Health Protection (Coronavirus, Restrictions) (North East of England) Regulations 2020
(3 years, 6 months ago)
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Lord Bethell
That the Regulations laid before the House on 17 September be approved.
Relevant document: 27th Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we are all aware of the rising rate of infection, particular after this morning’s candid briefings, and the risks that it poses. Your Lordships will therefore understand the importance of taking the necessary steps to keep members of the public safe, while continuing to keep the economy running and schools open, and heading off the need for a second national lockdown.
We know that some of the rules put in place have become increasingly complex and difficult to enforce. That is why the Prime Minister has set out—or will set out—how we will further simplify and standardise local rules by introducing a three-tiered system of local Covid alert levels in England. This is not the subject of the debate today, nor does it change the legal requirement to wear face coverings, but it should reassure noble Lords that we continue to work with the local leaders to tackle outbreaks with more targeted restrictions that are simple and constructive.
The regulations being debated today introduced the requirement that members of the public should wear a face covering in taxis and private-hire vehicles. In addition, they should be worn when inside premises that provide hospitality, such as a bar, pub or restaurant, except when eating or drinking, for which people must be seated. This means that people must wear a face covering when entering, leaving and moving around the premises.
Baroness Thornton (Lab)
I think the Minister will find that we are supposed to be discussing the north-east, rather than the face coverings. It does not make any difference—I am quite happy to do them that way round, but we might get confused.
Lord Bethell (Con)
My Lords, I apologise and give great thanks to the noble Baroness for the polite and kind way in which she brought that to my attention. At this point, we are debating statutory instruments that apply to the north-east of England and were in force on 18 September. As your Lordships may know, a Prime Ministerial Statement in the other place will address these sorts of issues and we will of course keep a careful watch on the progress of that debate.
Over the past few months, local restrictions have allowed us to home in on areas where cases are high and rising, and put targeted measures in place. I understand that the measures we are debating have greatly affected families living in Northumberland, Newcastle, North Tyneside, South Tyneside, Gateshead, County Durham and Sunderland. Families in these areas are no longer able to meet relatives as they used to. I recognise the disruption the measures cause, particularly for those relying on often complex networks of grandparents and friends to help out with childcare. We must celebrate the complex civil communions which underpin so much of our day-to-day regimes.
However, this virus is transmitted by people meeting up with each other and the horrible truth is that the closer our friendships, the more relaxed we are in each other’s company and the harder it is to keep socially distanced. These measures are not taken lightly. They are driven by our public duty to protect the most vulnerable people in our society and do our utmost to ensure that this virus does not adversely affect these groups. What is of concern is that the number of cases in the over-60s is rising; we know that coronavirus symptoms can be more severe for people in this age group. I recognise that the Government are asking many people living in these regions of the north-east to make sacrifices to protect those most vulnerable to this virus. We will need to make adjustments to our daily lives until we have suppressed or eradicated this terrible disease.
Unfortunately, as cases have gone up in these areas, we need to introduce more of these local measures. On 18 September, we introduced new restrictions on household mixing, business opening hours and table-only service in pubs, restaurants and other places serving food or alcohol right across Durham, Gateshead, Newcastle, Northumberland, North Tyneside, South Tyneside and Sunderland. Unfortunately, again, despite these measures the number of cases continues to rise sharply. Incidence rates across these parts of the north-east area are now some of the highest in the country, with Newcastle’s rate now more than 534. So, at the request of the local councils, with which we have been working closely, we will introduce legal restrictions on families mixing with other families in their homes and being able to enjoy food or alcohol only if served at a table, and with non-essential businesses being required to close at 10 pm.
These are not steps that we take lightly but we must take them, and that is what we did because we know that swift action is more likely to bring the virus under control. The quicker we can do so, the quicker we can restore the freedoms we all enjoy—in the north-east and right across this country. Targeted measures were needed to tackle the outbreaks in those areas. The council leaderships collectively agreed that a ward-level approach would not be appropriate, as widespread community transmission had been observed in all areas. People move freely through the local authorities for work and leisure; for example, 40% of people who live in County Durham work in other areas.
These regulations prevent gatherings involving more than one household in private homes or gardens. There are exemptions for those in support bubbles, for example, and on compassionate grounds. We listened to feedback from the local leaders and amended these measures so that informal childcare support bubbles are allowed. Before the national restrictions for the same purpose, we tackled the risks of community transmission by allowing table service only in hospitality venues so that people cannot move about and pass on the virus. To reduce riskier behaviours often seen later at night when people have been drinking alcohol, we imposed the restriction on entertainment and leisure venues, limiting them to opening between 10 pm and 5 am.
Noble Lords will be aware that these regulations have since been amended so that they now also prohibit families meeting up with each other in any indoor space in these areas. We revised the guidance for owners and operators of indoor settings, including places of worship, to say that they should not intentionally facilitate indoor gatherings between households. We also advised that care homes should allow visits only in exceptional circumstances to protect their vulnerable residents. No restrictions have been placed on travel, but people have been advised not to travel with people from other households.
The Secretary of State is required to review the need for the restrictions at least every 14 days. The first review was completed on 1 October, and it concluded that the restrictions must stay in place. The next review is due this coming Thursday. I thank the seven local authorities for acting collectively as well as the local resilience forum, Public Health England, the joint biosecurity centre, local council leaders and the local directors of public health. I also thank the people in the protected area in north-east of England, who have responded so well to the measures put in place. It has been a tough year for many, and these regulations have a serious but necessary impact on how they live their lives. I beg to move.
The Deputy Speaker (Lord Lexden) (Con)
I call the next speaker, the noble Baroness, Lady Thornton. I am sorry—it is the noble Lord, Lord Hunt of Kings Heath.
Lord Hunt of Kings Heath (Lab)
My Lords, thank you. Surely, the Minister was right to open by emphasising the gravity of the situation, but here we are again debating regulations that have already been superseded, which serves to underline the unsatisfactory nature of how we are dealing with local Covid lockdown regulations. I do not want to go over the grounds of my PNQ on Friday, but, when Mr Speaker called for the most significant of these regulations to be debated in Parliament at the earliest possible point, I think he spoke for the great majority of parliamentarians.
As the Minister has said, the Government propose to introduce a new tiered system of restrictions for local lockdowns, and, whatever the justifications for them—the noble Lord is right about the evidence that we are facing—they involve a serious reduction of people’s liberties and, of course, put many businesses in jeopardy. I am in no doubt that this House should be asked to approve them before they come into force, just as the Commons is likely to do. My understanding is that that is now likely, and, if so, this is very welcome.
Of course, the relationship between government and local authorities is highly relevant to this and the regulations the noble Lord spoke to today. Right from the start—going back to March—the Government seemed to exclude local bodies from the key part that they could have played in helping to combat and manage the virus. Public health directors were ignored, NHS and university lab capacity was overlooked and, as the Institute for Government has pointed out in its analysis of government decision-making:
“The decisions on lockdown and school closures were taken and introduced swiftly, and with little consultation and planning for how they would work in practice.”
I was very struck by a comment made by the Newcastle City Council leader Nick Forbes a few days ago. He said that confusion over the latest restrictions was deeply unhelpful and that they were very difficult to enforce and had left dangerous conspiracy theories to fill the void. We know that a frequent complaint of many leaders is that local authorities were often given little notice of when local regulations were to be made.
In parallel to the new regulations that we will debate later this week, it has been reported that the Prime Minister wants local leaders to help shape the package of local lockdown measures. Clearly, as a principle, that is welcome. Does the Minister agree that, generally, evidence shows that, globally, countries that rely on a central approach are not as effective as those that use trusted local bodies? Does he also accept that local authority test and trace services seem to have a much higher rate of contact, both for complex and non-complex cases, than the national scheme, which faces so many problems? Can he also expect to see the ending of decisions on lockdowns being leaked in advance of local leaders being told what is in them?
It is clearly important that the rules are complied with. Will the noble Lord say something about compliance rates? I do not know whether he has studied the recent report of the C19 National Foresight Group, which has been looking at the communications the Government have with the public over these restrictions. It concluded:
“National Integrity and Trust is Being Eroded”
because of the
“style, pace and timings of communications”.
It says:
“This mostly focussed around rhetoric, over-promising and timing (where late night national announcements created negative impacts on the relationship with the public). Apparent conflicting activities (where two announcements seem to contradict) and stating ambitious targets that are then not achieved were aligned to eroding trust with the public.”
Regarding local bodies, the C19 group went on to say:
“The lack of trust in the local structures from ministers and government departments… also impacts on their ability to feel included as part of a greater UK wide management”
of the pandemic. Does the Minister recognise this, and will this be considered as part of the recasting of the relationship between the Government and local authorities?
The Deputy Speaker (Lord Lexden) (Con)
My Lords, I apologise again, particularly to the noble Lord, Lord Hunt, and the noble Baroness, Lady Thornton. I was looking at the list for the next debate. I call the next speaker for this debate, the noble Lord, Lord Greaves.
Lord Greaves (LD)
My Lords, I support and underline everything that the noble Lord, Lord Hunt of Kings Heath, has just said. This is the latest set of local area statutory instruments that we seem to discuss on almost a daily basis. Yet again, they are out of date—it may be a little known fact, but this is actually now called the Health Protection (Coronavirus, Restrictions) (North East and North West of England) Regulations 2020 as a result of an amendment in another obscure statutory instrument that we received. This illustrates the confusion about the whole thing. If the new initiative that may be announced this afternoon provides more consistency and makes these things easier to understand, that, at least, will not be a bad thing. I will not talk about childcare today; I think we will want to talk about that when we discover what is being proposed today.
I do, however, want to talk about test and trace. I believe it is now generally understood that, whatever restrictions are imposed and whatever the legal background to them, an efficient, well-run and successful system of testing, tracing, tracking contacts and isolating as appropriate is key to tackling the coronavirus problem. It is clear that whatever claims are made about the number of people who have been tested and all the rest of it, the system throughout the country is a shambles. This has to be tackled, and I am sure that everybody wants that. The key to it must be to do it a local level and to involve the skills and knowledge of those who do it week by week as part of their normal jobs—not in the case of coronavirus but in the case of food poisoning and other outbreaks of disease. They are trained people and they know what to do.
As an illustration of how shambolic it has been, I want to go through what has happened in my own patch in Pendle, which of course is in the north-west and not in the north-east. Pendle Borough Council was desperate to get involved and to use its expert staff in setting up a proper system. It is about a month now since the Government, the authorities and the county agreed that we could do this. The first thing that we discovered was that where the local system identified contacts from positive cases—all of which had been sent down from national level, being cases which the so-called NHS Test and Trace system had not been able to reach, so they were the difficult ones; they were coming late but nevertheless quite a few of them were contacted—those contacts had to be sent back to national level to be dealt with by Serco or whoever in their call centres, even if they were in the same families or in the same street or working in the same factories, and even if local people using local knowledge could have contacted and traced them much more quickly. I would like an assurance that this nonsense has now been stopped, and that if there are to be a lot of local councils doing this work locally, they will be able to follow up the people they have found, because, otherwise, it is a nonsense.
To have a proper testing and tracing system, it is necessary that there are sufficient testing stations locally. One thing that people in Pendle did was set up four stations. That number is now going down to two because, in the case of the community testing station, the Government are refusing to send out any more testing kits, so it has to close, and of the three that come under the Government, they have closed one. We have gone from four to two despite the fact that our numbers are still going up alarmingly. It needs to be taken seriously; it needs to be done properly. Unless it is, nothing else will succeed.
Baroness Morrissey (Con)
My Lords, we all want the Government and this country to win the battle against coronavirus, but what if the present strategy is just plain wrong? What if the strategy of ever tighter restrictions on bigger swathes of the population is not only not containing the virus but will never do so, while causing untold damage to the lives of so many?
I am afraid that the evidence suggests that this is what is happening. People sometimes say that the cure is worse than the disease. Unfortunately, the measures may be no cure at all. As the Minister said, since tighter measures were introduced in many parts of the country, including the north-east, two months ago, we have seen a sharp rise in cases. At the same time, the collateral damage is mounting. The nascent economic recovery has stalled; unemployment is rising, albeit still the tip of the iceberg of what we might yet see. The poverty that will come as a result of those job losses is obviously not far behind. University students, already fearful for their future, are incarcerated in their halls of residence. Mental health issues are clearly arising and worsening. The arts, hospitality and sports sectors are on their knees. Everyone I speak to—I am sure that it is the same for everybody in the House today—is exhausted and dispirited and can see no end in sight.
Instead of doubling down on a flawed strategy, the Government should have a big rethink—after all, a popular definition of insanity is doing the same thing over and again and expecting a different result. The only plausible defence for this would be if it were the only way, but that is not so. We have seen in the past week the publication of the Great Barrington declaration by eminent scientists, now signed by 27,000 medical practitioners and other scientists, which sets out a different way. It recognises that younger, healthy people should be free to live their lives pretty much as normal, while the more vulnerable should be offered—not have imposed—greater, more focused protections.
Since March, when I think we were all frightened—I certainly was—by the spectre of a potential 500,000 deaths hanging over us, we have learned a lot. Lockdown might have seemed an appropriate measure at that point, however extreme. We now know that the fatality rate from this illness is not so severe as that, though it is still a very serious and harmful virus. What we have really learned is that it does not treat people equally. That may be very unfair, but we know that young people are a thousandfold less likely to suffer than people who are over 80. Some 70,000 students from 50 American universities tested positive; three were hospitalised and, fortunately, none has died.
There is no playbook to consult for coronavirus. There would be no shame—in fact, I think we would all applaud it—if the Government took account of the evidence that is mounting and came up with a different, more sophisticated approach that recognised that the restrictions are not necessary for every single person in this country, or if they were at least prepared to consider the evidence. If they do not, it is important that they are absolutely confident that it is the right way forward and only way forward and have the evidence to prove it.
We are reading a lot at present but I want to conclude by reading out a letter that I am sure some of your Lordships have seen already, so forgive me for repeating it. It moved me greatly. It was in the Telegraph last week and was written by an Elizabeth Clarke—she is not from the north-east but from London:
“Does no one in the Government hear the screams and whimpers of this tormented nation, amid the unemployment, the loneliness, the heartbreak, the fear, the poverty, the despair, the cruelty caused by blind deference to unproved theories? … It is as if someone who, to kill a hornet, sets off a bomb in a house—and in the ruins says it was the only way. Covid may be here to stay. There are many unpleasant diseases. Mortality is 100 per cent in the long run. I am 80, and it is no business of the Government to tell me whether or not to kiss my grandchildren, or whom I may invite into my house.”
Minister, what do you say to Elizabeth Clarke? What do you say to those who are lonely, who are scared, who are suffering poverty and who are frightened about their future?
Baroness Watkins of Tavistock (CB) [V]
My Lords, I declare my interests as outlined in the register. I thank the noble Baroness, Lady Morrissey, for her important contribution to this debate; I agree with much of it.
When I put my name down to speak, it was to express my concern that Parliament appeared to be managing rises in Covid-19 rates in different areas of the country through myriad secondary legislation instruments—at least 18, I believe. As a member of the committee that considers SIs in this House, I and other members were becoming concerned that it was increasingly difficult to understand the evidence base on which individual SIs were being developed. In addition, it has become crystal clear over the weekend that the public and local authority elected representatives, particularly in the north-east, Liverpool and Manchester, have begun to lose trust in the way in which we are dealing with local restrictions.
Fortunately, the Prime Minister and his Cabinet accept that we must adopt a more strategic approach to legislation, associated with changes in the number of infections per 100,000 of the population. Currently, different parts of the country have significantly different rates, estimated at between 16 cases per 100,000 where I live, here on Dartmoor, and 600 in Nottingham. However, any three-tier system to manage the virus should be applied in a uniform manner associated with virus increases, and hopefully decreases, over time. The three-tier system that the Prime Minister is expected to announce should be passed into law and applied across England equitably as the virus ebbs and flows. Any legislation should clearly indicate when an area will be enabled to move up or down a tier, associated with the ratio of virus cases to the population. This will ensure that the public can clearly understand the core reason for proposed restrictions.
At the core of managing increases in infections are the test and trace system and the public’s buy-in to restrictions of liberty, be this closing licensed premises or requests to reduce travel and meeting friends and family. In March, care homes were largely closed down in terms of relatives’ and friends’ visits; we know that this caused considerable distress in many cases. Careful consideration must be given to trying to ensure that we avoid transmitting the virus from the community to care homes, but we must also weigh up the devastating effects to people of not being visited by ones they love. What approach do the Government intend to take on this issue?
When Governments reduce their populations’ liberties, even for good reason, it is vital that they counterbalance the restrictions with effective leadership. In particular, did the breakdown in recording over 15,000 positive coronavirus tests 10 days ago contribute to the rapid increase in cases in certain parts of the north-west and north-east of England? By this I mean: did a high proportion of those 15,000 cases, where contacts were not traced quickly, occur in this area?
Will the Minister assure the House that, if hospitals in any area of England become overloaded, the Government will ensure that additional test and trace facilities, PPE and other resources required to manage the virus will be made rapidly available from other parts of the country?
Finally, I welcome the honours given this weekend to nurses and other health and social care workers who contributed in the first wave of the pandemic. However, the Government’s recent press conferences have focused heavily on scientific evidence, with little reference to applied, evidence-based public health interventions, which nurses are often involved with. Yet nursing is reportedly the profession that is most trusted by the UK public. Nurses should play an important role in the public health messages we are trying to get across. They can encourage the take-up and delivery of vaccinations, including for flu and tuberculosis, and the mass vaccination for Covid-19 as and when it is developed. Does the Minister agree that now is the right time to more effectively use the voice of nurses, including the Chief Nursing Officer for England, Ruth May, and locally based community, hospital and school nurses, to explain to the public how best to reduce the spread of the virus?
Lord Hain (Lab) [V]
My Lords, I agree in particular with my noble friend Lord Hunt about the Government’s failure to consult locally and that countries using locally rooted strategies are far more effective than those using centralised ones. The noble Lord, Lord Greaves—a friend from a past political life—made similar points. Ministers are guilty of incompetent centralism, for two central reasons. First, outsourcing to Serco, Deloitte and Boots testing and tracing tasks that they have never undertaken before has not worked. It was an astonishing thing to do when there are ready-made primary health and care systems in place, with one of the most respected local GP networks anywhere in the world. We could have utilised this network and resourced it better, rather than cutting it, as has happened remorselessly over the last 10 years. We could have poured into it all the money that has been given to Deloitte, Serco, Boots and other agencies. They have failed for six months and are still failing in the second wave.
The second major mistake has been imposing decisions on local councils and mayors. In recent days, we have seen an explosion of protest from Andy Burnham, the Mayor of Greater Manchester. We have seen similar sentiments from Steve Rotheram, Metro Mayor of Liverpool City Region. Other leaders of English regions, including some Conservatives, have expressed similar protests that Westminster keeps varying the rules by Whitehall diktat, and that they learn what the Government intend to do, not through Ministers consulting them—the people on the ground who know their areas and communities and what is happening—but from the newspapers.
The other day, the leader of Gateshead Council complained on the BBC that the rules are just dumped on them. He pointed out that in Newcastle and Gateshead, although cases in student populations have soared, Covid cases elsewhere in those communities have actually been falling, so it makes no sense to lock them all down, at great cost, especially to local hospitality businesses and jobs. Manchester City Council’s leader, Sir Richard Leese, told the BBC this morning that it had a much more granular system of local intelligence and information than Whitehall could possibly have, and so were better placed to judge what to do and how to do it. Importantly—I hope that the Minister might respond to this—he also wanted more local powers to enable these to be deployed selectively, for example to close a particular pub if it was transgressing the rules or being responsible for a crowding experience that might spread the virus, not the whole lot in a blanket approach
Precisely what has this incompetent centralism achieved? It has pushed us back to where we started: lockdowns, and rising infections and hospital admissions. How many lockdowns are still to come? Are we condemned to continuous lockdowns, lifting them and then reimposing them? There is no clear strategy. The strategy must surely be to localise testing, tracing and isolating and resource them properly, rather than having these failed, centralised diktats sprayed down on local communities by Whitehall, which are having the reverse effect and condemning the country to many more months of misery.
Lord Shipley (LD) [V]
My Lords, I am grateful for the opportunity to speak on the north-east regulations. I fully understand that this is a very complex and fast-changing situation, and I hope that the Minister will take my suggestions as a constructive response to current circumstances. However, the House should be discussing these orders much nearer the date of decision, not nearly a month later. I am speaking this afternoon from Newcastle upon Tyne, and we shall learn later today what changes may be forthcoming for our area, and for others.
The regulations before us today derive from the initial decision on 17 September to introduce the greater social restrictions requested by the seven north-east councils when Newcastle had a rate of 70 cases per 100,000. There was then a further tightening of restrictions, announced by the Secretary of State on 28 September, apparently without proper consultation with those councils. Of course, even tighter rules are now expected.
I want to look at the issue of student testing. Over 2,500 students of the two universities in Newcastle have tested positive, significantly pushing up the local infection rate. We know that most of the students being tested had no symptoms. That makes me wonder whether university cities in the south and the Midlands have had such extensive testing of students without symptoms. Can the Minister give us any information on the evidence base being used to decide which tiers are appropriate to each area, given the apparent differences in the amount of testing?
In terms of process, I remain concerned by the consistent evidence that local testing and tracing leads to better, safer outcomes. England is simply too big to be run on the centralised model of recent months, and the debate over the last few days has confirmed this. To command public confidence in their decisions, the Government need to publish far more than they do. The evidence that limiting the opening of pubs and restaurants even more will result in lower transmission levels may well be accurate, but it should be published.
Our experience of the last few days tells us that meetings between local leaders, civil servants and Ministers should be formalised and minutes should be published. There has been too much claim and counterclaim that the public cannot understand, which can undermine their confidence in the decisions made.
The Government should use district postcodes for their decisions on which tier an area should be placed in. I have not understood why the whole of the north-east of England, from the Scottish border to the southern end of county Durham—some 80 miles—is treated as one area when the infection rates can vary so greatly. Nor have I understood why the 10 pm closure time for pubs and restaurants applies. The evidence suggests it could actually be increasing the rate of infection. Might it not be better to have staggered times of closure set locally?
On the continuation of furlough, the current proposals for financial support are just not enough. If things get worse and more businesses are forced to close, the financial support has to be greater. People’s incomes and their ability to pay bills depend on that level of support from the Government.
I accept it is clear that we are at a tipping point, and great care is needed. I know that local hospital admission rates here are rising, and that we must be careful to get decisions right. That means maximising engagement between decision-makers and sharing as much information as possible through public health structures, with the general public receiving better standards of messaging so they understand what they are being asked to do, what is compulsory and what is advisory.
The directors of public health for Newcastle and Gateshead have both said in recent days that the curve may be flattening. For that reason, the Government should heed advice from local political leaders to be very careful about unnecessary extensions to lockdown rules.
Finally, we need better clarity about review dates. The Minister has said that they are going to be fortnightly; they may need to be weekly.
Lord Bourne of Aberystwyth (Con) [V]
My Lords, it is a great pleasure, as always, to follow the noble Lord, Lord Shipley, who put forward an exposition on some very relevant points, some of which I will be touching on. I thank the Minister for setting out the purpose of these regulations, which we are looking at retrospectively, as we always seem to do; they came into force on 18 and 22 September respectively. I am afraid it is yet more scrutiny by means of the rear-view mirror, which I think we all agree is far from satisfactory. I look forward to the day when we look at regulations much closer to the time when they come into force.
The first set of regulations relates to the closure of pubs, bars and restaurants in the north-east of England. The second set merely corrects some minor defects in the first; it is purely technical, and I make no complaint about that. The third set relates to enabling infant childcare arrangements, which the noble Lord, Lord Greaves, touched upon. I agree with him: it is probably not appropriate to dwell on it when we know that, as we debate the regulations, new arrangements are being discussed in the other place. So, I do not propose to spend time on that.
While I, like the noble Lord, Lord Shipley, recognise the need for these regulations and the fact that we are at a tipping point, I do have some general points to make about our whole approach, as well as some questions. First, we need effective parliamentary scrutiny and oversight. I have made this point many times, and I know the Minister has emphasised it, too, but it would be good to hear from him when this is going to happen—when we are not going to be constantly two to three weeks behind the curve, looking at regulations that are so out of date. These regulations, for example, talk about trying to align the north-east with the rest of England. As we speak, the “rest of England” is shrinking because new areas will be subject to the restrictions. But also, there is a sense we are in the tail-stream of what is happening out there. It is too late to be debating these in any effective way.
On a related point, we should be publishing the evidence. The evidence must be there—I certainly hope it is—and it would reassure people to know that rational decisions are being made on their behalf about the closure of hospitality undertakings, for example. Why on earth do we not publish this evidence? We had a review of these regulations before we even looked at validating them. Some regulations had two reviews before we validated them. It is not good enough. I hope the Minister will heed these points.
I agree strongly about the need for localism. Localism is trusted, effective and familial—it is what people want. When we look at overseas experience, as we on the Public Services Committee and many people in the news, television and other media have done, we see that controls are exercised better and test and trace is better at a local level. Just look at Germany’s record compared with ours. For goodness’ sake, let us learn the lesson and trust people locally much more.
I appeal to the Minister that we should learn these lessons. It would be good to know what the reviews said. We keep hearing that reviews are taking place; I never get to see them, and I do not know whether anyone else does. It is about time we were trusted with some of the evidence, so we can see for ourselves. I am sure the Government are acting in good faith and are generally making the right decisions, but it would be beneficial to involve the rest of Parliament, the rest of the country and certainly people locally, so that we know the decisions have been properly thought through. At the moment, it is not clear what the national strategy is. By that, I do not mean that we need a uniform, one-size-fits-all approach, but we need a national framework and a national indication of how we are attacking this virus and what we are doing locally.
I look forward to some clarity and some strategy, and to what my noble friend on the Front Bench, who carries a heavy load, has to say on these issues.
Baroness Wheatcroft (Non-Afl) [V]
My Lords, I share the sentiments of the noble Lord, Lord Bourne, about the weight on the Minister’s shoulders, and I have every sympathy with him. However, I share the qualms of the noble Baroness, Lady Morrissey, that we might be pursuing the wrong course, inflicting untold damage on our country in misguided efforts to fight the virus. But having embarked on this course, the Government have done so in a manner that has just caused confusion, because they themselves act in a confused manner. It is no wonder that the country is bemused.
Others have stressed the unsatisfactory test and trace system. Back in May, when the system was launched, we were told that test and trace was going to be the way that we would solve this problem. It was crucial. We were going to have a world-beating system. When that did not appear to be the case, the Prime Minister stated on 22 September:
“Testing and tracing has very little or nothing to do with the spread or the transmission of the disease. The spread and the transmission of the disease is caused by contact between human beings and all the things that we are trying to minimise.”
He went on to say:
“Of course NHS Test and Trace is vital”.—[Official Report, Commons, 22/9/20; col. 822.]
Test and trace is vital, and simply changing the rhetoric does not mean that it is any less important than it was in May, when it was launched. We need to get it working properly, which certainly is not the case at the moment.
The lack of logic in what the Government do is what really leaves people puzzled and often failing to comply with the regulations. For instance, we know that we are about to hear some fairly drastic changes to the way in which the Covid regulations are working, with a three-tier system. But we first got wind of that three-tier system a week ago. Seven days is a long time in a fight against a virus. Why did we have to wait seven days listening to rumour and conjecture before this becomes operative? If it is important and it needs doing, why not have a sense of urgency and move fast?
The lack of logic is in every aspect. We have heard time after time in this Chamber how local authorities, which have to cope with the 10 pm curfew, would like to see a clamp-down on off-licence and supermarket sales of alcohol, instead of encouraging people to leave restaurants and pubs at 10 pm and simply go drinking in groups elsewhere. There is no logic in that. We need to start applying common sense.
Finally, how can we expect anybody to stick to regulations that simply resort to gobbledygook? In those that we are currently looking at, it states that
“food or drink sold by a hotel or other accommodation as part of room service is not to be treated as being sold for consumption on its premises.”
This is nonsense. How can we expect anybody to comply with such gobbledygook?
Baroness Altmann (Con)
My Lords, I thank my noble friend for introducing these regulations and share others’ sympathy with the position he finds himself in on the Front Bench. I agree with him and echo his concerns that these measures have greatly affected families; they have interfered with the bonds that many children, parents, siblings, grandparents and friends rely on for their sense of worthwhile living. My noble friend mentioned that these SIs are vital to suppress and eradicate this disease. I understand how they suppress it, but how do they eradicate it?
As the noble Lord, Lord Hain, eloquently explained, we were in this position many months ago; the transmission rate fell but, once freedom was restored, the transmission reappeared. What consultation has occurred with the areas affected by these SIs? For example, will the 10 pm curfew merely transfer meeting to the street, or on to public transport, as all pubs and clubs empty at once?
We are once again being asked to rubber-stamp measures in this House that have already been introduced and amended twice—perhaps shortly to be thrice—yet there are still no impact assessments and no detailed cost-benefit analysis. I also echo the words of the noble Lord, Lord Shipley, in asking for evidence of how the rising number of cases is related to the extent of testing in any area, and how many are among only the young and asymptomatic, which may be of far less concern. These measures are so draconian, intrusive and dangerous to both lives and livelihoods that we surely need much more rigorous analysis than we have hitherto been offered.
When calling for a detailed cost-benefit analysis, we are not just talking about looking at the trade-off between lives saved by lockdown versus costs to business and economic growth, important though that it is. As mentioned so powerfully by my noble friend Lady Morrissey, analysis is required of the costs and benefits of Covid-19 deaths prevented by lockdown versus deaths from other causes caused by lockdown. Deaths and serious ill health, both physical and mental, will be increased by the measures we are debating today.
How many people will die or suffer life-limiting impacts? Who has done those estimates? For example, Hull University NHS teaching hospitals have already informed thousands of patients that they will have to wait two years for medical treatment. As another example, 16,000 fewer patients than expected are being urgently referred for lung cancer tests just since March—a 50% fall. Some fear going out, but others may develop a cough and just self-isolate rather than going for a check. Even if they try to see their GP, they may have only a virtual consultation, which may tell them to self-isolate. Cancer, heart failure and other illnesses are being worsened by the measures that we are debating today.
This is not an easy situation; we are in a very difficult position. But we need much better and more detailed information and analysis on which we can truly base judgments about these kinds of draconian measures, so that we can satisfy ourselves and the public at least that we understand what the costs are, that they are justifiable and that, in the end, we have a strategy for eradicating this virus rather than just suppressing it on an ongoing basis, with all the damage that that entails.
Baroness Bennett of Manor Castle (GP) [V]
I declare my interest as a vice-president of the Local Government Association. We are talking today specifically about what will soon be historic rules applied to the north-east of England from Westminster. My remarks are informed by observations of Green Party councillors from the region, and I thank them for providing them and hope that they may not be too late to inform the forthcoming changes, or at least their implementation.
There are many ways in which to approach these regulations, including the approach that I took last week in asking whether we were learning appropriately from global best practice—a question that needs to be applied to everything that the Government do and one that they invite with frequent claims to be “world-beating”. Reflecting the Green slogan, “Think global, act local”, today I outline some of the issues reported to me from the north-east, seeking to add information to that provided by other noble Lords rather than repeat their points, although I agree with much of what has been said.
One issue is what might be called the “edge effect”. Communities just outside the areas of restriction are concerned about people from inside restricted zones coming to use businesses and socialising in ways forbidden in their home area, potentially bringing the virus with them. Secondly, whether they are inside or outside a restricted area may not be known to significant numbers of residents. Local government areas and coverage have changed significantly over the years. For example, Darlington was part of County Durham until 24 years ago, and many residents still write “County Durham” on their address. Darlington was not covered by these regulations, and people may be experiencing unnecessary isolation and deprivation as a result. Conversely, in other places, people may be breaking the law without any ill intention.
The answer to the second problem is clearly the best possible communication and information and a broader reflection on the need to involve communities more in local governance, to ensure that local government has the resources and powers it needs to be relevant to people’s lives, which would also encourage residents to vote in local government elections, further building their knowledge. That should include control over anti-Covid measures, as called for by the noble Lords, Lord Hunt of Kings Heath and Lord Greaves.
My second point refers to what might be called “concentration effects”. My local observers were reflecting on schools and colleges, but it is true in many aspects of life today that people have been concentrated into a few small areas. Where once pupils from a wide area used to go to local colleges, now they all go to one place. That has obvious risks both in spreading coronavirus and for anxiety and concern. The communities which see a large influx of people are concerned about the risk they might represent to them. This is, in terms of resilience, a risk for future pandemics where infections have greater impacts on younger age groups.
As a final point on detailed local concern, the local voluntary aid groups that were so effective in the early stages of the pandemic have less capacity now. Funding is needed to fill the gaps.
To conclude with an overview, there was an understanding back in March that the virus, however much we should have been preparing for an epidemic in general, had arrived suddenly, with very limited information and understanding about it. There was good will and an understanding that mistakes would be made through lack of information and time to plan. That does not apply now. From the north-east and around the country, we are hearing clear understanding—which reflects what the scientists are telling us—that restoring any kind of secure, certain life requires a highly effective test, track, isolate and support system, and that local systems, not a distant privatised call centre, are the key to making that happen. We are finally seeing some moves in that direction.
However, we need much more of an understanding that, for the north-east and every other region, it is local people who know and understand their community who need the resources to make plans and decisions and to implement the measures needed to keep coronavirus under control. In understanding that many of these communities are already blighted by poverty and inequality, there is a moral responsibility to understand that levelling up means spreading out the concentration of money, resources and particularly power in London and the south-east and not continuing to stand in the way, as Westminster has for decades, of people taking back control in their communities.
Lord Naseby (Con)
My Lords, this weekend I thought I would try to do a bit of research to help my noble friend on the Front Bench.
In 1960, I joined the Reckitt Group in Hull, which is in the north-east, as a management trainee. I looked up my notes and found that I was shadowing a test market just south of Newcastle for a brand of Jane Seymour cosmetics. I noted that my tutor made it quite clear that you have to analyse the fabric of the society in which you are doing the test market. The north-east is nowhere near the same as Bedfordshire, where I lived. It is very different. Therefore, any campaign or programme must reflect that difference.
There is a huge community spirit in places such as Hull which does not exist to anywhere near the same extent in the south. There is also far more terraced housing, far more ethnic mixing and a wholly different attitude to life. In that part of the world, local government is very strong. I had the privilege of being the only ever—so far as I can find out—Conservative leader of the London Borough of Islington. I soon learned that the friends in the north in local government are really strong.
I thought, “What is the nearest analogy we have for this?” I am in a medical household. We had a look at what happened with Asian flu in 1957-58; no less than 9 million people suffered from it, the commercial world was hit and 14,000 died. The key element in the report I read was that it started out being controlled nationally, but they soon found that that did not work and had to use local medical officers and GPs for help. That is the evidence there.
After that, I had a look at the statistics in the latest report I could find from the Office for National Statistics: death rates in the first wave of this situation, which began in March, rose steeply from one per day on 2 March to 975 per day at the peak on 7 April. If we look at the second phase—now—there were two deaths from Covid in England on 1 September; five weeks later, on 6 October, this had risen only to 11. That is a huge difference.
As I said on Friday, I looked at what the death certificates show as the primary cause. Between 10 August and 7 October, there were 43 deaths—not hundreds. There were no deaths in the groups 0 to 19 and 20 to 39, four in the group 40 to 59, 14 in the group 60 to 79 and 24 in the group 80-plus. If the objective is to save real lives, we have to look at the elderly and the very elderly. Frankly, the young are not dying. That surprises nobody. Any of us who knows anything about medicine knows that very few young people die from any sort of disease.
I cut a lot of papers, that is a terrible trait of mine. In the Telegraph of 11 October, I read a report from Professor David Livermore of the University of East Anglia. He says, quite rightly:
“In March, we knew little … Now … we know that much infection is very mild and inconsequential”.
He then gives us some figures from Northumbria University and goes on to say that lockdowns might be good if the vaccine were just around the corner. But it is not, is it? At best, it will be here in the spring. We are taking quite a punt following the present policy.
It seems to me—and to Professor Livermore—that life should return to normal, as far as possible, for those at low risk and anyone older who accepts the hazards, which includes him and me. The virus will circulate among us, generating herd immunity. As we recover, it will run out of hosts and lose traction, rather as it did in Sweden.
Baroness McIntosh of Pickering (Con) [V]
My Lords, I will speak to the regulations relating to the north-east of England, particularly those that prohibit people in those areas gathering with one or more people from a different household, apart from linked households in a private dwelling, whether inside or outside the protected area.
It is very clear, and I share the frustration that I am sure Ministers and the general public feel about this, that Covid is not acting as one would expect it to. However, the communication and understanding that flow from the regulations which the Government are bringing forward are clearly key to enabling those in the north-east of England to follow the letter of the regulations before us this afternoon.
My particular concern relates to the fact that urban areas such as the Tees Valley were initially left out of the regulations, whereas deeply rural areas such as Teesdale, with a population of 25,000, and Weardale, with a population of just over 8,000, were included, lumped together with the whole of the city of Durham and other more urban parts of County Durham. This must be a feature of unitary government, and it is one I deeply regret. It leads to perverse consequences; I am not convinced that, when these regulations came into effect, the level of the virus in the rural areas was high enough to justify the draconian regulations that were introduced.
I will ask my noble friend a specific question, because I am being asked it by those I know living in County Durham. It relates in particular to linked households under SI No. 1010—Regulation 7 on page 6—and paragraph 7.2 on page 3 of the Explanatory Memorandum to the SI No. 1012 correction regulations. What does my noble friend understand exactly by a “linked household”? Is it just for the householders to agree or do they have to notify the authorities, or only if they were challenged in that purpose? Also, can my noble friend explain what a support bubble is? How many people can form one? If I can learn that from my noble friend, I can go on to explain what it is to others who are asking. Other noble Lords have expressed concern about the extent of the measures before us today, so can my noble friend explain what balance has been reached regarding the mental health and well-being of—and the feeling of isolation experienced by—those living in a single household who may not be part of a linked household or a bubble, or who may not quite understand the extent to which they are? They may take a complete turn for the worse in those circumstances. Physical conditions such as cancer and others itemised by my noble friend Lady Altmann are also important, as the timing of diagnosis and treatment is a particularly critical factor.
I have a general question for my noble friend in connection with the regulations before us. I know he said that consultations were held with the leaders of councils, so presumably that included the leader of Durham County Council. However, with particular regard to my concerns about the rural area of Teesdale and Weardale, what consultation and discussions were held with councillors elected to represent those areas?
Finally, what is the relationship now between the regulations before us and the new tiers announced this afternoon by the Prime Minister? What will happen if, even in spite of the new, even more draconian, measures announced along with the tiers this afternoon, there continues to be a rise in infection? What further action might my noble friend and the Government consider taking if such a course of events transpires?
Baroness Barker (LD)
My Lords, hindsight is frequently knocked as the privilege of an Opposition, but provided it is used wisely, it is a very useful tool to bring about informed decision-making in the future. That is what I have felt all these last six months as we have stood up to talk about these different regulations which have come before us, often weeks after they have been implemented. I like to think that at least some of the changes that will come about later today are the result of weeks upon weeks of penetrating questioning in your Lordships’ House of some of the Government’s assumptions. It is worth saying that some of the things that we have said and will continue to say still stand. Herd immunity is a strategy for when a vaccine is available. It is not a strategy for an illness for which there is no vaccine, and that will not change. However, it is also true that back in March we said to the Government, “You must be led and informed in your decision-making by local people—in local authorities, the police and local public services. Those people know how to deal with these sorts of outbreaks, and if we do not learn from them, we will waste a lot of time, money and resources.” Well, here we are today.
I am not in the brigade which has seized on the Barrington declaration and misinterpreted what the WHO has said to try to reject lockdown. There will be an ongoing place for lockdown until such time as we have an effective vaccine. However, there is not a place for reliance on generalised lockdowns in perpetuity, because they are very crude and ineffective, serving only to suppress a virus within a population. However, what we can and should be doing in these repeated regulations is learning from what has happened in different parts of the country to inform things.
We should have listened to the leaders of the local authorities in the north-east who predicted that, after a summer in which young people had been allowed to go out, go abroad and so on, if thousands of them turned up in a university town, they would make a difference to the incidence of infection, even if not to its transmission. We should listen to the public health officials, who tell us that they can see from the rise of infections in the 18 to 25 year-old group a lag but none the less a correlation with people with infections in the over-60 group on whom this has a differential effect. That evidence is there.
We ought not at this stage to rely on such crude geographic interpretations of statistics. I would like to know whether the low number of people infected in Northumberland and County Durham work in Newcastle, and how many of them work in the universities in Newcastle and have contact with students there, so that we can begin to see the patterns of transmission of the infection. That is the important thing that we are not yet learning. We are learning about incidence but we are not being told about transmission. I would like us to have the information to be able to differentiate between different businesses. I guess that transmission of infection is more likely in pubs than in restaurants, at which people sit down—or hotels, for example—and we should be able to make a regulation which differentiates between those different types of venue.
As I say, I am no Florence Nightingale. As noble Lords will know, she was originally a statistician. She was not a nurse; she went to follow the pattern of infection and illness in the Crimea. I am also tempted to say that I am no Dido Harding. What are we doing to get information from households? They are the easiest groups of people to trace. We should be getting differential information per household from all across the country.
I make a plea to the noble Lord for when we are using this information to plan for things. We saw what happened back in March, April and May in care homes. We should now be talking to the civic leaders and care home providers in the north-east and the north-west to make sure that we have no repetition of the daft and dangerous situation in which we had three different systems for ordering PPE, none of which worked.
I want to go back to the councils in the north-west, which my noble friend Lord Greaves mentioned. A few weeks ago, they wrote to the Minister to say that the protocols for the NHS 111 system needed to be looked at and changed. The Minister has told us that NHS 111 will become the primary point of access to the NHS. If we are talking about the NHS in these areas not falling over in the next few months, and as it is the one source of information that the public trust when they have long since lost trust in the Secretary of State for Health, can he assure us that the resources, training and protocols for NHS 111 will be resilient enough to make sure that people all across these areas get access immediately to the services that they need?
Baroness Thornton (Lab)
My Lords, after a weekend of speculation, leaks and press briefing, after the leaders of many councils—including the ones affected by these regulations—have rightly taken the Government to task about how they are conducting the local lockdowns, and after a Statement from the Prime Minister, which may be happening right now, the Minister must forgive me for feeling that we are yet again embarking on a fruitless exercise. He calls that scrutiny and assures us that we are being heard, but we on these Benches call it a continuation of the undermining of parliamentary democracy and the role of this House in particular. However, we can hope that all that might change.
Is it the case, as I heard just before I came into the Chamber, that the Nightingale hospitals are being reopened in the north-west and the north-east? If so, can the Minister explain that? If not, I would like to learn it.
My noble friends Lord Hunt and Lord Hain gave very good explanations of the issues that we face. Almost every noble Lord, possibly with the exception of the noble Baroness, Lady Morrissey, talked about the importance of localism and running things locally. The noble Baroness, Lady Barker, gave her an answer. In the face of no vaccine, how many millions of us does the noble Baroness, Lady Morrissey, suggest stay out of the way and locked up? In the face of no exit, how many millions does she want excluded from society? I am sorry that the hybrid rules do not allow her to answer those questions, but we will have another opportunity to have a go at this issue tomorrow; I look forward to that. Without any exit strategy, her proposition is not viable.
We can use this time to do what other noble Lords have done: see how things are going in the north-east. What do local leaders and others have to say? We can see certain patterns that we have seen before, with the regulations described as confusing and contradictory. As my noble friend Lord Hunt said, because of the way in which the restrictions were introduced, they have left space for dangerous conspiracy theories to fill the void. Councillor Nick Forbes, the leader of Newcastle City Council and the leader of the Local Government Association, said that the way in which the restrictions were introduced was “deeply unhelpful”. He said that, for example,
“the confusion allowed conspiracies to breed, such as the false claim that the 10 pm curfew was ‘part of a grand plan by the council to abolish alcohol’ to appease Muslims.”
Frankly, that is a very unhelpful thing to be said in a community. It was allowed to happen because the communications did not work in this case. It is deeply frustrating for local communities.
I have enormous respect for Councillor Nick Forbes, the leading councillor in this country. He called for help from the Government before the restrictions happened, but they were delayed and he says that they were confusing when they arrived. This weekend, he still came back to the Government to say how keen he was to work with them to make all this work. The Government are fortunate to have council leaders across the north-east who take that view. I hope that they respect that in the way that they conduct themselves from now on.
Noble Lords may have heard a 18 year-old Durham University student on Friday’s “Today” programme talking about having Covid, being seven hours away from home and not being properly fed. She lives in a college where she is supposed to have her meals supplied for her but was being given junk food, with no fruit or vegetables, for the week. Frankly, I thought, “Oh my God. Can’t somebody take this poor young woman some chicken soup or something?” She was also trying to complete her online lectures and so on. She said that
“it’s hard to concentrate when you’re hungry and haven’t had any vegetables in over a week.”
If I were her parents, I would be going absolutely spare with anxiety. I hope that Durham University has seen the error of its ways and is now providing nourishment for the students who have tested positive and are having to self-isolate.
I have several questions. What impact has the particular lockdown mentioned by the Minister had on mental health and well-being in the north-east? What will happen to that region next? What support will councils receive? Will test and trace be devolved to those areas? Will it be resourced?
Finally, let me say how much I welcome the third SI. I hope that support for people who need childcare is now built into the considerations on the restrictions being imposed, as we will discuss on Wednesday.
Lord Bethell (Con)
My Lords, I am enormously grateful for the debate on these technical but very important SIs. I want to say a few words about lockdowns generally and the role of the national/local framework, and then answer the question of where we go from here.
The Prime Minister is on his feet in the other place at the moment, talking about local alert levels. I cannot pre-empt what he will say but I remind the Chamber that the Leader of the House will make a Statement here and provide a platform to discuss those important measures tomorrow.
I also remind the Chamber that local lockdowns are likely to play and remain an important part of our response to Covid. They are a way of avoiding national measures, in that they help to preserve the economy, keep children at school, protect the NHS and maintain a normal way of doing things. For that reason, getting local lockdowns right is enormously important. A debate such as this one is an important part of lending scrutiny to the process; I am enormously grateful for that.
I should also mention that the British public are enormously supportive of the principle of local lockdowns. Some 73% of Brits support local lockdowns in principle, while 68% would support them in their area if they were needed. In this sense, we are not cutting across the grain of public opinion.
I say in response to the noble Baroness, Lady Watkins, that there have been instances where local lockdowns have emphatically worked, such as in Bolton, Leicester and Luton. We learned there how prompt, accurate and emphatic lockdowns can really nip an infection in the bud. I also mention Swindon—as I did in the Chamber last week—where car sharing was identified as a source of transmission and nipped in the bud at a very early stage.
In response to noble Lords’ questions, let me say a few words about the principles that we apply to local lockdowns. On our approach, the noble Lord, Lord Hunt, asked about enforcement. Our guiding principle is to use consent wherever possible, but enforcement is necessary. Up to 21 September, 18,912 fixed penalty notices had been issued in England and Wales. It is shame that that number has crept up as high as it has done but that demonstrates the determination with which we are prepared to follow up on this important principle.
The noble Baroness, Lady Watkins, asked about the exit strategy. Let me reinforce the absolute primary importance of the exit strategy. She is entirely right: the public absolutely deserve to know how they can help to get their area out of lockdown. An important principle behind the Prime Minister’s announcement on local alert levels will be trying to design a way to articulate that so that there is a sense of common purpose.
On data, let me assure my noble friend Lady Altmann that incident rates are not the only thing that we look at; we also look at positivity rates so that we are not distracted by the increase in testing.
I assure the noble Baroness, Lady Thornton, and my noble friend Lady McIntosh that the mental health impact is a major concern. As an illustration of that, let me say to my noble friend that we are concerned about people who live alone. There is clear guidance on making a support bubble with another household. I would be happy to write to her with a link to that.
On technology, the noble Baroness, Lady Barker, asked about 111. Privately, I am incredibly pleased that she listened to what I have said on the matter. I assure her completely that there is massive investment in both people and the tech behind 111. It is incredibly important that that stands up well and provides people with the reassurance and advice that they need to make that a success.
Lastly, on the observation from the noble Baroness, Lady Barker, on households and pubs, the Joint Biosecurity Centre makes that kind of analysis. I agree that there seems to be evidence that household transmission is extremely acute. Once in a household, the disease often spreads to many people within the household, but of course it needs to get into the household in the first place. That happens in places such as pubs, clubs and hotels, although I am not sure that there is any evidence to distinguish between different venues and their transmission rates.
Local/national interaction has been the subject of a huge amount of comment. I completely hear and endorse a lot of the sentiments that have been heard. Our approach, despite what might appear from the debate, is very much a national/local partnership. We have come a very long way since February and March, when we initially discussed these matters. There are more local testing sites, local test processing sites, local tracing partnerships and local dashboards, and there is more publication of data. I would be very glad to provide a guide for any of that public data to anyone who would find that helpful.
The noble Lord, Lord Hain, is shocked to observe the outrage of local council chiefs over these measures. I am surprised myself. I reassure noble Lords that a huge amount of dialogue goes on every hour of every day at the moment between local authorities and central government, and that the narrative on TV is quite different from what happens in private conversations between all parties. There is very much a deep commitment by the Government to work in partnership. That is one reason why so much care, time and consideration has gone into the design and funding of the tiers being announced by the Prime Minister as we speak. Local support for these measures is absolutely fundamental to changing behaviour and to the public committing to the rules we apply. That is the principle set out in the Chamber and the principle that the Government understand. Because of that principle, we are taking the care that we are over the national/local partnership.
My noble friends Lady Morrissey and Lord Naseby, and the noble Baroness, Lady Wheatcroft, all alluded to whether we have a choice. That is a really important question. I completely share the exhaustion, frustration and occasional “What if?” feelings. There is no monopoly on knowledge in this Government; we do not necessarily get everything right. However, I invite my noble friend to read the publication by the Home Office, the ONS, the Government Actuary and the Department of Health on the direct and indirect impacts of Covid-19. It spells out in very clear, graphic and numerate detail what happens to a country such as Britain when it runs out of bed space, when there is an overwhelming demand for bed space that means that those with Covid or seeking bed space for another reason simply cannot get the attention they need. It spells out in clear detail what the impact on mortality would be were that to happen.
That publication also spells out the challenge of trying to enclose those who are vulnerable—the millions who are elderly, those with learning difficulty, those with diabetes and those whose ethnic background puts them into a special category. Millions of people are in the “vulnerable” category. Locking them up is neither conscionable nor practicable. We have tried this. Every year people try to keep their relatives out of the flu season. It makes no impact at all because people want to be with the people they love, and they need the attention and support of the social care workers who support them. For those reasons, the idea of confining the vulnerable to some form of isolation is neither conscionable nor practical. It comes down to a mixture of a values judgment and an economic judgment. History teaches us that those countries that have the stamina to defeat the virus bounce back fastest. That is why we take the approach we do.
To conclude and look forward from here, I once again acknowledge noble Lords’ frustration about the manner of these statutory instruments coming to the House. All I can say in response is that it is a negotiation for the usual channels and the Joint Committee on Statutory Instruments to decide when these matters are programmed. I am very much committed to being here whenever it is decided by noble Lords that these SIs should be discussed. The Prime Minister’s recommendations on tiering should, I hope, bring a more predictable and easily scheduled progress to these SIs. I very much hope that that will work.
In the meantime, in response to the noble Baroness, Lady Thornton, the Manchester, Sunderland and Harrogate Nightingales have been put on standby. There are more patients in hospital with Covid today than they were before the restrictions came in in March. This is a sombre moment and I am extremely grateful to noble Lords for a rewarding and constructive debate.