Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
Lord Scriven Excerpts(3 years, 9 months ago)
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Lord Scriven (LD) [V]
My Lords, four months have passed since the Minister told the public that the memorandum of understanding on data sharing between the National Police Chiefs’ Council and his department was just a small administrative issue, nothing to do with health information that could undermine public health efforts. Yet four months later, the law is in place and data is being passed to the police without Parliament or the public seeing the MoU.
In answer to a Written Question from me on 17 February, the Minister stated that the MoU
“is currently being updated to reflect amendments”
to these regulations
“and feedback from the Information Commissioners Office.”
He added that,
“the MoU will be published as soon as practically possible.”
What are the issues on sharing non-sensitive health information, such as one’s name and address, that have taken four months and required the intervention of the commissioner? Did she require any changes to the original MoU, and if so, what?
As we move to the next stage of dealing with the virus and the new variants, we will still require people to self-isolate. As the noble Lord, Lord Hunt, has said, the BMA has already said that it is concerned that some people are deterred from being tested because they are anxious about loss of income if they need to self-isolate and that it is
“worried should police involvement add to this.”
Evidence has shown that most people do the correct thing and isolate if they have financial security and practical support to do so. These are the key tasks for the Government now if rates of people self-isolating are to be improved on. While some financial support is being made available, for many it is not enough. Will the Minister now commit to paying people their full wages, so that people will self-isolate for the full period without having to worry about paying bills or feeding their family?
Practical support is required too. If you live in a cramped or multigenerational household, it can be impossible to self-isolate in a separate room. Why will the Government not do what other countries have done and pay for some of the closed hotels to be used as isolation hotels? Excellent international practice has reduced the spread of the virus through supporting people to self-isolate, via community well-being and health teams. These teams support with shopping, well-being and other healthcare support. In countries where these teams are deployed, they increase self-isolation and compliance and help reduce the chain of transmission of the virus. These kinds of issues are at the root of improving self-isolation. The Government should focus on them and not four months of fruitless discussions about sharing health data with the police, fines and, potentially, criminalising people who just want the financial security and practical support to do the right thing.
Future of Health and Care
Lord Scriven Excerpts(3 years, 9 months ago)
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Lord Bethell (Con)
The noble Lord is entirely right: obesity is not only a major issue, it is specifically cited in the Bill, where we have clear measures to try to address it. I do not need to raise it with the Prime Minister or the CMO because they both take it incredibly seriously. The Prime Minister has spoken movingly about his own challenge when he caught Covid—the five stone by which he feels he was overweight, the impact that had on his life chances, and how close to death he came because of obesity when he went into hospital. That was a metaphor for the whole country, and that is why we have launched a major obesity strategy in respect of marketing and advertising. It is why we remain committed to the obesity strategy, and more measures will be rolled out during the course of the year. I am extremely grateful to the noble Lord for reminding me about World Obesity Day on 4 March, which we will be marking very seriously with a publicity campaign.
Lord Scriven (LD) [V]
My Lords, nearly 75% of NHS expenditure goes on hospital and ambulatory care. Will the Minister explain how the proposed reforms will, in reality, lead to the redirecting of significant hospital sunk costs into ill health prevention and improving population health outcomes, as implied in the White Paper?
Covid-19 Vaccines Deployment
Lord Scriven Excerpts(3 years, 9 months ago)
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Lord Bethell (Con)
My Lords, we have done an enormous amount to prioritise care home staff, for the entirely pragmatic reason that it would make no sense at all for vulnerable care home residents to be infected by the staff who come and serve them. It is not always possible to put care home staff in exactly the same queue as those residents, sometimes because they are the ones delivering the vaccines. There is in fact a hugely sophisticated NHS route for care home staff to get their vaccine. However, I hear loud and clearly the concerns of noble Lords on this area. Let me please look at it more closely and I will correspond with the noble Baroness, Lady Massey, if I can provide her with any more details that would be helpful.
Lord Scriven (LD) [V]
My Lords, some GPs in Sheffield have told me today that their hubs have a zero supply of vaccine and have been closed for over a week. However, they have not yet vaccinated all of their high priority patients. Those patients are now being directed to travel by bus up to 10 miles to the mass vaccination centre, but the most nervous and vulnerable say that they will not go there. What can the Minister say to GPs who are waiting and able to vaccinate patients but have no vaccine because it has all gone to the distant mass vaccination centre?
Lord Bethell (Con)
My Lords, I have heard the noble Lord’s concerns about this matter when he has brought them up previously, but I simply do not recognise the story he is telling. I would remind him that 95.6% of those aged 75 to 79 have had the vaccine. This is not the story of people who are concerned about going to mass vaccination centres. There are GP centres up and down the country that are closed because they do not have supplies, and it is supply that is undoubtedly the rate-limiting factor. That is because, as he knows, the supply comes in large boxes. If GPs do not have enough people to use up a large box, we have to prioritise those who have longer lists.
Covid-19: Self-Isolation
Lord Scriven Excerpts(3 years, 9 months ago)
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Lord Scriven
To ask Her Majesty’s Government what assessment they have made of the number of people self-isolating who have been asked to do so as a result of testing positive for COVID-19.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we know that the public continue to make enormous sacrifices. A recently published study by UCL indicated that, in the case of people who have been in contact with someone who tests positive, the proportion who report self-isolating is around 80%. Isolation remains critical to breaking the chains of transmission. We continue to improve our support to those who are asked to isolate.
Lord Scriven (LD) [V]
My Lords, surveys show that approximately a third of people stop self-isolating between one and five days, with many saying that, despite the current cash support, it is the financial crisis that they face that forces them out of isolation and back to work. Is it not time for the Government to deal with this and do what some other countries with high levels of self-isolation compliance do by paying people’s full wages while they isolate?
Lord Bethell (Con)
My Lords, the surveys are not crystal clear about practice, but on the whole the UCL survey and our own interrogation of those isolating suggest that compliance is much higher than the noble Lord implies. I pay tribute to local councils, which are doing an enormous amount to provide the kind of economic support that the noble Lord quite rightly alludes to. Blackburn with Darwen, for instance, provides an enormous amount of support for those with annual earnings under £21,152. In Colchester, applicants must not have more than £16,000 in capital, but the council provides a substantial discretionary payment. It is this kind of targeted local support that we believe can make an enormous difference.
Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021
Lord Scriven Excerpts(3 years, 9 months ago)
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Lord Scriven (LD) [V]
My Lords, another day, another statutory instrument on coronavirus. As the Hansard Society notes:
“The government has laid 364 Coronavirus-related Statutory Instruments … before the UK Parliament. The first two Coronavirus-related SIs were laid on 28 January and 10 February 2020, respectively. The rest have been laid since 6 March 2020, at an average rate since then of seven per completed week.”
No wonder people and businesses get confused. This makes a mockery of both Parliament and the tired excuse that Ministers keep trotting out:
“Owing to the speed with which the Government must take this emergency action to control the virus and save lives it is not possible for a debate to be held before these regulations come into force.”
The speed the Government said they needed for the 364 coronavirus-related SIs has not been effective, as we can see from the number of deaths. Some of the SIs have been superseded within days of coming into force, have caused confusion and have not achieved the goal of reducing the spread of transmission of the virus, thereby helping to keep people alive. The 364 SIs are indicative of a Government who have been far too reactive, rather than proactive, to the public health crisis we face. No other democratic Government across the world have introduced so much emergency legislation to deal with the coronavirus.
What is needed is a clear governmental strategy. It is sadly missing in the UK. That is what is required urgently, not more and more knee-jerk emergency legislation. The country is now at a crossroads in dealing with the virus. We have some hope on the horizon with the vaccination programme, but it is not the end. The world will be living with the coronavirus, new variants of it and all the health and economic risk this brings for years to come. It is time to reflect on what is needed for the next phase, what has been learned and what needs to change for the future. Part of this has to be less emergency legislation and more detailed and well thought-out laws and rules to genuinely save lives and get the country on a firmer footing to be able to deal with the next stage of the pandemic. This Parliament needs to stop just nodding through coronavirus emergency legislation. It needs to force the Government to come forward with a clear strategy for living with this pandemic and help set laws within that strategic framework.
As the past year has shown, 364 pieces of emergency legislation have not been the most effective way of keeping as many people alive as we would have hoped or proactively slowing down the virus. It is time for Parliament to do its proper job. For this House, that means having time to review and revise laws needed to deal with the public health crisis we face. This will help to ensure that the rules that people and businesses are required to obey are much more effective in reducing the spread of the virus and saving lives.
Covid-19 Update
Lord Scriven Excerpts(3 years, 10 months ago)
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Lord Bethell (Con)
The noble Lord is entirely right to raise this issue. There is the awful possibility that the mutant vaccine escape virus could get around the vaccine altogether. We need a plan B, which might be dependent on antivirals as an alternative way of managing the disease. That is what happened with HIV, as we discussed last week. The therapeutic taskforce is looking at antivirals and putting together a plan to upscale our investment in that area. I am aware of Synairgen and ACTIV-2, but he is entirely right that this should now be a greater priority. I will take the matter back for the department to look into further.
Lord Scriven (LD) [V]
My Lords, virologists tell us that, even with vaccines, we will be living with Covid for years to come. The Statement says:
“Our mission must be to stop its spread altogether and break those chains of transmission.”
To ensure that this happens, what changes have been made during this lockdown to improve the outcomes of the £22 billion test, trace and isolate system, for when the restrictions are eased?
Lord Bethell (Con)
My Lords, I pay immense tribute to the test and trace system, which, at 11 am, published remarkable performance figures, as the noble Lord probably knows; 92% of tests were turned around before the next day, and 86% of contacts were traced. This is an incredible performance. On his specific point, the creation of a variant-of-concern tracing group that is targeted at those rare appearances of VOCs in the community is the important development that we have put in place in reaction to the mutant variants. I pay tribute to Steve McManus, who is running that programme, for the impact that he has already made on the problem.
Covid-19: Vaccines
Lord Scriven Excerpts(3 years, 10 months ago)
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Lord Bethell (Con)
The noble Lord is entirely right: the vaccines are a hugely important development, but so is investment in all therapeutic drugs. We are extremely blessed to have had a contribution towards dexamethasone, tocilizumab and other therapeutic drugs which have greatly improved outcomes for patients in hospitals. He is right that antivirals also present an opportunity. The reason we have supported research into antivirals through the urgent regime in our clinical trials is to ensure that there is sufficient commitment in hospitals and primary care on antivirals. We are tasking the Therapeutics Taskforce with a specific mandate to look at antivirals and whether we should give greater resources to this avenue of therapeutic development.
Lord Scriven (LD) [V]
My Lords, having the second dose of the Pfizer/BioNTech vaccines in the right quantities in the right place at the right time is vital. Will the Minister guarantee that people will be able to get their second dose of it at the local GP hub where they had their first dose administered without being directed to a mass vaccination centre to receive it?
Lord Bethell (Con)
In response to the noble Baroness, I said that we were confident that we had the supplies of the vaccines to do the second dose. It is not our policy that anyone has the second dose of anything other than the vaccine they had the first dose of. We will work with people to give them the most convenient place to have the vaccine, but I cannot offer the guarantee that the noble Lord seeks.
Vaccine Rollout
Lord Scriven Excerpts(3 years, 10 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I am extremely grateful for that question, because it will help me to clear up a misconception in this area. Having an NHS number is very important. We cannot know who has had the vaccine and who has not if we do not know what their NHS number is. That is extremely important for their own treatment; it is also best practice. As any clinical practitioner will tell us, it is imperative to know the identity of the person being treated. It is also very important for pharmacovigilance and for the research that will come on the back of the vaccine. If we were to vaccinate a large proportion of the population without knowing who they were, we could not do the research necessary. There will be some people who do not have an NHS number, and we have put in place protocols to ensure either that they can get an NHS number or that a workaround can be found. Those we are pursuing with haste. I emphasise to noble Lords that this is an opportunity to ensure that everyone in this country, whether a visitor or a resident, has an NHS number by the end of this programme.
Lord Scriven (LD) [V]
My Lords, here in Sheffield, approximately 45,000 people have been vaccinated, owing to the excellent work of our local GP hubs, but because of lack of vaccine supply, 10 out of 15 of those will be closed and will not be able to get the jab into vulnerable people’s arms again until the middle of next week. Yet the new Sheffield mass vaccination centre has opened today and has vaccine. Local GPs have asked me to ask the Minister why the distant megacentre has been given priority for vaccine supply over the local and effective GP hubs.
Lord Bethell (Con)
It is not a question of one place taking precedence over another. I take a moment to applaud and pay tribute to GPs in Sheffield, and to all those who have proceeded at pace and got through their allocation as quickly as they could. That is absolutely the right priority and the right approach, and it is how we are going to get through the population very quickly. However, some people will get through their list more quickly than others, and it would be a mistake then to start asking them to move down the list when there are still those with very high priority who need to be vaccinated. Although I understand that it may be frustrating for a GP to stand idle, those are the practicalities of what we are doing. The mass vaccination centres are essential to deal with the very large numbers of people that we plan to vaccinate over the next few months. That is why the Sheffield vaccination centre is such good news.
Covid-19: Variant
Lord Scriven Excerpts(3 years, 10 months ago)
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Lord Scriven
To ask Her Majesty’s Government when they first became aware (1) of the new variant of COVID-19, and (2) that such a variant of the virus was prevalent in the areas placed into Tier 4 on 20 December 2020.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the second variant is a very serious matter. On 8 December, analysis of all genomes available in Kent showed that a new variant was circulating. Ministers were notified on 11 December. On Monday 14 December, the Health Secretary informed Parliament, PHE released a statement and the Government held a press conference on the new variant.
Lord Scriven (LD) [V]
My Lords, variant B117 was identified in October. From the second week of December, virus cases started to rocket in London and the south-east, yet the Government’s focus was on how to keep people mixing at Christmas, not on dealing with the alarming spread of the virus, ignoring public health experts who said that a tight lockdown was urgently required. What message of apology does the Minister have for those families attending funerals because the Government acted too slowly to help save lives?
Lord Bethell (Con)
My Lords, I am afraid that I just do not recognise the noble Lord’s proposition. Hundreds, if not thousands, of new variants are appearing all the time. Many of them have passed through the process, but identifying those that are threatening, have more transmissibility and are significantly different is extremely complex. As I said very clearly, it was on 8 December that, after analysing all the genomes available in Kent, we showed that an important new variant was circulating.
Covid-19: Vaccinations
Lord Scriven Excerpts(3 years, 10 months ago)
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Lord Bethell (Con)
I am extremely grateful for the noble Lord’s kind words. I know lawyers looked at the question he raises on informed consent; I am afraid I do not have the precise answer at the Dispatch Box right now, but I will be glad to write to him with a clarification.
Lord Scriven (LD) [V]
Up here in the north, the Yorkshire Post is running a “shot in the arm” campaign to get the Government urgently to allow the local community pharmacists who are screaming out to get jabs in people’s arms to do so. Why are the Government using excuses about batches of 1,000 for the AstraZeneca vaccine getting in the way of using these safe places on the high street that will improve access in the take-up of the vaccine?
Lord Bethell (Con)
My Lords, I am not sure we are using excuses; we are observing practical matters. The priority, quite reasonably, is to get the vaccine in as many arms as possible. We are totally committed to comprehensive distribution of the vaccine that reaches into rural communities and will include working with community pharmacies as important distributors. However, be under no illusion: our priority is speed and reach, which is why the deployment has taken the shape it has.