Public Health: Coronavirus Regulations

Steve Brine Excerpts

Tuesday 13th October 2020 Commons Chamber

[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.

--- Later in debate ---

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Madam Deputy Speaker, I have heard your message loud and clear; I will endeavour to be brief and not to detain the House for too long, given the points you have rightly made.

The House will understand that we are grappling with a virus that spreads with speed and severity. Throughout this crisis, we have urged the Government to adopt an approach with the strategic aim of suppressing the virus and bringing the R below 1 in order to save lives, minimise harm and keep our children in school. That has to be our priority, and no one should be surprised that, as we are in autumn and going into winter, that presents us with immense challenges.

Before the summer, the Academy of Medical Sciences, in a report commissioned by the Government, modelled that we could see 119,000 deaths between September 2020 and June 2021. The academy also warned, as did we, that without an effective test, trace and isolate regime the virus would get out of control. Sadly, we were proved correct. The Secretary of State has run through the numbers on the prevalence of the virus, but I will just underline the point that hospital admissions are rising.

Yesterday, there were 3,665 patients in hospital in England, 568 more than on 23 March when we went into lockdown. Since September, 856 patients have been admitted to critical care across England, Wales and Northern Ireland—more with every week that goes by. The largest number of critical admissions are in the north-west, north-east, Yorkshire and the midlands. More than 100 patients are on ventilation for covid across the north-east and Yorkshire. More than 130 patients are on ventilation across the north-west.

A disproportionate number of those in critical care today are from poorer backgrounds and from black, Asian and minority ethnic communities. That is a reminder that covid thrives on and exaggerates inequalities, and that any long-term covid strategy cannot just rely on a vaccine but demands an all-out assault on health inequalities as well.

Just as hospital beds fill, there are more concerns about the availability of beds for the rest of winter. Last week, there were warnings that some hospitals across the north of England are set to run out of beds for covid patients within days, and NHS Providers reminded us that the sustained physical, psychological and emotional pressure on health staff is threatening to push them beyond their limits. The British Medical Association is saying that without stringent measures rapidly introduced, the NHS and its workforce will very quickly be overwhelmed. This House cannot overstate how serious the situation is.

Yes, as the Secretary of State said, our clinicians have made extraordinary strides in treatment. We know that steroid and antiviral drugs will help improve mortality, but we also know that when infections rise, as night follows day, hospitalisations rise, and, sadly and tragically, that means that more will die as well. For those who avoid hospitalisation, many can be afflicted with serious, long-term, debilitating health problems—so-called long covid. None of us knows whether those conditions—that syndrome—will last for the rest of their lives or whether they will recover in the next 12 months.

Just as we have to protect our NHS, we cannot allow the mass, industrial halt to elective surgery and delays in treatment never seen before in the history of the NHS. We have to mobilise our national health service to perform the care for non-covid patients as well. The decision in March, although entirely understandable—I do not criticise the Government for taking it—has bequeathed us waiting lists of 4 million. Today there are 111,000 people waiting beyond 12 months for treatment. In January of this year, there were just 1,600. Three million people have missed out on vital cancer screening. One in three cancer patients has said that their treatment has been impacted by the effects of covid. I make these points not to criticise the Secretary of State but to reinforce the point that we have to protect our national health service as we go into the winter months.

I know that no Member across this House is complacent about these matters. Every hon. and right hon. Member is united and determined to see infection rates reduce and care improved. I know that everyone across this House wants to see the immense backlog in non-covid care tackled. I know that none of us wants to see this virus let rip and leave the weakest and the frail to fend for themselves. So I do not come to this House to caricature the position of any hon. Member. Our differences are about how we apply the tools we have at our disposal, and how we confront this, the biggest public health crisis for 100 years.

We know, as the Secretary of State said, that the virus thrives on close human contact, especially where air is stagnant and in conditions that are poorly ventilated. We know that the virus is airborne. We know that fundamentally our best defences are hand hygiene, distancing, mask wearing, and avoiding crowds. But we also know that a full national lockdown stretching for weeks and weeks, like we had through April, with a rule, effectively, of one-household contact—a rule of one, indeed, for some people—would be disastrous for society. Again, I do not believe that anyone in the House is proposing that.

The question is what measures can be taken now to bring R below 1 without resorting to that full lockdown. We know that when 8 million children returned to school, that would have put upward pressure on infection rates. I am critical of the Government for not providing the extra testing capacity that would have been needed, as should have been obvious. Yet we must do everything we can to keep our children in school. The implications of children not being in school are devastating for their life chances and development. We know that crowded public transport puts upward pressure on infection rates, but I do not believe that any Member of this House would consider it sensible to close public transport networks—to close the underground or to close the Metrolink across Manchester. We know we have to encourage people to work from home, and many are doing that, but we also know that there are many who cannot work from home, and they should be protected with access to mass testing—particularly NHS staff. I hope that the Government get on with routine testing of frontline NHS staff. We have repeatedly called for the Government to do that.

That then therefore leaves us with few levers to pull. That brings me to hospitality, because—I am sorry to have to say it—pubs and bars do bring people together. Every Member across this House knows that after a few drinks people lose their inhibitions. It should come as no surprise to us that social distancing breaks down, and if bars and pubs are poorly ventilated—as, sadly, some are—then airborne transmission is more of a risk. I know that Members will point out to me, as they have in the past few days, that the data show that household interaction is the biggest driver of transmission. That is correct—but how does the virus get into the household in the first place? It does not come down the chimney, like Father Christmas: someone brings it into the house.

If we cannot close, schools, workplaces or shops and cannot shut public transport, the only lever that we have is hospitality, so, yes, we support the restrictions announced yesterday by the Secretary of State and the Prime Minister. We know from experience in Bolton and Leicester that the pub closures had an impact—the virus is still prevalent in my city and in Bolton—but without the closures the virus would have been driven up further.

We therefore support the announced measures, difficult as they are. Indeed, we support the measures aimed at constraining the time people can spend in the pub. I understand the Secretary of State’s procedural points about the instruments before us and the 10 pm curfew, and he knows that I know that many Members are deeply sceptical about that curfew. We will not stand in the way of the passing of the statutory instrument, but if the House’s procedures had allowed it, we would have proposed an amendment to implement the Welsh scenario, where there is drinking-up time, off sales are banned after 10 o’clock and there is no hard stop at 10 pm.

We have all seen the pictures that the hon. Member for Bexhill and Battle (Huw Merriman) mentioned, although I must say to many of my hon. Friends who made the point about city centres being full of revellers after leaving the pub that it is not as though we have seen such pictures only once the 10 pm curfew was introduced—we have seen them before in our city centres, sadly. I have been on public transport after 11 pm! This is a longstanding issue. The 10 pm curfew does not help it, but let us not pretend it has caused all these issues.

[Steve Brine]

If the hon. Gentleman could amend the instrument, would he amend it so that off licences cannot sell after 10 pm?

[Jonathan Ashworth]

I think I made that point, but, yes, I most certainly would. If I had proposed that amendment, I hope the hon. Gentleman would have joined us in the Division Lobby, although I know that since leaving the Government he has been very lax about going through the Lobby with the Opposition—[Interruption.] I drank my water too quickly as the hon Gentleman’s intervention was shorter than I anticipated—[Interruption.] I beg your pardon; I assure Members it is not the virus.

Many Members affected by this in recent days will know that the decisions made to put an area into restriction will be effective only if they are made in conjunction with local people. I know that extremely well as a Leicester Member, where we have had restrictions for 105 or 106 days. People in towns such as Bury or Bolton or across Greater Manchester or in boroughs such as Wolverhampton, West Bromwich or parts of Birmingham need clarity about their future and local leaders need reassurance that there is a plan. Local leaders need reassurance that if they are put into a tier there is a plan to get them out of it and moved into the lower tiers. It is not clear at the moment why particular areas are in the medium tier and not in, for example, tier 2. I do not want to pick on my near parliamentary neighbour, the hon. Member for Charnwood (Edward Argar), but I hope he can explain when he responds to the debate why the city of Leicester is in tier 2 with restrictions yet his constituency, where the infection rate is 150 per 100,000, is not. Why is North East Derbyshire, where the rate is 164 per 100,000, not in that tier? Why is Barrow, where the rate is 277 per 100,000, not in that tier? There are many other examples across the House. People living in areas where restrictions are in place would like to be reassured that there is some consistency in these matters and that decisions are made transparently. I do not want to pick on the hon. Gentleman’s area, but he will see the point I am trying to make.

Of course, the areas where hospitality has closed need support to save jobs and protect livelihoods. At the moment, there is a financial package on offer for tier 3 —the Opposition do not think it goes far enough; we do not think it is adequate—but there is no financial support for tier 2, even though there will be a significant impact on the local economy, as we have seen in Leicester. On tiers 2 and 3, could the Minister, in responding to the debate, say a little bit about care homes? What does he say to the thousands of families who, under tier 2 and now tier 3, will not be able to visit their loved ones in care homes? The impact on a loved one in a care home of not being able to see their family is immense, especially in the winter months as we run up to Christmas. What steps will the Government take to support those areas in tiers 2 and 3 so that families can safely resume visiting their loved ones? Will he commit to a 24-hour turnaround in test results in care homes so that care homes and residents are protected?

This brings me to testing and tracing. One of the great strides we made in Leicester was door-to-door testing. Can the Minister guarantee that any areas in tier 2 and tier 3 will get capacity for door-to-door testing? Back in August, the Government promised that local areas would have more control over test and trace, with dedicated teams backed up by local authorities, but under this tiered system it was reported yesterday that only areas in tier 3 would have greater local control over contact tracing and testing. Why was this not put in place months ago, and why has it not been put in place everywhere across the country, not just for tier 3? This is the point that the right hon. Member for Forest of Dean (Mr Harper) made, and he made it extremely well.

I am sorry, but the testing and tracing regime has become a broken system that continues to misfire. We even have SAGE now warning that it is having a marginal impact on transmission, as the right hon. Gentleman said. To be frank, and I know Conservative Member will groan at this, if Serco has not come up with a solution by now, it never will. Scrap the contract, put public health and local NHS partnerships in control of testing, and invest in the widespread backward contact tracing we need. It is still only in its infancy, but it is absolutely vital to getting in control of the virus, and we need to expand it at a local level.