Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021
Lord Kamall Excerpts(2 years, 12 months ago)
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Lord Kamall
That the Regulations laid before the House on 29 November be approved.
Relevant documents: 22nd Report from the Secondary Legislation Scrutiny Committee. Instrument not yet reported by the Joint Committee on Statutory Instruments.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, in moving these regulations, I will also speak to the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 4) Regulations 2021.
We have always known that a worrying new variant could pose a threat to the progress that we have made as a nation. On Friday 26 November, the World Health Organization designated variant B.1.1.529, now known as omicron, as a variant of concern. I thank the Government of South Africa for their rapid identification of this variant and exemplary transparency in alerting the world. Yesterday, the Secretary of State spoke with Minister Phaahla to convey this unanimous message from G7 Health Ministers and reaffirm our commitment to working together to address the global impact of the omicron variant.
Some 22 cases have been confirmed in England and Scotland, but we expect that number to rise over the coming days. Omicron has been spreading across numerous countries. Early indications show that it may be more transmissible than the delta variant, and that current vaccines may be less effective against it. It may also have an impact on the effectiveness of one of our major treatments, Ronapreve. We are therefore concerned that omicron may pose a substantial risk to public health. That is why we are taking decisive action against it to buy ourselves time and strengthen our defences while our world-leading scientists learn more about this potential threat.
Our test, trace and self-isolate system continues to be one of the key ways in which we can manage and contain the virus and protect the nation. The self-isolation regulations that we are debating today were introduced to provide a legal requirement to self-isolate for individuals who have been notified that they have tested positive for Covid-19 or are a close contact of a positive case. On 16 August, thanks to the success of the vaccine rollout, we were able to introduce a number of exemptions to self-isolation for close contacts, including for those who are fully vaccinated or under the age of 18.
Given the greater threat that may be posed by the omicron variant, we have reviewed the application of these exemptions. This latest amendment to the self-isolation regulations is targeted at helping to slow its spread. Since 4 am yesterday, all individuals notified by NHS Test and Trace or a public health official that they are a close contact of a confirmed or suspected case of the Covid-19 omicron variant will be legally required to self-isolate, regardless of their age or vaccination status. Anyone who has been notified as testing positive for Covid-19, regardless of the variant, will continue to be legally required to self-isolate.
We have also reintroduced the requirement to wear face coverings in shops, including supermarkets, banks, and close contact services such as hairdressers, on public transport, and in transport hubs. Some noble Lords may ask why face coverings are not required in hospitality venues such as cafes and pubs. I would respond that this is part of a targeted and proportionate intervention. We recognise that not everyone is able to wear a face covering. That is why health and disability exemptions will continue to apply. However, those who are able to must continue to follow the rules so that we might slow the spread of this new variant.
I stress that these measures are temporary and precautionary, and will be reviewed in three weeks, which is the period scientists say is required before it is known how the variant impacts on the effectiveness of vaccines. Ultimately, the vaccination programme, and the test, trace and isolate system continue to be our most effective way of reducing transmission, along with continuing to practise good hygiene, keeping spaces well ventilated, and wearing a face covering in enclosed or crowded spaces.
Lord Kamall (Con)
The UK Health Security Agency continues to monitor the situation closely in partnership with scientific and public health organisations across the world. Covid-19 is not going away and so we are likely to keep seeing new variants emerge. If we want to learn to live with the virus, we must follow the scientific evidence and advice and act in a proportionate and responsible way if a variant has the potential to thwart our progress. As we do this, we are taking a well-rounded view, looking not just at the impact of these measures on the virus, but on the economy, education, and non-Covid health, especially mental health. I am confident that the responses we set out today are balanced and responsible steps that are proportionate to the threat we face.
The Deputy Speaker (Lord Brougham and Vaux) (Con)
I call the noble Baroness, Lady Brinton. No? I call the noble Baroness, Lady Thornton.
Lord Kamall (Con)
I apologise to noble Lords— I was looking forward to so many more contributions. I hope noble Lords will forgive me for enjoying the debate rather too much. I apologise to my noble friend Lord Greenhalgh, who has been waiting for ages, and to my noble friend behind me who says he has to go to the theatre. I hope he will wear his mask when he goes to the theatre.
I thank all noble Lords for their contributions to today’s debate. What is really important and what it shows is that we are still debating issues and contesting the science. Clearly there is a range of views across the House on the issues raised. There is no consensus on this. That is really interesting in the way it shows that we can debate these issues and question the statistics. I will turn to some of the points noble Lords made, particularly about some of the statistics but also on the regulations.
I hope noble Lords will forgive me if I do not answer every single question and refer to every single noble Lord who asked them—unless noble Lords want to stay here a bit longer and my noble friend Lord Greenhalgh can go and have another teacake or something while he is waiting.
Lord Kamall (Con)
Sorry, was that offensive? I apologise for any offence caused to my noble friend. I just assumed that because I like teacakes, my noble friend also does.
I will start with some of the questions. On the question of how many people have been helped by some of these financial services, as of 17 November 2021, local authorities have reported 362,573 successful claims since the start of the scheme, totalling £181 million in test and trace support systems.
Despite the easing of the restrictions at step 4 of the road map, the Government have continued to recommend that face coverings are worn in crowded and enclosed spaces. We accept that there is wide support for reintroducing mandatory face coverings, but we have always tried to balance these issues. As I said in previous debates, we look at a number of factors, not only medical but economic and social. Also, within health itself, many mental health experts are very concerned that we might go for more lockdowns and about some of the measures that a number of noble Lords have mentioned.
As we saw in the debate, there are noble Lords who believe that we have gone too far and noble Lords who feel that we have not gone far enough unless we effectively enter a second lockdown. That shows the range of views here and the difficulty, as my noble friend, Lady Altmann, said, that the Government are damned if they do, damned if they do not, but we accept that.
So, do face masks actually work? This is where there is still a debate. I thank my noble friend Lady Noakes for pointing out the article by Professor Simon Wood, who is professor of statistics at the University of Edinburgh, in which he analysed the BMJ paper. It is in effect a meta-analysis. A number of newspapers have taken a line saying that wearing a mask cuts Covid by 53%. I encourage noble Lords to read the article, in which he takes apart the statistics as a statistician and looks at, as those who have done statistics will understand, whether we have a significant number of samples to make it statistically sound. In addition, Professor Naismith of Oxford University has been quoted as saying that
“the Scottish and English approach to masking, although formally different since July, has made no meaningful difference to delta.”
Once again we see that there is a whole range of views, but we have listened to those views. Because we do not yet know enough about this variant, we will continue to review the data. For example, some say that it is very mild in South Africa so we should not be overly concerned about it, but we also have to remember that South Africa has a different demographic in terms of younger people. We know that when the virus first struck it disproportionately affected older people—as my noble friend Lord Robathan said, people aged over 85. On the balance of the data at the moment, we believe that wearing face masks works but we have always been very careful to make sure that it is proportionate where we do it.
On the expiry of some of these measures, as the Prime Minister said on Saturday, all the provisions that have been voted on will be reviewed in three weeks. They are necessary and proportionate while we learn more. I refer to the economics Nobel laureate Friedrich Hayek, who talked about humans having limited knowledge. He talked about the conceit of knowledge. The way to understand a lot of complex problems is to allow the discovery process to take hold and to look at what we can learn from that process. We should be very careful not to imagine that we have total knowledge. What we have to do is assess it proportionately.
It is our hope that these regulations will no longer be necessary in three weeks’ time and that we can return to the system that we lived under last week, but in the event that we need more time to understand the effect of the variant, or that the data shows that we need to take a different approach that requires new regulations, the House will return to Parliament ahead of the Christmas Recess for a debate and vote on the regulations ahead of their coming into force.
On regulations expiring, the international travel regulations will expire at the end of 16 May 2022. The face covering regulations will expire, unless extended, at the end of 20 December 2021. The self-isolation regulations at the moment expire at the end of 24 March 2022, but we will continue to review the data. Almost daily the data is being reviewed and conversations are going on. We will also continue to review the data on the new variant and we hope to update Parliament on the review in the week commencing 13 December.
A number of noble Lords asked about facilities. We are told that setting up dedicated testing facilities at border entry points such as airports is logistically difficult at the moment, and risks delays to passenger journeys and operations. Given the turnaround for a PCR test, passengers would still have to travel to their home or the place they are staying and isolate there before receiving a result. The Government are taking a measured and proportionate response. We want to try to protect the UK from omicron while allowing continued safe travel.
A number of references were made to points made by Dr Jenny Harries. As the Prime Minster said, the guidance remains the same as the measures that were in place to fight delta. We have now brought in tougher measures, but we continue to take advice from a number of experts. Individual experts are free to give their viewpoint but we look at the balance—some of it medical, some of it clinical, but also economic and social factors—and getting that proportionate.
Baroness Thornton (Lab)
I need to ask the Minister about the fact that our most senior adviser on these matters gave advice that was then completely denied by No. 10 and the Government. That will at least cause confusion. It is not a question of balancing this and that; Jenny Harries was very clear in her advice about what she thought should happen. It was quite the opposite to what the Prime Minister said should happen. The Minister needs to acknowledge that that will cause confusion.
Lord Kamall (Con)
I thank the noble Baroness for raising the point, but it depends on how it is reported. The real issue here is that a number of different experts are advising. Of course, you can pick and choose which expert you decide to listen to. A few weeks ago, noble Lords were picking up on comments made by the NHS Confederation. That is not a scientific body, but noble Lords claimed that it showed that we need to lock down. It is very easy to pick and choose your experts, but we continue to listen to a wide range of experts.
One of the great things about science that we should remember is that there is no such thing as “the science says”. Science should remain contestable. Can you imagine if science was not contestable? We would still be saying, “You can’t challenge the notion that the solar system revolves around the earth.” Scientists challenged that, and that is how we advance knowledge. It is really important that we continue to contest. Scepticism is one of the most important factors in science to make sure we make progress. We will listen to a range of experts.
I ask those noble Lords who really want to lock down more, and who say that we not only have not done enough but should do more and lock people down, to look at the impact that has on people’s mental health and on our economy. I ask them to think about the wider impact and to remember that we are not in the same place we were a year ago. We have been absolutely clear that vaccines work and that the best thing we can do to get through this is to get vaccinated. It is not too late to get your first or second vaccine. I am grateful to noble Lords who have asked questions—
Baroness Thornton (Lab)
The Minister is now saying that there is absolutely no doubt about the science behind vaccinations. That is not a matter of opinion; there is no doubt about the need for vaccinations. He is straying into dangerous territory when he says that there is science on this side and science on that, because the Government have rightly said that vaccination is the way forward.
Lord Kamall (Con)
I thank the noble Baroness for agreeing with the Government’s line that vaccination is the most important way forward.
Baroness Thornton (Lab)
The Minister is being patronising. We have always—always—supported the Government on vaccination; I am sorry that the Minister feels he needs to be sarcastic about that.
Lord Kamall (Con)
I apologise to the noble Baroness if I came across as sarcastic.
In terms of hospitality settings, quite rightly, as a number of noble Lords have said, even though we have mandated it in certain settings, it is being left to settings to decide. This is in line with property rights, but also something that people have been asking for—a number of noble Lords have asked “Why not just let the establishments themselves decide, so people can make a decision whether they go to somewhere where masks are mandated or somewhere where they are not mandated?” We are looking really hard at this and we want to make sure that we are proportionate. It could be that we find out that omicron is not that dangerous, but we have to make sure that we have the data and that we sequence it all. It could be that it affects us more in the UK that it would in South Africa because of the change in demographics. That is a really important point.
In terms of who is responsible for enforcement, the police and Transport for London officers have powers to issue fixed penalty notices for non-compliance with the regulations. They are using the four E’s in a proportionate way: engaging, explaining and encouraging before enforcement, just to remind people, if they can, to make sure that they wear a face mask.
The Health Secretary has also asked the JCVI to consider giving boosters to as wide a range of people as possible. If you are boosted, your response is likely to be stronger, so it is more vital than ever that we get our jabs.
On helping the rest of the world, the UK remains committed to donating 100 million doses by mid-2022. We are also extremely grateful to the South African Government; we have been talking to a number of partners, including South Africa directly, to make sure that we do not disincentivise other countries for doing the right thing by reporting the outbreak in the first place. We are doing all that we can.
I am trying to make sure that I answer all the questions; I apologise if I am not able to. My noble friend Lady Neville-Rolfe asked about exemptions for children under the age of 11 and those unable to wear a face covering due to health, age, equality or disability reasons. In terms of the impact to the economy, we do not know the extent to which the variant escapes the vaccine, but as soon as we do, we will be able to make a better measure. We do not at the moment expect there to be significant economic disruption. We have said that we believe face coverings are effective at reducing transmission indoors. The recent UKHSA study suggests that all types of face coverings are, to some extent, effective, but we also welcome challenges to that data. The advice remains the same: we believe that, on balance, it is better to wear a face mask. Many noble Lords have agreed and disagreed with that, but we have to balance these things.
Proportionate measures remain in place in schools. Face coverings should now be worn in communal areas by older students and teachers. The Department for Education is looking at how we make sure that there are clear guidelines on that. We advise staff, visitors and pupils to wear face coverings in communal areas.
I turn to the point from the noble Baroness, Lady Tyler, and that very personal case; it highlights—this should sober us up—those very powerful words that this is not over. We have said that consistently. It is not over. If we believed it was over, we would have removed all restrictions. It is highly likely, but not definite, that we may have to continue to get boosters. Just as we have an annual flu vaccine, we may in the future end up with an annual Covid vaccine, including looking at other strains.
We have said who is responsible. In answer to a point made by my noble friend Lord Cormack, may I suggest that he takes his point about continuous committees up with the Lord Speaker? That is not really in my remit as Minister for Health. My initial reaction is that it seems a good idea, but let us see what the Lord Speaker says.
I again thank all noble Lords for their contributions and for continuing to challenge. That is really important. I can assure my noble friend Lord Cormack that today I asked my department for a list of potential or forthcoming regulations so that we can lay them as early as possible, as my noble friend and other noble Lords suggested. I am grateful for the acknowledgement that we laid these regulations as quickly as we could, and I pledge that we will try to improve that as much as we can, I too, believe very strongly in procedure and the Government and the Executive being held to account. It is really important.
Baroness Neville-Rolfe (Con)
Before my noble friend sits down, I thank him for mentioning the economy. His assessment is that the impact on the economy should not be great, but of course there has already been an impact on the economy from this new strain. I think I mentioned in particular the transport industry, which has been affected. Would he be able to come back to me on this business of economic assessment—in fact, not only economic, as I am also worried about the impact of the measures being taken on things like cancer deaths. There is no time to discuss that now, but I would really like to have a further discussion, perhaps bilaterally. We will of course have my noble friend Lady’s Noakes’s regret amendment in due course, but that may be months away. It really is very important to understand the implications of what we are doing. We are doing it for the right reason, but it has a wider impact.
Lord Kamall (Con)
My noble friend raises an important point. We also have to clear about unintended consequences and the costs of what we have been doing. I read an interesting article from the leading behavioural economist Paul Ormerod, who asked where have all the economists been when it came to this debate, as economics is about considering trade-offs.
I again thank the Government of South Africa for their rapid identification of the variant and their transparency in alerting the global community. I commend our scientific and public health experts who continue to monitor the situation closely alongside our scientific and public health partnership organisations across the world. We are continuing to collaborate in order to understand the virus, including the data and the different demographics that our countries have and whether a study in one place is relevant to a study in another place.
I also thank the House for its valuable scrutiny today. The Government hope that the temporary and precautionary measures laid in these regulations will enable us to slow down the spread of the omicron variant while we gather more information on how best to deal with it and how infectious it is. The Secretary of State assured Members in the other place that if it emerges that the omicron variant is no more dangerous than the delta variant, we will not keep these measures in place for a day longer than is necessary. I hope that that is the case, but we must take precautions and act decisively until we have a fuller understanding of the omicron variant. I commend these regulations to the House.
Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 4) Regulations 2021
Lord Kamall Excerpts(2 years, 12 months ago)
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Lord Kamall
That the Regulations laid before the House on 29 November be approved.
Relevant documents: 22nd Report from the Secondary Legislation Scrutiny Committee. Instrument not yet reported by the Joint Committee on Statutory Instruments
Coronavirus Act 2020 (Early Expiry) (No. 2) Regulations 2021
Lord Kamall Excerpts(2 years, 12 months ago)
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Lord Kamall
That the Grand Committee do consider the Coronavirus Act 2020 (Early Expiry) (No. 2) Regulations 2021.
The Deputy Chairman of Committees (Lord McNicol of West Kilbride) (Lab)
Before I call the Minister, I must inform the Committee that the noble Baroness, Lady Brinton, will take part remotely so I will call the Lib Dem response at the appropriate time.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, the Coronavirus Act has been a central part of the Government’s response to Covid-19. It includes powers to bolster the health and social care workforce through the temporary registration of practitioners. More than 13,000 social workers and 28,000 nurses, midwives, paramedics, operating department practitioners, radiographers and other professionals have joined the temporary registers. This continues to provide extra resilience for our health and social care sector during these uncertain times. It also demonstrates the commitment and determination of our fantastic health and social care professionals.
The Act includes powers to ensure that critical functions in society are able to continue throughout the pandemic. For example, it has allowed virtual court hearings to take place in a wider range of circumstances. The Government plan to secure some of these powers in alternative primary legislation. The Act also includes powers that have enabled the Government to provide vital support to people and businesses, including provisions for statutory sick pay for Covid-19-related absences; the Coronavirus Job Retention Scheme, which has supported 11.7 million jobs; and the Self-employment Income Support Scheme, which supported almost 3 million self-employed individuals.
The Coronavirus Act has been a critical part of the Government’s response to the pandemic, but I acknowledge that some noble Lords are concerned about some of the powers in it. I assure them that the Government have sought to use the powers in an appropriate and proportionate way. There are arrangements in place to ensure accountability, including regular opportunities for parliamentary scrutiny; this accountability is vital. I am grateful to noble Lords, my honourable friends in the other place and the Joint Committee on Statutory Instruments, whose welcome review of our draft instruments continues to ensure their accuracy.
We will continue to review the powers in the Act and are committed to ensuring that emergency powers remain in place for only as long as they are necessary. The most recent six-month review of the Act in September identified seven provisions, and parts of an eighth, that could be expired. Once approved, Parliament will have expired half of the original 40 temporary, non-devolved powers in the Act ahead of schedule.
The regulations that we are debating today expire some of the most controversial provisions in the Act, including the powers under Schedule 21, relating to potentially infectious persons, and Schedule 22, giving powers “to issue directions relating to events, gatherings and premises”. The regulations also expire other powers that are no longer needed, such as those under Section 23 enabling the variation of “Time limits in relation to urgent warrants” under the Investigatory Powers Act and Section 56 powers related to “Live links in magistrates’ court appeals” in certain situations, as well as powers under Section 37 and parts of Section 38 relating to the education and childcare sectors. We are also expiring Sections 77 and 78, which were time-limited powers in the Act, and a further provision on behalf of Northern Ireland.
Expiring these provisions is an important milestone. It is possible only because of the significant progress that we have made so far in our fight against the virus, but we have continued to be clear that the pandemic is not yet over. The Government believe that the remaining provisions in the Act are important to continue to support the response to Covid- 19 over the coming months. Everyone should continue to do their bit to keep themselves and others safe as we tackle the winter months ahead, so let us encourage everyone to get their first, second and booster doses, when eligible. It is not too late for those who have not yet received their first or second doses to get them and we urge them to come forward. We also urge everyone to continue to wash their hands, to ventilate indoor spaces, to wear masks where mandated—but even where not mandated, if appropriate—and to stay home when they feel unwell.
We are conscious of how hard the pandemic has been for so many people and we are grateful to everyone who has made sacrifices. We are grateful for the dedication and determination of individuals and communities across our great nation and to all those who have worked so hard in the fight against Covid-19.
Lord Kamall (Con)
I start by thanking all noble Lords for their contributions to this important debate and for continuing to ask questions to hold us to account. The Coronavirus Act has been fundamental to facilitating the Government’s response to the pandemic, supporting individuals, our healthcare, our public services and our businesses. We see expiring a further seven provisions of the Act as a significant milestone towards winding down the emergency powers. To be clear, the Government retain only those powers seen as critical to the ongoing response and recovery, and I thank noble Lords for their general support for that principle, but we will continue to review every aspect of coronavirus legislation.
I now turn to some of the points made by noble Lords this afternoon. First, why are we making some of these changes now, given what happened over the weekend? In reality, a thorough, in-depth review of all the provisions was conducted in September. The provisions we expire today are seen as no longer needed, as we have explained. The provisions that give the Secretary of State the power to prohibit or restrict events and gatherings have been dropped, but most legal restrictions to date have been achieved under the Public Health (Control of Disease) Act 1984. Some of these additional powers are not required because the Government assess them as appropriate to expire, but they can also respond under that Act to increase our vigilance and restrictions in response to coronavirus and any possible variants.
A number of noble Lords raised concerns about the expiry of Section 77 on the uprating of working tax credits. Throughout the crisis, the Government have sought to protect people’s jobs and livelihoods, and to support businesses and public services. The Government have always been clear that the £20 increase was a temporary measure to support the households most affected, that it was time-limited and that it can no longer be used because it related to the 2020-21 tax year.
During the recent Budget, the Chancellor announced that, since the restrictions have been lifted, economic growth has exceeded expectations and the labour market is recovering strongly. The Government are now focusing on supporting people to move into and progress back to work, including the Plan for Jobs to help people move into employment so that they can get a regular wage. Also, workers leaving the furlough scheme and unemployed people over the age of 50 will be helped back into work as part of the more than £500 million expansion of the Government’s Plan for Jobs. Those on the lowest wages will also be helped to progress their careers, and existing schemes targeting young people will be extended into next year. On balance, it was considered appropriate to try to help those who genuinely want to get back to work.
Also, one of the struggles for any temporary government measure is, as I think Ronald Reagan once said, that there is nothing more permanent than a temporary government measure. We have to be aware that, whatever you do temporarily, there will be concerns when a temporary measure comes to an end. Frankly, I expect we will see that in a couple of years’ time when we reassign the uplift back to social care, given that we have given it to the NHS temporarily to help tackle the backlog. I imagine that in a few years’ time the Government will be accused of making cuts, even though we made it clear that it was temporary to help the backlog. We want to focus it mostly on social care.
A number of noble Lords raised points about Covid-19 vaccines. As many noble Lords will recognise, we stepped up yesterday in response to the variant. So far, the NHS has administered more than 17.5 million booster or third doses in the UK. Almost 51 million over-12s in the UK have now received at least one vaccine dose and 46 million have had at least two doses. The line that we continue to say is that it is important that people get jabbed.
Yesterday, the Joint Committee on Vaccination and Immunisation updated its guidance, which the Government accepted, that booster vaccination eligibility should be extended to all adults aged 18 to 39 years, as well as to severely immunosuppressed individuals who have received three primary doses. We will continue to ask and to campaign. The general campaign reaches lots of the people who have already had their vaccines, but we are looking at more targeted ways to make sure that people recognise that it is never too late. If you have not had your first or second jab, do not think that it is too late. You can still do so. There is plenty of opportunity to do so. Do not feel that you have been ignored. We are also working with a number of civil society organisations at a local community level. I thank noble Lords across the Committee who have given advice on how we can reach some of those hard- to-reach demographics. In some ways, it is a more targeted approach to spend that effort making sure that people are vaccinated, rather than on a message that reaches lots of people, many of whom say, “Why is that aimed at me? I’ve already been vaccinated and I’ve told my family”.
Local authority meetings were raised by a number of noble Lords. The Department for Levelling Up, Housing and Communities launched a call for evidence on 25 March to gather views and inform a longer-term decision about whether to make express provision for councils to meet remotely on a permanent basis. That consultation has closed and the department is considering responses to it. I hear and understand the point very strongly that these decisions really should be left to local authorities. I will definitely take that back, because it is important when we are talking about devolving power to the most local level. I hear that message strongly and understand the concerns.
There are many other meetings which are not main meetings where councillors have been able to participate virtually as well as in person. Not all decisions are taken in full council or in local authority committees. A lot are delegated. The problem is that any permanent change would require primary legislation. The Department for Levelling Up, Housing and Communities is looking at this.
I was asked why the changes are expiring now, given what happened over the weekend. We think that the powers that have been retained are sufficient to ensure that we can respond, for example, to omicron and other variants. Some civil libertarians would say that these powers are still too much. The other powers which are expiring are not necessary for us to be able to continue to respond.
I thank the noble Baroness, Lady Brinton, for giving me notice of her question about people who are waiting for lateral flow tests to come back. I immediately raised that in my department. I have been trying to get an answer as quickly as possible. I had hoped to have it in time for this afternoon’s debate. I apologise that I do not have it yet. I will write to the noble Baroness on that specific issue. As she said, it is urgent to get this information as quickly as possible. I have impressed that on my department.
The noble Baroness also raised the issue of doctors who are kept hanging around for months. I note what she said and will raise it within my department. It is always helpful when noble Lords raise issues with me. They enable me to take them back to the department. If noble Lords raise an issue that has previously been raised, it emphasises its importance.
There were a number of questions about face coverings. Many noble Lords clearly feel that they make a difference. I wear one, partly because I think we should be sending this message anyway, but also because it is not too much of an imposition. It is not too much to ask. I do not see that my individual liberties are being impinged or affected by wearing a face mask in public. The advice we receive from a range of scientists balances political, social and economic needs with health care. With some of the restrictions we introduced previously, there have been concerns about their impact on mental health. We always try to keep a balance. We listen to a range of experts. I have listed a number of them in the past, including the UKHSA and others. Some have chosen to express their own view, but we have always been clear that we listen to a range of views.
There are issues about masks in indoor spaces. It is quite right that they should be worn on public transport and in shops. I asked a few experts today about why they should not be worn in restaurants. The answer was that, in a restaurant, you are continually taking off and putting on your mask. There was a concern that, touching it and having breathed on it, it could lead to a greater chance of transmission. In a shop, the situation is fairly constant. You go in with the mask on, keep it on and come out. In a restaurant, you are taking it off and putting it on. One of the other concerns was about balancing social mixing and economic impact. It is still up to individual establishments. Noble Lords will be aware that some establishments have decided that they will continue to insist that their customers wear masks. Frankly, in some ways, that is an appropriate level. It is about property rights. It is up to them whom they let in. It is a difficult balance. Given that some people think that continually taking a mask on and off and walking around may make things worse, on balance, it has been decided not to extend mask-wearing to restaurants. We continue to review all the advice.
I know noble Lords were asking for more restrictions and for face masks to be used more earlier on. We never ruled that out; what we said was that there was sufficient evidence to suggest it, or there was sufficient consensus among all our advisers, we would move that way. There is clearly quite a lot of consensus on face masks in shops and on public transport, but not yet in other places. This is why we have been clear.
I am trying to think if I have missed any of the questions. If I have, I apologise to noble Lords. I will make sure that we go through the transcript—
Baroness Merron (Lab)
Before we go off the issue of face masks, I appreciate the explanation about restaurants, but my question was about large gatherings—for example, cinemas, theatres and conferences, to name but a few. The explanation about restaurants does not apply there. I hope the Minister will take this back as it is simply a question of where is the logic regarding the venue. It seems to make no difference; it is about the fact of there being a number of people.
The real point I would re-put to the Minister, which links with that, is my question about the comments of Dr Jenny Harries on Radio 4. She said that we should decrease our social contacts, whereas the spokesperson for the Prime Minister says that we will not be doing that. I am very concerned about mixed messaging, as I am sure the Minister is—I know he is from what he has said. It would be extremely helpful to put on the record where we are on whether decreasing social contact makes a difference.
Lord Kamall (Con)
I apologise if I was not clearer before. I thank the noble Baroness for taking advantage of the opportunity to ask that question and finding the urge to do so irresistible. On theatres and cinemas, one of the things that was put to us was that in a restaurant, you are constantly taking a mask on and off, whereas in a cinema or theatre you are not really eating that much. Okay, you might well go to buy your ice cream—I do not know whether they still sell ice cream and jelly babies in theatres, or whatever it used to be; this will look very odd in Hansard when someone reads it—but you are not constantly doing and you are more or less constantly wearing your mask. However, I will take that back. It is a fair point, and one thing that I do when I am being briefed is to challenge because I know that noble Lords will rightly challenge me on this issue.
In response to the comments by Jenny Harries, I hope I have been clear that we take advice from a range of advisers and there is not yet consensus, but we have been relying not just on making mask mandatory when necessary as a precaution, but at the same time on people’s individual behaviour and them acting responsibly. It is about getting that balance right. We listen to Dr Jenny Harries, but she is one of a number of experts whom we listen to. We weigh up the different views; it is as simple as that. As we have been clear, there is no one trigger for any of these measures. We always consider a range of measures, including capacity in the NHS, the trends et cetera. I have listed them in previous debates. It is not one person whom we listen to. We listen to a range of experts.
Baroness McIntosh of Pickering (Con)
Will my noble friend undertake to write to me about waiting facilities in GP waiting rooms? That would be helpful. I am also prompted by a question that I do not think he responded to from the noble Baroness, Lady Brinton, on the welfare aspects of staff shortages in meat-processing plants and the massive cull of pigs. While I appreciate it might not be the direct responsibility of his department, this is an animal welfare disaster about to happen.
One thing that I did not like to raise—I am sure it will go no further than the Grand Committee, which is why I feel confident to raise it now—is that my noble friend will be aware that there is PPE equipment which was deemed not fit for use, but it is in the system and is, to a certain extent, clogging up the supply chain by taking space which should be used for other goods. Will he undertake to use his good offices to look into this? Perhaps we could have a word about it afterwards because it is contributing to shortages and delays in the supply chain, particularly in storage terms.
Lord Kamall (Con)
First, I apologise for missing that point earlier. Regarding the supply chain provision, an SI was laid under the draft affirmative procedure on 21 April 2021. It was debated and approved by both Houses, came into force on 16 July and expired the provision. As the noble Baroness rightly acknowledged, some of her questioning was not within the scope of these regulations. However, given that she has asked a question, I will endeavour to find out the answer. Clearly, that will include going across departments, so I hope that she will be patient as I try to get that answer as quickly as possible.
On GP access, we recognise the pressure that general practitioners are under, especially in the upcoming and challenging winter period. We are investing £250 million in the winter access fund to improve GPs’ practice capacity. I will take the noble Baroness’s specific question about square metres and areas back to be answered; I hope she understands that I do not have those facts to mind.
The issue of measures was also raised. We must remember that one of the counterpoints put is that the country is in a very different position to the one it was in last year, due to the vaccination programme. Some of the restrictions that might have seemed appropriate last year are not as appropriate this year because we have reduced the link between cases and hospitalisations, as well as between hospitalisations and deaths. Clearly, we have the vaccine. I am sorry if I sound like a broken record but we continue to push the vaccine because it helps to break that link; it is part of the reason why we will not have to go back to some of the restrictions—those similar to last year’s—that many noble Lords are pushing for.
All I will say is that the Government’s autumn and winter plan set out how we will sustain and strengthen some of the progress made so far. We all know that winter will be a challenging period, but more so over the next few months. We all have a role to play in fighting the virus. There is much that government can do but sometimes, even when we mandate things, we know that there will be people who do not obey, so we must get the balance right and decide how to get the appropriate enforcement. Together, we believe that we can protect the progress that we have made, protect the NHS in the months ahead and help friends, loved ones and ourselves by being vaccinated against Covid-19, getting a flu jab if eligible and sticking to the advice on how to keep safe.
I thank noble Lords for their contributions to this debate and previous ones on the Coronavirus Act; I also thank them in advance for future contributions. I welcome noble Lords’ expertise and contributions, and I commend the regulations to the Committee.
Covid-19 Update
Lord Kamall Excerpts(2 years, 12 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, I shall now repeat a Statement made in another place. The Statement is as follows:
“Mr Speaker, with permission, I would like to make a Statement on the omicron variant and the steps we are taking to keep our country safe. We have always known that a worrying new variant could be a threat to the progress that we have made as a nation. We are entering the winter in a strong position, thanks to the decisions we made in the summer and the defences we have built. Our vaccination programme has been moving at a blistering pace and this weekend we reached the milestone of 17 million boosters across the UK. This means that even though cases have been rising, hospital admissions have fallen a further 11% in the past week and deaths have fallen by another 17%. But, just as the vaccination programme has shifted the odds in our favour, a harmful new variant has always had the opportunity to shift them back.
Last week, I was alerted to what is now known as the omicron variant, now designated a variant of concern by the World Health Organization. We are learning more about this new variant all the time, but the latest indication is that it spreads very rapidly. It may impact the effectiveness of one of our major treatments for Covid-19, Ronapreve, and, as the Chief Medical Officer said this weekend, there is a reasonable chance that our current vaccines may be impacted. I can update the House that there have now been five confirmed cases in England, and also six confirmed cases in Scotland, and we expect cases to rise over the coming days.
The new variant has also been spreading across the world. Confirmed cases have been reported in many more countries, including Austria, Belgium, the Czech Republic, Denmark, Germany, Italy, the Netherlands and Portugal. In this race between the vaccines and the virus, the new variant may have given the virus extra legs. So, our strategy is to buy ourselves time and strengthen our defences while our world-leading scientists learn more about its potential threat.
On Friday, I updated the House about the measures that we have put in place, including how, within hours, we had placed six countries in southern Africa on the red list. Today, I would like to update the House on the more balanced and proportionate steps that we are taking. First, measures at the border to slow the incursion of the variant from abroad. On Saturday, in line with updated advice from the UK Health Security Agency, we acted quickly to add another four countries to the travel red list: Angola, Mozambique, Malawi and Zambia. This means that anyone who is not a UK or Irish national or resident who has been in any of these countries for the previous 10 days will be refused entry; and those who are must isolate in a Government-approved facility for 10 days.
Beyond this red list, we are also going further to put in place a proportionate testing regime for arrivals from all across the world. So we will require anyone who enters the UK to take a PCR test by the end of the second day after they arrive and to self-isolate until they have received a negative result. The regulations for this have been laid before the House today and will come into force at 4 am tomorrow.
Secondly, we have announced measures to slow the spread of the virus here in the UK. We are making changes to our rules on self-isolation for close contacts in England to reflect the greater threat that may be posed by this new variant. So close contacts of anyone who tests positive with a suspected case of omicron must self-isolate for 10 days, regardless of whether or not they have been vaccinated. Face coverings will also be made compulsory in shops and on public transport in England, unless an individual has a medical exemption.
The regulations for self-isolation and face coverings have been laid before the House today and will come into force at 4 am tomorrow. I can confirm to the House that there will be debates and votes on these two measures to give the House the opportunity to have its say and perform valuable scrutiny. My right honourable friend the Leader of the House will set out more details shortly and we will review all the measures that I have set out today after three weeks to see whether they are still necessary.
Thirdly, we are strengthening the defences that we have built against this virus. We are already in a stronger position than we were when we faced the delta variant. We have a much greater capacity for testing, enhanced ability for sequencing and the collective protection offered by 114 million jabs in arms.
I will update the House on our Covid-19 vaccination programme, which has been a national success story. We have delivered more booster doses than anywhere in Europe, and we have given top-up jabs to over one in three people over the age of 18 across the UK. I pay tribute to the NHS, the volunteers, the Armed Forces and everyone else who has been involved in this life-saving work. Our vaccines remain our best line of defence against this virus, in whatever form it takes. There is a lot that we do not know about how our vaccines respond to the omicron variant, but although it is possible that they may be less effective, it is unlikely that they will have no effectiveness. So it is really important that we get as many jabs in arms as possible.
We were already planning to do 6 million booster jabs in England alone over the next few weeks, but, against the backdrop of this new variant, we want to go further and faster. So I asked the JCVI—the Government’s independent expert advisers on vaccinations—to urgently review how we can expand the programme and whether we should reduce the gap between second doses and boosters. The JCVI published its advice in the last hour. First, it advised that the minimum dose interval for booster jabs should be halved, from six to three months. Secondly, it advised that the booster programme should be expanded to include all remaining adults aged 18 and above. Thirdly, it advised that these boosters should be offered by age group in descending order to protect those who are most vulnerable to the virus. Priority will be given to older adults and people over 16 who are at risk. Fourthly, it advised that severely immunosuppressed people aged 16 or above who have received three primary doses should now also be offered a booster dose. Finally, it advised that children aged between 12 and 15 should be given a second dose, 12 weeks from the first dose. I have accepted this advice in full. With this new variant on the offensive, these measures will protect more people more quickly and make us better protected as a nation. This represents a huge step for our vaccination programme.
I will update the House on the part that the UK is playing. We currently hold the presidency of the G7, and, earlier today, I convened an urgent meeting of the G7 Health Ministers to co-ordinate the international response. We were unanimous in our praise for the leadership shown by South Africa, which was so open and transparent about this new variant, and we were resolute in our commitment to working closely with each other, the World Health Organization and the wider international community to tackle this common threat.
Our experience of fighting this virus has shown us that it is best to act decisively and swiftly when we see a potential threat, which is why we are building our defences and putting these measures in place without delay. Scientists are working at speed, at home and abroad, to determine whether this variant is more dangerous. I assure the House that, if it emerges that this variant is no more dangerous than the delta variant, we will not keep measures in place for a day longer than is necessary.
Covid-19 is not going away, so we will keep seeing new variants emerge. If we want to live with the virus for the long term, we must follow the evidence and act in a proportionate and responsible way if a variant has the potential to thwart our progress. As we do this, we are taking a well-rounded view, looking at the impact of these measures not just on the virus but on the economy, education and non-Covid health, such as mental health. I am confident that these balanced and responsible steps are proportionate to the threat that we face.
This year, our nation has come so far down our road to recovery, but we always knew that there would be bumps in the road. But this is not a time to waver; it is a time to be vigilant and think about what each and every one of us can do to slow the spread of the new variant: getting a jab when the time comes, following the rules that we have put in place and getting rapid, regular tests. If we all come together once again, we can keep this virus at bay and protect the progress that we have made. I commend this Statement to the House.”
Baroness Brinton (LD) [V]
My Lords, I thank the Minister for repeating today’s Statement. The World Health Organization and many globally respected scientists and doctors have been warning us that variants of Covid-19 might pose a serious risk, especially when a Government think that we are winning the war against the virus and that we can all afford to relax. Omicron reminds us that the battle is not won until it is won across the world. From these Benches, we also thank the South African scientists for their genome sequencing that has alerted the world, and I hope that the UK and the other G7 countries will offer them not just gratitude but countries in southern Africa more practical support.
I echo the comments of the noble Baroness, Lady Thornton, about arrangements for international travel and test and trace. I also support her request for a briefing for Peers. For some bizarre reason, the Liberal Democrat MPs were not included in the MPs’ briefing. Please could the Minister make sure that we are included in any such meeting in the Lords.
In April, before the Minister was appointed, we warned Ministers that the Government were responding far too late to the reports of the delta variant in India. So we warn again. While the face mask mandate in shops and on public transport is welcome and well overdue, we are absolutely bemused that it excludes hospitality and that the advice to schools excludes classrooms. Professor Chris Whitty said in Saturday’s No. 10 press conference that when there is a risk we should go in hard, so can the Minister explain how the virus will be kept at bay in those indoor settings where masks are not required? Why is there no encouragement for people to work from home where possible? Trains and buses are crowded and unventilated. Risks will remain there too, even if lessened with masks.
I have said before that I am in the clinically extremely vulnerable group. I have had my third dose of the vaccine and now look forward to my fourth, or booster, dose. But many of those who should be getting the third dose still face a series of problems in the NHS about who should get it, as opposed to a booster, and how it is recorded. Indeed, today, in response to a Written Question to my honourable friend Daisy Cooper about the recording of a third dose, the Minister, Maggie Throup MP, replied:
“Work to assess the need to include boosters in the NHS COVID Pass is ongoing and we will provide a further update in due course”,
so even the records cannot distinguish. Can the Minister say when “in due course” is? I am afraid this is symptomatic of the way the clinically extremely vulnerable have been ignored and left to fend for themselves.
I will ask a question that I have asked the Minister’s predecessor repeatedly since June of this year. In May 2021, Jenny Harries left Public Health England to set up the UKHSA. For the preceding 12 months she had specific responsibility for co-ordinating all the different elements of Covid issues for the CEV and for shielding. When she left, no one was given that responsibility, and it was noticeable that all communications with CEV people and the different parts of the NHS on Covid just stopped when shielding stopped. Can the Minister tell us which senior person in the NHS has that managerial responsibility? It has been five months since I first asked and there are 3.7 million worried people still waiting for answers. It would be good to know which Minister has the responsibility to co-ordinate all Covid matters for the CEV or former shielders. This is important, because the last letter from the Secretary of State tells the CEV not to go into any environment where people have not been double-jabbed. There is no mention of boosters, and obviously no mention yet of omicron.
Is there a confirmed register that distinguishes between the CEV and the severely CEV? Unlike in Scotland, hospital consultants in England do not have access to individual patient records that GPs use or even to the Covid app data. Can the Minister say how NHS England will be able to communicate directly with eligible people if they do not have a register? Is there a specific communications plan to ensure that primary care, secondary care and the 119 vaccine helpline are fully aware of plans and processes for this group? Reports are coming back of blood cancer patients being told at vaccine centres that they do only boosters—there is no knowledge or understanding of the third dose.
I recognise that I am asking the Minister a large number of questions on the immunocompromised. I really do not expect answers to them today—written answers are always very welcome—but please will he agree to meet with me, Blood Cancer UK and the Anthony Nolan Trust to discuss these key questions, not least because we are now in a different situation, with the 3.7 million, which is 5% of the country, left in limbo?
As the noble Baroness, Lady Thornton, said, it is too early to say whether omicron is more dangerous than delta or beta, or whether treatments such as Ronapreve and the current vaccines might not be as effective. The Government are right to be cautious. I echo her comments about Clive Dix, the former head of the Government’s Vaccine Taskforce. What plans are in place for vaccine development for an escape variant?
At a time when manufacturing is one of the key issues slowing down the delivery of vaccines worldwide, why is the Vaccine Manufacturing and Innovation Centre at Harwell, which has received in excess of £200 million of public funding via UK research and development, now up for sale, long before the pandemic is over? We still need its expertise. Selling off a publicly funded, not-for-profit organisation during the pandemic, if at all, seems, frankly, bizarre.
Finally, the Statement has a passing reference to test and trace domestically. It says:
“We have a much greater capacity for testing, enhanced ability for sequencing”.
Genome sequencing in the UK has been a real strength of UK science and has undoubtedly helped us considerably in this pandemic. But, in recent weeks, with the Government’s determination to open up and return to normality, test and trace has been scaled back, with reduced centres and reduced hours for those that remain open. Can the Minister say what plans there are to increase these back as needed? Are directors of public health and their local resilience forums receiving funding for the current omicron problem? It also appears that there is no Covid funding for them next year at the moment. If omicron is a viable variant, we must plan to fund them to keep these safety nets of test and trace in place, because without an effective test, trace and isolate system, including proper payments to those who need to isolate, we will not manage, let alone control, this virus. Defences are not defences when there are large holes in them.
Lord Kamall (Con)
I thank both noble Baronesses for their questions. I will try to answer as many as I can.
On the first issue of face coverings and why not all places, we are taking temporary, targeted and proportionate action as a precaution while we learn more about this new variant. Face coverings have been introduced as part of the temporary measures being put in place to slow the spread of the omicron variant. We know that face coverings are effective at reducing transmission indoors when people are likely to come together—for example, on public transport or in shops—while having a low impact on our daily lives. We continue to encourage everyone to wear face coverings in settings that are crowded or where they meet or come into contact with people they do not normally meet, but we are also guided by the advice of our scientific and medical experts. We are constantly keeping these under review.
One of the reasons why our advice is not the same for hospitality venues is that the advice has been that it is not seen as practical for people to wear a face covering when eating or drinking. It is not recommended that face coverings are worn when undertaking strenuous activity, including exercising and dancing. That is the advice we have had to date on that one.
Questions were asked about NHS capacity. The NHS can respond to local surges in demand in several ways, including through expanding surge capacity in existing NHS hospitals, mutual aid between hospitals, and making use of independent sector capacity and accelerated discharge schemes. The NHS is the Government’s key spending priority. That is why we committed to the historic settlement of the cash increase of £33.9 billion a year by 2023-24, and other investments we have made to make sure we have that capacity.
The booster vaccine will be offered in order of descending age groups, with priority given to older adults. This will probably be the most complex phase of the NHS vaccination programme so far, but the NHS is working through updated guidance and will set out how this will be operationalised shortly. It will contact you when you need to act and book in for your life-saving vaccination.
On helping the rest of the world, the UK remains committed to donating 100 million doses by mid-2022. We will have donated more than 30 million vaccines by the end of 2021 and we have announced plans for 70 million doses in total so far. We will continue to work to ensure that any vaccine that the UK does not need is reallocated to other nations that require it, wherever possible.
On future preparedness for variants and future pandemics, as noble Lords will know, the UK Health Security Agency, which focuses on health protection, became fully operational on 1 October 2021. It will operate as an integral part of our health system and utilise state-of-the-art technologies and ground-breaking capabilities in data analytics, including genomic surveillance, as acknowledged by the noble Baronesses. The UKHSA will play a critical role in the route to developing vaccines that are effective against new and emerging variants. In the longer term, to make sure we learn the lessons, we will build on the infrastructure developed for Covid-19 to tackle and prevent other infectious diseases and external health threats. This work will include a strong focus on the life sciences, strengthening relationships with academia, research organisations and industries that have developed and grown through the pandemic, in which there are now several centres of expertise.
We are delighted to see students back at schools and higher education settings, but to reduce transmission we are keeping some sensible measures in place across education and care settings. These include access to twice-weekly testing in secondary schools and the provision of CO2 monitors to all schools. We have said that education settings must continue to comply with health and safety law, and we are working between the Department of Health and the Department for Education to make sure we have the right and appropriate response in our education settings.
The noble Baroness, Lady Brinton, asked about severely immunosuppressed individuals—I thank her for the acknowledgement that I will not be able to answer all the questions in detail and that it probably would be better if I write to her in more detail. So far, however, the individuals who have completed their primary course of three doses should be offered a fourth booster dose with a minimum of three months between the third primary and fourth booster dose. If they have not yet received their third dose, they should have that now to avoid further delay.
The other point I will make is that it is not too late for anyone who has not yet had their first or second dose. Please do not think that, because we are advertising for boosters, it means that you have missed the boat. In fact, we are working very hard—and I have received a lot of advice from noble Lords across the House—on how to address the low take-up of vaccines among certain communities and demographics. I am grateful to noble Lords for that. I also reiterate the point that it is not over. I humbly disagree with the statement that we have given the impression that it is over. We have been quite clear that it is not and that we must continue to be vigilant.
In terms of briefings, I will commit to giving a briefing to all Peers. I thank the noble Baroness for that suggestion. I have apologised for not being more proactive on that—maybe I should have done so on Sunday afternoon or evening after the Secretary of State. To the noble Baroness, Lady Brinton, I can only apologise for not having an answer sooner to the questions she has asked in the past. The best way to resolve this is for me to commit to the meeting that she has requested so that we can try to answer the questions that she has outstanding. I apologise to her for those questions not being answered previously.
Baroness Masham of Ilton (CB) [V]
My Lords, it is very difficult to find out why many people are hesitant about having a booster jab having had two vaccinations. Does the Minister think that, if something went wrong and left a person seriously disabled from the vaccine, but if they knew they would have adequate compensation, they might be more willing to have the booster?
Lord Kamall (Con)
I thank the noble Baroness for raising that important point. We have made the point that it is not over, but one thing that we have seen, sadly, with the uptake of the booster vaccine is that a number of people felt that because they had had the first and second doses, they could almost return to normal. Maybe we could have been stronger with the message that it is not over, but we continue to say that we should be ever vigilant. The important point is that, if you have not had the booster, we ask you to come forward, just as we ask all those who have not had their first or second vaccine to come forward. We are trying to work with all those in different communities to make sure that they come forward. We are, for example, working with interfaith communities and local groups.
Viscount Hailsham (Con)
My Lords, I welcome the Statement, but may I express the hope that the requirement to wear masks in shops and on public transport is not relaxed prematurely? Is there not a case for continuing those requirements while the pandemic is prevalent?
Lord Kamall (Con)
My noble friend will be aware of the constant debate that there has been in the public sphere about the effectiveness of masks, when they are effective and who is affected. Therefore, we have always followed scientific advice on the wearing of masks and where would be most appropriate. We know that many noble Lords and others have called on us literally not to let the masks slip, as it were, and to make sure that people continue to wear masks. There have been others, however, asking why people still need to wear masks. We have always been vigilant, and the fact that we now have this new variant means we are taking a precautionary approach. We will continue to review it and it could well be that, in three weeks’ time, we will see how dangerous it has been and how effective mask wearing has been in the places that we have specified.
Lord Davies of Brixton (Lab)
My Lords, it is now recognised widely that none of us is safe until we are all safe, leading to the conclusion that we need a worldwide vaccination programme. However, there is mounting evidence that populations that are immunocompromised, especially people living with HIV, provide a particularly ideal environment for the mutation of the virus. Does the Minister accept that we must therefore contemplate the possibility of having a global programme of antiretroviral medicine as part of our response to Covid?
Lord Kamall (Con)
I thank the noble Lord for the point he just made. If he will allow me, I will take that back and try to get an answer for him.
Baroness Watkins of Tavistock (CB)
My Lords, I hear from colleagues in South Africa that nasal swabs alone are not as effective at picking up the new variant and that there have been many false negatives reported. I would welcome the Minister’s comment on that, as we are moving to more nasal swabs. I also suggest that it would be more sensible to encourage the use of face coverings in offices and to encourage people to work from home wherever it is feasible in terms of employers, so that the next two weeks can be used by scientists to really identify other problems that might be associated. This would help to safeguard NHS clinical staff as well as hospitals. If people are getting false negatives and then being admitted to hospital, it puts the very staff we need to keep at work at risk.
Lord Kamall (Con)
As the noble Baroness, Lady Watkins, will be aware, our scientific medical advice and the data are constantly reviewed. We are currently conducting thorough tests to review both LFT and PCR efficacy when it comes to the omicron variant. The advice that I have been given is that we must wait for the data and take a cautious, proportionate approach as scientists work urgently to better understand the variant. In terms of the question on more restrictions in terms of where face masks should be worn, the advice at the moment is still on public transport and in shops, and to continue to encourage people to work either from home or in offices, as appropriate.
Lord Lansley (Con)
My Lords, in my noble friend’s repeat of the Statement, he said that
“our strategy is to buy ourselves time and strengthen our defences”.
May I ask him about our border controls? Given our testing capacity, would it not make sense for us, for example, to test everybody who comes into our airports at the airport itself so that we have certainty that, where they are positive, we know who they are and are able to conduct the contact tracing required?
Lord Kamall (Con)
I thank my noble friend for giving me notice of the question; I appreciate it. The answer that I have been given in response is that we have built a thriving private diagnostic market to meet the demand of the international travellers and day 2 PCR testing for travellers is provided by these private providers. Based on forecast modelling, we are confident that the market has sufficient capacity to meet the rise in demand that omicron may pose.
Baroness Ritchie of Downpatrick (Lab)
My Lords, I thank the Minister for his Statement, in which he indicated that he was chairing a meeting of G7 members to deal with this specific issue. Will that meeting deal with the rollout of excess vaccines to the rest of the world, particularly those countries in southern Africa? I can only think of what my right honourable friend the former Prime Minister Gordon Brown said at the weekend, which was also reaffirmed in the leader column in yesterday’s Sunday Times: that nobody is safe in this world until everybody is safe. So is there a strategic plan to deal with excess vaccines to ensure that they are all used up, and particularly that they are used in those countries in the developing world that need them most?
Lord Kamall (Con)
I believe all noble Lords will agree with the points made by the noble Baroness on making sure that as many people in the world as possible have access to the vaccines. Someone said to me today that we are talking about third and fourth doses in the UK, but there are people in many parts of the world who have not yet had their first dose. I am sure noble Lords are aware of that. There is an analogy with when you are on an aircraft and the oxygen masks fall; do you protect yourself before you protect others? There is clearly a debate on this.
The UK remains committed to donating 100 million doses by the middle of 2022. We will have donated more than 30 million vaccines by the end of 2021 and have announced plans for 70 million doses in total so far. We will continue to ensure that any vaccines that the UK does not need are reallocated to other nations which require them wherever possible. Having sat in one of those G7 meetings with Health Ministers and joint G7 meetings with Health and Transports Ministers, I can assure noble Lords that one of the issues that comes up constantly is how we can help the rest of the world, particularly those countries which have not had access to even first doses of the vaccine.
Lord Patel (CB)
My Lords, on whether LFT swabs should be nasal or nasal plus throat, it is more important that the test is carried out properly; we know that LFTs have low specificity, as opposed to sensitivity, compared to PCRs. Those who test positive with the new variant and their contacts must isolate for 10 days. If a traveller arrives on these shores and tests positive for the new variant, will the whole of the aeroplane have to isolate for 10 days or only close contacts? If only close contacts, who counts as a close contact? What risk assessment have the Government made on the transmissibility of the new variant in superspreader events such as clubs and sporting events?
Lord Kamall (Con)
The noble Lord raises an important point. I will double-check the details as I do not wish to mislead him or the House. Given that this is a fast-moving situation, in which the data is very new, changing constantly and constantly being reviewed, it would be more appropriate if I double-check before I answer.
Baroness Tyler of Enfield (LD)
The new requirements are for all travellers arriving in the country to take a PCR test on or before day two and to self-isolate until they have received a negative test. However, on the government website today, it says that if someone has tested positive with a PCR, they should not be tested again using either a PCR or lateral flow test for 90 days, unless they have developed new symptoms. What are returning travellers who have tested positive in the last 90 days meant to do? Who is cross-checking the existing guidance against new regulations?
Lord Kamall (Con)
All I can do is thank the noble Baroness for her question. I will have to double-check; as she will imagine, I do not have all the answers at the moment. Throughout the day, as I was preparing for this, the advice was changing constantly, and things were being swapped in. Advisers from the Department of Health and Social Care were saying, “This is the latest advice”, but it was changing literally hourly. I will try to get the latest advice and share this with noble Lords.
Lord Naseby (Con)
In light of the overall success of the vaccination programme, is it now a condition of employment that every new recruit to the NHS, at every level, must be vaccinated against Covid and agree to accept any future recommendations on protection against it?
Lord Kamall (Con)
As my noble friend will be aware, vaccination as a condition of deployment has been brought in for the social care sector. It will be brought in for the wider NHS, but there is a grace period in certain cases. Management are being encouraged to meet with staff to encourage them, particularly staff who are vaccine-hesitant. There is a grace period to see us through the winter period; it runs up to April next year. However, we are encouraging as many members of NHS staff as possible to get vaccinated and we have a high rate of vaccination so far.
Baroness Bennett of Manor Castle (GP)
My Lords, the Minister referred to a thriving diagnostic market in PCR tests. When these were previously commonly required, there were huge problems with misleading advertising about costs and people being misled about the services and timings on offer. Have the Government solved these problems and are they looking at how much money these companies are making out of this thriving market?
Lord Kamall (Con)
The important thing for us is to make sure that PCR tests are available and that there is sufficient supply and capacity to deliver them. Frankly, as much as we want to make sure there are enough PCR tests, we want to make sure that supplies come to the market. But, as the noble Baroness will be aware, my right honourable friend the Secretary of State has raised concerns about the cost of some of the PCR tests and has been quite public about that.
Lord Robathan (Con)
My Lords, first, did the Minister see the interview with Dr Coetzee, the South African doctor who first identified the omicron variant, on “The Andrew Marr Show” yesterday? She said that the British Government were overreacting and, when asked, specifically agreed that they were panicking. Secondly, could he identify and publish for the benefit of everyone the studies that have shown that wearing these flimsy, non-surgical face masks is effective in preventing transmission? I refer to the excellent research which my noble friend Lord Ridley detailed in the Grand Committee on 26 October, which is in column 123 of Hansard. So far, no proper study has shown that wearing a face mask is effective.
Lord Kamall (Con)
I thank my noble friend for those points. On the comments made by the South African expert, I raised these issues with officials and experts today; one of the points made was that there are different demographics of who has been affected. We want to make sure that we are being cautious and proportionate. Therefore, we have taken these measures as a precaution. On the efficacy of face masks, the point my noble friend makes shows that there is a debate, but we have decided to err on the side of caution to make sure that we are prepared.
Baroness Hoey (Non-Afl)
My Lords, what is the position with aeroplanes coming into Dublin Airport? Have the Irish Government followed the United Kingdom Government? Otherwise, what will happen to people who have come into Dublin and then come across a border where there is obviously no restriction into the United Kingdom?
Lord Kamall (Con)
The noble Baroness makes a good point. Health issues are devolved to Northern Ireland, but I will double-check this point and write to her.
Viscount Waverley (CB)
My Lords, I too generally find the GOV.UK website wanting in the detail. Frankly, it is very confusing and is never kept accurate enough in a timely manner; I encourage the Minister to pay regard to that. May I drill into one particular issue on a point which other Peers have touched on? What is the rationale for the emphasis on testing after arrival into the UK, rather than catching those with Covid before departure?
Lord Kamall (Con)
The noble Viscount raises a good question; I am afraid that I will have to double-check the answer.
Viscount Stansgate (Lab)
My Lords, the Government’s Statement says that close contacts of anyone who tests positive with a suspected case of the omicron variant must self-isolate for 10 days, regardless of whether they have been vaccinated. Can the Minister tell the House what specific scientific advice has been received in the recent past to support that? Or are the Government being excessively precautionary? If so, is this a permanent or a temporary provision?
Lord Kamall (Con)
The Government have taken these measures as a precaution and we will constantly review them as we get more data. We have already committed to reviewing the measures after three weeks. If the data becomes available and we are clear about whether or not this is effective, we may well have an announcement before then, but we have committed to reviewing this within three weeks.
Lord Hope of Craighead (CB)
My Lords, can the Minister say what steps will be taken to enforce the regulations being made? I ask the question because Transport for London has been saying for weeks that the wearing of masks is required on London transport. I am a regular passenger on the London Underground, and something like a quarter or even a third of passengers are not wearing masks. It is all very well making regulations, but they need to be enforced.
Lord Kamall (Con)
The noble and learned Lord makes a valuable point. One of the points I made previously about enforcement on public transport is that it puts staff in a difficult position. We therefore have to be careful about how we do this. When giving advice, you assume that some people will not follow the advice, whatever you do. It has been found that most people will wait until it is mandated on public transport, sadly, rather than doing it of their own volition. The police and police community support officers can take measures if members of the public do not comply, and I am sure the noble and learned Lord will have seen a number of police and community officers.
We are clear that face coverings reduce the risk, and until now we have followed scientific advice. We are now adopting a precautionary approach and taking precautions. Some may argue that it is overly precautious, but we feel that it is the right balance. None of these things is binary, and we want to make sure we balance the steps we take with the data we receive.
Lord Oates (LD)
My Lords, what signal does the Minister think it sends to the world about doing the right thing when the consequence of South Africa’s excellent science and exemplary transparency is a total flight ban, with potentially devastating consequences for its economy and that of the region, with no apparent mitigating support package from the rich world? What conversations can he have with his friends in the Treasury so that they act to give some support to South Africa and the region?
Lord Kamall (Con)
The noble Lord makes a valuable point: we should pay tribute to the openness of the South African Government, in real comparison with the openness of the Chinese Government at the beginning of the whole pandemic. It is clear that they have been transparent. It is important to recognise that one of the things about the WHO is that it relies on experts in certain countries to report early signs. I will have a conversation internally and see what can be done; otherwise, it almost acts as a disincentive to report to the WHO. We have to make sure we are not disincentivising others who may wish to report similar cases in future.
The Deputy Speaker (Lord McNicol of West Kilbride) (Lab)
My Lords, the time allocated for supplementary questions has now been fulfilled.
NHS: Primary Care Surgeries
Lord Kamall Excerpts(3 years ago)
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Baroness Bakewell
To ask Her Majesty’s Government what steps they are taking to prevent the takeover of National Health Service primary care surgeries in the United Kingdom by American health insurance companies.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
The Government are clear that the NHS is not and never will be for sale to the private sector, whether overseas or domestic. Regardless of whether a service is run by an individual, a partnership or any other organisation, all providers of NHS core medical services are subject to the same requirements, regulations and standards. Patients will continue to receive high-quality care, free at the point of use.
Baroness Bakewell (Lab)
I thank the noble Lord for that Answer. I have two points to make. Once they know what is happening, NHS staff and the public increasingly oppose this move. A group action by Islington patients is going to court to challenge the change of control to an American profit-making company. First, will the Minister respond to such a groundswell and urge the Government to stop the encroaching control of the NHS by American health insurance companies? Secondly—
Baroness Bakewell (Lab)
Centene has a bad reputation across America. Since 2000, it has paid many millions of dollars in fines for 174 contract-related offences across the States, so will Her Majesty’s Government forbid the appointment of Centene-related staff and former staff to NHS CCG boards and their sub-committees?
Lord Kamall (Con)
I thank the noble Baroness for her speech. In answering, as this is for judicial review, I am sure she understands that I cannot comment on it. But I saw an interesting documentary over the weekend, so let me just read some words from it:
“Yes the NHS is a public service but how it spends its vast procurement budget, how it uses IT, how it fashions new processes and pathways for patients, plainly benefit from private sector experience.”
I admit I have plagiarised these words from Tony Blair, the last Labour Prime Minister to win an election.
Baroness Pitkeathley (Lab)
Is the Minister familiar with the research that shows that the longer the relationship between a patient and a GP, the less likely the patient is to need out-of-hours care or emergency hospital treatment, or to die, within 12 months? Are patients not right to be afraid that profit-making will interfere with those important relationships?
Lord Kamall (Con)
The standards of care that CCGs expect are clear in the contracts that they sign with GPs. However it is provided, patients should continue to expect the same standards of care.
Baroness Brinton (LD) [V]
My Lords, one of the concerns is the transparency of agreements between clinical commissioning groups and these private companies. Are CCGs required to make absolutely transparent any arrangements they have made with these private companies?
Lord Kamall (Con)
The noble Baroness will understand that it is not for the Government to intervene in the decisions of CCGs. All who believe in devolution and decisions being made as close to the people as possible believe that we should not be interfering. These decisions are made by CCGs and it is not for the Government to interfere.
Lord Bethell (Con)
My Lords, I entirely welcome the Minister’s assertion that much of what is great about the NHS is the collaboration with international partners and the private sector. During the pandemic, many things that went well, including the vaccine, relied on that. With a special session of the World Health Assembly next week to discuss new global agreements on pandemic preparedness, what steps will the department be taking to foster international and business collaboration?
Lord Kamall (Con)
I thank my noble friend for that important question. International engagement remains crucial to tackling the pandemic and ensuring future resilience. In my first few weeks in the job, I have had a number of meetings, at bilateral, G7 and other levels, to make sure that we are fostering international health partnerships. “It is also really important that we understand the contribution the private sector can make towards making the NHS better for all of us.” Those are the words of Alan Milburn, also a former Labour politician.
Baroness Finlay of Llandaff (CB)
My Lords, I declare that I am a fellow of the Royal College of General Practitioners. Do the Government recognise that, with an increasing number of GPs working salaried and part-time, it is essential that they have security in their contracts? There is a tension when commercial providers need to provide profits to their shareholders, which can work in the opposite direction to the needs of the community, as the medical staff should be working as a co-operative to improve services locally.
Lord Kamall (Con)
I am sure that we all want to pay tribute to the work of GPs, who are at the front line and, quite often, are the gateway to many services across the NHS and the wider healthcare system. It is important that we recognise some of the pressures they are under, but also work out how to help them and, indeed, patients. As I have said in the past, I will be a champion of patients and it is important that patients have access to their GPs, as a gateway to further services.
Baroness Thornton (Lab)
Notwithstanding the fact that the Minister says that the NHS is not up for sale, would he care to speculate what would motivate an American health insurance company to buy into a UK primary care GP market? Was this procurement carried out under the Covid relaxation that allowed contracts to be awarded without competition, or the usual procurement regime?
Lord Kamall (Con)
I wish I could read the minds of those who bid to run these services, but I am afraid I will have to admit that I cannot. The contracts are awarded at the local level by CCGs. It is their decision and it would be inappropriate for the Government to intervene.
Lord Jones of Cheltenham (LD) [V]
My Lords, my local GP, who has been extraordinarily busy during this pandemic, tells me that he just wants to get on with treating people who are ill and preventing others from becoming ill. He is not interested in fighting off unwanted backdoor interference from Americans or any other predators. Will the Government give proper support to our NHS, without which some of us might not be around to pass on these views from the front line?
Lord Kamall (Con)
We all understand the importance of the role that GPs play in our NHS. I remind noble Lords that, when the NHS was created, once the state had seized the voluntary hospitals and hospitals from churches, it left GPs independent. It has been left up to them how to run their services. What is important is that we expect all GP services to offer the best-quality care, despite the business model they use.
Lord Adonis (Lab)
My Lords, I commend the Minister for congratulating Tony Blair, who, of course, led the best Government of modern times in this country. The Blair Government trebled health spending in real terms—three times the rate of growth under this Government. I encourage the Minister to learn further lessons from Tony Blair, in particular to significantly increase health spending and leave the National Health Service in a better condition than he found it, rather than, as is now happening, in a worse condition.
Lord Kamall (Con)
I pay tribute to the noble Lord on his contributions to the Blair-Brown documentary, which I am sure a number of noble Lords enjoyed watching and learning from. It is important that we learn the right lessons from whichever political party, so when Tony Blair, a former Labour Prime Minister, says that we should encourage the private sector to be more involved in partnership with the public sector, we will take that advice.
Lord Rogan (UUP)
My Lords, I have great respect for GPs, but with general practices paid for the number of patients registered with the practice, profit-driven services might carry the risk of some GPs choosing to register younger and fitter patients, who will need to be seen less often than older patients. Would the Minister really be comfortable if that situation played out?
Lord Kamall (Con)
I am sure that noble Lords agree that it is appropriate that GPs register as many patients as they are able to see, and that their patients, whatever their needs, can access our great system of healthcare in this country. I would indeed be concerned if there were barriers to accessing GP services.
Lord Clark of Windermere (Lab)
My Lords, the cost of locum doctors to the NHS is £6 billion a year, much of it in primary care surgeries. Does the Minister feel that this is good value? What are the Government doing to try to get back to having regular doctors?
Lord Kamall (Con)
The Government recognise that it is important that people can see GPs and, as much as possible, invest in making sure that there are more full-time equivalent GPs. We have done that and we will continue to do so.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Food (Promotion and Placement) (England) Regulations 2021
Lord Kamall Excerpts(3 years ago)
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Lord Kamall
That the draft Regulations laid before the House on 21 July be approved.
Relevant document: 12th Report from the Secondary Legislation Scrutiny Committee. Considered in Grand Committee on 23 November.
Food (Promotion and Placement) (England) Regulations 2021
Lord Kamall Excerpts(3 years ago)
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Lord Kamall
That the Grand Committee do consider the Food (Promotion and Placement) (England) Regulations 2021.
Relevant document: 12th Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, obesity is seen as one of the biggest health problems this country faces. The latest national child measurement programme data from 2020-21 showed that around 40% of children leaving primary school were overweight or obese, with one in four living with obesity. Regular overconsumption of food and drink high in calories or the consumption of sugar and fat can lead to weight gain and, over time, obesity, which in turn has a significant impact on health and well-being and increases the risk of certain related diseases.
The Covid-19 pandemic has highlighted the impact that obesity can have on people’s health. Evidence from a University of Liverpool study shows that those who are overweight or living with obesity and who contract Covid-19 are more likely to be admitted to hospital and suffer worse complications. This measure is part of the Government’s healthy weight strategy, which we hope will contribute towards achieving the ambition of halving childhood obesity by 2030.
The instrument we are discussing today concerns the introduction of restrictions on promotions of less healthy products by volume price and location for retailers in England with 50 or more employees. Location restrictions will apply to store entrances, the ends of aisles, checkouts and their online equivalents—for example, home pages and payment pages. Volume price restrictions will prohibit retailers from offering promotions such as buy one, get one free or three-for-two offers on less healthy products.
Lord Kamall (Con)
I start by thanking noble Lords for their contributions to today’s debate. I shall try to turn to some of the questions from noble Lords and to answer as many as possible in the next three hours, if noble Lords will be patient with me. [Laughter.] Seriously, if I do not touch on a particular question, please write to me to follow up, particularly on some of the more technical questions.
I start with some of the questions from the noble Lord, Lord Brooke. He asked about the scope. Stores smaller than 185.8 square metres or 2,000 square feet—if you are wondering why such an unround number was chosen in metric—and specialist retailers that sell one type of food product category, such as chocolatiers or sweet shops, will be exempt from location restrictions but will need to adhere to the volume price restrictions. The policy will come into force in October 2022. The noble Lord referred to issues that I am always interested in, which are the evidence, as well as the impact, and how we look at the unintended consequences of any such moves. There will be a review within three—
Lord Kamall (Con)
The policy will be reviewed within three to five years of it coming into force. I reassure the noble Lord that the intention is that the policy will come into force in October 2022. However, as the noble Lord and I have discussed in the past, I am always concerned about unintended consequences and evidence to see what has worked and what has not. In many ways, I am a fan of the discovery process. We do not have complete knowledge—in fact we have incomplete knowledge—and all we can do is trial and see what works and use the best evidence that we can to assess.
Part of this review of the regulatory framework provisions of the restrictions will consider whether penalties under the Regulatory and Enforcement Sanctions Act 2008 have been implemented effectively and achieve their ambitions. We will continue to keep the policy under review to ensure that it is both impactful and proportionate. I am sure noble Lords will agree that it is not sufficient just to pass a piece of legislation and hope it does its job. In fact, as I think many noble Lords would acknowledge, this in itself is not enough to tackle obesity. It has to be a multi-angled view with many different approaches. Some will work, some will not, but we have to learn from what works and make sure that we are not driving consumers into unintended consequences and leading them to worse health outcomes.
We hope that this strategy that we published in 2020 will be world leading. I think the noble Lord, Lord Brooke, mentioned Sir Keith Mills and his programme. This shows that it is not just this piece of legislation; it is a multichannel approach, if you like, including incentivising people to have healthier lifestyles —monitoring their steps and other exercise functions. Anyone who has looked at successful and unsuccessful diets will recognise the fact that it is not just about reducing what you take in; it is also about burning off those calories. We have to get the right balance. Each individual will have different BMIs and different physiologies and different strategies will work for different individuals.
In terms of the businesses that these regulations will impact, the location and volume restrictions apply only to medium and large businesses in England and around 24% of stores are in scope of the volume price restrictions. Given the size threshold for stores subject to location restrictions, these apply to approximately 16% of stores in England. Some 94% of estimated food retail revenue falls under the volume restrictions, while 84% falls under location restrictions. This means that these restrictions offer considerable potential, if done correctly, while ensuring that small businesses are not disproportionately impacted by the changes. I acknowledge that many noble Lords were concerned about the cost for both large and small businesses.
The original timescale was to be April 2022, but having considered feedback from the industry, we have made the decision to extend the implementation to October 2022. I am well aware that some in the industry are asking for a further extension and, as noble Lords can recognise from the tone of the debate today, some are in favour and some are against and the Government are trying to get the right balance. The Government want to bring in these measures so we can start analysing whether they work. We are also very mindful of the fact that it falls on industry to implement them.
The other issue raised was about smaller stores and what are called symbol groups, which, as noble Lords may understand, are smaller retailers that come under a wider brand. If we excluded symbol groups in their entirety, that would take away some of the health benefits of the policy. Franchises and symbol groups make up about 60% of those in scope of the volume price promotions and 14% of the location restrictions. Approximately only 12% of symbol group stores are over 2,000 square feet, therefore the vast majority of these stores will be exempt from the location restrictions. I hope noble Lords understand the point about the cost falling particularly disproportionately on smaller stores.
Lord Kamall (Con)
My noble friend makes a very reasonable demand that is difficult for me to refuse. Let me put it this way: I hope that I have not caused any shock waves, as it were.
There has been an impact assessment, which shows that the location restrictions over the 25-year appraisal period are expected to bring health benefits of more than £57 billion and provide NHS savings of more than £4 billion. The volume price restrictions are expected to accrue health benefits of more than £2 billion and provide NHS savings of £180 million. We recognise that there will be costs to businesses; once again, this is all part of that difficult balance and debate. A phrase I have often heard is, “Do not let perfection be the enemy of progress”. We want to try as hard as possible to get this right. From the consultation that has been going on, we are very aware that this will have an impact on a number of businesses but, at the same time, there is lots of pressure, as noble Lords will have heard today, just to get on with it.
Baroness Neville-Rolfe (Con)
I am sorry to interrupt again, but £57 billion is a much bigger figure than I have seen anywhere; £3 billion, perhaps separately, I could understand. It is really helpful to have the impact assessment but it is difficult to understand what the benefits and costs are, which we need to understand to give my noble friend the Minister the full support that he requires.
Lord Kamall (Con)
Once again, I thank my noble friend for making that request. I always make it clear that it is important that we publish as much evidence as possible and let it be challenged; that is part of a healthy debate. If things do not work as intended, we should see what works and what does not. I am always very sensitive when someone says, “the evidence suggests”. We need to have that challenge but also make sure that we know what works. At the end of the day, we all want to see less obesity across our country, so surely it is important that we make sure that the evidence is there. Where something does not work, we will just have to try other ways.
On compliance, it is for local authorities to decide how best to enforce the requirements. Where an enforcement officer suspects that HFSS food or drinks may be inappropriately promoted, they should request further information to verify. If the product is in scope and has been promoted contrary to the law, an enforcement officer will consider what action should be taken.
Baroness Merron (Lab)
I thank the Minister; it is generous of him to give way. I would be very interested in how he sees the greater responsibility on local authorities. Picking up my question again, does he feel that local authorities are resourced suitably? Can they expect some recognition of this new and extremely important role, because the regulations require their co-operation too?
Lord Kamall (Con)
I thank the noble Baroness for that question. The Government are committed to ensuring that enforcement is proportionate and fair, and we intend to support local authorities and the judicial system on additional costs incurred as a result of enforcing the policy. Up front, I cannot say what those costs will be, but we want to understand what they will be to help enforcement.
I was asked whether we had watered down the policies for some products. We have excluded some products that are not among the highest sugar or calorie contributors to children’s diets or are not heavily promoted, but we will continue to keep the policy under review.
The noble Baroness, Lady Brinton, asked about weight management and other ways of tackling weight issues, including exercise. In March 2021, we announced an extra £100 million for healthy weight programmes to support children, adults and families in achieving and maintaining a healthy weight.
On infant foods, we will shortly consult on proposals to improve the marketing and labelling of commercial food and drink products for infants and young children. I acknowledge many of the concerns expressed by the noble Baroness, Lady Brinton.
The noble Baroness, Lady Merron, asked why we are using secondary legislation. The different legislative approaches being pursued reflect the current legislative framework and implementation routes available to the Government. For the promotion restrictions, we used existing powers in the Food Safety Act 1990 to lay secondary legislation before Parliament in July 2021. The statutory instrument has been subject to the affirmative parliamentary procedure.
On how we look at issues of inequality, noble Lords made a very fair point. Perhaps I may be so bold as to suggest that one issue for people I talk to in many of the communities that we are supposed to be reaching out to is that, for far too long, the public health industry has been dominated by white middle-class people who feel they know better than immigrant and working-class communities. It is really important that we understand those communities. As someone who comes one of the communities that have been patronised, I recognise that we have to make sure that we work with them and do not just sit in a place like this and assume that we know better. It is important that we really understand them. What is really good about the Office for Health Improvement and Disparities is that “disparities” are on the label, on the tin, which means that we have to look at how we address them.
There were some questions about why smaller businesses are exempt. I hope that I have answered them.
On people not being able to afford to eat a healthy diet, anyone who has watched daytime TV will know that some of those programmes can show you how to cook a meal very quickly and much more cheaply than is the case with many of the convenience foods that you can buy. The problem is how we translate that from the TV and entertainment to people’s lives in reality. In many ways, it means understanding families, where the decisions are made and what they have access to in many of their communities. Anyone who has been to many of the immigrant communities, for example, will know that there are plenty of shops that sell and openly display fresh food, but how do we make sure that we translate that into healthy diets?
On their own, these regulations will not be enough. We also have to look at how we translate all this into understanding people’s lives right at the family and the community level. It is our goal to improve children’s health and to reduce obesity. The shopping environment plays a vital role in the way products are marketed to us—for example, the pumping out of the smell of fresh bread from bakeries. We know that marketing people are experts in understanding consumer behaviours, with factors such as the location of products at the end of aisles affecting what we buy. The Government are committed to getting the right balance between stopping bad practice and working constructively with industry. We also want to evaluate the evidence of the restrictions once the policy is implemented.
We believe that retailers can play a vital role in creating a healthier food environment that does not promote the overconsumption of less healthy products. The Government hope that these regulations will enable us to achieve a healthier food environment and make progress to halving childhood obesity by 2030, and allow us all to live longer lives in good health. I commend the regulations to the Committee.
Dementia: Art and Music-based Interventions
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
Music can play an important part in supporting people who are living with dementia. Last year, NHS England and NHS Improvement facilitated three webinars resulting in the publication of guidance for social prescribing link workers to expand music prescriptions. We will be setting out a new dementia strategy in 2022. As part of that development, we are working in collaboration with stakeholders, including people affected by dementia, and will explore the role of arts and music-based interventions.
Baroness Greengross (CB)
My Lords, I thank the Minister for his reply. What further steps will the Government take to support brain health through social prescribing? How will any measures taken be incorporated into the Health and Care Bill currently being debated in the other place?
Lord Kamall (Con)
I pay tribute to the noble Baroness for all her work raising awareness of dementia, in this House and outside of it. The Government understand the importance of non-medical and lifestyle factors in supporting people’s health and well-being, including brain health. This is why we are continuing to roll out social prescribing across the NHS, in line with the NHS Long Term Plan commitment to have at least 900,000 people referred to social prescribing by 2023-24. The Department of Health and Social Care is working closely with NHS England and NHS Improvement to incorporate social prescribing into the guidance to integrated care systems. Some of this guidance has already been included in the document implementation guidance on partnerships with the voluntary, community and social enterprise sector that was published in September 2021.
Baroness Wheeler (Lab)
Around 25,000 people with dementia are from BAME communities and this is expected to double by 2026. The Alzheimer’s Society report, The Fog of Support, found that people from these communities, and those with English as an additional language, were more likely to use BAME-led groups. The report also found that there is generally a need for interventions to be much more culturally sensitive. What action are the Government taking to ensure that people with dementia can access culturally appropriate care, including art and music-based interventions, which reflect a wide range of cultures and languages?
Lord Kamall (Con)
The Office for Health Improvement and Disparities is looking at areas where there are clear disparities. As part of developing the dementia strategy, the Government are consulting with a wide range of stakeholders and ensuring that a diverse range of views from different communities is heard and that it is not targeted just at one particularly community.
Baroness Bull (CB)
My Lords, social prescribing is a key aspect of the NHS Long Term Plan. It has been described by the president of the Royal College of General Practitioners as an essential part of the toolkit for tomorrow’s doctors. Therefore, why is social prescribing absent from the core undergraduate curriculum in UK medical schools? Some schools offer optional modules, but there is no national consensus on what teaching should cover or how it is best delivered. Does the Minister agree that, unless social prescribing is integrated into the education of the future healthcare workforce, its benefits for patients and the NHS will never be realised?
Lord Kamall (Con)
The NICE quality standard on dementia, published in June 2019, includes guidelines for offering activities and social prescribing. They are also included in the NHS long-term plan. Obviously, different components are modelled that are social prescribe-enabled—not only music but other art-based activities. The education question will be for my noble friend in the Department for Education, but if the noble Baroness can write to me, I am sure that we can get the answer.
Lord Bethell (Con)
My Lords, music therapy is also increasingly helping Covid patients hit by inflammation and fibrosis that causes shortness of breath—a horrible condition. The Breathe programme from the ENO and Imperial College has classical-singing coaches providing psychological and physiological therapy to great effect. Can the Minister endorse this kind of social prescribing, and can he commit to meeting Dr Harry Brünjes and the Breathe team, which is seeking to take this programme nationally?
Lord Kamall (Con)
I thank my noble friend for that question. As an amateur musician—I stress “amateur”—I know that there is no better feeling than when you connect with your audience as a live musician. Music tugs at your heartstrings. Music touches your soul. But it can also unlock the mind. This shows the importance of music in social prescribing.
Lord Hunt of Kings Heath (Lab)
My Lords, I hope that patients get the benefit of what I am sure is the Minister’s excellent playing. He has been very positive in his responses, but he will know that the arts sector has been very stretched financially during the Covid years in particular. Will he open discussions with organisations such as the Alzheimer’s Society, with an offer of some funding to develop some of the schemes that we have heard about today?
Lord Kamall (Con)
I thank the noble Lord for his invitation to perform live—I am not sure that he will feel the same way after hearing my blues band. Last year, NHS England and NHS Improvement, in collaboration with the National Academy for Social Prescribing, the Alzheimer’s Society and Music for Dementia, facilitated a series of webinars. We are working in consultation with them. In February 2021, Music for Dementia also published social prescribing guides for link workers to help expand music prescriptions. The important thing here is that we are consulting with stakeholders.
Lord Clement-Jones (LD)
My Lords, for more dementia patients to gain access to music therapy through social prescribing, there must be more training on the value of music for carers and healthcare practitioners and greater support for musicians to train as music therapists, and music education must be a much more mainstream part of primary and secondary school education. What assurance can the Minister give that the necessary government cross-departmental action is being taken to deliver on this?
Lord Kamall (Con)
The department itself is working closely with Music for Dementia and other organisations. Across government, we are looking at music, beyond just performance, to see how it can impact our lives and the role that it can have in levelling up and community cohesion, for example. Across government, I am sure that a number of departments are looking at this.
Lord Vaizey of Didcot (Con)
My Lords, the former Secretary of State, Matt Hancock, deserves an enormous amount of credit for setting up the National Academy for Social Prescribing. Before he came into the department, the Department of Health could not have been less interested in the power of the arts and music to have an impact on people’s health. The second anniversary of the academy has just passed. Can the Minister commit to issuing a report on its third anniversary—since I know that he will still be in the post—to suggest how to take it forward? Also, we still do not know what instrument he plays, but perhaps he could take it with him on his first visit to the academy, as soon as possible.
Lord Kamall (Con)
I am not sure which question to answer first. If noble Lords will excuse a second of self-promotion, I am an electric bass player and sing the blues as well.
Lord Kamall (Con)
I thank noble Lords. Can I stop there? I also am aware that my noble friend is himself a music fan. I remember once bumping into him on the Jubilee line on his way to the O2 arena to see Led Zeppelin. Noble Lords across the House recognise the power of music and how it affects our lives.
Lord Jones of Cheltenham (LD) [V]
My Lords, someone very close to me has Alzheimer’s disease. Music-based interventions such as the Alzheimer’s Society’s “Singing for the Brain” groups have been proven to have multiple health and well-being benefits. What support are the Government offering to charities such as the Alzheimer’s Society to ensure that they can keep delivering this kind of intervention? Will the Minister, with his musical ability, commit to attending a “Singing for the Brain” session?
Lord Kamall (Con)
I should warn all noble Lords that they have not heard me yet—their requests may be quite different after hearing my band play. In terms of the ability of music and, if you like, the instructions, we are working with a number of stakeholders as well as ensuring that, when it comes to training social workers and others, they understand the ability of music to make a difference to people’s lives.
Lord Wigley (PC)
My Lords, I declare an interest: my wife is a music teacher and my son runs a recording studio, at which I am sure the Minister would be very welcome. Does the Minister agree that one initiative which could help both dementia sufferers and young musicians and artists would be to sponsor of an internship scheme whereby such students could be working part-time in the care sector, thereby benefiting themselves and those in care?
Lord Kamall (Con)
I thank the noble Lord for that suggestion. We are looking, across the health sector, at how we can think outside the box and train students in other disciplines to help in healthcare. Clearly, music can potentially play a role. In terms of the music studio offer, can I just say “Wait until you’ve heard me”?
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked. We now move to the next question.
New Hospitals
Lord Kamall Excerpts(3 years ago)
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Baroness Walmsley
To ask Her Majesty’s Government what progress they have made towards their commitment of building 40 new hospitals.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
The Government committed in October 2020 to build 40 new hospitals by 2030. We have confirmed an initial £3.7 billion to support these schemes for the first four years of the 10-year programme. This, together with eight previously announced schemes, will mean that we will have 48 new hospitals by the end of the decade. Six of the 48 new hospitals are currently in construction, including the first of the 40 new hospital schemes, and one scheme is now complete.
Baroness Walmsley (LD)
My Lords, as the Minister said, eight NHS capital schemes already under way when the promise was made were added to the Prime Minister’s pledge for 40 new hospitals by 2030, but now their cost overruns will have to be paid for out of the original pot of money. Can the Minister say how many of the originally promised 40 will now have to be postponed and how many are really new?
Lord Kamall (Con)
The Government have said that we will deliver 40 new hospitals by 2030 and in October 2020 we published the full list of the 40. This includes eight schemes that were announced by previous Governments but are to be delivered this decade and 32 new hospitals. We have also confirmed that we will identify further new hospital schemes, the process for which is ongoing, with a final decision to be made in spring 2022. This means that 48 hospitals in total are to be delivered over the decade.
Lord Hunt of Kings Heath (Lab)
My Lords, I have here the New Hospitals Programme Communications Playbook, which the noble Lord’s department has put out and which makes it clear that if you build a new wing of a hospital, that counts as a new hospital. What is worse is that NHS bodies are being instructed to lie and propagandise on behalf of the Government. Will he withdraw this disgraceful communication?
Lord Kamall (Con)
I hope that the noble Lord will recognise that whenever a new project is started and there is a decision to build a new hospital in a community, it surely makes sense to look at whether there is space on existing sites. Otherwise, if we start criticising new hospitals on existing sites, there may be a perverse disincentive for a hospital to say, “Well, let’s build elsewhere”. when there is a perfectly good site. It is important, whatever you call it, whatever the semantics, to recognise that we are building modern, digital, sustainable hospitals for the future.
Lord Bethell (Con)
My Lords, we very much welcome the investment in physical buildings, but the modernisation of the NHS also depends on digital infrastructure and training. Will the Minister please tell us what steps he is taking towards a programme of technological improvements that are needed to modernise the NHS?
Lord Kamall (Con)
I thank my noble friend for the question—I have picked up many of the things that he started when he was in post. One of the great things about being the Minister for Technology, Innovation and Life Sciences is having a real ability to drive through digitisation of the health service, making sure that we have a modern health service that is fit for the future, so that if you are a patient in one part of the country and something happens to you, all your information is available elsewhere for the clinicians at the time and you get the best possible care. That is something that we should be celebrating.
Lord Jones of Cheltenham (LD) [V]
My Lords, one of the principles of managing taxpayers’ money is to take account of the revenue implications of a capital budget. In view of the projected increases in building costs, is the Minister confident that the new hospitals programme managers understand this? What is being done to recruit the necessary doctors, nurses, technicians and maintenance staff for these new and existing hospitals?
Lord Kamall (Con)
One thing that is exciting about the new hospitals is that we are going to transform the way in which we deliver new healthcare infrastructure. First, it will be sustainable, with net-zero carbon across the NHS. Digital transformation is key, making use of the latest technology, so no longer will we have microscope slides couriered between sites, but we can instantly see a digital image and assess it using AI. There will be standardised design and modern methods of construction and new hospitals will be integrated with local health and care systems. This is a project for a health system that is fit for the future.
Lord Lancaster of Kimbolton (Con)
Many of these new hospitals will be built in existing centres of population. My concern, though, is for areas of high projected population growth, such as the Oxford-Cambridge arc, where we always seem to be playing catch-up when it comes to medical facilities. Can my noble friend simply reassure me that the principles of “I before E”—infrastructure before expansion—will be applied when choosing where these hospitals will be?
Lord Kamall (Con)
I assure my noble friend that, in deciding where to build a hospital, among the things that the NHS and others look at are the needs in the community, existing infrastructure and making sure that we can build hospitals that are fit for the future, that are digital, that are transformative, but are led by clinicians as opposed to construction experts.
Lord Mann (Non-Afl)
The Minister said, just a moment ago, “whatever you call it”. When David Cameron was Prime Minister, he gave a pledge on district general hospitals and the definition of hospitals became important. Many of us said that, in order to be defined as a hospital, it had to incorporate 24-hour accident and emergency. What is the Minister’s definition of a hospital and is the pledge from David Cameron on district general hospitals current?
Lord Kamall (Con)
Each of the building projects will be a new hospital that will deliver brand-new, state-of-the-art facilities. One thing that we must be careful of is that if we say, “Well, you can’t call that a new hospital, even though it is a new facility, because it’s on an existing site”, we do not create perverse incentives, where the local NHS or the local ICS says, “We mustn’t build it there, because we will be accused of not having a new hospital”. Surely what we should be focusing on is outcomes, not inputs, and the fact that we are delivering modern, digital hospitals for the future.
Baroness Thornton (Lab)
My Lords, leaving aside the dubious and overinflated claims of 40 new hospitals, many of which are, in reality, upgrades—as welcome as they are—I and others in the House raised with the Minister’s predecessor but one in 2019 that there was an alarming repairs and infrastructure crisis, which was then in the region of £3 billion. Could the Minister explain to the House which part and how much of the new hospitals programme will address the immediate and urgent matter of crumbling wards, sewer leaks in wards and old and dodgy kit?
Lord Kamall (Con)
The noble Baroness will recognise that we need not only to build new hospitals but to upgrade existing infrastructure and this is all part of the capital programme. The decisions on individual hospitals and upgrades will be taken in local communities in consultation with clinicians and local ICSs.
Lord Balfe (Con)
My Lords, will the Minister avoid getting caught in a numbers game? We need an adequate number of beds in a good geographical spread to deal with the needs of the whole population. I hope that he will see this as part of an integrated expansion of the health service and that we will not get tied up with the numbers, as we did years ago—how many hospitals, how many this, how many that. We need an improved health service. This is a vital part of it, but it is only a part.
Lord Kamall (Con)
I completely agree with the sentiments expressed by my noble friend. Surely what we should focus on is output; surely what we need is the best healthcare system across the country. We need up-to-date healthcare with the best information from patients to make sure that we can diagnose and give them appropriate treatment, working with the very latest technology such as artificial intelligence to spot patterns, to make sure that we can also build in prevention when we look at tackling health issues in the future. I welcome my noble friend saying that we have to focus on output—modern digital infrastructure and modern digital hospitals fit for the future.
Baroness Brinton (LD) [V]
My Lords, my local hospital, Watford General, is on the list of 40 so-called new hospitals, although the plans have been in place and supported cross-party for close to two decades, and its infrastructure is failing. Despite a clear promise of funds by the Prime Minister during a visit to the hospital in October 2019, the trust is yet to be allocated funding from the Treasury and it remains a pathfinder. I want a clear outcome. When will funding be confirmed and granted?
Lord Kamall (Con)
On the point about the noble Baroness’s local hospital, I am afraid that I am not aware of where she is situated geographically, but I can tell her that six of the 48 hospitals are already under construction and one is now completed. I hope that the noble Baroness will write to me on the hospital that she referred to so that I can give her an answer.
Lord Foulkes of Cumnock (Lab Co-op)
My Lords, will the Minister stop waffling and put on record an answer to the question asked by the noble Lord, Lord Mann, saying precisely what he means by a “new hospital”? I tell him not to waffle back.
Lord Kamall (Con)
I thank the noble Lord for his advice just before I was about to answer. Whatever you call it—and we can debate semantics—the important thing is surely that we build new hospitals and upgrade existing infrastructure. Surely we should celebrate the fact that we are building 48 new state-of-the-art hospitals—
Lord Kamall (Con)
We should not celebrate building new hospitals? Well, there we are. We should celebrate the fact that we are building new hospitals to give patients the best possible care, aided by digital technology and making sure that they are sustainable.
Covid-19: UK Arrivals
Lord Kamall Excerpts(3 years ago)
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Baroness Royall of Blaisdon
To ask Her Majesty’s Government why international students and others who have been fully vaccinated and are not required to self-isolate on arrival in the United Kingdom subsequently have to self-isolate if a close contact contracts COVID-19; and what plans they have to change this policy.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
Our current system for validating the vaccination status of close contacts relies on checking against records in the NHS national immunisation management system. We do not have access to equivalent records for those vaccinated overseas. We recognise the pressing need to resolve this issue as soon as possible and are urgently exploring a number of different options to extend the existing exemptions to contacts who have been vaccinated overseas. I hope to be in a position very shortly to brief the House on a proposed solution.
Baroness Royall of Blaisdon (Lab)
My Lords, I will welcome that solution when it comes. The Minister talks of urgency but we have been waiting since the beginning of September for a resolution to a problem that I believe is rather small but which clearly disadvantages international students. To me, it feels slightly xenophobic and as though to date the Government have been intransigent. I know that Public Health England agrees that the policy is not logical in any sense or form, so why do international students have to self-isolate for 10 days when our own students from the UK do not? This disadvantages the international students and puts people off coming to this country. Also, how can international students who have had non-MHRA-approved vaccines be immunised in the UK in order to get a Covid pass, should that be necessary in the not too distant future, as it is in some other parts of the UK?
Lord Kamall (Con)
As someone whose family comes from outside the EU, who has taught in universities and who recognises the great asset that there is and the great advantages that there are in being open to the world, and global Britain, I share the noble Baroness’s frustration. Yes, we have left the EU, which is very much a project of white privilege, and moved to a more global outlook. It is really important that we now focus on the world generally. The issue is quite technical at the moment. One of the things needed for the test and trace system to work is that you need access to the underlying data and verification. We are looking at a number of different options for how to achieve that.
The Lord Speaker (Lord McFall of Alcluith)
The noble Lord, Lord Flight, is not present so I call the noble Baroness, Lady Hayter of Kentish Town.
Baroness Hayter of Kentish Town (Lab)
As the Minister has said, our universities have long been a welcoming and inspiring academic hub for international students but stories such as the ones that we have heard—along with, I am afraid, the attack on freedom of speech at the LSE and the shameful treatment of Professor Stock, which we will come to shortly—added to Covid and online teaching, to say nothing of the Brexit fallout, which means that EU schools can no longer use group passports, all question our ability to attract youngsters from across the globe. What are the Government doing to re-establish our reputation in this sector?
Lord Kamall (Con)
The noble Baroness makes an important point about us being a global hub and welcoming the whole world. For centuries the UK has been open to a number of different nationalities from across the world. Indeed, my own family came to the UK in the Windrush generation. I have always been clear that we should be a global Britain, not just focused on one small part of the world.
I want to take the opportunity to answer the question that I forgot to answer about international students. Anyone in England is eligible for the vaccine if they fall within the current eligibility criteria, and international students are encouraged to register with a GP.
On free speech, it is critical that our universities remain places where you can have free expression without fear. The essence of free speech is being able to tolerate views that you may not agree with but it is important that they are expressed. Universities should remain hubs of free speech.
Baroness Stuart of Edgbaston (CB)
My Lords, I refer to my registered interests. Given that this is not really a public health problem in its scale, but it is a bar to the recruitment of international students and their integration once they are here, may I urge the Minister—even if he cannot find a quick solution to the NHS app—to put out some information on how Covid passes can be obtained and to make sure that all universities and students have access to that information as soon as possible?
Lord Kamall (Con)
Last night I took part in a debate that involved the issue of the Covid pass, particularly with the boosters. I was frustrated because I thought I had a date I could announce. That was pulled at the last moment, but we are very close to a solution. The technical point on test and trace is that, at the moment, it is unable to validate the vaccination status of people whose vaccines are not registered on the database. We are looking at whether that can be done on trust, or whether that would open a loophole for getting around the system. I have been assured when pushing the NHS on this that it is looking at an answer.
Baroness Thornton (Lab)
The Minister must accept that this a very confusing area for everybody. Perhaps he would like to clarify the Prime Minister’s comments yesterday on what impact tougher overseas travel rules and self-isolation for those without a jab might have. He mentioned those yesterday in the press conference. I think they are linked to the Question my noble friend asked. It is very important that the NHS app shows the booster as soon as possible, because it is going to cause a lot of trouble for Christmas travel.
Lord Kamall (Con)
I welcome questions from noble Lords, particularly on getting the booster on the app, because when I am talking to officials in the department and the NHS it shows how important it is that we do this as quickly as possible. One of the tasks is to be accountable and to push the NHS and others to make sure that we are doing this. Sadly, when I ask what the problem is on test and trace, I am told that it is unable to validate the vaccination status of people whose vaccines are not recorded on a national immunisation management system. I have asked about passenger locator forms and whether we could use a similar technology. At the moment that is done on trust, but you face a very high fine if you are misleading; maybe that could be a solution. I assure noble Lords that I really am pushing.
Baroness Smith of Newnham (LD)
My Lords, I refer to my registered interests. I have printed off the advice given by my university, Cambridge, to international students and what it means to be fully vaccinated. To come into the country, if they are fully vaccinated, they do not have to isolate when they arrive, as the noble Baroness, Lady Royall, pointed out. If the system can understand when they arrive in the country that they are fully vaccinated, why can the NHS app not understand that they are fully vaccinated when they get pinged by test and trace?
Lord Kamall (Con)
I share the frustration of the noble Baroness and others. This is not great for our international, global outlook, or for the fact that we want to attract the best students from around the world, not just Europe. We are a global country and we have to address this. I am pushing the NHS on this because it is really important. The problem is the national immunisation management system, to use the technical term, and the inability to validate the data of overseas visitors.
Baroness Warwick of Undercliffe (Lab)
My Lords, I can sense the Minister’s frustration in this, but we have been aware of it for some time; this should have been sorted out a long time ago, yet here we are now in November. Does the Minister accept that all departments must play their part in achieving the Government’s aim of increasing the number of international students? Will he assure us that his department will be both flexible and creative—with the emphasis on “creative”—in resolving this and other similar problems that may arise?
Lord Kamall (Con)
I assure the noble Baroness that when I was pressing this issue yesterday with officials in preparation for this Question, I stressed the importance of flexibility and creativity. We need to think outside the box on many issues. One issue we are looking at is: if passenger locator forms can do this, why can the NHS Test and Trace system not? I am told that is because it is based on self-certification. I am pushing the NHS to address and analyse the different options as soon as possible. It is really important we send a message to the rest of the world that we are open to the brightest and the best from across the world.
Baroness Ritchie of Downpatrick (Lab)
My Lords, in Queen’s University Belfast, the current position is determined by the Public Health Agency in Northern Ireland and is based on your vaccination status and age, rather than on whether you have home or overseas status. Would the Minister engage with the devolved Administrations, particularly the Northern Ireland Executive, who seem to have best practice in relation to this issue?
Lord Kamall (Con)
One of the advantages of having devolved Administrations and different practices is that we can learn from best practice, so I will take the noble Baroness’s advice.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, does the noble Lord believe the rules and regulations regarding the Covid-19 pandemic are clear, consistent and easy to understand?
Lord Kamall (Con)
I thank the noble Lord for that question. It depends on who you ask.