Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Motion to Approve

That the Regulations laid before the House on 22 February be approved.

My Lords, I understand that there is an amendment to the Motion. Given that, I think it would only be appropriate to allow the noble Baroness, Lady Brinton, to speak first so that I can respond at the end. I beg to move.

My Lords, the noble Baroness, Lady Brinton, is participating remotely.

Amendment to the Motion

Moved by

As an amendment to the above motion, at the end insert “but that this House regrets that the Regulations are (1) contradictory to guidance provided by the UK Health Security Agency and NHS England on what action to take when you test positive for coronavirus, (2) an example of public health messaging that has caused confusion amongst the public, and (3) financially exclusionary to those on low incomes who cannot afford either the costs of tests or to isolate without financial support.”

My Lords, I want to make it clear that this amendment to the Motion is not a discussion about plunging the UK back into lockdown or imposing mass restrictions on individual liberties. I am talking here about the Government’s decision to scale back sensible public health measures—measures that would help us to continue to manage and monitor this pandemic, which is far from over.

Last week, the WHO reminded nations such as the UK that even when a virus is endemic, it needs managing, including testing, self-isolation and mask wearing. Even if not required by law and regulation, the WHO says that messaging and communications from Governments are vital in ensuring that people can take personal care. I am talking about clear and consistent messaging from our leaders about what they mean by “personal responsibility”. I am talking about support and guidance for those who still want to do the right thing and avoid spreading Covid-19. We still need to protect our NHS and ensure that those who are most likely to get severe disease, even if vaccinated, are also protected. I hope that we can all agree on these principles.

By the way, the Government keep changing the terminology for the group who have variously been called shielders, the clinically extremely vulnerable, immunocompromised and immunosuppressed. I hope the House will forgive me if I just refer to them as the CEV as a shorthand; otherwise, it becomes a real mouthful.

Time and again over the course of this pandemic, we have seen boom and bust policies relating to controlling Covid, stretching our NHS and care systems to the brink of breaking point and then introducing half-baked policies to tackle a fire that is already raging. Now we are seeing the bust again, with the withdrawal of almost all our tools to tackle this pandemic.

While we continue to allow Covid to spread through our hospitals, we cannot possibly hope to tackle the backlog of over 6 million patients waiting for treatment. The weekly average for Covid hospital admissions last week was 1,500 per day—an increase of 18% on the previous week. I am hearing that the NHS in the east of England and in London regions is already at level 4, and cases are still rising extremely quickly. Can the Minister say what plans there are if hospital admissions continue at this pace, and, given that they are a lagging indicator to cases, which have risen over 50% on the government dashboard in the last few days, how will people be protected from infection without access to test and trace from 1 April?

My Lords, I have some sympathy with the arguments that the noble Baroness has just made, but I think this is probably not the time to have a general debate about the Government’s handling of the Covid-19 pandemic.

These regulations are fairly narrowly drafted and are designed to repeal the earlier regulations that required vaccination against Covid-19 to be a condition of deployment in the NHS. I support the repeal of these regulations. The Government have made a good case for the repeal in the Explanatory Memorandum, but none the less, it represents quite a significant and dramatic U-turn in government policy.

I do not think it made a lot of sense to require compulsory vaccination; there were other ways of ensuring the protection from harm of NHS patients. Of course, the loss of critical front-line NHS staff which the earlier regulations might well have produced would itself have represented quite a significant risk of harm to NHS patients.

Today, I have only one question I want to ask the Minister. Again, it is something that is contained in the Explanatory Memorandum. Paragraph 7.29 says that the Government will engage with NHS employers to review their policies on the hiring of new staff and the deployment of existing staff to take into account their vaccination status. I ask the Minister what the Government want to see change in NHS hiring and employment practices. Will new employees in the NHS, for example, need to have been vaccinated against Covid-19? What does this paragraph in the Explanatory Memorandum actually mean?

My Lords, I speak in support of the amendment from my noble friend Lady Brinton. One of the main reasons I am doing so is that I think the messaging being put over at the moment is entirely wrong and out of sync with where we are in this pandemic.

I watched a very short World Health Organization video this morning. It was only a minute long and it was called “Moving from Pandemic to Endemic”. The clear message was that endemic does not equal good. During an endemic, you actually require strong health control programmes if you are going to continue to reduce infections, hospitalisations and deaths—something I am sure we all want to do. In my view, there is a pressing need to maintain some of the public health measures that can help us control this virus as it becomes endemic. You can change the label but that does not change the challenges facing us, which, in my view, require sustained protections, particularly for the most vulnerable, and a very strong public health system.

Looking back at the Statement from the Prime Minister when the living with Covid plan was introduced, I was perplexed. He set out the rationale that cases were falling, hospitalisations were falling and the number of excess deaths from omicron was actually in negative territory. Were that still the case, I suspect I would feel quite a lot more relaxed than I do at the moment. This morning, I reviewed the figures and the latest stats from the ZOE study, the ONS and the Government’s own dashboard. Just on the Government’s dashboard we are seeing an increase of 52% in people testing positive over the last seven days and an increase of 18% in patients admitted to hospitals over the last seven days. That is not a virus in retreat.

For that very reason, I have some real concerns and some questions that I would like to put to the Minister. I am perplexed at the statement that people should stay at home if they can and what that means. I think people will find that extremely confusing. I am very concerned that there is going be only limited symptomatic testing available in the population. Can the Minister say what that will mean, for example, for people who are asymptomatic but attending hospital appointments, for unpaid carers who work on a daily basis with people who are extremely clinically vulnerable, and for relatives visiting their loved ones in care homes?

Many relatives visit their loved ones in care homes on a daily basis and, to my knowledge, those care homes—certainly the care home where my mother is—are still insisting, quite rightly, that all visitors do lateral flow tests before they visit. Who is going to fund these tests after April when my understanding is that they stop being free? What funding are the Government going to make available to both the NHS and social care settings to continue with testing where they feel that that is required for patient and staff safety and for relatives? At the start of the pandemic, we found out to our cost what happens when you do not have the right measures in place in very vulnerable settings such as care homes. I do not understand the rationale for why PPE will continue to be provided but not testing. We so clearly need both. Can the Minister explain the rationale for that?

I have two final points. On vaccines, I am worried that the current messaging will mean that people who have not had the vaccine will perhaps be less likely to take it up. What does it mean for a fourth booster? What does it mean for primary-age children? I know from a number of colleagues, and indeed from my own family, that primary-age children are coming home and testing positive. What are the Government’s plans for vaccinating primary-age children?

Finally, on the issue of mental health, I fully understand that the end of restrictions is a welcome moment for many people, but, frankly, for those with mental health problems or underlying health conditions it is going be a time of immense worrying, particularly now people are allowed to leave home, it seems, while Covid-19 positive. What are the Government going to do to make sure that support, particularly mental health support, is in place for those who are very anxious about the Government’s policies?

I conclude by saying that I just do not think it is possible to put across the message that this is now endemic, Covid-19 has gone away and we do not need to worry any more. I do not think that that is a responsible position for the Government or anyone else to take.

My Lords, I would like to ask some questions about data. We are told that the Government’s policy has been data driven. As my noble friend just pointed out, the Prime Minister suggested that the case figures and hospitalisations are going down, when in the last seven days cases have gone up by 52% and hospitalisations by 18.4%. This is a trend: the Prime Minister constantly fiddles the figures. First, we had him misleading Parliament on unemployment figures, then on crime figures, and now on Covid figures. This is very important.

I would like to know why the Government are withdrawing funding from some of the studies that enable us to know what the data is, such as the ZOE study. Without the data, the experts cannot properly advise the Prime Minister and the Prime Minister then cannot, if he chooses to, take the right decisions. Why are we withdrawing funding from these studies? As my noble friend says, if the virus is endemic, we still need to control it and we need the figures to do so.

Lateral flow tests that people can take at home are particularly important, especially in the light of the symptoms of this new subvariant—B2, I think—of omicron because the symptoms start as a bit of a runny nose. If somebody has a runny nose, yes, it could be a cold, but it could be Covid. If we are being asked to be sensible and to protect other people, if it is a Covid runny nose one should stay at home, and if it is a cold one should take precautions, but without the test—and poor people cannot afford £20 a box—people will not know which kind of runny nose it is. Can the Minister say how people on benefits or low incomes, who cannot pay the price that some companies are charging for these lateral flow tests, can afford to have them standing by at home so that when they get symptoms they can check the cause of those symptoms and protect everybody around them?

My Lords, as I said in this House on Monday, I had to stay at home for seven days because I had a very bad chest cough, a bad cold and a lot of catarrh. I tested myself and the test was negative. Those bad symptoms continued for nearly six days and I tested myself every other day. It was very clear that I had a sudden form of flu, but its effects on me were quite strong. I was encouraged because I was able to test myself and the lateral flow tests revealed that I did not have Covid but had an awful cold and flu.

The programme that the Government embarked on in testing and tracking was world class. When we are still in the middle of this very cold weather, why withdraw free testing in April? It is the only assurance we have. I hope the Government will think again about that possibility, although the regulations have gone. To take responsibility for yourself, you need to know whether you have Covid, otherwise you will go out and infect other people, which you should not do.

The messaging still needs to go out. I was quite shocked when “Look North” said that people in our area who are testing positive and sometimes ending up in hospital had stopped washing their hands. That is a shock. It may be said that we have all grown up and know how to wash our hands regularly, but I am afraid that in some places that has gone, so the messaging should still be going out that for the protection of other people we must take responsibility and wear a face covering, not because it is regulated but to be considerate towards others. Sometimes you should keep your distance when you hear people coughing. You are keeping your distance to try to protect people.

When these regulations have all gone and such things are no longer mandatory, will the Government please continue to inform people that there are some places where you still need to keep your distance, some places where you must continue to wash your hands and some places where wearing a face covering is the responsible thing to do? Although it is not going to be policed, we need to create that culture. It happened during lockdown. I used to be shocked when I went to a toilet and people who had not washed their hands came out. We are now going back to our bad habits. Although the regulations have gone, could the messaging still go out to persuade people that the steps we took during lockdown and before these regulations are still worth doing?

My Lords, we, too, do not want to see restrictions in place for a day longer than necessary but, as noble Lords have said, lifting the legal requirement to self-isolate needs to be backed up with a plan and an understanding. While it is one thing to acknowledge that free tests cannot go on for ever, while the number of infections remains so high, it is surely sensible to monitor the situation and guard against any new and potentially more severe variants. Not to do that risks being somewhat blindsided by future mutations of the virus. We know that testing is one of the key ways that the return of the restrictions can be avoided. It makes long-term sense to make tests widely available while the threat of a new wave remains.

Questions remain about the implications of the revocation for people’s lives. For example, if you need to care for a clinically vulnerable relative, will you be left out of pocket for that test? After all, should we not be encouraging people to make sensible decisions rather than making it harder for them to do so? I remain unclear about whether unpaid family carers, in particular, will retain access to free testing to allow them to look after their loved ones safely. Perhaps the Minister will comment on this point in addition to confirming that free tests will remain for NHS staff. We cannot have vulnerable patients going into hospital and being treated by NHS staff who have been unable to get tests.

I agree with my noble friend Lord Hutton that this does not feel like the right time to be having this debate, but we are in the situation we are in. In acknowledging that, I echo the points made by the noble Baroness, Lady Brinton, about those who are clinically extremely vulnerable and immunosuppressed. We should have regard to how they are feeling as well as giving them continued practical support. I am sure the Minister will respond to the questions asked by the noble Baroness, Lady Brinton.