Public Health Debate

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Department: Cabinet Office
Tuesday 1st December 2020

(3 years, 4 months ago)

Commons Chamber
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Keir Starmer Portrait Keir Starmer (Holborn and St Pancras) (Lab)
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May I start by welcoming the fall in infection numbers, with the drop in the number of people being admitted to hospital, and crucially that the national R rate is now below 1, and below 1 in many parts of the country? That is very welcome news across the House. Before this lockdown, the infection rate was doubling every two weeks, the R number was above 1 in every part of England and rising, and the number of people in hospital was going up sharply across the country. In other words, the virus had been allowed to get out of control.

If anyone doubts that a lockdown was necessary, I would point out that since 2 November, when this lockdown started, 10,711 people have tragically died within 28 days of testing positive for covid-19. In the past week alone, that is an average of 460 deaths per day. Those are appalling numbers, and every one is a tragedy. So we can argue about why this lockdown did not happen earlier, when the infection rate was lower, as we argued for on this side of the House, but whatever view was taken of the timing, it is clear that the lockdown was necessary and has helped to reduce infections.

May I also welcome the progress on vaccines? I have nothing but admiration for our scientists and the amazing progress that has been made. This is a great moment for our scientists. I went to Oxford University the week before last, to see the vaccine group there and to see the remarkable work that it was doing, just before it announced its results. A vaccine may now be in sight, and we must do everything we can to encourage take-up and make sure that it is rolled out quickly, fairly and safely.

However, the questions before this House today are these: how can we save as many lives and livelihoods as possible until we reach the light at the end of that tunnel, and are the measures that the Prime Minister has announced today going to control the virus and provide the right support to the communities worst affected by these restrictions? Labour has supported the Government in two national lockdowns. I recognise the need for continuing restrictions and I do recognise that the tiers have been toughened, as it was obvious to everyone that the previous tiers were a one-way street to tier 3, but I am far from convinced by what the Prime Minister has said today. In particular, the economic package is nowhere near sufficient to support the communities most affected, and they have been suffering for many months.

Tanmanjeet Singh Dhesi Portrait Mr Dhesi
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Will my right hon. and learned Friend give way?

Keir Starmer Portrait Keir Starmer
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I will just make some progress, and I will come back to my hon. Friend.

I also fear that without the right health measures in place—in particular, a working trace and isolate system—there are real risks that this plan is incapable of controlling the virus this winter. I want to set that out in a bit more detail, but before I do so I will give way.

Tanmanjeet Singh Dhesi Portrait Mr Dhesi
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I thank the Leader of the Opposition. Does my right hon. and learned Friend agree that the support for businesses, especially in tier 3, that are struggling—in the hospitality and in the arts sectors specifically—is just not enough, because many of them are on the brink of collapse?

--- Later in debate ---
Lindsay Hoyle Portrait Mr Speaker
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We have lots of speakers, and interventions from those who are down to speak early is not fair on those later in the list. I do understand that people who are not going to speak might need to intervene, but please let us think about each other.

Keir Starmer Portrait Keir Starmer
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I do agree, and I will come on to business support in a minute, but let me make the points in support of the case we make today.

The first point is this: we have been here before. On 10 June, the Prime Minister told us for the first time of his “whack-a-mole” strategy to control local infections. He told us it would be so effective that restrictions would only be for a few weeks or even a few days. That was far from reality; Leicester, for example, has just gone into the 154th day of restrictions, and by the time these regulations run out on 2 February, Leicester will have been in restrictions for 217 days. So that 10 June proposal did not work.

Roll on to 22 September: by now, infections are rising in 19 of the 20 areas then under restrictions. The Prime Minister announced new restrictions, including the rule of six. He told the House that the rule of six would

“curb the number of daily infections and reduce the reproduction rate to 1”.—[Official Report, 22 September 2020; Vol. 680, c. 798.]

That is what he said about the rule of six. So that did not work.

Two weeks later, on 12 October, with the precise opposite happening, the Prime Minister stands up again—for the third time—and introduces a three-tier system. Again, he said that this will work: he told the House that this would deliver the reduction in the R rate locally and regionally that we need. That did not work.

Nineteen days later—the fourth attempt now—in a hurried press conference on a Saturday, the Prime Minister announced that the tier system had failed, the virus was out of control and a national lockdown was now unavoidable.

The reason that this all matters is that there is a pattern here. The Prime Minister has a record of overpromising and underdelivering—short-term decisions that then bump into the harsh reality of the virus.

And then a new plan is conjured up a few weeks later—we are now on at least the fifth plan—with an even bigger promise that never materialises. After eight months, the Prime Minister should not be surprised that we and many of the British people are far less convinced this time around.

Katherine Fletcher Portrait Katherine Fletcher (South Ribble) (Con)
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I have a biology degree and I am going to take a wild punt that I am one of the few Members of this House to have used the word “epidemiology” in anger before January this year. We have choices to control this virus: we can have a lockdown, we can have a tiered system, or we can have no lockdown, where lives, such as those of John and Ken, family friends who we have just recently lost, are lost to this awful covid. Why will the right hon. and learned Gentleman and the Labour party not tonight support these measures that are saving lives?

Keir Starmer Portrait Keir Starmer
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I am grateful for that intervention and I am setting out exactly why not—and I will take interventions along the way so that what I say can be challenged—but the first point, which I have just finished making, is that we have been here before; this is at least plan no. 5 and the first four have not worked. So I think everybody would forgive the British public for being sceptical about the fifth plan.

I will go on now and set out the second point I want to make, which is that the public health risk of the Prime Minister’s approach is significant. The prevalence of the virus remains high; even if the R rate is below 1, it is only just below 1, and we know that the virus is at its most deadly during the cold winter months, exactly when the NHS is under the most strain. So if we are to keep the R rate below 1 during winter and not waste the progress that has been made in the past four weeks, we need to proceed with precision and caution. But instead of levelling with the British public, the Prime Minister spent the weekend telling his Back Benchers that the plan is all about, in his words, loosening restrictions across the country, and he has been fuelling a promise that within two weeks or so local areas have a real prospect of dropping to a tier below the one they are in.

We need to level: in my view, that is highly unlikely, and we might as well face that now. It is obvious that the new tier 1 may slow but will not prevent a rise in infections, and it is far from certain that the new tier 2 can hold the rate of infection. [Interruption.] I hear the mutterings, but let us just see where we are in two weeks. I look across the House to Members who think that perhaps, in two weeks, their area is going to drop down a tier just before Christmas. Let us see.

Keir Starmer Portrait Keir Starmer
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This isn’t hindsight; I am telling you what is going to happen in two weeks. We know where we will be in two weeks. I have no doubt that there will be Government Members getting up and saying, “I thought my area was going to drop a tier just before Christmas.” That is not levelling—that is not being straight —because that is not going to happen. The new tier 1 may slow the rate of infection, but it will not prevent it from increasing, and tier 2 will struggle to hold the rate of infection. I hope that it does. I hope that I am wrong about this, and I think that all Members hope I am wrong about it, but tier 2—[Interruption.]

Lindsay Hoyle Portrait Mr Speaker
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Order. Mr Sambrook, it is continuous; we have had it for a few weeks now. Let us have a rest today.

Keir Starmer Portrait Keir Starmer
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Tier 2, crucially, depends on all other factors falling into place at exactly the same time. Although we all welcome the chance to see our loved ones at Christmas, I am not convinced that the Government have a sufficiently robust plan in place to prevent a spike in infections over the new year.

Of course this is difficult, and all systems would have risk, but that brings me to my third point. The risks we face in the decisions we make today are much higher because the Prime Minister has failed to fix the major problems with the now £22 billion track and trace system. Before the Prime Minister simply brushes the point aside again, let me remind him and the House that one of the major reasons that the Scientific Advisory Group for Emergencies advised a circuit break back in September was that track and trace was only having, in its words,

“a marginal impact on transmission”.

The great thing that was going to control the virus was not working then. If we are to control this virus, that really matters, and the Prime Minister having his head in the sand is not helping.

I know that the Prime Minister will say, “We’ve made advances in testing.” I recognise that, and I genuinely hope that it helps to tackle the virus, but let me quote the chief scientific officer, who said that

“testing is important, but of course it only matters if people isolate as well.”

That is blindingly obvious, but only a fraction of people who should be self-isolating are doing so, and the Prime Minister still has not addressed the reasons for this, including the huge gaps in support.

I know that there has been an announcement about the change for those notified by the app—a ridiculous omission in the first place—but it does not affect basic eligibility. Only one in eight workers qualify for the one-off £500 self-isolation support. Anyone not receiving that has to rely on statutory sick pay, which is the equivalent of £13 a day. That is a huge problem that needs to be addressed. People want to do the right thing, but for many there is a real fear that self-isolation means a huge loss of income that they simply cannot afford.

I think—I cannot prove this—that one of the main reasons that people are not passing on their contacts in the way we want is that they fear that those they pass on contacts for will not be able to afford to self-isolate. That is a real problem, and we cannot carry on ignoring it.

Edward Leigh Portrait Sir Edward Leigh
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The right hon. and learned Gentleman is doing a very good job—it is his job to criticise the Government, and of course mistakes have been made—but a credible Opposition would have a plan of their own. What is the plan of the Labour party?

Lindsay Hoyle Portrait Mr Speaker
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Sir Edward, that is your second bite of the cherry; there are other people as well—please.

Keir Starmer Portrait Keir Starmer
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I will come to that. I have accepted the case for restrictions—we were very clear about the need for a circuit break; we are clear that we need to go into restrictions—but we need a scheme that works, and I am explaining what the problem is with this scheme as we go through it.

Let me stay with track and trace. We know the claims the Prime Minister made about this at the beginning of the year and in the middle of the year. On tracing, which is crucial, the latest figures show 137,000 close contacts were missed by the system in one week. That is the highest weekly figure yet. This is not a figure that is going down; it is a figure that is going up. Over 500,000 close contacts have been missed by the system in the past month. That is not a statistic. That is half a million people who should have been self-isolating, but instead of self-isolating, they were with their friends, their families and their communities—half a million people in one month. That is a huge gap in the defences. I raise this issue every week, and the Prime Minister pretends it is getting better, but it never does. The Prime Minister has almost given up on it and put mass testing in its place, but again, that is blind optimism, not a plan. The idea that we can go through the next few months and successfully keep the virus under control when 500,000 people a month are wandering round when they should be self-isolating is not a sensible plan going forward.

My fourth point is the level of economic support that is provided. I have to say to the Prime Minister that it is hard to overstate the level of anger about this out there in our communities, many of which have been in restrictions for months on end. Yesterday, I did a virtual visit to local businesses in the north-west. Their emotions range from deep disappointment with the Government to raw anger that the Prime Minister and Chancellor just are not listening and do not get the impact of months of endless restrictions and the impact they have had on local communities. In March, the Chancellor vowed to do whatever it takes to support households and businesses, but there have now been six economic plans in nine months, and the level of support is still insufficient.

For these reasons, and let me spell them out—[Interruption.] The Prime Minister mumbles, but let me spell them out. First, the scheme does not fairly reflect the difficulties faced by businesses across the country. [Interruption.] I would be surprised if Government Members are not picking that up from their constituents and businesses. Let me start with the additional restrictions grant, which gives a flat figure to local areas, regardless of how long they have been in restrictions. That means Greater Manchester, which will be on its 40th day of severe restrictions when it enters tier 3 tomorrow, has received the same one-off support as the Isle of Wight, which went into restrictions far later and will emerge tomorrow into tier 1. That is unfair, and everybody knows it is unfair, and everybody in this House is being told by their constituents and by their businesses that it is unfair, so to pretend it is not just is not real, Prime Minister.

The second aspect—[Interruption.] The second aspect is that the grant does not take account of the number of businesses that need support in each area. Our great cities are being asked to spread the same sum far more thinly, and that is also clearly unfair. Our constituents know it is unfair, our businesses know it is unfair, and nothing has been done about it.

The third aspect—even allowing for today’s announcement on pubs, which is the definition of small beer—is that many businesses are now receiving less support than they did during the first wave. That is a huge strain for businesses, particularly those that have been so long under restrictions, and it makes no economic sense for the Government to allow them to go to the wall.

Putting the grant system to one side, the second major point about the economic support is that millions of self-employed people remain unfairly excluded from the Government support schemes. Again, nothing is being done about that. I have raised it so many times with the Prime Minster, as have others, and every time he chooses to talk about those who are within the scheme, ignoring those who are not in the scheme. It is eight months on, and we are facing another three or four months of this. That will mean 12 months without the support that is needed in those areas.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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I am extremely grateful to the right hon. and learned Gentleman for giving way. He talks about those people who have been excluded from support. To focus in on who those people are, they include people who set up their own businesses 18 months ago, directors of very small limited companies, taxi drivers, hairdressers and the like. These are the entrepreneurs we need to build Britain back as we recover from the economic wreckage of the coronavirus. Does he agree we should be investing in those people, not excluding them and leaving many of them in deep and dangerous debt?

Keir Starmer Portrait Keir Starmer
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I do agree, and their cry still has not been heard. I accept that in putting together a support package in a hurry back in March, there may have been reasons why certain groups were overlooked, but this is eight months on. It has been pointed out over and over again, and here we go into a tiered system and there is still that gap in the system, and it is being very strongly felt out there.

The third point about the economic package is this: the Government must remove the uncertainty about furlough and rule out changing the scheme again in January. That is crucial, because businesses are beginning to make decisions about what they do in January. The Chancellor made this mistake before. By the time the furlough was extended, many businesses had laid people off because it came too late. We know what happens in that circumstance. The uncertainty has already caused real economic damage and we cannot afford the same mistake again. So, taken together, the business and economic support just does not stack up.

I want to make a wider point about the economic damage that this pandemic and the Government have done to our economy. Last week’s autumn statement laid bare the huge and worsening economic cost of the crisis. I know there are those who say, “That is the reason to end restrictions”, but the reality is that we cannot protect the economy if we lose control of the virus—that just leads to more uncertainty, more restrictions and more long-term damage to the economy. The failure to get control of the virus or take a long-term approach to shielding our economy has left the UK with the worst economic recession of the G7 and the highest death toll in Europe.

The fifth reason for scepticism about the Government’s approach is this: managing and priorities. The past 48 hours have been a summary of the mistakes the Government have made in this crisis. The Prime Minister is fatally split between appeasing his Back Benchers and following the science, and he is ending up pleasing nobody. I think the Prime Minister knows that tough restrictions are now needed, but he pretends that the restrictions might not be in place for very long. He pretends that it is quite possible that everybody will be in a lower tier in two weeks’ time. The reality is that tough restrictions will be needed until the vaccine is rolled out, and that may be months away. The Prime Minister will doubtless be back in a few weeks with another plan, but he does not make that case today or provide the certainty or the consistency that we need. So in the past 48 hours we have had concessions, letters and promises to his MPs, not clear and reliable messaging to the public, and that is symptomatic of the problem.

Coronavirus remains a serious threat to the public’s health, our economy and our way of life. We recognise the need for continued restrictions, but it is not in the national interest to vote these restrictions down today and we will allow them to pass. But it is another wasted—

Keir Starmer Portrait Keir Starmer
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We accept the case for restrictions. We want a plan that is going to work, we are on plan 5 and this one is full of holes; we have been there so many times. So many times the Prime Minister has stood there and said, “This is the plan, this will solve the problem.” This is the fifth time around and we still have a plan with holes that have been there for months. Why is track and trace still not working? Why are the gaps in the support still there? Why are those we are excluding not included? Why are those who have to self-isolate not given the support to do so? Those are huge gaps in the system and to simply vote through a plan without recognising those problems is not going to help.

I accept the case for restrictions—we will not stand in the way of these regulations; we do not want the restrictions to come off—but I am not going to stand here and pretend, as the Prime Minister does: “This is the plan that will solve it all. Vote for this and it will all be fine through to Easter.” That is not going to happen and nobody should vote on that basis today.