have heard, different rules for different countries. It should have been a simple colour-coding scheme—amber, red and green, according to each country’s risk. But of course, as we saw last week, there are as many different interpretations of what amber means as there are countries on that list.

We saw on Tuesday the Environment Secretary saying that people could fly to amber-list countries if they wanted to visit family or friends—something that the signatories of this petition would of course like to see—but then in the afternoon the Health Minister in the other place said that nobody should travel outside Britain this year at all. Later the same day, though, the Welsh Secretary said that some people might consider holidays abroad as essential.

That was three Ministers with three different interpretations in just one day, so it was left to the Prime Minister—the paragon of precision in this place—to clear up any confusion or contradiction at Prime Minister’s questions last Wednesday, when he came up with his own definition that people could still travel in “extreme” circumstances. That, of course, is also open to interpretation, but it does at least set the bar a little higher—until we remember that the new rules that he has actually brought in make it easier for people to travel to amber-list countries.

In fact, it is even easier than that, because if someone returns from an amber-list country, they can halve the time that they spend in self-isolation by paying for an additional test after five days. It is hardly a consistent message when it comes to what extreme circumstances in relation to international travel means. Perhaps the problem is that there is no definitive answer—it is all guidance. We have had issues in the past year where there has not been a clear-cut distinction between guidance and law. The Foreign Office website tells us:

“Whether travel is essential or not is your own decision… Only you can make an informed decision based on your own individual circumstances and the risks.”

That is the nub of the problem: everyone can have their own view on what is essential, which means there is ambivalence at the heart of Government policy, which I am afraid the virus is set to exploit.

We have spent the last year painstakingly legislating for every facet of life where covid could intrude, from when people could leave home or leave the pub to how many people can attend a funeral, yet when it comes to one of the biggest threats to our future prosperity—variants from abroad—this Government are inexplicably and recklessly letting people interpret the rules for themselves. The ambiguity over amber has to end. People should not travel to particular countries. Do not let them—it is not difficult.

I cannot believe that the more than 100 countries on that amber list all have the same level of risk. As Members have said, it is clear that more clarity and transparency are needed about why countries are on that list. One might conclude that it has been left deliberately vague so that the Government do not have to compensate the travel industry for all the cancellations that would happen if there were proper laws in place on restricting international travel. Last week, it was reported that 1,300 flights, carrying up to 54,000 passengers a day—[Interruption.] Ms Fovargue, should I continue?

[Yvonne Fovargue (in the Chair)]

I think we will pause until the bells have finished.

[Justin Madders]

Saved by the bell. Although I am not sure whether I am or whether—[Interruption.]

[Yvonne Fovargue (in the Chair)]

Justin Madders, would you like to continue?

[Justin Madders]

Thank you, Ms Fovargue. It is almost as if someone does not want me to carry on speaking, but I will not be put off that easily.

We have all seen images from airports of people from red, amber and green countries mixing and standing side by side for hours in conditions where the virus can be transmitted. That makes a mockery of the sacrifices that people have made over the last year. Then, they move through the airport, on to public transport and go back to their homes, without proper controls in place.

I asked the Home Office how many visits had been made to check on people who are supposed to be quarantining at home after returning from abroad. I was told that there is no data on that, because it is an operational matter for the police. In short, the Government do not know whether people are complying with these rules. The Government could be overcompensating that lax approach by having so many countries on the amber list. As the hon. Member for Bromley and Chislehurst (Sir Robert Neill) said, it is not clear how a country gets on or off that list. It seems that putting lots of countries on the amber list is a quick and easy way of solving some of the issues in the rest of the system.

The hon. Member for Richmond Park (Sarah Olney) mentioned the cost of tests for those who have to quarantine at home. Actually, it is not just the cost of those tests but the service that people are receiving that is a problem. Hundreds have had complaints about these firms, which are listed on the Department of Health and Social Care’s website. Some people have either not received their tests or not got them in time. Some have not got their results at all and have been left in limbo.

Last year, some of these private companies did not exist, and some had zero experience in the area they are benefiting from, but with the Government’s open-door policy it seems they can request to be put on the list on the Government website if they declare that they meet the required standards and either they are UK Accreditation Service-accredited or they have applied for accreditation but do not yet have it. As of March, the UKAS website said it had received 80 applications from such companies and had accredited nearly 30 such providers, but many more than that are listed on the Department’s website as providers of day two and day eight testing—when I checked this afternoon, it was 333.

I do not know about the Minister, but I find it astonishing that for one of the most critical parts of our defence against covid we are relying on companies to self-certify that they can do the job, and less than 10% of them have been properly accredited to provide the service. We must get much more rigorous in our testing and ensure that these companies can do the work accurately and safely. Will the Minister update us on how many companies are now accredited and what the Government are doing to investigate how they are operating to ensure that they are doing what they are supposed to do?

Why do these restrictions at the border matter? It is because the emergence of new variants of concern is the biggest single risk to the road map. We have seen outbreaks of South African, Brazilian and now Indian variants in this country and, once again, the Government have been too slow off the mark to deal with the Indian variant. It was first identified back in February, yet travel from India was not banned until more than two months later. During that time, travellers from India came into the UK without any need to quarantine at a hotel. The consequences are now clear in the clusters of outbreaks we see.

There is a suggestion that the Prime Minister delayed adding India to the red list until he decided that he had to cancel his trade visit to India. I suppose we will add that to the long list of questions he will have to answer at the inquiry. If it is true, it is another serious error of judgment from him. In the meantime, will the Minister confirm whether decisions to place countries on particular coloured lists are all to do with health issues and not also trade deals and other such considerations?

We need to get this right now. A comprehensive, easily understood system that does not undermine the gains we have made is necessary. The Government finally decided to introduce a hotel quarantine system only in February, over a year after cases first arrived in this country. That is inexplicable. That they continue with an ineffective system that is clearly not working and is creating the injustices we have heard about today is also inexcusable. They have failed with their inadequate covid border protections. They were late to home quarantining, late to mandatory border testing, late to hotel quarantine and late to add India to the red list. We cannot afford to have the Government be late to fix the ambiguity and confusion over the amber list as well. The public have made huge sacrifices, which must not be undone now by laxity and ambiguity. The Government need to get a grip of the situation as a matter of urgency.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve with you in the Chair, Ms Fovargue. First, I thank my hon. Friend the Member for Don Valley (Nick Fletcher) for raising this important issue on behalf of the Petitions Committee. I thank all Members of the House who have taken time for this wide-ranging debate: my hon. Friend the Member for Don Valley, the right hon. Member for Exeter (Mr Bradshaw), my hon. Friend the Member for Bexhill and Battle (Huw Merriman), the hon. Member for Ealing, Southall (Mr Sharma), my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill), the hon. Member for Richmond Park (Sarah Olney), my hon. Friends the Members for Cities of London and Westminster (Nickie Aiken) and for Bracknell (James Sunderland) Bracknell, and the hon. Member for Ellesmere Port and Neston (Justin Madders). The one thing it did absolutely perfectly was display the complexity of the area and how difficult it is to get to a perfect solution.

I will take from the debate that we all agree that people have made enormous sacrifices, both in the country and out of the country, and that the vaccine roll-out has been a tremendous success. However, I point out that we have not yet reached the under-30 age group. While everybody was lucid about allowing people who had had a vaccination to travel, nobody said anything about those who had not, or what the solution was for them. This debate has ranged from the travel industry to business travel and has covered the Department for Transport, jobs and a wide range of Departments, but at its heart is how we are dealing with family and friends.

The past 14 months have presented huge challenges for all of us, and it is only right that members of the public, like Ms Sinclair, should debate such issues of enormous interest to us. My heart goes out to everyone who, 14 months ago, did not want to spend the past year like this. However, many of the reasons why people make sacrifices, in this country and without, are well known to us all. Last Monday, we took an important move to step 3 of the Government’s road map, in that we removed the provision to stay in the UK. International and leisure travel is slowly—I repeat, slowly—starting again and there is a new traffic light system.

In essence, the petition asks whether family members and unmarried partners should be able to visit their families and partners abroad, specifically regarding the “stay at home” and “stay in the UK” measures, which were in effect until 29 March and 17 May respectively. Under “stay in the UK”, individuals had to have a reasonable excuse to leave the UK. As with all restrictions during the pandemic, no decision has been easy, and none has been taken lightly. Where international travel is concerned, we acted to control the spread of the virus and to reduce the risks of variants being imported and exported. It struck me as interesting that people assume that that is completely possible while exempting people in a whole range of different areas.

I have often argued against the party of the hon. Member for Ellesmere Port and Neston, which has said that we should have a more stringent managed quarantine system. Everyone cannot have everything; we have to have a balanced approach in what we are doing. At the heart of everything is protecting people. We are opening up, but we are going slowly. Where international travel is concerned, we do not want to export or import variants, as I said.

Infection rates have fallen back at points but, crucially, a large amount of the population are not yet vaccinated, so it is vital that we maintain additional restrictions while the programme continues through the cohorts and to counter the risk of import or export. I of course appreciate the desire to see loved ones. I sympathise with those who have not seen partners and family members for a long time. I, too, like everyone else in the Chamber, have constituents who have come to me with such challenges. I recognise how difficult it is for people with family and partners based abroad. The pandemic has presented unprecedented challenges. My thanks go to everyone for their contribution and to all those working in the health service. That is what has allowed us to arrive at where we are today.

Acknowledging instances of those with family members overseas, the “stay in the UK” regulations included a number of reasonable excuses—no one appeared to allude to them—to allow international travel in circumstances where visits could not be delayed. I have had constituents—[Interruption.] I will try to beat the bell. I have constituents who have used those exemptions, which include travel to support someone giving birth, to accompany someone to a medical appointment, to provide care or assistance to a vulnerable person, including those of 70 years or older, a woman who is pregnant or those with underlying health conditions, or to say your last goodbyes at the end of life. So, there have been possibilities; to say that there has been none is just wrong. People could also travel out of the UK to attend their own wedding or civil partnership, or that of a close family member if at least one of the persons getting married or entering the partnership lives outside the UK.

As part of the road map, however, the Government took the prudent decision, informed by the latest data and analysis, not to allow international travel to see family members and partners more generally, however hard that feels. It was not an easy decision. Indeed, it is one of the many tough but necessary decisions taken as we continue to follow the road map out of lockdown. It is about finding a balance between priorities, including the need to save lives and to mitigate another surge in infections, as well as to avoid putting pressure on the NHS.

Those restrictions have bought us time: time to establish the vaccine roll-out and reduce the spread of disease, time to vaccinate front-line staff and care staff, and time to vaccinate care home residents and the most vulnerable. We continue to make good progress. As of 22 May, over 37.9 million people have received their first vaccine, another 22.6 million people have received their second dose and a staggering 60.5 million covid vaccine doses have been administered across the UK, through the enormous efforts of our general practice teams, pharmacists and mass vaccination centres.

Public Health England reports that the UK covid vaccination programme has prevented about 12,000 deaths in those aged 60 or above in England. Furthermore, it has saved 33,000 hospital admissions for those over 65. Restrictions on international travel have helped us achieve these things and have helped protect people so we can move to step 3. It is important that we remain vigilant and continue to manage the risks, so that we do not lose the benefits gained through the efforts thus far. Step 3 includes a cautious, managed return to international leisure travel, which I hope colleagues across the House will embrace.

I will address some specific points raised by hon. Members. When we talk about opening up, it is important to keep in mind that we had the indication only this weekend that the Pfizer and AstraZeneca vaccines were both effective against the Indian variant, so asking us to see into the future is incredibly difficult.

On 17 May, we moved to a traffic light system that categorises countries based on their level of risk to public health and the potential effect of variants of covid-19 to limit the efficacy of the roll-out. Decisions on designating countries to red, amber or green lists and the associated border measures are under constant review, to ensure that we manage the risks. These risks are challenging. They are about the impact on people’s jobs, livelihoods and all those things, but they are predominantly about people’s health and wellbeing, and about protecting people.

The decisions are taken by Ministers, who consider the Joint Biosecurity Centre analysis, as well as wider public health considerations. As I have explained, decisions are under constant review so that we manage the risks. I was glad that the hon. Member for Linlithgow and East Falkirk (Martyn Day) outlined how rigorous this process is and how we are now in better lockstep with our friends across the border.

We are making progress as we journey along the road map, but we have to remain vigilant. Variants continue to pose a significant risk that we are monitoring closely, and action will be taken as necessary to stop the spread. Border measures, including testing and quarantine, continue to help manage the risks. That includes the requirement for international arrivals, except those from green list countries, to take a pre-departure test and isolate for 10 days, either at home or in a managed quarantine hotel if they have come from a red list country, and to take a post-arrival test on day two and day eight.

Several hon. Members talked about testing. From May 15, NHS Test and Trace reduced the cost of tests from £210 to £170, and day two tests for green list countries went down to £88. These costs include genomic sequencing if someone has a positive test. Other private providers are stringently tested to ensure quality, and they are available. PCR tests continue to fall in cost, to around £100 to £120 for a day two test. We expect green arrival tests to be somewhere between £20 to £60. As the market develops, that cost will keep dropping as prices become more competitive, but I gently ask, is the British taxpayer meant to pay for the test for leisure purposes and travel?

[Justin Madders]

I understand the point that the British taxpayer should not be expected to pay for these tests for leisure purposes. However, a person who goes on to the Government website now does not need to give a reason to receive a lateral flow test, and we know that for a number of sporting events that have taken place, the condition for entry has been tests, which have also been free. There is not any consistency here, is there?

[Jo Churchill]

As I say, these things are kept under constant review. The Department for Digital, Culture, Media and Sport is testing large-scale events involving large groups of in-country crowds. That is completely different from testing those people who are returning to the country. Measures for these international journeys are essential, and it is vital that we follow what restrictions remain in place.

It is also essential that offers of vaccination are taken up by everybody as soon as possible. We hope that the continued success of the vaccination roll-out, including increased testing capabilities, alongside falling infections and hospitalisations, will allow us to continue to lift restrictions. However, we have to protect our hard-fought gains made over the past few months, and we are taking a cautious approach to opening up international travel, given that the risk from those travelling back from countries with high prevalence or where there are variants of concern is not only to the individual, but to wider society.

Some Members brought up the difference between allowing us to enlarge business travel and travel to visit family, friends and so on. They are, in fact, completely different—I very rarely behave with family and friends as I might in a business meeting, so I would urge a little caution before drawing a comparison between the two. Like everybody else, I feel for travel agents and so on in this time of uncertainty. However, they are supported by Her Majesty’s Treasury and the different interventions that have been put in place. Those things will be ongoing after we open up on 21 June, so long as we keep on the road map, and there is some assistance for businesses going forward.

This is a first step, and more opportunities will come along. It is important to remember that, and to highlight that the Joint Committee on Vaccination and Immunisation looks at the outcome of vaccine programmes on reduced levels of infection, high levels of vaccination, and the transmission risk and variants of concern. I reiterate my sympathy for those who have not been able to visit family and partners, and my thanks to those who have stepped up. Getting to this point has taken remarkable perseverance and resolve, and I am grateful to everyone who has got us here. The collective effort has meant that we can reopen our borders, allowing us where possible to reunite families, loved ones and friends. We must continue this careful approach. It is a risk-based approach, informed by the latest data and scientific evidence and by the abiding need to protect the population’s health and wellbeing, and thereby the economy.

With all this in mind, I believe we have good reason to feel optimistic, although there will be new and unexpected challenges, and there will be some setbacks as well. I have not hugged some of my children for 14 months, and they all live in this country—we have a large family. It is tough, and I get that, but we are doing what we are doing for the right reasons. We are better protected and better prepared to take on those challenges than we have ever been.

Health Protection (Coronavirus, Restrictions) (Steps and Local Authority Enforcement Powers) (England) (Amendment) Regulations 2021

Justin Madders Excerpts

Monday 26th April 2021 General Committees

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

It is a pleasure to serve under your chairmanship, Mr Gray. I thank the Minister for her introduction to this instrument, which, as she said, came into force on 12 April. It amends both the original steps regulations and the local authority enforcement powers regulations. I join her in thanking all those who have contributed to the national effort so far in our struggle against the virus. I echo what she said about the great commitment that has been shown by so many. I also agree that we are not out of the woods yet.

We do not oppose these regulations, but I do of course have some observations and questions for the Minister on the various amendments in this instrument. Let me start with the amendments relating to the steps regulations. As we heard, this instrument primarily amends those regulations to move all of England into step 2, as per the Prime Minister’s road map. It also includes amendments to allow businesses or services otherwise permitted to open at step 2 also to open at self-contained accommodation, caravan parks and campsites.

According to the explanatory memorandum, the instrument also makes

“minor drafting changes to remove superfluous wording and to amend references.”

I was particularly struck by that last assertion, which, it is fair to say, somewhat underplays the utter mess that was made of the original steps regulations when they were drafted. I have never seen such a harsh report as the 46th report of the Session from the Joint Committee on Statutory Instruments, which said that the original steps regulations that this instrument amends needed to be highlighted because of a number of serious concerns: first, because of their unusual or unexpected use of enabling powers; secondly, because of defective drafting; thirdly, because they required elucidation; and, fourthly, because they fail to comply with proper legislative practice.

Those are not just a couple of minor errors, but systematic failures throughout the document. The Joint Committee report identifies that those regulations make unusual or unexpected use of the enabling powers in two respects, are defectively drafted in relation to nine issues, require elucidation in relation to five issues, and fail to comply with proper legislative practice in one respect. That is quite a damning list of failures for one statutory instrument, whose purpose is to see us safely opening up society following lockdown. As we have said many times before, how can we expect people to follow the rules if they are not clearly communicated?

These regulations do not deal with all of the Joint Committee’s concerns, but, be in no doubt, we will be dealing with the consequences of them all for some time to come. If a Committee of legislative experts is unsure what is or is not meant by certain regulations and does not believe they give sufficient certainty and clarity, how can we expect the average person to understand them? In one instance, the regulations are so unclear that the Joint Committee said that the law being laid down was unsatisfactory in terms of the rule of law. I am sure the Minister will agree that such statements are pretty damning. It is just not good enough. Who in Government will be responsible for dealing with all the litigation that arises from the inevitable legal challenges to the unsatisfactory drafting of these regulations? Will the cost come from the Department of Health and Social Care’s budget? Who will be paying for the mistakes?

To take one example, regulation 2(2)(b) before us today amends the definition of “private dwelling” in regulation 2(5)(i)(ii) of the Health Protection (Coronavirus, Restrictions) (Steps) (England) Regulations 2021, which is a list of exceptions and includes the magic words “as otherwise specified”. When the Joint Committee asked the Department to identify those “as otherwise specified” exceptions, the Department replied that there were none—hence the amendment made by the regulations before the Committee.

That begs the question whether there have been arguments or challenges to the regulations based on exceptions that turn out not to have existed. I should appreciate it if the Minister would explain why those words were included in the first place when they were clearly not needed, and whether there has been any cost to the public purse from what I have outlined. That is just one error that is rectified by the regulations that we are considering today.

Another concern of the Joint Committee appears to have been overlooked altogether. As we know, the regulations make a number of amendments relating to businesses, including allowing businesses or services otherwise permitted to open at step 2 also to open at self-contained accommodation, caravan parks and campsites, including public toilets, baby changing rooms and communal areas. Of course, as part of the road map, those changes have been known about for some time, and there are restrictions. Those who can stay in the accommodation are limited to those in the same or linked households.

There has not, however, been clarity in relation to one of the concerns that the Joint Committee picked up: how the providers of holiday accommodation are expected to know with certainty whether people occupying their accommodation are linked householders. That matters because there remains a question whether the provider of the accommodation could unwittingly commit a criminal offence if they were led to believe that households were linked on the basis of false evidence submitted by a household.

In its memorandum, the Department asserts that it

“would expect a provider of holiday accommodation to take reasonable steps to ascertain whether persons for whom holiday accommodation was booked were from the same household or linked households”.

It adds that a provider who is misled by the submission of false evidence

“may well have a reasonable excuse for having breached the regulations but this will depend on the facts”.

That hardly gives us much clarity or reassurance, does it? What might those reasonable steps be, and why is nothing set out anywhere about that?

As the Joint Committee said, providers of accommodation could have been made the subject of a statutory duty to carry out a verification process, or the regulations could have set out another process for them to follow. Compliance would then have been clear, and there would have been a clear defence to a prosecution. With the regulations in their present form, there is no compulsory or voluntary statutory process, and the evidential burden of proving linked households seems to be a trap for the unwitting to fall into.

As we are talking about a criminal offence—a serious matter—who is policing it? Many people who own self-catering accommodation market it through a third party—usually an internet service. Where does the responsibility lie in that situation for verifying the households of the occupants? That is important, and we need clarity on it if possible.

The regulations also clarify that individuals may enter indoor premises that serve alcohol for the purposes of paying for food and drink, as that was not in the original regulations. Businesses have obviously been preparing for the 12 April reopening for some time, so it is quite possible that, until that last-minute change was made, preparations were being made on the basis that customers would not be able to enter the premises. Is the Minister aware of whether additional unnecessary costs have been incurred by businesses because of that oversight?

As the Minister outlined, the statutory instrument also amends the Health Protection (Coronavirus, Restrictions) (Local Authority Enforcement Powers and Amendment) (England) Regulations 2020. The Joint Committee also reported on those regulations, in its 36th report of the Session, where it again raised the matter of defective drafting on a number of counts.

The regulations before the Committee amend the 2020 regulations to clarify that coronavirus improvement notices and coronavirus restrictions notices that require businesses to remedy unsafe practices within a set period or, where rapid action is needed, to close and address an issue before reopening may be issued in relation to the restrictions on accommodation venues as set out in step 2.

The Minister will be aware that, earlier this month, the Secretary of State for Housing, Communities and Local Government wrote to all council leaders in England urging them to ensure that they work with pubs and bars that are trying to open safely and within the rules. He said that official guidance on what is defined as an outdoor shelter had to be

“applied proportionately and consistently in your areas to support businesses to reopen safely and to avoid overzealous interpretations of the rules”.

He also said that

“if a disproportionate regulatory approach is taken, it risks driving residents into unregulated activity and premises which may be far less Covid-secure and/or illegal.”

That sounds to me as though the Secretary of State believes the Government’s guidance is open to misinterpretation. Does the Minister agree that we really must have clear criteria for our local authorities and local businesses? We are too far down the line now for there to be any confusion about what the rules are and how they should be applied. That is totally unfair on the people on the ground who have to enforce the rules and on the businesses that are trying their best to get on their feet again.

On the powers to issue notices, we are only two weeks into step 2, so it is perhaps unsurprising that I did not find any figures on how many notices have been issued under the step 2 regulations. However, it was a surprise that no data seem to exist for any notices issued under the original regulations, which had been in force since December. That is an awful long time for there to be no record of how the powers have been used. I am sure hon. Members will be aware of local examples of where notices have been issued, but it is not clear whether there is intended to be any collation or publication of figures across the board. If local authorities are not publishing the data, and if the figures are not collected centrally, how are the Government measuring the effectiveness of such notices in relation to enforcement?

I hope the Minister is able to shed some light on that and on whether the Government have plans to collate and publish the figures in future, because we need to know whether the regulations are working—not just whether the timetable in the road map is being adhered to, but whether the restrictions and the draconian powers that we have handed to the state are being used effectively and proportionately and how they play into our shared objective of keeping case numbers and hospitalisations down. Too often there has been a failure to do a proper analysis of the measures taken, as well as a lack of willingness, frankly, to engage with the systemic underlying issues and to ensure that people who are sick with the virus are properly supported financially to do the right thing when they test positive.

I will make a few comments on the general process, which I hope the Minister will reflect on. She will know much of what I am going to say, because I have been saying it for the last 12 months. The SI that we are debating today is yet another example of what is wrong with the Government’s approach, because we are once again retrospectively approving legislation. The regulations have a dramatic impact on individual liberty, as well as an economic impact, and they should not be approved after the event.

The regulations were laid before Parliament on 9 April, before coming into force on 12 April—that is just three days’ notice of their introduction. Although that is actually an improvement on the three hours’ notice that we have had for some other regulations in the past, it is still a pretty poor show that these regulations arrive so late in the day, especially when a large part of this SI essentially deals with errors and oversights from earlier regulations. Again, that is not for the first time either.

On where this legislation sits on the road map, we know that the road map has been in place for several months now, so why are we debating elements of it only now? That suggests to me that there is continuing indifference to the importance of parliamentary scrutiny, disdain in the corridors of power for the impact of the rules on those affected by them, and carelessness about the clarity and accuracy of the laws governing this country. I would have expected enough experience to have been gathered by now for there to be no need to come back and correct errors time and again, especially when dealing with regulations of this nature. After all, we are a year into the pandemic. This is the third time that we have come out of lockdown, yet we still see basic errors being made. Mistakes have consequences and, frankly, there have been too many of them. I really think a proper explanation ought to be forthcoming about why we are having to deal with these things as an afterthought. They should not be an afterthought, because we are talking about people’s livelihoods.

What is the urgency for the SI? The regulations state that

“the Secretary of State is of the opinion that, by reason of urgency, it is necessary to make this instrument without a draft having been laid before, and approved by a resolution of, each House”.

That is plainly wrong. As I have already said, the Prime Minister set out the road map more than two months ago. There is nothing in the regulations, or in what has been said by the Minister today, to justify the Government once again claiming urgency to ride roughshod over proper procedures and processes. It is little wonder that we have so many errors in the regulations if they are not subject to proper scrutiny before they become law.

The Government have got into bad habits and do not think the rules apply to them. Yes, they had to act quickly at the start of the pandemic—in an emergency, that is understandable—but that is no excuse for standards to drop, for transparency to be jettisoned and for scrutiny to be considered an inconvenience to them. There can be no justification at this point for normal procedures to continue to be ignored and the claim that regulations needed to be introduced urgently. That is simply a sticking plaster for an Administration who have found that they rather like not having to bother with the norms of going through good governance. This Government have found that having to explain and debate laws before they become law is all a bit inconvenient. We should be better than that, and I think the Minister knows that we should be doing better than that.

History is full of temporary arrangements and powers that somehow became permanent because Governments found that they actually rather liked doing things that way. I will not stop raising this issue until the Government stop using the pandemic as a cover to get away with things that no self-respecting democrat would consider acceptable. I really hope that this is the last time I have to make these comments, because once the slide away from a liberal democracy starts, it can be very hard to stop.

Stroke: Aftercare

Justin Madders Excerpts

Wednesday 21st April 2021 Westminster Hall

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

It is a pleasure to see you in the Chair, Sir Edward. I thank the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for securing the debate and for his detailed introduction. He highlighted that there is increased awareness of the symptoms of strokes, and that acute care has certainly been on an upwards trajectory. The point that he made so eloquently and so personally was that there is still a long way to go on aftercare. He spoke of courage, patience and consistent professional care being needed, and that is something that we all want to see. A number of hon. Members added their personal perspectives to the debate. I believe we always do better when we hear those perspectives.

We also heard a professional perspective, from my hon. Friend the Member for York Central (Rachael Maskell), who set out clearly the importance of specialist services. The question she asked about the future of those in the new structures was very important.

As we heard from various Members, strokes are very prevalent in this country—100,000 a year, or one every five minutes. We also know that two-thirds of stroke survivors leave hospital with a disability, and it is the fourth-largest cause of death in the UK. It is perplexing, as the hon. Member for Bromley and Chislehurst said, that it does not get more of our attention. As my hon. Friend the Member for Stockport (Navendu Mishra) said, it is also something of a mystery why the level of research funding is not as high as in other areas, even before the challenges of the pandemic that all voluntary fundraising organisations have faced.

Members will know that the national priority in the NHS long-term plan is the national stroke programme. It is intended to deliver better prevention, treatment and care. It is an ambitious programme, but if it is to succeed, it needs adequate funding. I hope the Minister will be able to set out briefly how that funding is being allocated and what progress is being made to meet the targets and aims set out in the plan. A recent report by the Stroke Association found that thousands of stroke survivors are being let down—in various ways, as we heard in the debate, but particularly in the current provision of post-stroke support and rehabilitation.

The most recent Sentinel Stroke National Audit Programme data for April 2019 to March 2020 shows that only 41% of patients received a recorded six-month post-stroke review, and just over a third of applicable patients received recommended levels of physiotherapy or occupational therapy. Less than a fifth received the recommended levels of speech and language therapy. As hon. Members put it in different ways, those figures are clearly not good enough. It needs to be emphasised that that poor record is from before the pandemic.

There were concerns before the pandemic about the shortage of specialist stroke consultants. Figures from Kings College London showed that almost half of hospitals had a shortage of specialist stroke consultants, with 48% of hospitals in England, Wales and Northern Ireland having at least one consultant vacancy in the previous 12 months or more. To pick up on the comment by the hon. Member for Beaconsfield (Joy Morrissey), the Stroke Association called on the Government and NHS England to make stroke medicine a more attractive proposition for junior doctors to specialise in, as well as the other specialities, and drew attention to the need for nurses and rehabilitation. Can the Minister update us on the number of consultant vacancies and say what steps are in place to introduce a plan to deliver the staffing levels that we so clearly need?

It is clear, from what everyone said, that we need to go further and faster to provide support for stroke survivors. Further investment is vital to ensure equitable access to services, avoid digital exclusion and improve health outcomes, to stop the kind of disparities that we have heard about. We must end the postcode lottery. It is so important that, no matter where you live, you get access to the same quality stroke support services, which are consistent with clinical guidelines. I hope the Minister will address the issues that Members have raised, and will set out what steps the Government intend to take to support more survivors of strokes.

Elective Surgical Operations: Waiting Lists

Justin Madders Excerpts

Tuesday 20th April 2021 Westminster Hall

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

As a fellow Cheshire MP, it is a pleasure to see you in the Chair, Ms McVey.

Every Member who has contributed to the debate has spoken with great knowledge and sincerity about the challenge we face as a society. I pay particular tribute to my hon. Friend the Member for Bootle (Peter Dowd) for securing the debate and for his excellent introduction. As every Member has pointed out, he was right to say that we have record waiting lists. We should never forget that we had already seen a huge rise of over 40% in the decade before the pandemic. As some Members mentioned, it is possible that covid is masking an even worse situation. We know that the number of referrals plummeted around this time last year, as the NHS rightly focused all its intention on the pandemic.

As Members have said, we know that the NHS aims to ensure that no more than 8% of patients wait more than 18 weeks for treatment. That is a target that has not been met for five years, so this situation cannot be laid entirely at covid’s door. Indeed, just over a year ago, in February 2020, 17% of people on waiting lists had been waiting longer than 18 weeks. It is clear that the past year has had an impact, because the figure has now doubled to 35%.

Sadly, it is now the case that over a million people have waited longer than six months for hospital treatment. There are now 388,000 people waiting more than a year. Again, that is the highest number on record. That is nearly 400,000 people waiting for things such as knee and hip replacements. As Versus Arthritis points out, they

“are in extreme distress, with many struggling to cope with pain which is impossible to ignore, worsening mental health and reduced quality of life.”

My hon. Friend the Member for Bootle set out clearly some of the implications not just for physical pain, but for mental health and uncertainty about job prospects. My hon. Friend the Member for York Central (Rachael Maskell) eloquently set out the reduced outcomes and difficulties we will face if the process is not followed as well as we would like and patients enter the system at a later date.

As my hon. Friend the Member for Bootle said, this is an issue that cannot and should not be ignored. He described the challenges as possibly overwhelming—an apposite description, given that the Government’s strategy for the last year has been to avoid the NHS being overwhelmed. As that challenge was met, we hope that this challenge will be met as well. He also made the important point that, if we do not get this right, it will cost us more in the long run and will have economic and as well as physical and social impacts. The lessons learned from the pandemic ring true in that respect as well.

When we look very closely at the figures, we see that around 18,000 people are now waiting longer than 18 months. The figures we have relate to people waiting more than a year. Obviously, I have discussed this with the Minister on previous occasions and we hope that we will get the official figures shortly. We must remember that at the moment, we only have details for people waiting over a year, but the information I have suggests that more than 175 people have been waiting for more than two years. Those figures are slightly out of date, as they are from January, but that is a horrendous situation and I hope it has got better in the last few months. If it has got worse, I hope and expect that the Minister will be on the phone to those trusts inquiring exactly why people are waiting over two years to receive their treatment.

The importance of dealing with the backlog quickly cannot be overstated, because of the likely pressure that will manifest itself over the coming months. As my hon. Friend the Member for Bootle said, the Health Foundation has estimated that there could be as many as 4.7 million missing patients. If only three quarters of those are referred to treatment, that would lead to a waiting list of 9.7 million people by 2023-24. Obviously, that is an estimate, but if the Minister has done his own calculation, can he tell us what it is?

Over the last year, the NHS has adapted fantastically to the challenges of covid in a way that has rightly won the respect of everyone in this place and in the country. That has meant decisions have been taken about how treatments should be prioritised. We have seen appointments cancelled, operations postponed and staff redeployed, but even with those challenges, the NHS managed to carry out 1.9 million operations in January and February this year, which Stephen Powis, NHS England’s medical director, said is

“a testament to the hard work and dedication of staff”.

I join him in paying tribute to those staff for delivering that. However, even with that fantastic effort—to put into context the challenge that we face—the number of routine operations in January was down 54% on last year and in February it was down 47%.

Thankfully, I think we are past the peak of the third wave and there are only just over 2,000 patients with covid in hospital, which is the lowest since last September. However, the NHS is still under enormous pressure, with so many people now waiting for treatment, stricter infection control measures and, as many Members have referred to, an exhausted healthcare workforce. We have to be realistic: this could take years to address unless there is a credible and costed plan in place at the earliest opportunity.

Modelling by the NHS Confederation suggests that the sustained impact of the pandemic will leave a backlog of care in excess of anything seen over the last 12 years and that to maintain any sense of control over its waiting list, the NHS will need to increase capacity considerably above levels that have previously been sustained. My hon. Friend the Member for Bristol South (Karin Smyth) referred to the huge efforts that were made by the previous Labour Government to get waiting lists down. It seems that a strategy at least on a par with that will be needed.

The NHS Confederation has said:

“Without a comprehensive new plan, the government faces the…legacy of hundreds of thousands of patients left with deteriorating conditions”.

It warns that the additional £1 billion agreed in the spending review will not be enough to clear the backlog. The chief executive of the NHS Confederation Danny Mortimer said:

“health leaders are clear that the NHS will be recovering for years to come, and this must be appropriately resourced in the long-term.”

He called for

“investment in growing and maintaining the workforce”.

NHS Providers has said that the situation could take three to five years to resolve. Its chief executive, Chris Hopson, said:

“Trusts believe they can clear the backlog within a reasonable period of time”,

but that treating this like another waiting list initiative, relying on overtime and private sector use, will be insufficient. He said that the NHS will need to transform “how it provides care” and that the Government will need to provide

“the extra funding required to enable that transformation.”

As my hon. Friend the Member for Bootle set out, a number of practical steps can be taken to deliver transformation, but they come with a price tag. The Prime Minister was quick to pledge that the Government will ensure that the NHS has the funds it needs to beat the backlog, but how can we have confidence in him when he has already gone back on a promised pay rise for NHS staff? NHS England said that although the £1 billion fund will help, it will not be enough. Of course it will help and it is welcome, but helping is not the same as solving. Nobody, probably not even the Minister, believes that what is on the table represents a solution.

There is no doubt that the NHS has a monumental task ahead of it to restore services, meet demand and reduce the care backlogs, but it also must support staff and take steps to reduce inequality in access, experience and outcomes. Now is the time for the Government to deliver on their promise to deliver to the NHS whatever it needs. It certainly is not the time for another expensive reorganisation, as my hon. Friend the Member for Bristol South said. If that is the road we go down, it is important that patients’ voices are put front and centre of those new bodies, particularly if they are forced to deal with some of those extremely tricky issues.

As many Members said, 10 years of underfunding have left us in this precarious position. The challenge is there for the Minister. The experts say that we can tackle the backlog, but it will need funding. If the Minister can confirm any specific figures, that would be wonderful. I suspect we will not get that today, but at the very least will he confirm on the record that he agrees that the £1 billion that has been allocated so far is insufficient?

To pick up on what Chris Hopson, chief executive of NHS Providers, said about relying on the private sector, we know that huge sums were provided last year. As my hon. Friend the Member for York Central said, we have never had transparency about what that money was spent on. Can the Minister tell us how many NHS patients were seen in the private sector last year, and how many procedures were carried out using taxpayers’ money? I am sure that he is as keen as all of us to ensure that the best value has been achieved.

Many Members said that none of the backlog will be tackled if we do not have the staff to do it. A recent Institute for Public Policy Research report based on a YouGov poll of 1,000 healthcare professionals said that a third more nurses and midwives are leaving the NHS than a year ago. Those figures are scaled up across the workforce—that means 100,000 nurses and 8,000 midwives leaving. With 40,000-plus vacancies already, we cannot afford to lose one more, never mind 100,000 more.

Dame Donna Kinnair of the Royal College of Nursing said that that is

“The reality of a failure to properly invest in the nursing workforce”

and must be a

“wake-up call to the Government.”

It should indeed, especially when we are still waiting for the publication of the substantive long-term workforce plans to deliver a lasting solution to recruiting and retaining the workforce and ensuring there are enough skilled staff to provide safe and effective care now and in the future. That is why it is vital that Ministers bring forward a fully funded plan to tackle the backlog—we have been calling for that for a long time: an NHS rescue plan that will bring down waiting lists and ensure that patients can receive the quality of care that they deserve. As my hon. Friend the Member for York Central put it, we cannot carry on with business as usual.

Let me end with the important comments from Dr Rob Harwood, the chair of the British Medical Association’s consultants committee:

“Without further financial support and investment in increasing staffing numbers, patients will be waiting even longer for care, and there is a risk that patient care becomes unsafe the more exhausted staff become. The future of our NHS, already walking wounded, must not be put in jeopardy.”

The NHS is the jewel in our crown, but it needs protecting, sometimes as much as the patients it treats. We need financial support, a detailed people policy and a credible plan to deal with the backlog if we are to avoid coming back in 12 months to talk about an even worse situation.

[Esther McVey (in the Chair)]

I call the Minister, mindful that we will have a winding-up speech from Peter Dowd at the end.

Oral Answers to Questions

Justin Madders Excerpts

Tuesday 13th April 2021 Commons Chamber

[Mr Speaker]

This is Mrs Hoyle’s effort, but there we are.

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

Congratulations to Mrs Hoyle on a job well done.

New investment is welcome, but it is no consolation to those patients missing out because the rest of the NHS estate is being starved of investment. We have seen a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and the maintenance backlog went up by another 50% last year. We are not going to see those record waiting lists drop if operations are cancelled because basic repairs are not done, so will the Secretary of State tell us by what date we will see no more delays to treatment because of crumbling buildings?

[Matt Hancock]

We are putting a record amount of investment into the infrastructure of the NHS. That is evidenced by the questions that we have had already, with the improvements in Stoke, Scunthorpe and across the rest of the country. It is about not just the physical investment, but making sure that we support staff to be able to deliver and making sure that the NHS gets the support that it needs to tackle this backlog. We have a very significant backlog because of the pandemic and we are working incredibly hard to tackle it.