Public Health: Coronavirus Regulations

Matt Hancock Excerpts

Tuesday 13th October 2020 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I beg to move,

That the Health Protection (Coronavirus, Local Covid-19 Alert Level) (Medium) (England) Regulations 2020, (S.I., 2020, No. 1103), dated 12 October 2020, a copy of which was laid before this House on 12 October, be approved.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this we shall take the following motions, on public health:

That the Health Protection (Coronavirus, Local Covid-19 Alert Level) (High) (England) Regulations 2020, (S.I., 2020, No. 1104), dated 12 October 2020, a copy of which was laid before this House on 12 October, be approved.

That the Health Protection (Coronavirus, Local Covid-19 Alert Level) (Very High) (England) Regulations 2020, (S.I., 2020, No. 1105), dated 12 October 2020, a copy of which was laid before this House on 12 October, be approved.

That the Health Protection (Coronavirus, Collection of Contact Details etc and Related Requirements) Regulations 2020 (S.I., 2020, No. 1005), dated 17 September 2020, a copy of which was laid before this House on 17 September, be approved.

That the Health Protection (Coronavirus, Restrictions) (Obligations of Hospitality Undertakings) (England) Regulations 2020 (S.I., 2020, No. 1008), dated 17 September 2020, a copy of which was laid before this House on 17 September, be approved.

That the Health Protection (Coronavirus, Restrictions) (Obligations of Undertakings) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 1046), dated 26 September 2020, a copy of which was laid before this House on 28 September, be approved.

That the Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 5) Regulations 2020 (S.I., 2020, No. 1029), dated 24 September 2020, a copy of which was laid before this House on 24 September, be approved.

[Matt Hancock]

Two weeks ago, I pledged to the House that for significant national measures we will consult Parliament in advance of their coming into force wherever possible, and today we deliver on that commitment with votes tonight on national measures to slow the spread of coronavirus. This pandemic remains a formidable threat. Our strategy is to suppress the virus, supporting the economy, education and the NHS, until a vaccine makes us safe, and I must report to the House that the number of cases of coronavirus has quadrupled in the last three weeks.

There are now more people in hospital with coronavirus than there were on 23 March, and in the last four weeks hospitals in the north-west and north-east of England have seen a sevenfold increase in the number of covid patients in intensive care. In those worst-affected areas, the virus is spreading just as quickly in older age groups, not just among younger adults.

[Ms Angela Eagle (Wallasey) (Lab)]

Given that Liverpool city region, which includes my constituency of Wallasey, was placed in tier 3 yesterday, could the Secretary of State outline whether there are plans to reopen or revive the Nightingale hospitals to serve that region? I do not mean the hospital in Manchester.

[Matt Hancock]

Yes, as the hon. Lady will know, three Nightingale hospitals were put on alert yesterday to be reopened. The closest Nightingale is in Manchester, but we keep that under review because expanding the capacity of the NHS is one of the things that we can do. Nevertheless, no matter how big the NHS is, if the virus is not under control it will make more people need hospital treatment than there could possibly be hospital treatment available for. While we are, of course, restarting the Nightingales, which have been mothballed for months, that is only a precaution; it cannot be the full answer to the question. We had a very good discussion yesterday about the measures in Liverpool city region, which I will come on to in some detail.

[Steve Brine (Winchester) (Con)]

To follow on from what my right hon. Friend said about our strategy being to suppress the virus until a vaccine makes us safe—until science saves us—the Prime Minister yesterday was, very wisely, cautious in his answer to our hon. Friend the Member for Wycombe (Mr Baker) on the vaccine. What if it does not come, and what if it comes and the efficacy of it is not good enough, and there are challenges with roll-out and all sorts of other challenges that he and I know about—the anti-vaxxers notwithstanding? Can he give those of us who are nervous about—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. This is not a question but a very quick intervention. I have 89 people who want to speak. If there are to be interventions, they must be short.

[Matt Hancock]

Of course, the work on a vaccine continues. No vaccine technology is certain, but we have already bought six different vaccines and there are more than 100 in development around the world. That is what underpins the strategy, and the work on the leading vaccines, including the AstraZeneca Oxford vaccine, continues effectively. We have seen, both here and overseas, just how quickly the virus can take hold, and we have to act now to get it under control.

[Craig Whittaker (Calder Valley) (Con)]

At the beginning of August, Calderdale had just four people in hospital with covid, zero in intensive care units, and spikes in just two wards. This morning, we have 43 people in hospital with covid, six in ICUs, 12 deaths this month, and almost 800 positive cases coming through. Can my right hon. Friend say what steps he is taking to ensure that the NHS is not overwhelmed by the virus in the coming months?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I have just said that we must not have long interventions. These points are for the speeches that people are waiting to make later. If a Member wants to intervene on the Secretary of State about something that he has just said, that is all very well, but if they make points about their constituencies at this stage rather than waiting until later, it is simply dishonourable; it is just not right.

[Matt Hancock]

My hon. Friend—and he is an honourable man—makes an important point that has wider context than just his constituency, which is that we must make sure that we control the virus. My heart goes out to the families of those in his constituency who have died. The only alternative to suppressing the virus is that it then expands exponentially. That is what happens with a virus when the R is above 1. I know that some people feel that we should adopt a more relaxed approach, but that will lead to more of the sort of thing that my hon. Friend has related from his constituency.

Some people have set out this more relaxed approach, including those in the so-called Great Barrington declaration. I want to take this argument head on, because on the substance, the Great Barrington declaration is underpinned by two central claims and both are emphatically false. First, it says that if enough people get covid, we will reach herd immunity. That is not true. Many infectious diseases never reach herd immunity, such as measles, malaria, AIDS and flu, and with increasing evidence of reinfection, we should have no confidence that we would ever reach herd immunity to covid, even if everyone caught it. Herd immunity is a flawed goal without a vaccine, even if we could get to it, which we cannot.

The second central claim is that we can segregate the old and vulnerable on our way to herd immunity. That is simply not possible. As the medical director of the NHS said yesterday, we cannot somehow fence off the elderly and the vulnerable from risk while everyone else returns to normal. It is neither conscionable nor practicable—not when so many people live in inter- generational homes, not when older people need carers who of course themselves live in the community, and not when young people can suffer the debilitating impact of long covid. Whenever we have seen cases among young people rise sharply, we then see cases among the over-60s rise inevitably thereafter, and we are not the kind of country that abandons our vulnerable or just locks them up.

If we let this virus continue unchecked, the loss of life would be simply too great to contemplate. We know that it would put our NHS at risk, as my hon. Friends have just said. We know that both because of what happened in March and because of what is happening right now. We have already heard from the heads of the Academy of Medical Royal Colleges and the Royal College of Emergency Medicine that, if we do not act fast and come together to quash the virus, we risk putting the NHS under extraordinary strain both for covid treatments and for non-covid treatments.

[John Redwood (Wokingham) (Con)]

How long do the scientists think we will need these lockdowns for, and what is their exit plan?

[Matt Hancock]

We have seen the exit plan from local lockdowns. For instance, in Leicester, where we had a firm local lockdown, the case rate came right down. We lifted that and we have sadly seen it start to rise again. The case rate is determined by the amount of social mixing, and it reduces during a lockdown. In some parts of the country where the case rate has continued to rise, there is an argument for further ensuring that we do not reach the level of contact that is at the root of the virus spreading. The challenge is how to calibrate the lockdown to get the virus under control while doing the minimum damage to the economy and to education.

[Munira Wilson (Twickenham) (LD)]

Will the Secretary of State acknowledge—a simple yes or no—that we should not be in this position in the first place and that the best exit strategy is having an effective system of testing, tracing and isolating that is locally led? If that were working properly—even SAGE has admitted that it is not—we would not be here.

[Matt Hancock]

We have one of the biggest systems of tracking and tracing in the world. The idea that I sometimes get from people in this House is that, somehow, it is not one of the biggest systems in the world or one of the most effective in the world. I get that in this House, but I do not get it when I talk to my international colleagues. They ask me, “How did you manage to build this capacity so fast?” That is the truth of it.

Of course we need to continue to build it and to make sure it is continuously more integrated into the local communities, who can often go to reach the contacts that the national system finds it hard to reach. However, to argue that the enormous system that is working so effectively, with so many brilliant people working on it, is at the root of this challenge is, unfortunately, to miss the big picture, which is that, sadly, this virus passes on—until we have a vaccine or a massive testing capacity that nobody yet has, this virus passes on through social contact and that is, unfortunately, what we need to tackle in order to get this under control.

Let me make a point about the numbers. In the first peak, about 8% of people caught covid and 42,000 people died. If we do not have the virus under control, even with the better survival rates we now have, thanks to both drug discoveries by British science and improvements in clinical practice, those figures will multiply. In addition, harder economic measures would then inevitably be needed to get it under control and they would be needed for longer. If you, Madam Deputy Speaker, like me, want our economy back on full throttle, we need to keep this virus in check.

[Dan Carden (Liverpool, Walton) (Lab)]

Yesterday, in his call with Merseyside MPs, the Health Secretary was asked about a circuit breaker lockdown and he did not say that SAGE had recommended that three weeks ago. Is that the case? Will he now publish the full scientific evidence for a circuit breaker lockdown?

[Matt Hancock]

The SAGE advice that Ministers receive is, of course, published; we have had great debates in this House about that and it is published. We make decisions that are guided by the science, taking into account all the different considerations we need to look to.

[Mr Mark Harper (Forest of Dean) (Con)]

It is worth giving credit to the NHS Test and Trace team for the growth in testing, but the evidence published yesterday said that the impact of the testing and tracing system was having only a marginal effect on reducing the virus. So can the Secretary of State look not just in high-risk areas, but in all areas to get more of the contact tracing done by our fantastic directors of public health and their teams?

[Matt Hancock]

Yes, absolutely. We are doing precisely that. The way it works where it works best is that the big national system makes the immediate and rapid contact with people who test positive—for more than half of people that is immediately successful—and then when contacts are harder to make the data is passed to the local teams, which do not have the scale to do the immediate, rapid contacting but do have the boots on the ground and the local knowledge. That combination of the two is what works best where it works well.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

My right hon. Friend is making a compelling case, but will he bear in mind that in the west midlands we are concerned that yesterday’s change was made on the basis of neatness, not of medical need? Will he reassure me that he will always listen carefully to the West Midlands Mayor, Andy Street, as these matters all develop?

[Matt Hancock]

Yes. The introduction of the three-level system means that, in some areas where the local area has been working so effectively to get the curve flattened, as in the west midlands, under the leadership of Andy Street—there has been a rise in the past few days of data, but essentially a huge amount of progress has been made—changes have had to be made. However, I will absolutely recommit to working with Andy Street, who is an incredibly effective voice for the west midlands, to make sure that what we can do together can best deliver to control the virus in the west midlands. I pay tribute to my right hon. Friend, who makes the case on this so effectively, because protecting our economy and protecting our health are not alternatives. We must act and keep the virus under control to protect lives and livelihoods. I strongly believe that every one of us, young or old, has the ability to suppress the virus through the actions we take and the best way to protect the vulnerable, support the NHS and protect the economy is to get the rate of transmission down.

I turn to the steps we are taking to do that and, therefore, the instruments before the House today. Yesterday, the Prime Minister provided an update on the measures we are taking, which centre on three local covid alert levels in England.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The rate of transmission varies significantly within the eight different districts of North Yorkshire. When we are looking at putting different areas into different tiers, can we look at that by district rather than at county level?

[Matt Hancock]

Yes, absolutely, and I will go further than that: we look at this at sub-district level, if that is appropriate. In High Peak we put four wards into level 2 and the rest of the wards stayed in level 1. So we are prepared to look at the sub-district level if that is appropriate. Some districts within North Yorkshire have individual outbreaks in individual institutions that we are managing, and we should not mistake that for general community transmission and therefore put those areas into a higher level than is necessary. I am happy to go through the local epidemiology from near Thirsk that affects my hon. Friend’s constituency.

In a sense, that brings us to the point of these local covid alert levels. These are the first statutory instruments to be debated under our commitment to consult Parliament on significant national measures that have effect in the whole of England or are UK-wide and, wherever possible, to hold votes before the regulations come into force. That is what we are doing today.

Local action has proved to be one of our most important lines of defence. Where firm action has been taken—for instance in Leicester, or in Bolton, where we flattened the curve—our local approach has inevitably produced different sets of rules in different parts of the country, as my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) set out. We have already moved towards simpler national rules that are centred on the rule of six, and we are now acting to simplify and standardise the rules at a local level.

The regulations set out three levels of alert: medium, high and very high. The medium alert level, which will cover most of the country, will consist of the current national measures. This includes the rule of six and the closure of hospitality at 10 pm. The high alert level reflects the interventions in many local areas at the moment and that aims to reduce household-to-household transmission by preventing social mixing between different households indoors, with the rule of six outdoors. That is super-simple: no household mixing socially indoors and the rule of six outdoors.

The very high alert level will apply where transmission rates are rising most rapidly and where the NHS will soon be under unbearable pressure without further restrictions. In those areas the Government will set a baseline of prohibiting social mixing, while allowing households to mix in public outdoor spaces, because that is where the risk of transmission is lowest, as long as the rule of six is followed. That baseline is set out in the very high alert level regulations being considered today. Pubs and bars will be closed, and we will advise against travel into and out of very high-risk areas.

We also offer a package of support for individuals, businesses and councils. That includes more support for local test and trace, which many have asked for, more funding for local enforcement and the offer of help from the armed services, as well as the job support scheme announced by the Chancellor. That is best done as a team effort and, wherever possible, we want to build local support on the ground before we introduce these measures. So in each area we will work with local government leaders on the extra measures that need to be taken. We do not rule out further restrictions in the hospitality, leisure, entertainment, or personal care sectors, but retail, schools and universities will remain open.

[Dr Luke Evans (Bosworth) (Con)]

On buying-in the local community, would the Secretary of State consider having a Government postcode checker so that people know exactly where they should be, in having the three tiers?

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

That was my idea.

[Matt Hancock]

My friend, the hon. Member for Ellesmere Port and Neston (Justin Madders), says from a sedentary position that that was his idea, but success has many fathers and I can tell my hon. Friend the Member for Bosworth (Dr Evans) that such a postcode checker was launched this morning. I will send him the link. It is still in beta, so it will be constantly improved, not least to ensure that, if a postcode covers an area that is in two different levels, that is clear. That is being sorted at the moment. A postcode checker is a great idea. It tells you the level of local risk. Furthermore, the NHS covid app, which has now been downloaded by over 17 million people, has a link to the local alert level as well.

To turn back to the measures before us, we will keep the measures under constant review. The overarching regulations sunset after six months, but regulation 8(1) of statutory instrument 1105 makes clear that the allocation of a particular area to local alert level 3 will automatically expire after 28 days. We will work with local areas on the level they need to be at and that work continues at pace. Decisions to move local areas between the levels will be considered by the JBC, working across Government and with local government on the normal weekly cycle. While, of course, there will be times when we need to act quickly to contain the virus, we want to give the House the opportunity to consider the measures on the medium and high local alert levels, and the baseline measures for the very high alert level. I urge the House to support the measures set out today.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

The Secretary of State mentions that they will work with local authorities when moving authorities between areas. Will he also give time to measures that local authorities may already be taking, such as in Newcastle-under-Lyme, to see their effect before moving areas from one tier to another?

[Matt Hancock]

Yes, that is a very important point. Taking into account all local considerations, and working with the local director of public health and political leadership, is important to get exactly that sort of consideration into the decisions.

I would like to set out, as the Prime Minister did yesterday, the details of where we have reached with the Liverpool city region. Liverpool will move on to level 3 tomorrow. As well as the baseline measures—that is, as well as closing pubs and bars—gyms, leisure centres, betting shops, adult gaming centres and casinos will also close. I thank all the local authorities that have been working with us to keep the virus under control, but there is more work to do.

The regulations under consideration today include measures on the obligations for businesses. Statutory instrument 1005 makes it a legal requirement for a range of premises to collect, retain and, where relevant, disclose contact details as part of NHS Test and Trace. Statutory instrument 1008 allows for fixed penalty notices to be given for breaches of covid-secure business guidance in various settings, primarily hospitality. These are amended by SI 1046, which adds the need for a range of premises to display information about the need to wear face coverings.

SI 1029 increases the fines for those flouting targeted action to close specific public places that are a threat to public health. Although SI 1029 was intended to deliver the 10 pm closing time when laid, the elements relating to the 10 pm closing time are superseded by the local alert level system. The powers in SI 1029 are therefore revoked. In practice, the effect of SI 1029 is to deliver enforcement against individual places that have been flouting the rules, which is the one of the top demands of councils in their fight against coronavirus. I know that most people and most businesses have been doing their bit. These changes are there to ensure that the vast majority of responsible businesses are not undermined by others that are not following the rules.

[Huw Merriman (Bexhill and Battle) (Con)]

The Secretary of State talks about a regulation on pubs closing at 10 o’clock, which has been in force for four weeks. There may be some undoubted positives for health, but we see some negatives with people amassing together on public transport and in the streets. Do the positives outweigh the negatives, as far as the science is concerned?

[Matt Hancock]

Yes, I believe that they do, and I will give three reasons why I think these measures are the right ones. The first is that we already now have evidence from accident and emergency departments that we have seen a reduction in alcohol-related admissions late at night, after the 10 pm curfew. That is important in its own right, but it is also a proxy, a measure of how much people are drinking late at night. Therefore, it is evidence that there is less mixing and less drinking late at night.

The second is that, while people may be coming out and mixing after 10 pm, they are doing so largely outside, when they would otherwise be mixing inside the premises; it is just easier to photograph outside.

The final point, though, and the appeal I make to the House on this, is as follows: since, sadly, in order to control this virus, we need to reduce the amount of social contact, and since we are trying to protect, as much as is possible, education and work, that essentially leaves socialising as the other part of life—of activity—where people transmit the virus. It is therefore understandable that Governments around the world and around this United Kingdom, Governments of all different stripes and political persuasions, have all come to broadly the same conclusion that it is necessary to restrict socialising, because that way we reduce the transmission with the least damage to education and the economy. While there is both direct and proximate evidence for the positive impact of this measure, there is also the strategic point that, if we wanted to control the virus and we were not to do this, we would have to do something else, and as a matter of policy choice we want to protect education and protect work.

I will now come to my concluding remarks. We know only too well the damage this lethal virus can inflict, the strain it can put on our NHS and the way it can upend our closest relationships and our freedom to do the things we love. I know that we are asking a lot of the British people, but we also know that together we can shift this curve, and we are now called upon to do it once more. The measures before the House today will help in that fight, and I commend the regulations to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Just before I call the shadow Secretary of State, it will be obvious to the House, both those in the Chamber and those watching around the building, that I have more than 80 people who are trying to catch my eye and that we have until 6 pm to conclude the debate. I am afraid that, in order to be fair to everybody, because I appreciate that this is not an occasion for long-thought-out speeches on matters of principle, but on matters to do with individual constituencies, and to try to give as many people from as many parts of the country as possible the chance to contribute, we will start with a time limit of three minutes.