My Lords, we have come to a critical juncture. Incidence rates are growing, and the NHS is under increasing pressure. The ONS now estimates that approximately 568,100—one in 100 people—in England have Covid-19. That has risen from one in 2,000 in July, and one in 240 at the beginning of October.
The Prime Minister explained things very clearly in the other place. The R number is above one in every part of England, the virus is spreading even faster than the reasonable worst-case scenario, there are already more Covid patients in some hospitals than there were in the first wave, and, even in the south-west, current projections mean that we will start to run out of hospital capacity in a matter of weeks. The chief executive of NHS Providers, the membership organisation for NHS trusts, said:
“Looking forward, there is a clear and present danger that the NHS will not be able to treat all the patients it needs to in the best and most timely way.”
The modelling presented by our scientists suggests that, without action, we could see up to twice as many deaths over the winter as we saw in the first wave.
I recognise that some noble Lords are sceptical about whether the full range of measures in these SIs is needed right now, or whether they are needed at all. I acknowledge the concern that perhaps the cure does more damage than the disease itself, but that is not the belief of the Government. Without action, the NHS will be overwhelmed, which could put life-saving procedures, cancer therapies, emergency services and diagnostic investigations at risk.
It is true that we are much better prepared than before, with large stockpiles of PPE and ventilators, the Nightingales on standby and 13,000 more nurses than last time. However, the virus is growing exponentially, far faster and heading far further than we could ever conceivably add capacity for. Even if, by some incredible national effort, we doubled capacity, that gain would be consumed in one gulp of the virus doubling once.
Meanwhile, the scientific evidence shows us that the measures have worked and lives have been saved. The analysis of my department, the Office for National Statistics and the Government Actuary’s Department has shown that the mitigations we have put in place have prevented more than 500,000 deaths, and our previous sacrifices and efforts have therefore saved us all from untold personal heartache, civic pressure and economic disruption.
However, we recognise that these interventions are difficult for many people, and that is why we have evolved our approach from the first wave and the previous lockdown. I will say a few words about this. For the first lockdown we paused non-urgent care to stop the NHS being overwhelmed. This time, we are maintaining as many NHS services as possible. In response to arguments made forcefully by noble Lords in this Chamber, we are prioritising education—doing everything we can to keep open schools, colleges, universities, childcare and early years settings.
Leave out from “That” to the end and insert “this House declines to approve the draft Regulations because no impact analysis of the social, economic and health costs of a national lockdown, compared to the benefits of addressing the transmission of COVID-19 of such a lockdown, has been laid before Parliament, and because Her Majesty’s Government have not published a comprehensive long-term strategy for the lifting of all the restrictions put in place to address the pandemic.”
My Lords, I declare an interest in that I am 69 and am definitely entering the danger zone for coronavirus. Actually, I believe I had it in late March after lockdown. It was largely asymptomatic and possibly acquired here in this House. I appreciate that my noble friend the Minister and the Government are in an impossibly difficult position. Nobody doubts that this is an unpleasant, virulent and highly contagious virus that is killing people, especially the old and vulnerable. Beyond that, there is huge disagreement among the public, politicians and scientists.
This morning, I attended a meeting with Sir Jeremy Farrar of SAGE. He was very reasonable, plausible and balanced but not ultimately convincing because of differing and competing views. For instance, Professor Heneghan, of the Oxford Centre for Evidence-Based Medicine—I emphasise “evidence-based”—said that the R rate in Liverpool is falling among the over-60s. Apparently, Covid cases in Liverpool hospitals are falling. King’s College London believes that the R rate in England and Wales now is approximately one and Tim Spector, a professor of epidemiology at King’s, thinks that the peak of the second wave has passed. Professor Gupta at Oxford and many other eminent scientists disagree with the SAGE analysis. We were told on Saturday by Sir Patrick Vallance of a trajectory of 4,000 deaths each day without a lockdown and yesterday, the Chief Medical Officer, under questioning, reduced that number to 1,000.
What I am saying is that nobody really knows, and scientists and doctors disagree. For instance, just over 1 million people have officially had Covid but I think that there are very many more. I suspect that all of us know people who believe that they have had it. We do not know how many cases are hospital-acquired infections; yesterday, Jeremy Hunt said that it is 18%. We do not know when and if a viable and effective vaccine will be produced. We still do not know why people have such totally different responses and symptoms. My son had the virus before the lockdown in mid-March. He recovered but said that he could not taste or smell anything. That was not declared a symptom until late May. This morning, Professor Farrar said that we still do not know much about the long-term effects—so-called long Covid. Of course, respiratory diseases such as pneumonia have a lingering effect that sometimes takes six months or more to recover from. The truth is that nobody knows much about this virus or the epidemic.
I should inform the House that if the amendment in the name of the noble Lord, Lord Robathan, is agreed to, I cannot call any of the other amendments by reason of pre-emption.
My Lords, on 13 October, I asked the Minister why the Government were so resistant to following the SAGE advice of 21 September. I said that I could see us back here in this Chamber debating a national lockdown within weeks, during which time more lives would have been lost. I have never been less gratified at having been right, like so many other people. If this Government reject hindsight, they have certainly failed at foresight.
Yesterday, in response to questions from my noble friends asking why the Government have chosen now to commit to a national lockdown, the Leader of the House said:
“We were presented with national data that we could not ignore.”—[Official Report, 3/11/20; col. 682.]
Can the Minister tell me why, having been presented with evidence that they could not ignore in September about exponential rates of infection, the Government chose to do just that? What evidence were they acting on? SAGE was clear that national measures were needed and was clear about the urgent need for more rapid, more stringent interventions that would more quickly reduce incidents, prevalence and Covid-19-related deaths.
Since the start of this epidemic, we have known that a second wave of infections this winter was probable. We in this House have asked constantly what evidence was being used to assess risk and what had been learned from the first wave about preventing the spread of infection. We asked what was being done to prevent spillover from areas of high to low infection. We asked time and again what was being done to support local authorities and correct for the diverse failures of the test and trace system. Over the months, we have had no answers; there were none because it was just drift and dither and now a bit of panic. It is no wonder that, even now, with a reluctant lockdown that is subtly different from the first, there is still a sea of confusion and deep anger across the country. No one underestimates the seriousness of what the Government are asking people to do or the impact that the next month will have on mental health, jobs, family and social life. I welcome the fact that schools are being kept open but it needs extra vigilance.
My Lords, in September 500 people were in hospital with Covid-related symptoms. Today, as we speak, the figure is nearly 11,000. If the Government had taken the advice of SAGE at the beginning of September, the number would clearly have been lower.
The effect on the NHS of having 11,000 Covid patients is not just a crisis in critical care for Covid patients; it is a crisis for anybody who has a life-threatening condition. Beds are filling up and, if this rate continues, people with life-threatening conditions will not be able to get the life-saving treatment they need in the NHS. That is why we need to act. I have some sympathy with some of the amendments that have been tabled but, because of that one fact, I cannot support them today. It is beholden on us to act, not just because of those with Covid but because of those who will have strokes, heart attacks and other life-threatening conditions now that we have got to this stage. I blame the Government for getting to this stage by not acting faster, but that one statistic alone makes me feel that we have to act.
We then have four weeks in which the Government have to put in place a national system for sorting out test, trace and isolate. On testing, it is not just a case of putting another two or three noughts on the number of tests carried out; it is about getting to the right people at the right time and getting the test back speedily. That is absolutely vital. The Government need to make sure that they stop talking just about quantity and start talking about quality as well.
Tracing is a national disgrace and is causing the virus to spread faster. We need to localise the tracing system, with local knowledge and shoe-leather epidemiology. We need people who know the streets, back doors and ginnels, and who know where to get to and how to speak to people. The Government need to localise by working with industry, academia and local government. It has to be about not just money but expertise, getting the data in a way that local areas require. That is absolutely vital.
5:24 pm
The Lord Bishop of Winchester [V]
My Lords, I am grateful to Her Majesty’s Government for seeking to ensure that the appropriate measures are in place to protect the most vulnerable and restrict the spread of this virus. It is important that we do not prolong such stringent lockdown measures because of the way that they impact on the mental, physical and, indeed, spiritual well-being of the population. However, I will not be supporting the fatal Motion. I recognise the exceptional nature of these times, and welcome that the regulations will enable places of worship to remain open for private prayer and broadcasting acts of worship. Creating such broadcast acts of worship often requires a team of people, both amateurs and professionals. I would welcome more clarity from the Minister on the number of people allowed to do this.
Clergy across the country have worked hard to ensure that our church buildings are Covid-secure for public worship, education settings, food banks and other essential services. In most places, by distancing and limiting congregation sizes, communal worship can safely take place without the need for an outright ban. Religious worship is not a leisure activity: the freedom to worship and to assemble for this purpose is a right that we enjoy in this country and strongly advocate for in other countries. The law will be adhered to, but I hope that the Prime Minister and the Government have understood from the united response of faith leaders yesterday that legal and safe acts of public worship are not things to be switched on and off by government regulation. Many have already asked this, but I will reiterate: can the Minister commit to providing the scientific evidence to justify such a suspension? The impact of this suspension will be felt publicly.
On Remembrance Sunday, a day in the year that is hugely significant for so many veterans and their families and for the whole country, our commemoration services will now be severely limited. Furthermore, over the next few weeks, important religious festivals for Hindus, Sikhs, Jains and the Jewish community will be disrupted by the lack of access to communal worship. I regret this. Faith groups serve the needs of their local communities, and clergy and healthcare chaplains provide significant support for the mental, social and spiritual well-being of the nation. Public worship is essential for spiritual and mental well-being, and a source of strength to many. It is not an optional extra for the Christian faith: our weekly worship services are part of a whole way of life. The importance of this must not go unrecognised. It is in drawing on their Christian faith and in the hope that Christmas brings that the Archbishops say in their letter to the nation today that it would help the whole nation if we adopted a “calm, courageous and compassionate” response to this trial.
My Lords, all the trade-offs that the Government have to make during this pandemic are unwelcome: trade-offs between our health, our prosperity, our freedom, our future and our happiness. We would all like to maintain them all, but the rise in numbers makes a lockdown unavoidable. Noble Lords should watch Fergus Walsh’s measured and harrowing report on Monday’s “BBC News at Ten”, from the Royal Liverpool Hospital in my home city, if they need human citation to bring the stats to life.
On the eve of our second lockdown in England, however, I ask the Minister what will come after. We all pray that new vaccines and improving treatments will gradually restore normality, but what if they do not? Is there active contingency planning in government on pessimistic, as well as optimistic, assumptions for the moment when this second lockdown is lifted? How can we avoid turning a new period of relative freedom into a third wave where—in the nightmare scenario—we tumble on in this way for years, always fearing the grim reaper at the door or in the supermarket queue, while becoming significantly poorer and ever more disunited in the process?
I hope that the Government are investigating in careful detail exactly what went wrong when the first lockdown was lifted. What were the primary drivers of rising infection? Who obeyed and who ignored the guidance, whether in workplaces, social or family settings? Did those reached by test and trace quarantine when asked to? Which sanctions worked and which failed to bite? Next time, how can we better persuade every section of society that the Government do not give you the virus but other people do; and that, absent a vaccine, we have no hope of achieving a modicum of normality until we stop transmitting this dread virus to one another? In conclusion, are the Government preparing now to ensure that this will be not just our second but our last lockdown?
My Lords, these regulations will bring misery to the lives of millions of our fellow citizens. We know now what lockdowns do from our experience in the spring and from that of other countries which took the same course.
Jobs are destroyed and perfectly good businesses are forced to close their doors for the last time. Anxiety, depression, mental illness, suicides and domestic abuse increase, as the noble Baroness, Lady Andrews, pointed out. Lives are lost as screening programmes are disrupted and people are fearful of going to hospital. Young people’s education is disrupted, their employment prospects blighted and their career paths distorted. The elderly are separated from their families and grandchildren as they ponder their own mortality. There is a cruelty here too, in cutting off folk in nursing homes from family visits, banning weddings and denying people the comfort of religious observance and the chance to join immediate families to mourn the passing of friends and relatives.
Tax revenues evaporate, and we add to the burden of our children a legacy of eye-watering debt. The deficit is now heading to £400 billion and probably on to half a trillion. Parliamentary democracy is a casualty too, as most of us in this debate get three minutes to speak, late at night, on the merits of nothing less than the shutting down of the entire economy and these extraordinary assaults on our liberty and prosperity. Who would have thought Ministers and officials would start telling people whom they can sleep with? The decisions are taken by folk in secure public sector employment, with inflation-proof pensions and good salaries. The highest price is paid by the poorest and those whose livelihoods depend on enterprise and the ability to make a profit. Lockdowns are the midwives of inequality.
Occasionally you see signs in shops saying, “If you break it, you pay for it”. I believe this applies to the Government today. It is irresponsible to present these regulations to Parliament without having done any analysis of the costs and means for mitigating all the consequences of their actions. I am grateful to Julia Hartley-Brewer of talkRADIO for succeeding where I failed through parliamentary questions in getting an answer from my right honourable friend Robert Jenrick MP, who told her it was unfair to ask whether the Government had done a cost-benefit analysis of the consequences of lockdown. After very robust interrogation, he admitted that he had not seen one, because it did not exist.
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We have taken steps to mitigate the impact on the vulnerable: the new lockdown measures include allowing support and childcare bubbles, support groups and unlimited outdoor exercise, for instance, to continue. We have amended guidelines to suggest that the clinically vulnerable and the over-60s should minimise their contact with others, and the clinically extremely vulnerable should work only from home, rather than asking them and their households to shield themselves, as we did for the first lockdown. On funerals, we have changed the Covid-secure guidelines to allow up to 30 people to attend.
Lastly, we have improved how we work with local authorities to support them in responding to this crisis. My department has regional teams made up of PHE regional directors, Contain regional convenors and Joint Biosecurity Centre regional leads, who work continuously with local authority chief executives, the directors of public health and local resilience forums. I pay testimony to all those noble Lords who have brought this challenge to our attention. These groups attend local incident management meetings and outbreak boards as well as meeting more informally. They also organise meetings at a regional level to share good practice and help areas support each other through mutual aid.
In relation to those who are less privileged and in the area of financial support—another subject raised by noble Lords—we completely recognise that these measures are difficult for the general public and business, which is why we will provide support to protect jobs and get people through the crisis. This includes extending the furlough scheme until the end of November, helping with mortgages, helping the self-employed—as the Prime Minister outlined earlier this month, we are doubling our support from 40% to 80% of trading profits—extending the deadline for applications to the Covid loans schemes, cash grants of up to £3,000 per month for business premises closed as a result of the national lockdown, additional funding worth £20 per head to enable local authorities to support other business affected by the lockdown, and other measures.
My final points are on the steps out of this lockdown. I stress that these restrictions are time limited: after four weeks, on Wednesday 2 December, they will expire, and we will return to a tiered system on a local and regional basis according to the latest data and trends. As the Prime Minister set out in the other place, the best way to get R down now is to beat this autumn surge and use the breathing space to exploit the medical and technical advantages we are making to keep it low.
Our doctors and scientists have led the way in improving how we treat people with Covid, work continues to progress on developing a vaccine and we are working to continue to increase our testing capacity, most notably with cheap, reliable and rapid-turnaround tests with results in minutes. As the Prime Minister outlined, plans are already in place for the deployment of these quick-turnaround tests, which we will manufacture in this country and apply in an ever-growing number of situations to allow us to beat the disease.
By way of conclusion, I acknowledge that these measures are difficult for us all. There is not one of us who does not regard them with a heavy heart, but I know that the general public will continue to come together, as they always have done. Together, we can protect the NHS and the vulnerable, and save lives. We must place difficult but time-limited curbs on our freedom in the short term so that we ensure greater freedom and prosperity in the long term. If we act now to suppress the virus and support the economy, education and the NHS, we can restore those cherished freedoms more quickly and get closer to the lives that we all want to be living. We cannot do this with the virus growing exponentially so we must all make sacrifices now for the safety of all. It will not be easy, I know, but in a pandemic the effective steps are not always easy. We are called on to make fundamental changes to how we work, live and interact with each other, in pursuit of a common cause. I beg to move.
Amendment to the Motion
However, we now know that one has only a 50% chance of survival if put on a ventilator. We were not told that in April during the panic to get more ventilators, so advice changes. We know that only something like 320 deaths from coronavirus, every one of which is a tragedy, have occurred among those aged under 60 without comorbidities. Among the under-40s, there has been a total of about 250 deaths from the virus during the epidemic, overwhelmingly of people who were already vulnerable with comorbidities.
We know that our young people—our children and our grandchildren—will be saddled with debt for decades, as my parent’s generation spent decades paying off debt from the Second World War. Will our children ever forgive us? We know that unemployment will rocket next year. We know that businesses, large and small, will be closed in their droves. In hospitality, pubs and restaurants will close their doors tonight and many will never reopen. We know that cancer treatment has ground to a halt for hundreds and thousands of patients. We know that domestic abuse and mental health issues have increased dramatically—as, it appears, have suicides. We know that students are locked into halls of residence, ruining their time at university; they are turned into criminals if they leave. They will then face a desolate employment landscape in which to find a job. Therefore, is it not reasonable to ask for a cost-benefit or risk analysis? Yesterday, Robert Jenrick, a Cabinet Minister for whom I have a high regard, said that there had been no impact assessment. Surely we should expect such an assessment before embarking on a serious act of national self-harm, yet the Government do not appear to have done one.
The second part of my amendment calls for an explanation of the Government’s comprehensive long-term strategy. In the last century, when I was in the Army, it was a given that one explained to all one’s soldiers the rationale behind orders if one expected them to follow them. It is called leadership. I ask the Minister to tell the House what the strategy is behind government policy. The country is locked down so infections should fall, but when restrictions are lifted, it seems to me that infections may rise again, meaning a third wave. Then what? An effective and reliable vaccine may appear, or it may not. It may be only 50% reliable anyway, as I read from another expert. As I understand it, a vaccine makes the patient’s body produce antibodies, but now we are told that many recovered patients lose their antibodies within six months. Is that the case?
As a loyal Conservative, I want to believe that the Government have a strategy but my credulity has been strained somewhat. We were originally told, until late August, that face masks were essentially of no use. We have been told to go back to work. It is only two or three weeks since we were told that there would definitely not be a second national lockdown. I regret to say that an enormous amount of good will and trust has evaporated. We are told that the public support a second lockdown. I am not so sure, but the role of leadership is to lead. We need courageous leadership to explain the costs, benefits and risks surrounding this crisis and this measure. We need to a clear strategy to take us through this crisis.
I do not underestimate the extraordinarily difficult choices before the Government; nor do I envy Ministers having to make these decisions. I will listen to the 50 or more contributions and look forward to the Minister’s response, but I currently intend to divide the House on this amendment.
In a spirit of hope over experience, therefore, I shall ask the Minister some more questions. What is the current state of intensive-care hospital capacity in the south-east, where, like the south-west, the virus is rising faster? When will those beds be full? What range of criteria will be used to determine when the lockdown can be lifted on 2 December? People want certainty that it will end but if they are expected to comply, they want to know the plan and what it is based on. People also want to believe in the prospect of a vaccine, so can the Minister tell me what steps the Government are taking on all current vaccine candidates to license production in the UK to ensure that a supply is assured, regardless of which is approved? Who will get priority?
Finally, people want to be able to trust the scientific consensus and to know that the Government do too. But the Government have undermined that trust through their inconsistency, which has fuelled the scepticism that we see in this evening’s amendments expressing regret. Therefore, I agree with the noble Lord, Lord Robathan, in this respect: the management of the epidemic is an object lesson in the failure of leadership, governance, management and communication. However, I am sure that the House will support the regulations.
Isolating is about giving people financial security so that they do not have to worry about feeding their children or paying their mortgage or rent. It should be seen as a national and civic duty which the Government support, without more sticks or penalties. Taiwan has shown how this can be done: with Covid teams which go in and support people, not just financially but with psychological help. There is help with childcare and food, and by checking on people’s health.
So, through gritted teeth, I will support these regulations. We, the public, will do our bit. We will stay at home, protect the NHS and save lives, but over the next four weeks the Government have to do their bit—sorting out the test, trace and isolate system.
Again and again, Ministers rightly say they have to balance lives against livelihoods, but to achieve balance you need to weigh both sides of the scale. We are told that the models say we have no alternative, as the NHS will be overwhelmed. We of course have a duty to take this very seriously, but the Explanatory Memorandum for these regulations says the Government are assuming an R rate of 1.1 to 1.3. Professor Tim Spector from King’s College has suggested that R is now one in England and the UK as a whole, and Professor Heneghan from Oxford University says the infection rate in Liverpool is falling from a run rate of 490 a day over seven days to 269 and the R value is well below one, a point that the noble Lord, Lord Birt, may not have noticed. It seems the Government’s tiered approach is not only hurting but working.
The last financial crisis was caused by groupthink and people believing models which told them they could convert lead into gold at the expense of common sense. Then, the poorest paid the price, and those responsible became very rich. The fact that we were all scared by headlines over the weekend telling us that 4,000 people a day would die, and learned within hours that this came from a discredited model which predicted four times as many deaths as occurred in real life on 1 November, is worrying to say the least. With all models, the rule is very simple: garbage in, garbage out.
We also know that, once implemented, lockdowns are hard to exit. On Saturday the Prime Minister told us it would be for a strictly limited period, until 2 December. In less than 24 hours, Michael Gove was telling Andrew Marr it could be extended. When asked about this yesterday, Professor Whitty said:
“I think that the aim of this is to get the rates down far enough that it’s a realistic possibility to move into a different state of play at that point in time.”
What are people running businesses meant to do? Do they listen to the PM and take on more debt to survive another month if they can, or do they conclude, after listening to Mr Gove and Professor Whitty, that they should throw in the towel?
The Chancellor has done brilliantly, but he knows we are heading for Carey Street. What will this lockdown cost—perhaps £12.5 billion for furlough and the self-employed alone? He will need to extend the £20 a week standard allowance for universal credit from April. When folk who thought they were in secure jobs—say, on £25,000 a year—discover that they are not eligible for universal credit because they have savings or a working partner, his colleagues in the Commons with be inundated with constituents worried about how to pay their bills and feed their families. Where will he find the money for health, welfare and social care, and for the job creation initiatives that will be needed? To paraphrase Tacitus, we will have created a desert and called it protecting the health service.