Covid-19 Update

Lord Newby Excerpts

Wednesday 14th October 2020 Lords Chamber

[Baroness Smith of Basildon (Lab)]

My Lords, I doubt that the Prime Minister, Boris Johnson, shares my admiration for Harold Wilson, but even he will recognise that his oft-quoted comment that a week is a long time in politics is very relevant today. With the pace of events over the last couple of days they must have felt like at least a week. I expect that the noble Baroness the Lord Privy Seal might be relieved not to be repeating the Statement made by the Prime Minister in the Chamber today.

The Statement on Monday, announcing a three-tier system of restrictions, is already wilting under close examination and the publication of the scientific advice received by the Prime Minister. In the Statement, the Prime Minister said that we needed to “go further” than the existing restrictions. He is right to consider and announce further actions, but the scale and rate of infections is increasing. There are now more people in hospital, including ICU, than there were in March when we went into lockdown. On the positive side, our knowledge and ability to treat have improved, but we have a clearer understanding of how devastating this illness is for so many.

The Prime Minister referenced the Government’s advisory body SAGE in his announcement, but if you go back and read it again there is a very serious omission. This was clearly no accident; it was calculated and deliberate. Unlike earlier Statements from the Prime Minister and members of his Government, this one makes no reference to following the scientific evidence or to evidence-based policy-making. We now know why. The minutes of the SAGE meeting of 21 September, published after the Prime Minister’s Statement on Monday, are very clear about the scale of the challenge and the action needed—not suggested—to tackle it. Its warnings are stark:

“not acting now … will result in … catastrophic consequences in terms of direct COVID related deaths and the ability of the health service to meet needs.”

The report then lists a range of short-term measures to be considered for “immediate introduction”. That was on 21 September, three weeks ago, and it said “immediate”: not next week or next month.

Since then, the Prime Minister has made two announcements of new restrictions but has failed to act on, or share with Parliament or the public, the advice that his Government have received. Let us be clear: any restrictions are difficult; none is pain free. But surely the worst kind of restrictive measures are those that are piecemeal. They fall short of what is required and, therefore, go on longer without the level of impact that is needed. The Prime Minister has, therefore, twice announced measures knowing that they fall short of what the scientific advice says is essential.

The seriousness of this cannot be overestimated. He knows that his measures are inadequate, as evidenced in an article in today’s Telegraph that says that the Government are now considering the circuit break that was recommended by SAGE three weeks ago and called for by my colleague and Leader of the Opposition yesterday. At the same time, the world-beating test, trace and isolate system that the nation was promised has failed to materialise. After the Government have spent £12 billion, SAGE has concluded that that is having “marginal impact”.

For those who are suffering lockdowns, desperately missing and worrying about loved ones, worried about their own and their families’ health; for the self-employed, the now unemployed and struggling businesses, to go through that pain without the gain, with the Government ignoring the scientific advice, is deeply shocking and unacceptable.

It has to change. The stop-start approach has failed; we have to break that cycle. It is so much harder to deal with the economic consequences unless there is public confidence in the Government’s ability to protect the nation’s health. I get upset and quite angry when it is suggested that this is a binary choice between our health and the economy. That is plain wrong. It is so evident that they are two sides of the same coin and totally interlinked.

Last night, having considered the scientific evidence and consulted widely, Keir Starmer called on the Government to reset their approach—to introduce that circuit breaker alongside the other measures deemed necessary by the scientific experts, along with the essential economic support, and to get a grip of the test, trace and isolate system. That is not a single measure; it is a complete package of health protection, economic support and future planning.

I have a couple of questions for the noble Baroness, who is a member of the Cabinet and of Cabinet committees. I appreciate that the details of Cabinet discussions are not published, but can she confirm that members of the Cabinet were informed of the SAGE advice of 21 September? Following that, can she explain the rationale, which must surely have been discussed in Cabinet, in ignoring that advice?

Too often, the Government’s approach has been very centralised, and effectiveness has been lost through a failure to properly engage, consult and support local authorities. What action is being taken now to ensure local capacity, knowledge and experience is being effectively utilised, particularly in test, trace and isolate, with the necessary resources being provided for that? I refer to all local authorities, not just those in tiers 2 and 3, because this has to be a nationwide engagement.

The costs of tackling the crisis and preparing for the post-Covid future are huge. Obviously, we need to ensure such large amounts of money are used to the greatest effect. Many in your Lordships’ House have been in government or in positions of authority where difficult decisions have to be taken. No one is pretending this is easy, but it is even harder when members of your own party are pulling in different directions. There is only one thing to do in those circumstances; it is not possible to steer a middle course and try to placate different views. You just have to do what is right, because that is what true leadership is really about.

[Lord Newby (LD)]

My Lords, I thank the noble Baroness the Leader of the House for responding to questions on the Prime Minister’s Statement. Although we are discussing a Statement barely 48 hours after it was made, things on the ground, as the noble Baroness, Lady Smith, has said, have moved on apace since Monday. Infections have risen, deaths have risen rapidly, and people have become more confused and more worried.

In the Statement, the Prime Minister said the Government are seeking to balance the

“objectives of saving lives and protecting the NHS while keeping our children in school and … protecting jobs and livelihoods.”—[Official Report, Commons, 12/10/20; col. 23.]

What he did not do was level with the British people about what his scientific advisers have been proposing. We now know that last month, SAGE urged an immediate circuit breaker of more restrictive measures, because, as the noble Baroness said, and in its words,

“not acting now … will result in a very large epidemic with catastrophic consequences.”

That was several weeks ago. No action was taken, and we do now have a “very large epidemic” on our hands. That is why my colleagues in the other place and those on these Benches support the leader of the Opposition’s proposal for a short circuit breaker, to give time to get firmly in place some measures to get the virus under control, in the hope that we might have some relaxation—albeit possibly temporarily—at Christmas. I have never seen the Prime Minister as one of nature’s Roundheads but as things stand, he looks set to succeed and follow Oliver Cromwell by cancelling Christmas as we know it.

The one welcome change in the Government’s position over recent days is that they have been willing, for the first time since March, to have a serious dialogue with civic leaders in those areas most heavily affected by the virus. This is extremely welcome but long overdue. However, it needs to go much further. The national test, track and trace system is failing, and failing badly. A large proportion of people who have been in contact with someone who has tested positive are still not being contacted. Some 27% of those asked to isolate do not do so. Will the Government now effect a step change in the role they give to all local directors of public health to implement the track, trace and isolate system in their areas? Will they do so across the country and not only, as currently envisaged, in very high-alert areas; and will they give them the resources they need to do the job properly? If they do not, I fear we are simply going to see a large increase in the number of areas requiring the highest level of restrictions.

The Prime Minister’s Statement seems to bring clarity to an extremely confused picture, but it simply does not. It is completely unclear, for example, on the criteria the Government will use to decide which areas fall into the “very high”, “high” and “medium” categories. Can the noble Baroness tell the House what those criteria are?

The Prime Minister said the measures announced on Monday could lead to additional measures if local government leaders agreed. What measures do the Government have in mind? What happens if the Government think additional measures are needed and local leaders do not? Equally, if local authority leaders think that more restrictive measures should be imposed in advance of any government initiative—as is now the case with Essex County Council, and which is, I believe, the policy of the Mayor London—what will the Government’s response be?

The Government have briefed that they are preparing to open some of the Nightingale hospitals. It is widely believed in Yorkshire that, as far as the Nightingale hospital in Harrogate is concerned, this will not happen, because the hospital simply does not have the staff available to allow it to operate safely. Can the noble Baroness assure the House that this is not the case?

The country is now at a very dangerous point. The Government are at odds with their own scientific advisers, many council leaders and many of their own Back-Benchers. Their rules are complex and, in some cases, perverse. Track and trace is a shambles: it has lost the confidence of the majority of the population. It is time for a reset.

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

I thank the noble Baroness and the noble Lord for their comments and questions. First, they are right to point out some of the statistics to highlight the situation we are in. As the noble Baroness rightly said, there are now more people in hospital with Covid than when we went into lockdown on 23 March, and the number of people testing positive for Covid has quadrupled in the last three weeks, so we are very cognisant, as I know we all are in this House, of the issues that face us.

The noble Lord and the noble Baroness referenced the need for action in September. We did take robust and proportionate action when introducing measures in England, including the rule of six and the 10 pm curfew, which we discussed in this House, as well as advising people to work from home when they can. Each of those was carefully judged to protect lives and reduce transmission, while minimising the impact on people’s livelihoods.

So, we did take robust action, but with the step change in cases, more action is needed, which is why we made the decision to move to the tiered approach. The reason we have gone for the tiered approach rather than the circuit breaker is that, as the Prime Minister said to the leader of the Opposition at Prime Minister’s Question Time today, the disease is appearing more strongly in some areas and regions than others, which is a different situation from March. That is why we are introducing this approach, which can be tailored more effectively to local situations. However, having said that, we regularly, and will regularly, keep measures under review to ensure that we are always taking the best action we can.

The noble Lord and the noble Baroness mentioned evidence. Evidence is considered by SAGE and its advice is published regularly online when it is no longer under live consideration for policy decisions. That is exactly what happened in this case. I hope I can reassure noble Lords that we will continue to take advice from a wide range of scientific and medical experts, as we have done throughout the pandemic, to inform our decisions. We are, as the noble Baroness rightly said, constantly having to evaluate the balance between protecting the NHS, saving lives, keeping our economy moving and keeping our children in school. These are very difficult issues to balance and I think the tone of the noble Lord’s and the noble Baroness’s questions, which I very much welcome, expresses the gravity of the situation and the difficult decisions that are being made.

I can assure the noble Baroness that as a member of Cabinet I have regular briefings, along with my Cabinet colleagues, from the Chief Medical Officer and the Chief Scientific Adviser about the latest data. As I have said, the Prime Minister and the Cabinet have to take decisions based on the best available science, along with considerations of the economic, operational, social and policy implications that follow, and that is what we do.

The noble Lord and the noble Baroness both reiterated criticisms of the test and trace system. I remind noble Lords that our daily capacity for testing is now around 340,000, with the aim of reaching more than 500,000 by the end of October. We increased capacity by around 30% in September alone. We are testing at a higher rate than other European countries and we have assembled the largest testing network in our history, including 96 NHS labs, 151 walk-in sites, 258 mobile testing sites and 77 regional sites. We are also looking to combine, as effectively as possible, the national framework and local expertise, which is why, since August, NHS test and trace has provided local authorities with dedicated teams of contact tracers to work alongside local public health officials to provide a more specialist service. We have provided more than £300 million to local authorities to help with this and, across the country now, we have 95 local authority contact tracing teams that are live, and more are coming online in the coming weeks. We have been very cognisant of some of the criticisms and are improving the situation on the ground. More than 700,000 people have been contacted and advised to isolate through the system and the latest figures show that more than 82% of contacts were reached and asked to self-isolate where contact details were provided.

The noble Lord, Lord Newby, asked about moving between tiers. Decisions on which areas are in which tier are made on a number of factors, including the rate of transmission, how quickly it is increasing and the effectiveness of current interventions, as well as hospitalisations and hospital capacity. Of course, all is also done in line with work and conversations with local leaders to discuss all their evidence and what they are seeing on the ground. It is a collaborative effort, but a range of factors is taken into account.

The noble Lord also asked about the Harrogate Nightingale Hospital. I am not sure whether he is aware, but it is currently being used. CT scanners have been made available to provide people with safer and faster access for a range of conditions, including cancer. As he will be aware, there are two hospitals providing that kind of support, Harrogate and Exeter, and another three Nightingale hospitals in some of the areas with the highest rates have been put on standby in order that they can play their part, along with the rest of our fantastic NHS, as we deal with this crisis.