Public Health

Mark Harper Excerpts

Tuesday 30th November 2021 Commons Chamber

[Maggie Throup]

I am sure the people my right hon. Friend is referring to will have heard him loud and clear. We all enjoy socialising but, as he will appreciate, we are in a difficult situation. However, we also have personal responsibility.

We are confronted with an emerging threat, which is familiar but not yet well known. The measures that we are putting in place are proportionate, precautionary and balanced, and are being made in response to the specific threat.

Late last week, the challenge arising from the latest covid-19 threat from the variant of concern known as omicron emerged. Public health officials in South Africa shared information on the omicron variant and it was identified as a coronavirus variant of concern. Thanks to our world-leading genomic sequencing experts at the UK Health Security Agency, we were able to identify that some cases of the new variant are present in this country. So far, we have identified 14 cases in the UK and, unfortunately, we expect to find more in the coming days.

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

The Minister mentioned the UK Health Security Agency, the head of which my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) was referring to. Dr Harries said two things this morning. First, she said that people should not socialise. Secondly, she also implied—only implied, to be fair—that people should work from home. When the Prime Minister was asked about that, he made it clear that that was not the Government’s position and that people should follow the advice. I listened carefully to the Minister’s answer and I do not think that is quite what she said. Could she be clear that Dr Harries was speaking only for herself, not for the Government?

[Maggie Throup]

As my right hon. Friend said, the Prime Minister said that we are putting these measures in place, about which I will speak more. I cannot speak for any other person who goes on the airwaves.

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[Mr Harper]

Will the Minister give way on the timing?

[Maggie Throup]

I know I keep saying I will take one last intervention, but I give way.

[Mr Harper]

I am very grateful. I listened carefully to what the Minister said about the timing. The Government have said that they are going to review these measures after three weeks and she is right—on the face masks, the regulations expire on 20 December—but the self-isolation SI has no expiry date, which means it will run all the way until the main statutory instrument expires on 24 March 2022. Why is that?

[Maggie Throup]

My right hon. Friend makes a very good point. I would like to reassure him that we will continue to update the House over the next few weeks, that we will not continue to have these regulations in place for any longer than is necessary, and that—[Interruption.] If I may just finish. The type of regulations he is referring to are reviewed under legislation every four weeks and are more likely to be reviewed every three weeks. I understand his point and I do take it very seriously. I wish we were not in a situation where we have this conflict, but I reassure him that I take his point very seriously and these measures will not be in place for any longer than is absolutely necessary.

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[Maggie Throup]

No, I must make progress.

The self-isolation regulations were introduced to provide a legal requirement to self-isolate for individuals who have been notified that they have tested positive for covid-19 or that they are a close contact of a positive case. On 16 August, thanks to the success of the vaccine roll-out, we were able to introduce a number of exemptions to self-isolation for close contacts, including for those who are fully vaccinated or under the age of 18 years old. Given the greater threat that may be posed by the omicron variant, we have reviewed the application of these exemptions. This latest amendment to the self-isolation regulations is targeted at helping to slow its spread. From 4 am today, all individuals notified by NHS Test and Trace or a public health official that they are a close contact of a confirmed or suspected case of the covid-19 omicron variant are legally required to self-isolate for a period of 10 days, regardless of their age or vaccination status.

[Mr Harper]

Will the Minister give way on that one point?

[Maggie Throup]

No; I have been very generous up until now.

Anyone who has been notified as testing positive for covid-19, regardless of the variant, will continue to be legally required to self-isolate. We appreciate that self-isolation is not easy and that it places a burden on people, but we also know that it is highly effective in limiting the spread of the virus. The Canna model estimated the impact of testing—

[Mr Harper]

Will the Minister give way?

[Maggie Throup]

I really must make progress.

The model estimated the impact of testing and tracing and self-isolation on covid-19 transmission from June 2020 to April 2021. During the period of the study, the model found that testing, tracing and self-isolation had a critical impact on identifying cases of covid-19 and reducing onward transmission. The model found that between 1.2 million and 2 million infections have been directly prevented as a result. Additional assistance is available to those who are being required to self-isolate through the range of financial and practical support measures that the Government have put in place.

I am confident that these two sets of regulations represent proportionate precautionary and targeted action in the face of the new covid-19 variant, the risk of which we still do not yet fully understand. [Interruption.]

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[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak for the Opposition in this important debate.

The omicron variant is a sobering reminder that this pandemic is not over. We need to act with speed to bolster our defences to keep the virus at bay, and to keep each other safe throughout the difficult winter period. We on these Benches were critical of the Government’s slow response to the delta variant—slow to protect our borders, slow to act to reduce transmission in the community—so we welcome swifter action with regard to the omicron variant and, as my hon. Friend the Member for Tooting (Dr Allin-Khan) said in this place yesterday, we support the measures laid out in these two statutory instruments, one on face coverings and one on public health restrictions. It is right to be acting urgently given the seriousness of the threat, but it is sad to be debating these SIs after the fact; we need to build public confidence in whatever measures we bring in and it is always better to discuss them beforehand, rather than afterwards, to show that parliamentary scrutiny really matters.

[Mr Harper]

I am very pleased to hear the hon. Gentleman say that about parliamentary scrutiny. He will know that yesterday I asked the Government for assurances if they were to want to extend or strengthen these measures after the House has risen for the Christmas recess, as I feel that if that is the case the House should either continue sitting or be recalled. In answer to my question, the Leader of the House suggested that it would be up to the House. I therefore ask this of the hon. Gentleman speaking for the Opposition: if the Government were to bring forward strengthened measures or want to extend them after the House has risen, would the Opposition support the House being recalled so that we can debate and vote on the matters in advance, or is he prepared to give the Government a blank cheque?

[Alex Norris]

My predecessor as Member of Parliament for Nottingham North had a strong record on recall of Parliament in 2003 and would smite me down if I were to dismiss the right hon. Gentleman’s question out of hand. It is a hypothetical question, however, and I am not going to be drawn on that, but I will say this: when we were getting through the backlog of such SIs over the summer I said to the Minister at the time, the hon. Member for Bury St Edmunds (Jo Churchill), that I would have met at any hour at any time to get through some of them, since they were weeks and weeks delayed at some points. I have not changed my view on that.

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[Sir Graham Brady (Altrincham and Sale West) (Con)]

I shall be brief, but I have a number of concerns about the regulations, the first of which is about the manner in which they have been introduced. I am glad that the hon. Member for Nottingham North (Alex Norris) made this point in opening his remarks. Why on earth did the regulations come into force at 4 am today when we are here now, at 20 minutes to 2 in the afternoon, debating them? Surely it would have been possible to have a debate yesterday, or indeed to delay their implementation until this afternoon. I think that indicates a rather casual attitude to parliamentary scrutiny that persists in Government.

My right hon. Friend the Member for Forest of Dean (Mr Harper) has asked important questions about what will happen if the regulations are renewed after the three-week period, when the House is not sitting. We still have no clarity as to whether the House would be recalled or whether the regulations would simply be extended for a period of weeks without the House having the opportunity to comment.

[Mr Harper]

It is also worth saying that one of the things we get from Ministers when we press them on these things is about parliamentary time, but my hon. Friend will know that the House normally sits until 10.30 pm on a Monday. Looking at yesterday’s performance, the House got to the Adjournment debate at about quarter past 7. There were hours yesterday when the House could easily have debated both these measures, which means we could have debated them before they came into force. Even the Opposition agree that that is invariably the better solution when it is at all possible.

[Sir Graham Brady]

Absolutely. As a former Chief Whip, my right hon. Friend knows very well that there is always parliamentary time available when the Government want to do something; it is only when they are reluctant to do something that parliamentary time becomes elusive.

There is a further question as to why only one of the instruments before us has an expiry date in the regulations. Surely it would have been better to put an expiry date in place, which would have required some positive action to renew or extend the regulations if that was deemed necessary.

There are also serious concerns about the efficacy of what is proposed. We know enough about covid by now that we can see which interventions are ineffective. We can see that even full lockdowns possibly delay the spread of covid but do not eliminate it. In this instance, I am intrigued to know from the Minister exactly what action the Government propose if their research finds that this new variant is effective in evading the vaccines. Surely they do not propose to return to a full lockdown, knowing that that would simply defer the problem for a period of days, weeks or months.

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[Dr Whitford]

We do not suffer the same deaths, hospitalisations or outcomes from flu. [Interruption.] Well, we don’t. Look at 170,000 deaths over the last 18 months in the UK. We certainly have bad flu winters where we can get up into the teens towards 20,000, but we have never got close to 170,000 over 18 months.

[Mr Harper]

I know the hon. Lady has a great deal of medical experience, but she is referring to a period when we did not have vaccination. Am I not right in thinking that in a vaccinated population, the case fatality rate of covid is not remarkably different from that of influenza?

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[Dr Whitford]

It is very difficult at the moment. Cases go up and down and we swap positions. At the moment, Scotland has the lowest incidence of cases at 349 per 100,000. Northern Ireland has the highest at well over 600 per 100,000. Obviously, we have whole baskets of measures, so it is harder—other than in the review that the Royal Society published last June and in the BMJ paper from a week ago—to pick out exactly which measures are having the impact. The BMJ found that masks and hand hygiene were equal in their impact and, in fact, bigger in their impact than physical distancing. To me, they enable people to engage and enable people who are vulnerable to feel safe and to come out, because otherwise, those who were shielding will be stuck in their houses all over again.

Although mask wearing was not mandatory in England, it has remained in this Government’s guidance if someone is in a busy public space. I am sorry to say that that guidance has been undermined by what Members on the Government Benches have demonstrated on television every day. Initially, when we came back in the autumn, approximately five people wore masks, then the number more than doubled to 14, and after the measure was pushed, the proportion rose to about two thirds. On the day when mask wearing in busy places is meant to be promoted, about a third of Government Members are still not wearing masks.

People will be led by the example of not just the Prime Minister, but every one of us.

[Mr Harper]

Will the hon. Lady give way?

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[Steve Brine]

Having been a Minister of the Crown, I hope that the regulations have been through the right-round process, albeit an accelerated right-round process, but my hon. Friend is absolutely right. It will worry the travel industry that the regulations that have not been subject to a motion today are not being debated in the House—and yes, I am greatly concerned. I have to say that I agree with the Opposition about departure testing. Other countries, such as the Netherlands, have introduced it. I do not think that the Opposition have had an answer from Ministers about why they have not chosen to do the same, and I should like to hear an answer in the Minister’s winding-up speech.

[Mr Harper]

My hon. Friend has touched on an important point about the process within Government to ensure that all aspects are considered. What normally happens is that regulations are thought about and there is a right-round process—which, for the benefit of those listening to the debate, means that all Government Departments have the opportunity to provide an input. One thing we have discovered is that in the case of covid regulations, that right-round process does not operate in the normal way. Through my hon. Friend, I ask the Minister to clarify in her winding-up speech whether, as these regulations were being drafted, other Departments were consulted and given the usual opportunity to provide an input, or whether this was done purely in the Department of Health and No. 10 Downing Street.

[Steve Brine]

I thank my right hon. Friend for his comments, which will have been heard on the Treasury Bench.

I do not understand the timing here. What will we really know in three weeks’ time that we do not know now? This causes me to question the three-week rule. South Africa does not give us the insight into the progress of the virus, and of this variant, that we were able to take from, say, Italy—with a broadly similar European population—this time last year. South Africa has a much younger population, and, sadly, a greatly under-vaccinated population. As we heard from the hon. Member for Central Ayrshire, it was spreading like wildfire among students, who, of course, are younger and fitter and therefore less susceptible to serious illness as a result of this variant.

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

I shall endeavour to be mindful of that, Mr Deputy Speaker, and shall try to put some of those questions on the record for the Minister.

As many Members have said, and the chief scientific adviser agrees, covid is going to be with us forever and variants are going to be with us forever. This is the first test that we—the Government, the House and society—face in respect of how we deal with covid in a post-vaccine world, where we have vaccines and have vaccinated most of our population. It is important that we do not mess this up and fail that test. It seems to me that we need to respond calmly and proportionately, so I give the Government credit for resisting the calls for the economically damaging measures in plan B. Working from home, for example, does have significant economic consequences, as we saw from the Treasury’s own analysis. Vaccine passports are both illiberal and, as we have seen from the evidence—or lack of evidence—from Scotland, ineffective, so they are the worst of all worlds. They are an ineffective and illiberal policy, and we certainly do not want them introduced here.

Before I deal with the measures, I want to pick up on the point about the NHS made by the hon. Member for St Albans (Daisy Cooper), the deputy leader of the Liberal Democrats. She is absolutely right that the NHS is facing significant pressure, but it is not facing pressure from the number of patients in hospital because of covid, which is around 6% of total bed capacity. The NHS is under enormous pressure dealing with the significant number of patients who were both unable to be treated and scared away from the national health service during the pandemic. We must be careful not to repeat the mistake and scare away a whole new set of patients, as it will take the NHS another very significant period of time to deal with them. There is nothing about the measures that she suggested that will deal with those pressures; they will just make them worse.

[Daisy Cooper]

Although I recognise the right hon. Gentleman’s assertion that covid accounts for 6% of patients in hospitals, I urge him to think about the impact that covid in-patients have in the hospital setting. We know, for example, that for every one patient being treated, an entire ward can be taken out, because it has to be cleaned and if a staff member catches covid, they have to take time off work. I have asked the Government to produce an assessment and provide this House with the details of the impact of covid patients on the availability of beds, staff and elective procedures. Will he support me in asking the Government again to provide that assessment so that we can take an informed decision in this House as to whether these restrictions are necessary and how they may or may not help?

[Mr Harper]

I support the hon. Lady’s general call for transparency, but my point about the numbers is not an assertion; it is about looking at the data and seeing how many patients are in hospital because of covid. That information is published. It is not an assertion, but a fact. Secondly, if hospital trusts do what my trust does, they put covid patients together in hospital. My trust currently has one ward full of patients. It clearly has an impact, but it is not the thing that is causing the biggest problem. The biggest problem in my trust is that it has at least three or four times the number of patients who are not able to be discharged because of inadequate social care. That is the point that I have made several times in the House.

Mindful of your admonition to be relatively brief, Mr Deputy Speaker, let me touch on the regulations in front of us. On the face-covering regulations, they are relatively not damaging economically. I listened carefully to the speech of my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), and I agree that it is disappointing that we have moved away from a model where the Government lay out the evidence and the arguments and allow people to make their own decisions. That was a big choice that the Government made last year, and I am very disappointed that they have moved away from it. Weighing against that—this was set out very clearly by the Chairman of the Transport Committee, my hon. Friend the Member for Bexhill and Battle (Huw Merriman), and my hon. Friend the Member for Winchester (Steve Brine), a distinguished former public health Minister—is that at least those regulations have quite a tight expiry date, and they will expire in three weeks’ time. Although I do not like the move back to mandating, I am prepared on this occasion—balancing up the pressures, and because there is an expiry date—not to oppose the regulations, but I will not support them either.

On the self-isolation regulations, I am afraid to say that I am much more concerned, as was my hon. Friend the Member for Winchester, for two reasons. First, while Ministers have been clear that the regulations will be reviewed in three weeks—I will press the Minister on what we might learn in those three weeks—the regulations are not time limited; they amend another set of regulations that do not have an expiry date until March next year. Although the Minister tells me that they will not be enforced for a day longer than necessary, she must recognise that, given the events of the past few weeks and how Ministers handled, among other things, the standards measures, there has been a diminution in trust between Back Benchers and Ministers. Ministers must work hard to rebuild that trust. Having open-ended statutory instruments that do not expire for many months—when they are telling us that the measures only need to be in place for a few weeks—is not, I say respectfully to the Minister, how to build that trust.

Secondly, there is the point that my hon. Friend made. Let us remember that we are making the law, which should always be clear, precise and specific so that people know what their legal responsibilities are and what they are not. I am afraid that reference in the regulations to people who are “suspected” or “confirmed” as having the omicron variant, with no detail about what that is, is simply not good enough. I was trying to be genuinely helpful to the Minister when I intervened on her. I wanted to give her the opportunity to set out in her opening remarks—and I hope she will do so in her closing remarks—how the Government determine whether someone has the suspected omicron variant and what measures have been taken in terms of the scripts that are used by NHS Test and Trace, the information provided to people whom it contacts, the training that staff undergo, and, indeed, whether the app is to be changed to deal with the new regulatory approach. I am afraid that nothing in the regulations that I have seen gives me any confidence that those matters have been properly thought through. Despite what the Minister may or may not say at the Dispatch Box, the law should be clear in the regulations, and it simply is not. On that basis—how the regulations are drafted—I will oppose them.

Mindful of your instructions, Mr Deputy Speaker, I have only a couple more points. When I said that I was worried that the regulations would trigger a new pingdemic, it was picked up in a number of publications. Politico’s London Playbook, which is much read in the Westminster village, said that a Government insider, trying to allay concerns about a pingdemic, had argued that, because people no longer check into restaurants or pubs, they will not be contacted by NHS Test and Trace. They said that contact tracers are really only interested in catching contacts of cases coming into the country on planes. If that is true, I would suggest that the £30,000 million-odd we spend on Test and Trace is not terribly useful. I would be grateful if the Minister confirmed at the Dispatch Box whether what that Government insider has said is Government policy.

It has also been reported in the Financial Times that officials in the Department of Health and Social Care are drawing up contingency plans to require masks in many indoor settings, with a possible work-from-home order over Christmas. Apparently, these plans are being worked on by officials. Will the Minister confirm whether officials are working on such contingency plans? If they are not working on them under instructions from Ministers, can she, as a Minister, instruct them to stop working on such contingency plans and focus on the Government’s actual policies?

My final point is the one that I made yesterday. Ministers have said that they will review the measures in three weeks’ time, as of yesterday. That would be 20 December, when the House will have risen for the Christmas recess—I touched on this in my intervention on the Opposition spokesman. If any of the measures are to be extended, or if further measures are to be brought in, it would be unacceptable for Ministers to do it by decree, which is effectively what the Minister at the Dispatch Box did with these two orders. They should be brought forward to this House for a debate in advance of their coming in. If we have to sit in the days running up to Christmas, so be it. Many people in this country work over the Christmas period in many industries serving the public. We are better paid than most of those people, so if we have to come here and do our jobs, working on behalf of the public, to scrutinise the laws that affect their lives, then I for one am very happy to do so. It would be a failure of the responsibilities that Ministers have if they do not seek to keep the House sitting or recall it if they wish to take those powers. Ministers are accountable to the House and to our constituents through us, and they would be wise never to forget it.

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[Maggie Throup]

I am pleased to bring this wide-ranging debate to a close. We are now almost two years on from when this virus first emerged in Wuhan. Since then, science and disease have been locked in a battle for ascendancy. For the last year, science has been on top as the global effort on vaccines has dramatically reduced the risk of hospitalisation and death for those who catch covid-19, but we know from the history of previous diseases that they mutate and change, so that vaccinations and treatments become less effective. That is why only one disease, smallpox, has been eradicated, although we are close to eliminating polio, too.

The virus is fighting back, and we must respond. To those who say that the regulations we have debated—the reintroduction of face coverings in some settings and self-isolation requirements for close contacts—are an imposition on our liberties, I agree, but they are a necessary imposition to slow the spread of a new variant and allow science to catch up. However, there is a balance to be struck. Too many restrictions have a crippling effect on social and economic life, as well as adding to the burden of mental illness. For those who say that the regulations we have debated are not enough, I say that they will buy us time to understand this new variant better. That is why they will be reviewed in three weeks’ time.

We will continue to closely monitor all the emerging data on the new variant. We have committed to review all of the measures in three weeks’ time, ahead of the face coverings regulations expiring. Restrictions will not be in place any longer than necessary. We do need to learn to live with this virus, but it is right, in the face of a potential threat, to take balanced and proportionate measures, and we will continue to closely monitor all the emerging data on the new variant. Overall, I would like to reiterate that this will be a moving picture over the coming weeks. We will get a better idea of its nature in the next couple of weeks. Its transmission advantage, vaccine escape and severity of infection are some of the things we are looking at as we observe how the variant develops in southern Africa and the rest of the world, too. Alongside that, the scientists will continue to study it in the lab, but it will be several weeks before we get a clear picture. The most important thing is that the world keeps sharing information and findings as new cases emerge. I thank my hon. Friend the Member for Christchurch (Sir Christopher Chope) for raising an inconsistency in our explanatory memorandum at paragraph 12.3. For clarity, I will read out the section as it was intended:

“Furthermore, the policy will be supported by a communications campaign that will make clear that some people are exempt from these regulations and people should not be challenged by members of the public for not wearing the face regulation.”

I trust that that reassures my hon. Friend on the matter and on the seriousness with which the Government take supporting those who are exempt from these requirements. I will be working with officials to rectify this.

With respect to omicron-positive cases, NHS Test and Trace will work with the positive case and/or their parent to identify close contacts. Contacts from a school setting will only be traced by NHS Test and Trace where the positive case and/or their parents specifically identify the individual as being a close contact. There is likely to be a small number of individuals who will be most at risk of contracting covid-19 due to the nature of the close contact. I reiterate that the direct contact will be by NHS Test and Trace, rather than via the covid app.

My hon. Friend the Member for Winchester (Steve Brine) and my right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about suspected cases. My right hon. Friend hit the nail on the head: many of the laboratories processing the PCR tests will be able to test for the S-gene dropout and that will give a very good indication of cases of the omicron variant. While it does not provide 100% confirmation, we can get that information very quickly and at the same time the test result is reported and that is ahead of any genomic sequencing.

[Mr Harper]

Will the Minister give way?

[Maggie Throup]

I want to continue as many points have been raised and I was very generous in giving way when opening the debate.

A debate on this subject would not be complete without the Opposition spokesman asking about financial support for those in self-isolation. I reassure the Opposition spokesman that anyone who is legally required to self-isolate as a contact or positive case will be able to apply for a test and trace support payment or practical support such as the medicines delivery service if they meet the normal eligibility criteria. The latest figures show that almost 363,000 people have received a test and trace payment since the scheme began, and over £180 million has been paid out. The help is there.

We have set out proportionate and balanced measures which do not include limiting socialising. It is the Government who set policy and guidance, which is what the public should follow. The Secretary of State updated the House yesterday on the changes to the JCVI guidance for boosters and the NHS will be issuing instructions on how that guidance should be operationalised shortly.

These regulations are precautionary and proportionate, helping to safeguard the gains made by our fantastic vaccination programme, which has seen almost 18 million people across the UK get a booster jab already. The Government have acted rapidly and reasonably to ensure that science retains the upper hand in the struggle with the virus and I commend these SIs to the House.

Question put.