Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020

Motion to Approve

Moved by

That the Regulations laid before the House on 17 December be approved.

My Lords, despite all the pressure we are under, I would like to take a moment to celebrate some good news. The Government have today accepted the recommendation from the Medicines and Healthcare products Regulatory Agency to authorise Oxford University/AstraZeneca’s Covid-19 vaccine for use. This follows rigorous clinical trials and a thorough analysis of the data by experts at the MHRA, which has concluded that the vaccine has met its strict standards of safety, quality and effectiveness. We have hundreds of thousands of doses ready to go and 100 million on order—enough for everyone.

On 4 January, the NHS will start administering doses to a revised list that reflects many of the interventions by noble Lords in this Chamber in recent debates. While the vaccine project is an international collaboration, we should take a moment to recognise the contribution of the British life sciences sector and reflect that this easy-to-administer, affordable and mass-produced vaccine offers Britain a way out of this disease, and will make a huge impact on the global response.

But, in the meantime, news from the front line remains grim. While the November national restrictions drove cases down in most areas, it is now clear that cases are rising again at a worrying rate. Across the whole country, cases have risen 57% in the last week, driven by the highly transmissible new variant. The number of people testing positive for Covid-19 has increased rapidly and a growing proportion have the new variant. Data from 29 December showed that there were an enormous 53,135 new Covid cases across the UK—half with the new variant—an increase of 272,551 over seven days. NERVTAG has concluded that the new variant demonstrates a substantial increase in transmissibility, of around 70%, and the R value appears significantly higher, with initial estimates at 0.39 and 0.93 higher—a massive margin in epidemiological terms.

My Lords, we are at the point of a national emergency. If things continue as now, the NHS will fall over in the next few weeks. The virus is moving at frightening speed, yet the Government have not kept up. The time for the Government to follow public health and not public opinion is now. Hope is on the horizon with the vaccines, but short-term action is more important to keep people alive than extenuating future positives.

These regulations were too little, too late. Today the Government have to go further. The balance between the economy and saving lives is difficult, but you cannot contribute to the economy if you are dead. Government policy based on balancing the splits in the Tory party over lockdowns has to stop. The number of new cases, people dying and the stress on the NHS show that further action is required now, to slow the spread of the virus, keep people alive and protect the NHS. The Government have to follow the SAGE advice and implement a lockdown until R is well below one.

Evidence shows that secondary school pupils do spread the new variant, and therefore action is required on secondary school openings. Not to do so will endanger public health. To mitigate the educational issues facing young people, a Covid-19 premium must be implemented and given to schools so that young people get the support they need to catch up. This should be in place for the whole of this Parliament and not just a payment to schools for the next few months.

The NHS is getting to the point of not being able to cope. When will the promised insurance policy Nightingale hospitals be open to take, in London, say, 100 Covid-19 patients, rather than transferring people over 300 or 400 miles? People seek decisive and evidence-based leadership from government—not to do so is the biggest gift for the virus. These regulations have not stopped the speedy spread of the virus and deaths. Further action is required now.

Dame Deirdre Hine’s report on the 2009 influenza pandemic recommended raising public awareness and understanding about the key characteristics of a pandemic and core response measures. Yet we learned little. A failure of public communication through excessively optimistic mixed messages has led to deepening distrust. Some reporters, such as Fergus Walsh, have explained the scientific and clinical reality well, but we need clear, consistent messaging across the UK, sharing uncertainty and true risk. For example, the B.1.1.7 variant infectivity in effect adds more than 0.4 to the R number. The current reality is proving even worse than the modelling predictions for the coming months for bed shortages, overloaded services, staff infections and exhaustion. Second-time infections are now presenting, as antibodies seem to be short-lived.

Yes, the vaccine is brilliant news; it should prevent fatal infection. But infection control measures will remain essential in the long term. We do not know how long the immunity will last, whether those immunised will still get infected and be viral carriers and spreaders, nor how rapidly further mutations will develop, leading to the need for new modifications and new vaccines. Will the Government collate immunisation data from the NHS number with diagnostic data in the long term to understand the epidemiology as it evolves? Mixed messages and false hope fuel mistrust. Control will only be achieved by collaboration with the public when they understand that vaccination is not a quick fix.

My Lords, it is ironic, is it not, that on the very day that we are considering the European Union (Future Relationship) Bill, which should, in theory, make government far more accountable to Parliament, we are also considering yet more restrictions, retrospectively, which suggest that, in practice, we are moving in the opposite direction. If I were speaking in the Bill debate later today, I would applaud the achievement of the Prime Minister and the noble Lord, Lord Frost. It is immense, not least because it was secured in the face of sustained “scrutiny” by your Lordships’ House and the other place at every single step of the way.

I do not mean to detract at all from the fantastic progress made in finding a vaccine. I welcome today’s announcement that the AstraZeneca vaccine has been approved. It is, of course, wonderful news, but equally welcome would be a new approach by the Government of engaging with parliamentarians, such as Mark Harper in the other place, on cost impact assessments, for example —an issue so ably addressed by my noble friend Lady Neville-Rolfe in the debate on her regret Motion earlier this month.

Difficult decisions have had to be made; doubtless, more lie ahead of us. That is why I would urge the Government to make this new year’s resolution: to trust Parliament more and to treat it with the respect it deserves. That is the best way, indeed the only way, we are going to emerge from such a testing time as a renewed and reinvigorated parliamentary democracy, able to embrace the exciting opportunities afforded to us by our future relationship with the EU.

My Lords, I remind the House of my membership of the GMC board. We meet while the NHS is under huge pressure, with a record 53,000 Covid cases reported yesterday. Yet the Government’s record has been one of delay, indecision and vacillation.

The errors in the spring were compounded by the Government’s decision to ignore the advice of SAGE given in September for a two-week circuit breaker. Then on 2 December, a consensus statement signed off by SAGE warned that additional mixing to be allowed at Christmas could have a large impact on prevalence. Again, this was ignored by the Government. On 9 December, the Health Service Journal was reporting a rise in admissions. Yet still Christmas plans remained unchanged. On 14 December, the Secretary of State updated the Commons on the new variant associated with the faster spread in the south-east of England. The next day, the Health Service Journal and the British Medical Journal called for the Government to respond to this worsening situation by cancelling their plans to allow household mixing over Christmas and tightening the tiered restrictions immediately. This was ignored. On 16 December, Boris Johnson dismissed concerns raised by Sir Keir Starmer. Three days later, we saw the U-turn which sent thousands of people on to overcrowded trains, exporting the new variant far and wide.

Have the Government finally learned their lesson? I hope that this afternoon they will show they are prepared to act decisively. I also hope that, with the fantastic news today of the approval of the Oxford AstraZeneca vaccine, the Government are able to raise the weekly vaccination rate up to 2 million a week, as Professor Neil Ferguson has recommended. I also hope to hear from the Minister what plans they have to reduce the immediate pressures on the NHS. Are the additional nearly 30,000 doctors who were brought on to the GMC’s supplementary list really being used sufficiently to help the NHS?

My Lords, the last time that we discussed restrictions, I asked the Minister whether volunteers would be used for non-medical tasks to improve the speed of testing and tracing. The Minister dismissed the idea. Now they are asking for volunteers to marshal patients in vaccination centres. Will he now recognise the important role of these public- spirited people and tell us what resources will be given to St John Ambulance to organise them?

The Government spoiled Christmas for head teachers by insisting, on the last day of term, that schools should open on time next week and that all children and staff should be given the rapid test. Yet virtually no time, money or person power has been provided to enable them to do this. While I believe that keeping schools open safely should be a priority, what are the Government doing to support heads and teachers? Will there be enough testing kits provided for schools to use? Will staff be given priority for vaccination to give them the confidence to return to work? Will volunteers be recruited to help with the testing to allow teachers to teach?

Children’s education is vitally important, but many of them have lost weeks of classroom time intermittently, not because of lockdowns but because of serial Covid outbreaks in the school and the need to go home for two weeks—over and over again. If the imminent announcement by the Secretary of State for Health and Social Care does not introduce strict measures to stop the virus in its tracks and if the Government do not implement an efficient vaccination rollout, this stop-start education will continue. The effect on our children’s education is not just whether or not we open schools but whether or not we win the battle against the virus. Does he agree?

My Lords, we keep on hearing about the end of this tunnel, at which there is some light. It is an extraordinary long tunnel, and the pinprick of light seems to be very small. In the past I have asked the Minister whether he still stands by Professor Ferguson’s prediction of 4,000 deaths a day, which has never been withdrawn and never got near, and whether he is willing to widen the pool of experts that the Government rely on. Many experts are casting doubt on the figures and their interpretation, not on a one-off basis, but very regularly. I would like to see those people inside the government tent that is producing the projections we are asked to live with.

In particular, will the department publish an updated table showing deaths by age and previous condition? Are we still dealing with people aged on average 84.4 years-old with underlying conditions, or is the disease spreading to a lower cohort? We need to know more what its impact is and a bit less about the numbers, as has been agreed. The numbers have gone up because the number of tests has gone up, among other things.

The second thing is: can we have some idea of hard plans for vaccinations, not just that they are there or that they will be used? What are the plans, and when is it expected that all the over-80s, the health staff, and the over-75s will be vaccinated? Can we have a plan for each area and something that we can hold the Government to account against?

My Lords, I congratulate the Government. The Minister just announced the MHRA’s clearance of the Oxford University AstraZeneca vaccine. I congratulate Kate Bingham and the Vaccine Taskforce on this phenomenal example of collaboration between business, universities and the Government, and of international collaboration between Sweden and Britain. India has a contract for 1 billion doses to the Serum Institute of India—the largest vaccine manufacturer in the world. Could the Minister assure us that there will be all hands on deck for vaccinators, including retired doctors and nurses, wherever we can get volunteers, and that we will use all possible premises, including workplaces, as long as they are in a safe supervisory environment?

There was an excellent article in the FT the day before yesterday on rapid Covid tests, titled:

“Rapid Covid tests are being used more widely: can they be trusted?”

Yet here we have the example of Britain and France using rapid Covid tests to unblock the 48-hour blockage of movement. Enabling the use of these tests has saved so much. Can the Minister confirm that permission was granted on Tuesday for the public to use these tests on their own? Will the lateral flow tests now be available to the public? Professor Sir John Bell, Regius Professor at Oxford University, said:

“Testing asymptomatic people is an enormous priority … If there’s no testing, they don’t get caught. Every successful positive you get is a win.”

Surely that gives validation to this, yet we have others who say that we will miss half the cases. Professor Tim Peto of the University of Oxford said:

“They’re not perfect, but that doesn’t stop them being a game changer for helping detect cases of infectious disease”.

Would the Minister agree? There is also the very clear example of Slovakia. That test was employed throughout the country and lead to a 60% to 70% reduction in the rate of infection across Slovakia.

Baroness Royall of Blaisdon. No? I call the next speaker, the noble Lord, Lord Greaves.