Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020
Baroness Thornton Excerpts(3 years, 6 months ago)
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Baroness Thornton (Lab)
My Lords, the pertinent question that has been asked by several noble Lords, and indeed by the noble Lord, Lord Scriven, is why this is emergency legislation. We knew this was coming. We should be grateful that we are doing this on the day it is being enacted, not three weeks later, as I have already said. But the high tier already affects 20 million of our fellow citizens, so this is extremely serious.
Areas already under additional local restrictions are automatically in the “high” alert level, which means bans on households mixing indoors are extended to include hospitality venues. Noble Lords have already asked questions on the illogicalities involved. I think the Minister realises that this is not simple or straightforward. As several noble Lords have said, the criteria on which local lockdowns are enacted remain a mystery to us. Regions with similar infection rates are being treated differently. The criteria by which an area will move from one to another, down to “medium” or up to “very high”, also remain a mystery.
The problem that causes, apart from a lot of confusion, is that there will always be a suspicion that a political choice is being made. It is another reason why a local partnership to create safety locally is so important, as those suspicions still exist. The Minister and other members of the Government have said that we should not take too much notice of what is being said in the media by local politicians when, behind the scenes, you are all working together and it is all going extremely well. Too often, it is clear that that is not the case. Those questions remain.
This is very important, as many people in high-risk areas are on tenterhooks following the announcement last night that the Government are set to hold a Gold Command meeting today to discuss whether Greater Manchester and Lancashire need to be reclassified into tier 3. The Minister said that negotiations with local leaders are key to deciding whether an area moves into a higher level of restrictions, and presumably a lower level as well, as we move forward—hopefully.
I would like to ask the Minister about the Prime Minister’s suggestion that Manchester was not placed in tier 3 because the local authorities refused. The Prime Minister said:
“I also hope that Opposition Members who are calling on me to do more in Greater Manchester will prevail on the authorities there to come into tier 3 and to help us to get there.”—[Official Report, Commons, 12/10/20; col. 32.]
Can the Minister explain to us how that works and what is happening?
As other noble Lords have said, and indeed as we said in the last debate about the “very high” statutory instrument, testing and tracing is absolutely vital. Jamie Driscoll, the North of Tyne Mayor, whose area is also in the second-highest risk tier, said the new system was
“like whack-a-mole without knowing where the moles are”,
because of failings in the test and trace system in his area. Can the Minister confirm that the contact-tracing app for England and Wales has sent only one alert about a coronavirus outbreak in a venue since it was launched two weeks ago, despite being used for millions of check-ins? This is despite the Government stating that hospitality settings such as pubs, bars and restaurants are a “significant” source of coronavirus infections, with data shared by the CMO suggesting that more than 30% of coronavirus exposure is in fact in pubs, bars, restaurants and cafés. Does the Minister accept that the absence of targeted venue alerts is undermining the core principle of this system? Will he devolve further responsibilities for test and trace to local leaders in the high tier, to help them take the action they need to avoid the economic damage of being placed in the highest tier of restrictions at a later stage?
Does the Minister share my concern that the focus on areas causing the most concern means that areas with comparatively lower infection rates risk being overlooked? The key word here is “comparatively”, because the goalposts keep moving as infection rates increase in certain parts of the country. Bristol’s case numbers, for example, are considered to be “low”, but would have been considered “horrific” two or three weeks ago. The noble Lord, Lord Scriven, was quite right: we have not had time to discuss real cases and real issues. These tiers may be the right way forward, and we certainly will not oppose these restrictions, but we have not teased out all the problems that are caused by the lack of real consultation and discussion.
Health Protection (Coronavirus, Local COVID-19 Alert Level) (Medium) (England) Regulations 2020
Baroness Thornton Excerpts(3 years, 6 months ago)
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Baroness Thornton (Lab)
I thank the Minister for his explanation of this SI and indeed of the others. I compliment him, as other noble Lords have been doing, on—I do not know what the word is; “sturdiness” is not quite right—his resilience under fire, apart from anything else.
In many ways, this might be the most important SI before us today because it concerns the whole of the rest of the country, which is subject to restrictions that we are all very familiar with and know about. The success of combating the virus will depend in part on those restrictions being adhered to by the rest of the country, so that communities do not move into the next tier. As the Minister said, coronavirus cases are increasing at a terrifying rate.
I want to ask particularly about London. While it seemed that lockdowns were happening mostly in the north, it now seems that London might be heading towards one. Indeed the mayor, Sadiq Khan, has been pressing the Government to put in tougher restrictions in the capital for some time, such as a ban on households mixing. I echo what other noble Lords, including my noble friend Lady Andrews, have said: why are the Government hesitating?
All London’s 32 boroughs have been placed on the Government’s official watch list, which highlights that they are areas of concern, but some are more concerning than others. Eight London boroughs are above the infection rate threshold of 100 per 100,000. Ealing is 136.9; Richmond is 133.3; Redbridge is 124.5. Some of those rates are higher than those for boroughs and cities that are already included in the second tier. This is an important issue because London has very diverse communities and some very poor ones. One of London’s great strengths and, in these days of Covid, vulnerabilities, is how mixed it is and how large its BAME communities are. We have already lost too many BAME fellow citizens, particularly those who work for the NHS. London has not been spared any of that.
Compared to London, Doncaster has an infection rate of 136.9 per 100,000 and is currently in the high tier. Leicester went into lockdown on 30 June with an infection rate of 135 per 100,000. My honourable friend Jonathan Ashworth has asked why the city of Leicester is in tier 2 with restrictions, yet Charnwood—the constituency of Edward Argar MP—where the infection rate is 150 per 100,00, is not. Why are North East Derbyshire, where the rate is 164, or Barrow, where it is 277, not in that tier? There are questions about why other areas have not been included.
Sadiq Khan says that across our city
“the average over the last 7 days is about 90 per 100,000. All the indicators that I have: hospital admissions, ICU occupancy, the numbers of older people with cases, the prevalence of the disease, the positivity, are all going in the wrong direction. Which means, I’m afraid it’s inevitable over the course of the next few days London will have passed a trigger point”.
Is that correct? When was the Mayor of London invited to a COBRA meeting? Have conversations happened at a senior level with the leading citizen of our capital city, as they should have?
As my noble friend Lady Donaghy said in her pertinent questions, we are very concerned about probity. At some point, there has to be a reckoning of the governance of the contracts that the Government have given during this pandemic. My noble friend Lord Robertson underlined that point, in relation to track and trace. My noble friend Lord Rooker also raised the issue, with his usual tenacity. My noble friend Lady Andrews asked the Minister the key question which has been asked all afternoon. I am not sure that I have heard an answer yet. Why did the Government ignore the advice they were given on 21 September?
On a lighter note, the Minister referred to “the rose garden”. My noble friend Lady Donaghy asks whether he means the rose garden at the White House in Washington or the one that Dominic Cummings occupied in Downing Street?
Lord Bethell (Con)
I thank noble Lords for a detailed and illuminating debate which focused, quite rightly, on the interplay between the local picture and the national one. If these restrictions are about one thing, they are about trying to make focused, local lockdown work, so that we can avoid another great, clunking, national lockdown, which would come at enormous social and economic cost. We have seen some incredibly impactful local lockdowns work in Swindon—it was an intervention there, rather than a lockdown—Luton, Leicester and other cities. We are determined to try to make these work.
Getting them to work, as the noble Baroness, Lady Donaghy, rightly said, totally depends on getting the interplay between national and local government right. I am grateful to her for reminding us that the LGA has welcomed these restrictions and the spirit of partnership between local and national government.
In response to the noble Baroness, Lady Donaghy, yes, we absolutely want to work with and deploy the expertise of local authorities. We also absolutely need to back major restrictions with the money to support those communities—the charities and civic institutions, the businesses that are hard hit and the individuals whose jobs are put at risk or who need to stand down. I reiterate the sentiments of the noble Lord, Lord Dholakia, who said we will end up more united than we have ever been. I would really like to dwell on that positive sentiment.
To reassure the noble Lord, Lord Rooker, environmental health officers have been part of our thinking from the very beginning, and reminding us of that has been central to these debates. We spoke about this in some detail in the debate on the “very high” restrictions so I will not repeat myself, but we have put in a huge quantity of resources. We now have 1,000 tier 1 central tracers and 90 contract tracing partnerships, and we have doubled the number of local protection teams. In answer to the noble Baroness, Lady Jolly, local partnerships are absolutely central to our response to Covid.
In response to the noble Baronesses, Lady Thornton and Lady Andrews, the situation in London is very much on our mind. We are in daily, if not more frequent, contact with Sadiq Khan, who has made his sentiments very clear. The encouraging thing is that with these restrictions, and the other investments we have made over the last months, we very much have a shared platform of data on which we can make joint decisions informed by the latest information—information which in no way existed in February, March and April. Talk of data in those days was wishful thinking rather than practical. With these restrictions we have a structure for applying local lockdowns, and we have a much stronger spirit of partnership between national and local government.
The noble Baroness, Lady Andrews, talked about exit strategies, which is a critical question. We have local Covid plans in place in every local authority, and these plans govern the response of the local authority and create a template for the response to the epidemic. These restrictions give a new poignancy to those plans and a new importance to the exit component. Only by working collaboratively with the communities in those local areas will the kind of behavioural changes and containment strategies that can lead to exit really work.
The noble Lord, Lord Robertson, asked about Scottish interoperability. I completely share his frustration, but it is an aspect of the mobile phone app phenomenon that they tend to interfere with each other. We are working with the Irish, Welsh and Scottish DAs to bring about the kind of interoperable nirvana of which he dreams. We hope to introduce a new version shortly.
I would be very glad to write to the noble Baroness, Lady Uddin, with the protocols for those caring for the vulnerable. Those protocols exist and I would be glad to share with her a link to them.
To answer the noble Lord, Lord Rooker, youth clubs are open. There are extremely detailed guidelines for making them Covid-safe; that is the only way in which young people can mix together in those youth clubs. Again, I would be very glad to share those guidelines with him if that would be helpful.
Towards the noble Lord, Lord Bilimoria, I feel a degree of resentment. I thought that I was the country’s leading evangelist and advocate for mass testing, the power of surveillance and innovative technologies such as LAMP and lateral flows, but it seems that the noble Lord has stolen my crown, because he is absolutely the No. 1 evangelist for them. I applaud wholeheartedly his sentiments on that matter.
I am genuinely touched by the kind comments that people have made about these debates and my contributions to them. They are really important; there is a huge amount of them—nor do I think they will stop any time soon. I am glad that this debate is happening on the day that these SIs have been brought into force, which brings a new relevancy to it. I extend my thanks to my opposite numbers: to the rota of spokespeople on the Lib Dem Bench and to the noble Baroness, Lady Thornton, for her enormous stamina. She has been in lock-step with me all the way, and I am grateful to her both for her insightfulness and for the collaborative way in which she has gone about these debates. I extend my thanks also to the Whip, my noble friend Lady Penn, who has been a huge support and demonstrated massive stamina.
My noble friend Lord Eccles asked about the relevancy of these debates. They are absolutely relevant. There are instances where what has been said in this Chamber has been carried into the decision-making and discussions of policy as it has happened. On masks and face coverings, on the importance of sharing data with local authorities, on issues around shielding and communications to the vulnerable, on the role of local infection control and the directors of public health, on the entire areas of social care and mental health and on the impact of restrictions on the economy, noble Lords have expressed clear, insightful and well-informed views and wisdom, and those views have been shared in the decision-making process. It has been a demonstration of this Chamber at its very best.
Covid-19: Great Barrington Declaration
Baroness Thornton Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, there is some shared interest with those who drafted the Great Barrington declaration. They quite rightly make observations about the impact of the pandemic on education, and we are providing £1 billion to support those whose education has been hit by Covid. They make observations about support for those who are shielding, and we have written a new letter to 2.2 million people who are undergoing shielding. However, the noble Lord is entirely right: this is Johnny Bananas science, and we will not support it.
Baroness Thornton (Lab)
My Lords, the Minister and I are in complete agreement about this. The scientific understanding of Covid-19 suggests that having had the virus does not guarantee immunity. In fact, cases of second infections are emerging around the world. Does the Minister agree that, until we have a vaccine, this proposal is both dangerous and uncertain, and begs the question of who decides who needs to lock themselves away, and for how long?
Lord Bethell (Con)
The noble Baroness is entirely right. Not only is the evidence of reinfection mounting—a source of huge disappointment, frankly, but something that we have to realistically face up to—but the evidence of long Covid is also mounting, with nearly one in 10 young people infected with Covid reporting some kind of ongoing illness, and many reporting extremely worrying neurological, cardiac or renal damage. This is not flu; this is not a complex cold; this is not a posh version of a duvet day. This is a very serious infection that leaves a long effect on those who are vulnerable, and even on the young and fit. We should be very wary of it.
Health Protection (Coronavirus, Restrictions) (North East of England) Regulations 2020
Baroness Thornton Excerpts(3 years, 6 months ago)
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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.
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.
Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020
Baroness Thornton Excerpts(3 years, 6 months ago)
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Baroness Thornton (Lab)
My Lords, the contributors to this debate have asked the Minister pretty much all the questions that need to be asked on this issue. Perhaps I may say to my noble friend Lord Campbell-Savours that I would not have minded if he had been here doing this job, because he is definitely the expert on face masks in the House.
I want to make two procedural points. First, as we move forward to discuss face masks, I cannot see any reason why we would not be discussing them before regulations are made. If there are to be any changes to the regulatory regime around face masks, I cannot see that emergency legislation needs to be used. The House is perfectly capable now of discussing whatever needs to be changed, as the science evolves, prior to enactment rather than several weeks after. Secondly, I cannot resist teasing the Minister about the fact that the Secondary Legislation Scrutiny Committee has asked the Government if they can please take care about not publishing three amended statutory instruments to correct the mistakes that they made in the first one—and they did it within 24 hours. It said:
“The Committee has noticed a recent increase in the number of correcting instruments, with several Coronavirus instruments having to be revoked or amended immediately after laying … We therefore remind all Departments to check all instruments thoroughly before laying them before Parliament”.
I think that probably counts as a B.
The noble Baroness, Lady Finlay, was correct to say that the need to wear masks was about protecting each other. The Prime Minister said last week, concerning the sharp rise in coronavirus cases across the UK, that the country had become blasé about following restrictions designed to bring the pandemic under control, but I think a lack of enforcement is partly to blame. The Prime Minister’s father, former MEP Stanley Johnson, has been pictured three times either not wearing a mask or with one tucked under his chin, in places where face coverings are required: a London shop, a Tube station and an airport.
Therefore, it is legitimate to ask the Government not specifically about Stanley Johnson’s conduct but about what assessment they have made of the levels of compliance and of people’s reasons for not following the rules. Perhaps it is because the rules are changing so quickly and are confusing, or because people are becoming blasé. As I have said, I travel in and out of London on Tubes and buses every day; as the Minister said, the wearing of masks is significantly better than it was a month ago. There is absolutely no question of that. However, there are still people refusing to wear them.
Business enforcement is an issue here. Shops and supermarkets are required by law to inform customers to wear a face covering—unless they have an exemption—which they do through signs or by telling them when they enter the premises. This is enforced by local authorities and businesses risk a fine if they fail to do so. However, there is concern that the Government may not be following through on their own advice. Four retailers—Sainsbury’s, Lidl, Morrisons and B&M, the homeware stores—were issued with warning notices by Barking and Dagenham Council in east London, after their staff were seen failing to enforce mask-wearing and social distancing by customers. After the enforcement notices were issued under anti-social behaviour legislation, stores were understood to have complained to the Department for Business, Energy and Industrial Strategy. It has been reported that a senior official at BEIS then telephoned the council and said that it
“did not have powers to enforce these guidelines using the Government’s Covid-19 emergency powers”
and that
“the action had caused a negative reaction from the operators”,
according to a letter of complaint from the council to Alok Sharma, the Business Secretary.
This is rather important. Can the Minister confirm these reports? If so, does he share my concern that maybe his colleagues are undermining these regulations, and public health? Who will enforce these regulations, and how? As the Minister said, the British Medical Association has called for face masks to be mandatory in busy outdoor areas as well as indoors, and where there is a risk of coming within two metres of other people, including in offices. It is clear that most workplaces were never designed for people to work two metres apart. The Government need to revisit the science and enforcement of wearing face masks. It would be great to have that debate before enactment.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
Can we try the noble Baroness, Lady Uddin, again?
Covid-19: Local Restrictions
Baroness Thornton Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
Well, my Lords, our rule—if there is a rule—is that we are clear that our measures should be locally led. We work with local leaders first and communities to take swift action to prevent and manage outbreaks, ensuring that our responses work for them, supported by a national service which they plug into. It is for that reason that we are considering local tiers. Local alert levels or tiers are designed to standardise the interventions in place in local areas across England to make it easier to communicate what restrictions apply, and in what areas, to the public.
Baroness Thornton (Lab)
I follow on from the question asked by the noble Baroness, Lady Hayman. I thought the answer was remarkable, but maybe the Minister did not understand the question. In March, the Government were very keen to work with all parties and many others to get the emergency powers in place and, since then, really it has been nothing—letters to leaders informing them, diktats to local government, and accusations of undermining the national effort when legitimate questions are asked and comments are made. As we face another spike, will the Government change their habits and let stakeholders and Parliament, including your Lordships’ House, play a fuller role in designing and agreeing the national effort?
Lord Bethell (Con)
My Lords, I take exception to the noble Baroness’s characterisation of our approach. In fact, local planning and response are recognised as an essential part of our response to Covid, and are very much at the heart of the service. We want to have local outbreak control plans across the country. The development of local outbreak control plans is led by directors of public health; they are done on behalf of upper-tier local authorities, where the statutory responsibility for directors of public health sits, and are regularly reviewed by the local NHS, GPs, local employers, voluntary organisations and other community partners. There is also a link with local resilience forums, integrated care systems, combined local authorities and directly elected mayors as appropriate.
Health Protection (Coronavirus, Collection of Contact Details etc and Related Requirements) Regulations 2020
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
I begin every discussion of statutory instruments these days with a preamble outlining our serious concerns about the way in which decisions have been made, announced and brought into law. Somebody said, “Groundhog Day”—I think it might have been me last time—and it sort of feels like that.
In the case of these regulations, there is no justification for their having been laid at the eleventh hour using an urgent procedure. In his introduction, the Minister used the word “housekeeping”. That is an inappropriate word for what is democratic accountability. The app has taken six months to roll out and, in that time, thought should have been given to these regulations and key stakeholders should have been consulted. Those stakeholders should have included the industries affected by them, and local government, as several noble Lords have mentioned. That can only help the Government to allow time for those who are going to have to implement the regulations to review them, which would prevent mistakes and reduce the need for amending regulations. As noble Lords will be aware, we have regulations that have had been amended and regulations that have been revoked. A bit of thinking about this could avoid wasting our time and that of the Minister and his officials. Lead-in time to prepare new regulations is vital.
The NHS Covid-19 app was finally rolled out across England and Wales on Thursday 24 September; it uses Bluetooth technology in smartphones to keep an anonymous log of people with whom an individual comes into close contact. However, as we know, it has been plagued with problems, including the fact that up to 70,000 users were blocked from logging their positive test results. Can the Minister explain how that was able to happen? There was never an issue with test results from Public Health Wales labs. I understand that that oversight has now been corrected, but I fear that confidence in this technology is being further eroded.
I am concerned that the UK’s contact tracing apps are not cross-compatible. Plenty of people regularly cross the border between England and Scotland, but the NHS Covid-19 app and Protect Scotland do not seem to work in conjunction with one another. Positive test results from one nation cannot be entered into another nation’s app—is that true?—and alerts can be received from only one app at a time. This is obviously worrying, so what steps are the Government taking to develop interoperability—a terrible word, but I could not think of another one—between the three UK apps to ensure that contacts between citizens are reliability identified? Does the Minister acknowledge that this could be important to citizens in the border regions of England and Scotland?
It is of course great that 14 million people, including me and my family, have downloaded the NHS Covid-19 app in England and Wales; that is some 24% of the UK population of 66.5 million. However, public health bodies the world over have said that Covid-19 contact tracing apps need to reach a 60% adoption level to give the population effective uptake, so it seems to me that more work needs to be done to reach the 58 million smartphone users in the UK, which is far more than 60% of the population. Why do the Government think that people have not downloaded these apps? Can the Minister confirm that one of the main barriers to the wider use of these apps is compatibility? One in five iPhones and 8% of Android smartphones currently in the use in the UK are deemed to be too old, a matter I have raised with the Minister before. Moreover, I understand that the newest models of Huawei smartphones, launched in May 2019, will not be able to run the app due to a ban on sharing technology. Is that true? Does the Minister share my concern that significant numbers of smartphone users are locked out of digital test and trace?
I now turn to the use of the QR code as a precondition of entry. I shall add to the questions that have already been asked. Has the Minister and his officials read the Big Brother Watch brief on this? It is very interesting and says that those of us on the Parliamentary Estate are not complying with the Government’s rules and the laws in these regulations, so that is a matter of some concern. I confess that I have not used a QR code on entering our canteen. I will do if that is what I am required to do, but I did not realise that I was supposed to. I would hate to think that we on the Parliamentary Estate are in breach of these laws. However, people who are older, on lower incomes or are less familiar with this technology are sometimes being humiliated because business owners do not understand the regulations or are applying them in an inappropriate way. There are a series of questions that the Minister needs to answer to make these things work.
Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab) [V]
I start by asking the Minister a procedural question, as other noble Lords have. Will we in this House get to discuss the statutory instruments following the debate on the renewal of emergency legislation in the Commons? We know that the Commons will be able to vote. My understanding of what the Minister has said is that we will not get to see these statutory instruments in advance. I had been rather optimistic and excited, because I thought we might see an end to the dozens of pointless, time-expired statutory instruments that we have had to endure for the last few weeks and months—and indeed can look forward to between now and Christmas.
I fully understand why the noble Lord, Lord Lamont, is frustrated by the rule of six and has asked many pertinent questions. I thank the noble Lords, Lord Hunt, Lord Liddle, Lord Lipsey and Lord Wood, and the noble Baronesses, Lady Donaghy, Lady Massey and Lady Mallalieu, for making strong, sensible and quite often witty remarks today—which is quite hard when you are discussing statutory instruments that have already been in place a couple of weeks. The theme running through their remarks, and those of other noble Lords today, is that we are all fed up with these unsatisfactory legislative and accountability decisions.
I have a few questions of my own. As we know, it is now illegal for groups of more than six to meet. That is simple and clear, we are told by the Secretary of State and the Prime Minister. The law applies to all parts of England, except of course places with local lockdown rules, where the rules may be tighter. It is therefore clear, as long as you know the rules and the lockdown situation in your area. We are told that the reason for this restriction is the rise in coronavirus cases in England. The Government have decided to lower the number of people allowed to socialise at any one time to help keep people safe. Scotland took similar steps, cutting the number of people who can meet but excluding children under 12. Wales too has its own rule of six, which came into force on the same day, but it does not apply to children under 11 and covers only indoor meetings. Northern Ireland has stopped people meeting indoors completely, but allows six people to meet in the garden and up to 15 in a public area.
Can the Minister please point me to the science that has led to all these different decisions? His explanations did not provide that, and I dispute the idea of this being at all simple. We did not see an impact assessment. Would it be possible to see one? When is the effectiveness of the rule of six to be reviewed? When will there be an assessment of its impact on the young? The Children’s Commissioner has asked for children to be excluded from the rule in England, and I agree with that.
Last week, when she responded to the Prime Minister’s Statement, my noble friend Lady Smith pointed out that she could have breakfast with one group from this House and lunch with a different group—I think she even invited some of us to join her for a curry in the evening. This was to demonstrate the fact that the rule is flexible and probably rather unclear. I think that she is right, and I am looking forward to having a curry with my noble friend.
These rules will work only if people comply. While the police have powers to fine people who break the rule of six, forces in England and Wales have said that they will do so only as a last resort. I do not understand how that works, because people will be in a group of six or more only for a very short time. How on earth will the police issue warnings to all those people and then watch them to see whether they get themselves into another group of more than six? Can the Minister confirm how many fines have been issued for breaking the rule of six and their value? The penalty for failing to wear a mask or breaking the rule of six has now doubled to £200 for a first offence. I would like to hear from the Minister whether that is working as a deterrent.
The Metropolitan Police also said that officers will not generally pursue people retrospectively—whether famous or otherwise—if photographs or video footage emerge of them breaking these rules, including the rule of six. Does the Minister agree with that approach? Does he share my concern that people flouting the rules and getting away with breaches undermines public faith in their effectiveness? Perhaps that could act as a deterrent.
On the other hand, does enforcement of the rule of six rely on people grassing up their neighbours? Can the Minister confirm how these regulations will be enforced in public spaces? For example, if an employer suspects that two or more groups of six in his pub are actually together, and in breach of the rules, what enforcement action are they required to take?
One of the more controversial exemptions from the rule of six is for those involved in certain sports, including shooting and hunting. Will that also be reviewed? Does the Minister accept that these are often social occasions and that, if we follow his line of thought on pub curfews, people will be less likely to observe social distancing guidance across the piece?
In other words, it is a very confusing framework and the rule of six is very far from being simple.
Covid-19 Update
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab) [V]
I thank the Minister for this Statement, which was made yesterday in the Commons, and for the one made on Thursday in the Commons. It seems like a good idea to take them both together, since the news about the unreported and untracked positive tests needs urgent scrutiny, and the Minister does not have to suffer double the pain of explaining the very real problems we face with the winter and the second spike.
For example, today, we see another increase in positive tests—14,522 cases reported, with two-thirds of those in the north and north-west. To summarise, we have had people being told to travel hundreds of miles for a test; hundreds of children out of school unable to get a test; tracers sitting idle, watching Netflix; care home tests taking days to be processed; the Minister’s hyperbole, saying this could be a moment of national pride, like the Olympics; and a Prime Minister in a complete muddle over the rules. The Prime Minister seems to be able to learn large chunks of Greek by heart, so why, when he does regional media, could he not at least learn which lockdown rules apply where? It is not much to ask.
The questions from my honourable friends Jonathan Ashworth and Stella Creasy in the Commons yesterday were very pertinent. The reason why they needed to ask what the contractual teams were for the contracts supplying test and trace is that they are not working well and a large amount of public money is being spent on them. Is it not sensible to ask if there is a break clause if goods being purchased with public money are faulty or not working properly, given that they have been sold to us as world-class and planet-beating? What did the Secretary of State say to these questions? Unfortunately, he reverted to the government line of blaming Public Health England. Can we see the terms and conditions and profit margins on all these contracts? Is it true that there is no break clause addressing whether these contracts do what they are supposed to? As the former chair for a few years of the procurement committee of a local CCG, at a very lowly level in the NHS, I can tell the Minister that these are vital questions which have to be asked—questions for which I would expect to be held to account.
Does the Minister agree that transparency would ensure proper governance and accountability for those charged with the stewardship and responsibility of spending public money? Let us examine this for a moment. Is it true that Public Health England’s older version of Excel has a 65,536-row limit, meaning that, in the data transfer from the big CSV file, rows were chopped off? Can the Minister confirm that the data could not be handed over to Public Health England due to the size of the Excel spreadsheet files? Why are critical databases in a national pandemic being hosted on Excel spreadsheets? Is it true that the upgrade to a later version of Excel, which copes with just over 1,000,000 rows, costs about £100? Is this an issue with one particular lighthouse lab or across all the lighthouse labs? Public Health England’s sources say that they report the data when they get it from NHS Test and Trace, so if the information is coming in incomplete, they cannot do their job.
We know that the budget for test and trace is in the region of £10 billion to £12 billion, and it seems to me that an IT audit might have been a good place to start. Was there one? What did it say? We know it is true—so, presumably, does the Secretary of State, who is ultimately responsible for Public Health England—that Public Health England’s budgets were cut by 40%. So, is it the case that Public Health England had no IT upgrades of any kind recently? Given what we know, is it legitimate to ask where all that money has gone?
Why in October, after all the promises of the Prime Minister, the Secretary of State and the noble Baroness, Lady Harding, are we now facing the possibility of 60,000 people unknowingly spreading Covid in their homes and communities, which might account for some of the sudden increases seen today? Have all those people been contacted, traced and isolated?
These are not irrelevant, disloyal or silly questions: they are vital if these matters are to be remedied. They are vital if the Government are to dispel what communities are feeling, described on Sunday by the leader of the Labour Party, Keir Starmer, as
“This deep sense of despondence, anxiety. And actually, what they want is hope.”
We on these Benches want the Government to do that: to give hope. Assuring us that they have everything under control will, however, not work anymore, because it is clearly not true.
Surely, what is needed is transparency and a strategy, expressed with clarity, that everybody understands and supports. It is, furthermore, urgent. Tonight, a group of leaders of the largest councils in the north—Manchester, Leeds, Newcastle and Liverpool—has written to the Prime Minister asking for, among other things, significant local control and support. I beg the Minister not to chant the mantra that test and trace are working closely at local level, because clearly they do not believe that it is. Again, it does not seem to be true. I hope that the Government will respond positively to these councillors.
Yesterday, Jeremy Hunt asked whether responsibility for NHS and care home staff testing should be moved to hospitals and laboratories, and that idea was repeated by the Nobel laureate Paul Nurse, of the Crick Institute, on the radio this morning. The fundamental problem is that there is no strategy: there is a vacuum. That is because there is division in the Cabinet over which strategy should be followed. This needs to be remedied and a clear way forward explained.
Finally, with regard to the part of the Statement concerning treatment: will the Minister clarify whether the establishment of Orbis will be in co-operation and collaboration with EU medicine protocols or in competition with them? Will Parliament scrutinise Orbis, and when?
Baroness Barker (LD)
I thank the Minister for yet again turning up at the crease to defend what is becoming increasingly indefensible: the poor performance of the NHS Track and Trace system.
The noble Baroness, Lady Thornton, was right to note the admission in this Statement that 16,000 positive results had not been uploaded, and that by yesterday only 51% of those people had been contacted, despite the injection of resources into NHS Track and Trace over the weekend to try to make up the deficit. Given that we know that each person who tests positive is likely to report between four and five contacts, that is potentially 60,000 people who last week were walking around, not self-isolating and possibly infecting others. It is not their fault—they did not know. It is a really significant breach of trust.
In the part of the Statement that I find most curious, the Secretary of State said that the Chief Medical Officer’s analysis of the Government’s assessment of the disease as a result of the new data was that
“its impact has not substantially changed.”
Can the Minister give us further detail about that? The omission of 60,000 people not having any impact does not add up at all. The Secretary of State went on to say that the Joint Biosecurity Centre had confirmed that
“it has not impacted the basis on which decisions about local action were taken last week”.—[Official Report, Commons, 5/10/20; cols. 625-6.]
When will that data come through and when will we be able to see the impact on local areas? As these statements make clear, the virus is beginning to have different impacts in different places. Can the Minister say at what point directors of public health were informed about this breach? Six months in, it is clear that, when local authorities are properly resourced and given correct and timely information, the virus is managed and contained. The major problems come about when decisions are made centrally, poorly communicated and badly executed.
Time and again, it comes back to track and trace, whether it is about a lack of skills and capacity or a lack of foresight. Who could not have foreseen the impact that hundreds of housefuls of students moving around the country in September would have on transmission?
Yesterday when this Statement was debated in another place, speaker after speaker, mostly from the Conservative Benches, got up to complain about the effect of the 10 pm arbitrary cut-off. They explained how well-run businesses, especially in the hospitality sector, will be going to the wall because of continued use of blunt instruments designed nationally and applied over wide geographical areas. How long will it be before the Government realise that local people—local professionals, directors of public health and environmental health officers—have detailed knowledge about businesses in their area, their hygiene ratings, their previous breaches of licensing conditions and where crowds congregate? When we can get decision making to a more local and granular level, we will be better able to protect good businesses without jeopardising public health.
I welcome the announcement of hospital funding for upgrades to A&E departments. We need a greater capacity for A&E. However, could the Minister give the House the definition currently used by this Government of what constitutes a new hospital?
On the Orbis project, we go into this having left a safe and highly effective system of medicines regulation, one where patient safety is paramount. How does the Government propose to withstand the commercial imperatives of American pharmaceutical companies in these circumstances?
The public are getting very worried about the extent to which the Government continue to wing it. It is time for them to bear down on the fundamental flaw in their strategy—thinking that they know best in the centre, above people who are professionals at a local level.
Covid-19: Adult Social Care Complaints
Baroness Thornton Excerpts(3 years, 7 months ago)
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The Lord Speaker (Lord Fowler)
Baroness Warsi? We will move on to the noble Baroness, Lady Thornton.
Baroness Thornton (Lab) [V]
My Lords, given the pattern and themes of complaints emerging during Covid, what will the role of the Health and Social Care Ombudsman be in the forthcoming inquiry into the pandemic? Will the Minister give a guarantee of full involvement of that ombudsman, given the evidence it can bring to the table?
Lord Bethell (Con)
My Lords, the nature of any future inquiry has not yet been defined. However, all parties will be taking learnings from Covid and bringing forward their lessons-learned experience. As the major regulator, the CQC will play a leading role in bringing together the data and information from the front line but, as the complainant of last resort, the ombudsman will also play an important role in that process by bringing insight from patients and those who have made complaints.