Covid-19 Update - Statement

– in the House of Lords at 1:10 pm on 10th September 2020.

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The following Statement was made in the House of Commons on Tuesday 8 September.

“With permission, Mr Deputy Speaker, I would like to make a Statement on coronavirus. As a country, we have made huge strides in our fight against this invisible killer. Today’s Office for National Statistics figures show that weekly coronavirus deaths have dropped to the lowest number since mid-March, and the latest daily number of recorded deaths is three. However, we have seen a concerning rise in the number of positive cases, particularly among younger people. These figures serve as a salutary reminder that this virus is still very much with us and remains a threat, so it is critical that we maintain our collective commitment to controlling this disease.

Social distancing is the first line of defence. While young people are less likely to die from this disease, be in no doubt that they are still at risk. The long-term effects can be terrible, and of course they can infect others. Six months on, many people are still suffering chronic fatigue, muscle pain and breathing difficulties. Previously fit and healthy people have been reduced to barely being able to function. A King’s College survey published today shows that 300,000 people in the UK have reported symptoms lasting for more than a month and that 60,000 people have been ill for more than three months.

I also want to address the point, which is of course good news, that the number of people who are sadly dying from coronavirus in this country is currently low. We have seen all across the world how a rise in cases, initially among younger people, then spreads, leading to hospitalisations and fatalities. In Spain, where the rise in cases started around two months ago, hospitalisations have risen 15 times since mid-July. The number of daily deaths there has reached 184. In France, hospitalisations have more than tripled in the same period.

This must be a moment of clarity for us all. This is not over. Just because we have come through one peak, it does not mean we cannot see another one coming towards our shores. But together we can tackle it, so long as we remember that, in a pandemic, our actions today have consequences tomorrow for the people we love, for our communities, and for our country. Each and every citizen has a responsibility to follow social distancing and help to stop a second peak.

After social distancing, the next line of defence is test and trace. Over the past six months we have built the biggest testing system of any major European country, and one of the biggest testing systems in the world. Today, I can tell the House that we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.

But I will not rest. We are working flat out to expand our testing capacity even further. Using existing technology, we are expanding our capacity right now, and we are investing in new testing technology too. Last week, I was able to announce £500 million for next-generation tests such as saliva tests and rapid turnaround tests that can deliver results in just 20 minutes. The ability to get rapid, on-the-spot results will significantly increase the weapons in our armoury, in our fight both against coronavirus and for economic recovery. We are rolling out these tests right now, and plan to use them to relieve capacity constraints, to expand asymptomatic testing to find the virus and to give people the confidence that a negative test result brings.

Where it is necessary, we will not shy away from taking targeted local action. In June, I established the joint biosecurity centre, to provide the best possible data analytics, using information from all possible sources. Our local action is driven by the data. We now publish daily local data on cases, so that everyone can see the data on which these decisions are taken, and this shows that our approach is working. For instance, in both Leicester and Luton, the weekly case rate more than halved during August. I want to thank the people of Leicester, including the honourable Member for Leicester South (Jonathan Ashworth), of Luton and of the other areas where we have taken local action, who have followed social distancing and helped to bring the virus under control.

Sometimes local action requires us to act fast and respond to changing circumstances. Unfortunately, after improving for several weeks, we have seen a very significant rise in cases in Bolton. Bolton is now up to 120 cases per 100,000 population—the highest case rate in the country—and I am publishing the data behind the decisions that we have taken. I must therefore tell the House that, working with the local council, we are taking further local action. The rise in cases in Bolton is partly due to socialising by people in their 20s and 30s; we know that from contact tracing. Through our contact tracing system, we have identified a number of pubs at which the virus has spread significantly. We are therefore taking the following action in Bolton, starting immediately. We will restrict all hospitality to takeaway only, and we will introduce a late-night restriction of operating hours, which will mean that all venues will be required to close from 10 pm to 5 am. We will urgently introduce further measures that put the current guidance—that people cannot socialise outside their household—into law.

I want us to learn the lesson from Spain, America and France, not to have to learn the lesson all over again ourselves through more hospitalisations and more deaths, and take this local action in Bolton. Crucially, we all have a part to play. Young people do not just spread the virus to each other. They spread the virus to their parents and their grandparents. They spread it to those they come into contact with and others who they love. I know that social distancing can be hard and that it will be extra tough for students who are starting university, but I ask them please to stick with it and to play their part in getting this virus under control.

We are also putting in place extra measures, including visitor restrictions, to restrict the spread of the virus into care homes and hospitals in Bolton. I want to thank the leadership of Bolton Council, who are doing an outstanding job in very difficult circumstances, and colleagues who represent Bolton in this House, with whom I have discussed these measures. I want to say this directly to everyone living in Bolton: I know how anxious you will be, and I know the impact that these measures will have. We are asking you to take a step back, at a time when we all just want to get on with our lives and what we love and get back to normal, but we need to take this crucial step to keep the virus at bay, because as we have seen elsewhere, if we act early and control the virus, we can save lives.

As well as controlling the virus using the tools we have now, we will do everything in our power to bring to bear the technologies of the future. Over the past few months, we have seen the pivotal role that technology has played in our response, such as next-generation rapid testing, machine-learning tools to help the NHS predict where vital resources might be needed, and the discovery here in the UK of the only two treatments known to save lives from coronavirus. We want to keep that momentum going, so today, we are allocating £50 million from our artificial intelligence in health and care award. That fund aims to speed up the testing and evaluation of some of the most promising technologies, because through bringing new technologies to the front line, we can transform how we deliver critical care and services across the country.

Finally, the best way out of this coronavirus pandemic remains a vaccine. We have already announced that we will roll out the most comprehensive flu vaccination programme in history this winter. We now have agreements with six separate vaccine developers for early access to 340 million doses of coronavirus vaccines, and we will use every method at our disposal to get as many people protected as possible.

This virus feeds on complacency, and although time has passed since the peak in the spring, the threat posed by the virus has not gone away. Now, with winter on the horizon, we must all redouble our efforts and get this virus on the back foot. I commend this Statement to the House.”

Photo of Baroness Thornton Baroness Thornton Shadow Spokesperson (Health) 1:30 pm, 10th September 2020

First, I place on record our thanks to the teachers, head teachers, school staff, university and FE college staff and others making it possible for our children and young people to return to their education. I hope this will remain a top priority for the Government as we move through and, we hope, out of this pandemic. It has been wonderful to see my great-nieces and nephews and granddaughter joyfully going back to school in the last week. As a non-executive director of one London’s hospitals, which is in my record, I can testify to the huge amount of work going on preparing for the winter stresses.

But here we go again. We need to start by reflecting on why we do not have before us the incredibly important new Covid restrictions announced yesterday by the Secretary of State and the Prime Minister, which aim to deal with the new surge in coronavirus infections. In fact, the Statement has been made in the Commons in the last hour or so, and I suspect we will see it in due course at the beginning of next week. I accept that the hybrid nature of the House means that we will not be able to take it today, which might have helped us all enormously. It is not the Minister’s fault; it is just one of the casualties of the situation we find ourselves in. Perhaps, the noble Lord could confirm when the new regulations will be laid.

Yesterday, Mr Speaker said quite rightly in the Commons:

“It is really not good enough for the Government to make decisions of this kind in a way that shows insufficient regard to the importance of major policy announcements being made first to this House and to Members of this House wherever possible.”—[Official Report, Commons, 9/9/20; col. 619.]

The Secretary of State made a Statement about current Covid-19 issues on Tuesday and failed to mention major policy proposals of which he must have had prior knowledge and which were already being discussed on social media. Thus, he did not allow a discussion of the current proposals, which the Prime Minister then announced in a Downing Street press conference and a letter which noble Lords will have received overnight. This suggests that the omission was deliberate and reveals yet again the disregard with which the Minister and his colleagues hold their duty to be accountable to Parliament, which is undermining our democracy. If Mr Speaker follows through on his threat to allow Covid-19 UQs at the beginning of every day to ensure that the Secretary of State can and will report new policy and be accountable to Parliament, I assure the House I will be arguing to take every single one in this House every day, so that the Minister can do his bit for accountability, too.

We have a Statement before us, press announcements made and a new law of six, but I need to return to the question I asked yesterday about what has gone wrong with the testing system. I would be grateful if the noble Lord would engage with what look like widespread problems some people are having accessing tests, rather than repeating the mantra about the high proportion of successful tests close to home, which is accurate, I am sure, but not the way to solve a clearly growing number of problems. I know the Minister will not shout at me, as his right honourable friend did to Keir Starmer yesterday, or accuse me of undermining the whole test and trace system when legitimate, evidenced problems are being articulated by many Members of Parliament and reasonable questions are being asked. The Minister needs to address the problem of the availability of tests.

Yesterday, I mentioned schools, where inevitably children will become ill. Parents are advised to keep them at home and get a test, and some are finding this impossible. Unsurprisingly, parents turn to teachers and head teachers for advice, placing even greater stress on our schools, which are working so hard to keep our children safe and educated. A reliable, rapid testing regime is vital, as we have said from the outset.

As for moonshot, which the Prime Minister mentioned in his letter, with his fondness for hyperbole, if the Government cannot even deliver testing for those ill with symptoms, how on earth are they going to deliver 10 million tests a day? I want to correct a statement the Secretary of State made in the Commons an hour or so ago, when he said to my honourable friend Jonathan Ashworth that the Labour Party was opposed to mass testing. That is absolutely not true. What we are against is incompetence. We are saying: how on earth will moonshots be delivered if basic testing is not working well?

The new regulations are meant to make it easier for people to understand. But does the noble Lord agree part of the confusion stems from the fact that some of these rules may be inconsistent with government messaging that people should return to work. Does he accept that, even where employers are taking necessary steps to facilitate social distancing, busy commuter trains, tubes and buses are not Covid-secure? On these Benches, we have said from the outset that one of the biggest barriers to self-quarantining would not be Covid fatigue but personal finances. Does the Minister accept that the Government need to go much further in helping people who need financial and housing support to self-isolate? Otherwise, how will we get on top of infections in areas characterised by low pay, child poverty and overcrowded housing?

Finally, to contact tracing: in Bolton, contacts were reached in only 57% of non-complex cases; in Oldham, 50%; in Blackburn 47%; and in Bradford, only 43%. Nationally, only 69.4% of contacts are reached and asked to self-isolate. These are Government’s latest statistics, and they make me wonder whether “world-beating” is yet another piece of hyperbole. On the effectiveness of testing, my colleague, the shadow Health Secretary, highlighted that only 69% of contacts were identified by the test and trace system, and I am afraid the noble Lord’s colleague Matt Hancock said he was wrong. He was right. I yet again have to ask the noble Lord—privately, if he wishes—to correct his boss’s record. More importantly, how can we improve on that record of testing and tracing?

Photo of Baroness Barker Baroness Barker Liberal Democrat Lords Spokesperson (Voluntary Sector), Deputy Chairman of Committees

My Lords, this is a Statement made two days ago in the other place, but it has been largely overshadowed by yesterday’s deluge of hyperbole and hokum. The Prime Minister said yesterday:

“We know, thanks to NHS Test and Trace, in granular detail, in a way that we did not earlier this year, about what is happening with this pandemic. We know the groups that are suffering, the extent of the infection rates, and we have been able, thanks to NHS Test and Trace, to do the local lockdowns that have been working.”—[Official Report, Commons, 9/9/20; col. 609.]

If that is true—and given the record of the Prime Minister and Health Secretary, one is always entitled to ask whether it is—how come local authorities and directors of public health are given only limited access to the test and trace case management system and not given full access to the contact system? Why are the Government sitting on data or passing it to companies run by their mates, instead of passing it to local authorities, which, for weeks, have been trying to predict and manage the inevitable spike in infections that follows people starting to travel and going to school and university. Why are they not getting that data in a timely manner?

From the start of this pandemic, experts advised the Secretary of State to invest in public health teams and NHS labs that are numerous and easily reached by many communities, including in rural areas. Instead, he gave the money to outsourcing firms such as Serco and G4S, which have no expertise and have not had to compete for the contracts. He could have invested in local public services; instead he has built a system on a foundation not fit for purpose. On Tuesday, in the Statement, the Secretary of State for Health said of care homes that

“we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.”—[Official Report, Commons, 8/9/20; col. 517.]

But on Monday, the Government were forced to apologise for continuing delays to Covid-19 testing for care home bosses and GPs, who are threatening that these will lead to more infections among vulnerable people.

The Secretary of State’s own department, the Department of Health, admitted to breaking its promise to provide test outcomes within 72 hours. Care managers have described the Government’s centralised testing service as “chaotic” and “not coping”, amid reports that whole batches of tests are coming back not only late but also void. Testing officials told care homes by email on Monday morning that

“immediate action has been taken at the highest levels of the programme to bring results times back” within 24 hours.

“We apologise unreservedly to … you … and your staff.”

The ring of steel that the Secretary of State claimed to have put around care homes never was. With upwards of 40,000 deaths, when will the Government sit down with care home providers, local authorities and CCGs to develop a comprehensive system of testing and supply of PPE? It does not have to be world beating; it just has to work.

The Prime Minister’s Statement yesterday would have been risible were the consequences not so serious. Most ludicrous of all was the announcement of a team of Covid-secure marshals to enforce the new laws on public gatherings. The Government could have done any number of things. They could have announced resources to enable the rehiring of retired public and environmental health professionals, since there is a shortage. They could have given funding to local community and voluntary groups to communicate ongoing health risks and the law to communities. They could have given additional funding for trained police officers to work with health officials and businesses to improve adherence to infection control. But, no, instead we got another vacuous attempt to steal the headlines. Maybe these marshals, with no training, no resources, no local management and no authority could join up with the 750,000 volunteers for the NHS and the trackers, and like them they could sit and twiddle their thumbs, waiting for the phone to ring.

One thing we can be sure of is that this is another stunt which will be an utter waste of time, money and resources. Local authorities, police forces, health authorities and schools are using their professional expertise and local knowledge to plan effective public health interventions. They are not only following the science but also using it to actively protect people in their authorities. In stark contrast, this Government ignore advice, misrepresent the science and carry on winging it, but the data on infections and the lack of reliable testing are evidence that the Prime Minister’s bumbling bombast and the Health Secretary’s growing litany of half-truths are indicators of world-beating incompetence and, sadly, people in black and minority ethnic communities and poor communities will suffer the consequences. It is time for the Government to change.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I am enormously grateful for the thoughtful and informed questions from the Front Bench, and I echo the comments about teachers made by the noble Baroness, Lady Thornton. The return to school is a fundamental priority of the Government. It is a massive challenge for those involved, for governors, teachers, parents and school kids. I endorse the thanks the noble Baroness gave to teachers, who are performing incredibly well. The high return rates—percentages in the mid to high 90s—is remarkable and shows enormous confidence in the system among schoolchildren and their parents.

I also echo the noble Baroness’s thanks to NHS and social care staff who are preparing for winter. Enormous amounts of preparation are going into that. In response to the point made by the noble Baroness, Lady Barker, I reassure the Chamber that engagement with social care, local charities and local councils is incredibly intense and we are working extremely hard with local partners in all areas.

The noble Baroness, Lady Thornton, asked when the new regulations will be delivered. I am afraid that I cannot confirm the precise date, but I can reassure her that this Government are committed to being accountable to Parliament for those regulations and I look forward to that debate.

The noble Baroness also asked about the sequence of announcements. I reassure her that the Prime Minister brought his Statement to Parliament in good faith to update Parliament first. We cannot prevent leaks from happening, and leaks that get on to social media and then into the papers are something that we did not design or deliberately create. They are something that we regret. It would have been massively our preference for the Prime Minister to put Parliament first in his announcement.

The noble Baroness also asked about the testing system. The capacity of the testing system has never been higher: it has increased by 10,000 per day for the last two weeks and continues to increase dramatically. But demand has never been higher either, and there are good, laudable reasons why that demand is going up. The number of tests for supporting the vaccine programme has gone up. The number of tests to support our therapeutics programme has gone up. The surveillance of local prevalence has gone up, and the marketing around the use of tests by those who show symptoms has proved to be much more effective and the take-up among those who have Covid-19 symptoms has gone up. For those reasons we are extremely pleased by that effect.

However, there has also been a significant rise in the use of tests by asymptomatic individuals, largely tied to children returning to school. That is why we have been clarifying the guidance on the use of tests—that they should be used by those who have symptoms and not by those who are asymptomatic. One day, when the capacity is there and the system can bear it, I hope that we will move towards a system where anyone can have a test whenever they like, however they feel, but right now we must live within the system that we have. We are doing hundreds of thousands of tests per day and clarifying with teachers and parents that tests should be used by those who show symptoms and not by those who are seeking some other form of guidance.

Regarding the questions asked by the noble Baroness about the moonshot, I am a little confused. “If we cannot do millions of tests today, how can we expect to be able to do millions of tests tomorrow?” seems to be the question. I will answer it very clearly. The innovation around testing has moved much quicker than anyone could have expected in terms of scale, cost, accuracy and speed. The industry and the professionals in the NHS, academia and private business have come together in a triple helix to collaborate in a massive revolution in testing, which has changed considerably in this country from the days when we were struggling to do 2,000 or 3,000 tests per day to when we had the capacity to do 200,000 or 300,000 tests per day.

We have a clear view of how we can dramatically increase the tests. That clear view has two components: those tests that use existing technology that is purchasable in today’s world, and a clear idea of where innovation will take us in the very near future. This Government are committed to grabbing the opportunity of that innovation in order to dramatically increase the number of tests. There will be nay-sayers who will question whether that innovation will deliver, and undoubtedly there will be set-backs. Not everything will deliver as promised. However, I am extremely optimistic that we will be able to harness the power of science and innovation to invest in the backbone of our data and our delivery mechanisms, and to engage with the British public to deliver a testing system that enables us to return to the life that we love.

The noble Baroness, Lady Thornton, questioned whether the testing system could be relied on to deliver results. Let me explain: the people of Luton and Leicester have used testing and contact tracing, and infection rates are dramatically lower—less than half what they were in late July. Those are two excellent case studies of how our system of testing and contact tracing has turned around difficult situations and pushed back the spread of Covid by breaking the chain of infection. The noble Baroness also asked what we will do to improve the system as it stands. There are three areas of improvement: first, technology; secondly, infrastructure, by which I mean the data and the presence on the ground; and thirdly, engagement with the public so that they understand how to engage and we understand better how to interact with the public.

The noble Baroness, Lady Barker, asked about the contact system and gave some statistics. I reassure her that since 28 May we have rung 272,000 people who have been reached by the test and trace system. Where communication details have been provided, the service has reached 88.6% of close contacts, and 78.4% of people who have tested positive have been reached. Within the bounds of epidemiological effectiveness, these are extremely impressive statistics. Compared with those from other countries, they range among some of the highest. It is an incredibly impressive set of results for a system that was stood up in relatively recent history. Local public systems are complementing the central contact tracing hub, and I pay thanks to all those local authorities that either work with their full-time employees, or, as is often the case, have employed local businesses, to support it.

We have hit our target on care homes—the noble Baroness, Lady Barker, might like to take a moment to celebrate that. We are also trying to work with a degree of transparency in our operations. I do not regret for a moment the fact that the operational senior leadership in the track and trace team has been on the level about the present supply constraints, with social care and the general public. I reassure the noble Baroness, Lady Barker, that care homes absolutely remain top of our priorities. Many of the frustrations the public face, such as longer distances to travel, are exactly because we have put care homes first and have therefore had to dial down some of the availability of tests to the public. We sit down with care homes to discuss winter preparations. An indication of that is the 31 billion items of PPE that we have contracted to buy for this winter—an astonishing figure. That pays great tribute to the work of the noble Lord, Lord Deighton, and the PPE team, who have built up a fantastic stock.

Finally, I would like to express a small amount of confusion about the remarks from the noble Baroness, Lady Barker. On the one hand, she attacked the involvement of major private companies and central control of our track and trace system, but on the other hand, she attacked civic engagement, the volunteering of members of the public to support our track and trace system, and local initiatives whereby NHS trusts have brought back retired staff. The combination of these two themes is the heart of our success, and I celebrate both.

Photo of Lord Rogan Lord Rogan Deputy Chairman of Committees, Deputy Speaker (Lords)

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can maximise the number of speakers.

Photo of Lord Lansley Lord Lansley Conservative 1:54 pm, 10th September 2020

My Lords, the consistency of messaging over time is immensely important to secure public support and adherence. Over the last six months, we have consistently explained that indoor and outdoor gatherings are significantly different, and that the scientific evidence has clearly shown much greater risk for indoor gatherings. Can my noble friend the Minister explain to the House why the Government appear to have abandoned this important distinction in their current guidance?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My noble friend is right to point out this important change. The truth is this: from the feedback we had from the public, and from our own analysis of the facts, we see that our guidance was growing increasingly complicated and was confusing the public. While the science may suggest all sorts of clever differences between one situation and another, and between inside and outside, the guidance is effective only if it is clear, understood and obeyed. At the end of the day, what we have done is to clarify some of the more complex areas of our guidance to make it more effective.

Photo of Baroness Meacher Baroness Meacher Crossbench

My Lords, sadly, Professor Spiegelhalter has seriously questioned the Prime Minister’s rather splendid Moonshot mass testing proposal. I understand his concerns. Nevertheless, can the Minister assure the House that he will press for a significant investment in saliva home-testing kits, to enable families with a parent in the former shielded group and with children at school to live a reasonably normal life? Children need to be at school, but the lives of these parents are now in grave danger—I am sure the Minister appreciates this—with the R number above one and, as yet, no daily testing capacity. Can the Minister say when daily testing will be available for these families and other top-priority groups in the country?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I reassure the noble Baroness, Lady Meacher, that saliva testing is a massive priority for the Government. I reassure her and Professor Spiegelhalter that the positive error rate in the saliva test trials in Southampton has been incredibly low—virtually zero. From that, we take great reassurance that this will be an effective vector for testing.

Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Labour

My Lords, will the Minister accept that the reason for scepticism about the Moonshot gimmick is that the Government have a consistent record of overpromising and underdelivering? The Minister will know that the latest test and trace stats are not good: they show that 69.2% of close contacts of people who have tested positive with Covid-19 in England were reached—that is the lowest percentage since the scheme was launched. What would he say to Bridget Phillipson, the MP for Houghton and Sunderland South? Because Sunderland has a rising number of cases, she checked online this morning the availability of tests: no home tests were available and no drive-through tests could be found. Later in the morning, the only test offered was a two-hour drive away in Scotland. Why should anyone believe the ideas that the Government float from week to week?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I completely and utterly reject the noble Lord’s suggestions. I remember well the nay-sayers, the sofa epidemiologists and the sceptics who, when we had testing at the level of 5,000, poured cold water on the idea we would get to 100,000. We hit that target. We have made amazing progress since and we will continue to push for more testing.

Photo of Baroness Walmsley Baroness Walmsley Co-Deputy Leader of the Liberal Democrat Peers

My Lords, the Secretary of State has blamed the recent failure of laboratories to process tests in a timely way on members of the public who are not eligible—as he calls it—seeking to take a test. Is this not another example of Ministers blaming someone else for their failures? How do people know if they are not eligible? If they are concerned about something, what system is in place to enable testing centres to know who is eligible, so that they can refuse to test those who are not?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness is right, but it is sometimes difficult to know whether you have the symptoms of Covid, the flu or something else. That is why it is a complicated matter. What we have seen through our engagement with the public in the last few weeks is people who show no symptoms of anything but who seek a test to provide themselves with reassurance. It is not a question of blame, but rather of clarification: we simply do not have the national resources to support that kind of activity.

Photo of Baroness Noakes Baroness Noakes Conservative

My Lords, as a Conservative, it grieves me that the Government are pursuing policies, such as the rule of six and Covid-secure marshals, which belong in a police state. The Government have chosen a highly risk-averse approach, driven by guesstimates of hospitalisation and mortality rates, and doubtless derived from mutant algorithms. In the meantime, the economy is tanking. Can the Minister say what evaluation the Government have made of the economic and societal impacts of different responses to the small spike we have seen in infection rates? Will they publish that evaluation?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, it is not a mutant algorithm that is sending people to hospital in France, Spain, Belgium and other countries up and down Europe, and it is not a desire to introduce a police state that is seeing prevalence leading to hospitalisation and death in many countries in Europe. It is our fear that Britain is going that way that leads us, regretfully, to put these measures in place; it is not any desire to exert state influence.

Photo of Lord Patel Lord Patel Chair, Science and Technology Committee (Lords), Chair, Science and Technology Committee (Lords)

My Lords, I am sorry that the Minister keeps having a hard time, but that is partly because he is having to defend the indefensible. I had a completely different question to ask, but I have changed my mind and, instead, will follow on from the question asked by the noble Lord, Lord Lansley, and the Minister’s response to it. In terms of transmission of the disease indoors as opposed to outdoors, which bit of science is confusing?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I answered the question as clearly as I possibly could. This is about communication and clarity and making sure that people understand the instructions; it is not about science. If that is not effective then the guidelines are pointless.

Photo of Baroness Andrews Baroness Andrews Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, perhaps I may take the Minister back to the question asked by the noble Baroness, Lady Walmsley. I was sorry to hear him say rather dismissively that people are clogging up the system because they seek some sort of reassurance, although they do not have symptoms. That seems to me a perfectly natural and human reaction. Can he confirm that basically government policy now is actively to discourage anybody without any symptoms in any situation seeking a test? If that is the case, what is his answer to the letter that he received from the directors of public health in the south-east, who are deeply worried that an area of low infection could easily become an area of high infection? What will he say to the universities that have introduced testing for all students, asymptomatic or not, because they want to protect their local communities, given what we know from America—from Chapel Hill, for example—about the absolutely devastating effect that university populations can have?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, it is not a question of blaming anyone or of in any way condemning people’s natural curiosity. However, the bottom line is that we have only so many resources, and people know full well whether they are showing symptoms of some sort. It is not appropriate that someone who shows no symptoms whatever uses valuable, scarce resources that could and should be used for more important priorities. We could not be more clear about that. Universities are using private testing facilities, and we applaud and support them on that. It is my sincere hope that one day we will have sufficient testing facilities to be able to offer everyone a test whenever they like. However, we do not live in that world today, and that is why I deliver the message that I do.

Photo of Lord Taylor of Goss Moor Lord Taylor of Goss Moor Liberal Democrat

The Minister has just said that a significant plank of the policy is not the science but communications. I fear that the Moonshot programme falls into exactly that category. I do not believe that it can be delivered at the scale that the Prime Minister has talked of, but, if it could, it would throw up false results that would overwhelm track and testing and mislead people, throwing both education and the economy into further chaos. Is not the right policy to target the groups that we know are vulnerable to this disease with the protections that they need, starting with care homes, and to allow the rest of us, and the economy and education, to move forward?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord is right to be concerned about false positive results. However, our experience, our piloting and the emerging technologies suggest that that will be the case in a relatively small proportion of the tests and is entirely manageable within a mass population testing system. With regard to the idea that we can somehow identify vulnerable groups and target them pre-emptively, I wish that that were true, but this disease constantly confounds expectations and turns up in places where we least expect it. If we could tell people that they were going to get the disease, we would not have this problem in the first place.

Photo of Baroness Blackwood of North Oxford Baroness Blackwood of North Oxford Conservative

I thank the Minister for his answer, but those who were formerly shielding, those whom we had identified as being most at risk, will be watching the rise in cases and some of this debate with anxiety. There were a number of problems with the rollout of the shielding programme the first time round, and we have new evidence about who is most at risk from Covid. Has there been a reassessment of the criteria for those who might need to shield this winter? If so, what is the Minister doing to ensure that this is communicated early and much more clearly to both those who will not need to shield this winter and those who might need to, so that we can reduce anxiety among those groups and protect the most vulnerable?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I completely recognise the problem identified by my noble friend. I reassure her that the expert sub-group NERVTAG is developing a predictive risk model to enable a more sophisticated approach to clinical risk and to identify more clearly those who need to shield. The model incorporates known relevant risk factors, such as age, sex, BMI and ethnicity. We are working at pace and will continue to engage patients, those on the shielding list, healthcare professionals and the voluntary sector as we embed this important insight into what we do.

Photo of Baroness Campbell of Surbiton Baroness Campbell of Surbiton Crossbench

My Lords, the Minister will be aware of the difficulties faced by disabled and older people during the first major lockdown, such as insufficient social care support services. Will the government guidance to this group now change to address those difficulties, especially if the R rate keeps rising over the coming months? Will he now consider switching off the social care coronavirus easement powers, which were meant to be only a temporary measure, especially as local authorities are now telling us that they no longer use them? These easement powers are a major cause of anxiety among older and disabled people, and it would be an easy thing to do—just switch them off. They are no longer needed, yet they cause untold anxiety.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I am not sure that I have a precise answer to the noble Baroness’s question on easement powers. It was my impression that they had not been used in the vast majority of areas—only in a few areas—and that, where they had been applied, their use had been of a mainly administrative rather than practical nature. However, I am happy to look into the question that she asks and to reply to her by letter.

Photo of Lord Harris of Haringey Lord Harris of Haringey Labour

My Lords, the noble Lord has responded rather testily to a number of your Lordships in providing answers. In particular, he failed to answer the substantive question from my noble friend Lord Hunt of Kings Heath about why people were being sent, or being told to go, such extraordinary distances when they wanted and needed a test. He says that he does not want to have the blame game, but that is blamed on people who did not need a test going for one. First, can he tell us what those figures are and, secondly, can he reassure us that the messages he is now giving out will not lead to people who should be tested feeling that they should not bother the system? That would be just as big a danger.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I shall be extremely careful about how I reply to that question because I would not want to come across as testy. The noble Lord is right: it is a challenge to strike the right balance between guiding towards testing those who truly need tests because they have symptoms and trying to get those with less of a priority away from testing. I reassure him that, even under current circumstances, 90% of those who apply for a test get one within 20 miles and the average distance to travel is six and a half miles. Therefore, even though some of the anecdotes about being recommended to travel long distances might seem extraordinary, the lived reality of most people who go for tests is that they are quick, near, accurate and effective.

Photo of Lord Truscott Lord Truscott Non-affiliated

My Lords, will the Minister confirm that Her Majesty’s Government will not let people die for ideological reasons? Are the Government prepared to buy a vaccine from any country, provided that it is safe and it works?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, this country has been absolutely on the front foot on vaccines. We have negotiated agreements with six different vaccine providers for 340 million courses of vaccine. We are completely open to anything that is effective, and we have championed the cause of fair vaccine distribution on a global basis.

Photo of Lord Robathan Lord Robathan Conservative

My Lords, I regret to say that this Government’s policy on Covid is contradictory, confusing, hugely damaging to the country and, frankly, nonsensical. Should I have the opportunity, I will vote against it. We were exhorted, from the very beginning of this public health crisis, to save lives. As noble Lords know, some 11,000 people die on average every week in the UK under normal circumstances, so can the Minister tell us how many people under the age of 65 have died of coronavirus in the last 26 weeks? Of those, how many did not have some serious underlying health condition such as diabetes, obesity, respiratory problems or the like? If he does not have those figures to hand, perhaps he might write to me and put them in the public domain by putting them in the Library.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I entirely welcome the challenge from my noble friend but, respectfully, I completely disagree with his approach. I want to flag two issues. The first is the enormous public support for the Government’s response to Covid and their adherence to the measures we have introduced. The second is the recent King’s College survey, published today, showing that on top of the deaths, 300,000 people in the UK have reported symptoms that last more than a month and 60,000 have been ill for more than three months. The effects of this disease go far beyond the “simply recover the next day” effects of flu; it is a profound illness that we are right to try to suppress.

Photo of Baroness Masham of Ilton Baroness Masham of Ilton Crossbench

My Lords, how is new technology being brought to the front line to deliver critical care and services across the country? Is the Minister aware of the desperate shortage of doctors and nurses working on the front line of infections, and that they are exhausted? What can be done to solve this problem?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness absolutely speaks my language when she talks about the technology that is being brought into the front line. My sincere hope is that Covid will bring a benefit to the healthcare system by being an inflection point whereby we introduce new technologies in a whole host of fields to bring in much greater community-based treatment for people, digital technology and the more effective sharing of data, among a wide range of technical advances. Regarding the workforce, I completely sympathise with the noble Baroness’s comments. I pay tribute to those who work hard on the front line and am aware of the challenges and difficulties they face. This Government have committed to recruiting 50,000 more nurses. We are more than half way there already, and we will continue to recruit to ensure that we have the human resources needed to meet our commitments.

Photo of Lord Dubs Lord Dubs Labour

My Lords, what is the policy regarding the testing of domiciliary social care workers? What is being done to ensure that these people—who are at risk themselves and meet and support the very vulnerable, travelling around to different people every day—have full protective equipment and that they use it?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord is entirely right to emphasise the challenge of itinerant domiciliary care. Such workers were always a vector for potential disease and are putting their own lives on the line. That is why we have radically changed the guidelines. We have put more resources in place to ensure greater support for domiciliary care, PPE is stocked for them to use and there is regular individual testing

Photo of Lord Dobbs Lord Dobbs Conservative

My Lords, the new guidelines require political protests to be “organised in compliance with” government rules and

“subject to strict risk assessments”.

Who will undertake these assessments, when and how will they be undertaken—I presume they will have to be undertaken before any protest is mounted—and does this mean that the type of protest we saw the other day by Extinction Rebellion will by definition be unlawful?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, my understanding is that the risk assessment is done by the local police force in conjunction with Public Health England, but I am happy to check that and write to my noble friend. With regard to Extinction Rebellion, I found the protest last week particularly tedious but I am not sure if it will be outlawed quite yet.

Photo of Baroness Bennett of Manor Castle Baroness Bennett of Manor Castle Green

My Lords, the Minister has taken great pains today to stress the need to ensure that our limited number of tests are well used. I want to revisit the issue I have raised with him before: the list of symptoms as a result of which people are encouraged to take a test. I am sure he is aware of the University of Belfast study of paediatric infection rates, which showed that among children with antibodies a cough was no more common than among those without, while gastrointestinal symptoms such as diarrhoea, vomiting and abdominal cramps were significantly associated with coronavirus infection. Given that many other countries, including the United States, and the World Health Organization list a greater range of symptoms, will the Government consider communicating clearly with the public when the tests are needed, based on the scientific evidence?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness raises a very difficult subject. A huge amount of work has gone on in this country and others to define the most effective possible list of symptoms. The honest truth is that this disease manifests itself in different people in a great many different ways, and we have done a huge amount to try to understand the list of symptoms to be described in a way that will capture the greatest number of people in the clearest way possible. We keep that under review, but the work that has gone into it could not have been more thorough.

Photo of Lord Bilimoria Lord Bilimoria Crossbench

My Lords, a programme of nationwide mass testing is exactly the ambition we will need to build confidence in the public and businesses before a vaccine becomes available. Professor Devi Sridhar of Edinburgh University says that the only safe way is mass testing. I agree with the Minister: look at where we were in March, with 2,000 tests a day, and now we have the capacity for well over 300,000 tests. Given that, why can we not get on with instant mass testing? The Abbott BinaxNOW test laboratory in America is producing antigen tests—10 million this month and 50 million next month—that give results within 20 minutes, and they are already FDA-approved. Why can we not do that at such speed? Can we get this into the market quickly? Likewise, Germany started testing at airports in June, and France did so in August. Why can we not start testing at airports quickly? Jobs, the economy and lives are at stake.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, we could not be moving more quickly to engage with the producers of tests in order to sign up the resources we need to put in mass testing. That cannot be switched on overnight, but we could not be moving more quickly. On airport testing, the CMO has been crystal clear: he is deeply concerned about day-zero testing and about any but the most thorough airport testing measures. We were caught out on this at the beginning of the epidemic and we remain extremely cautious.

Photo of Lord Berkeley Lord Berkeley Labour

My Lords, I want to follow up on the Minister’s answer to the noble Lord, Lord Bilimoria, about airport testing. Apparently, we have this world-beating system and many millions of tests that we can do, but now we have limited resources. The number of people who have had to cancel their travel arrangements, lost money and not come back—for whatever reason—is enormous and it is affecting the air industry as well. If our testing system is so good, surely it can be done at airports, plus track and trace, which has worked quite well, even for one plane that came from Greece. I hope the Minister will take this away and try to move it forward a bit more quickly.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord, Lord Berkeley, is entirely right that the impact of this on our economy is profound, affecting the tourism economy, business and the professions. It is not something that we undertake lightly. However, it is the science-based belief of the CMO that the challenge presented by global travel is so profound that this is a step we have to take. When there is a surfeit of testing—when there is a vast amount of it—we may be able to put in place much more extensive measures, but, even so, the CMO remains extremely cautious on this point. However, we are working with Heathrow, the airlines and the airports to keep the matter under review. We take into consideration pilots and are working closely with them to try to resolve the issue.

Photo of Baroness Neville-Rolfe Baroness Neville-Rolfe Conservative

I do not want to add to my noble friend’s difficulties, but I have received some worrying reports that pregnant women are prevented having the father of the baby with them right through labour or when undergoing related treatments, such as scans. This can be devastating, especially if there is bad news, such as a miscarriage. Can my noble friend the Minister do his best to get the rules changed across the country, so that parents can support each other at this vital time?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I completely understand the point that my noble friend is making. The issue of scans is compounded by the problem that many scanning machines are in small, airless rooms, where the risk of contagion is high. None the less, I completely recognise the point she makes about the pastoral and psychological effect of splitting people up at this incredibly sensitive time in their lives. We are reviewing it and we very much hope to make some progress.

Photo of Baroness Blower Baroness Blower Labour

My Lords, can the Minister say whether the Government will publish the science behind the decision not to test teachers and education staff—I congratulate them on being back at work—routinely and regularly, bearing in mind that there have already been school closures due to outbreaks? Is it a matter of science or of testing capacity?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, the regulations are not in place at the moment to test the millions of teachers and other important workers who are returning to the workplace on a regular basis. We have neither the science nor the capacity to do so, but we are reviewing this and looking at ways of using testing to restore confidence and enable a return to workplaces or other situations where social distancing is more challenging.

Photo of Lord Lucas Lord Lucas Conservative

My Lords, I encourage the Government to be completely open with the data and research regarding this epidemic and to put it all on the GOV.UK website. When we opened up the data on BSE, the problem was solved within two weeks by researchers who were outside of government. When Ofqual refused to open up on its algorithm, it resulted in our recent troubles and disasters. Being open with data results in much more criticism, but that criticism is much better directed. And it makes it much easier for people like me to accurately defend government policy.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I completely agree with the sentiments shared by my noble friend. Transparency has the effect of sunlight, putting a spotlight on information. It helps those who wish to contribute to make their efforts felt. We have embraced transparency: I cite the example of SAGE, where the minutes of its meetings and the data it works on are routinely published. I completely endorse my noble friend’s comments.

Photo of Baroness Wheatcroft Baroness Wheatcroft Non-affiliated

My Lords, given that there have been hardly any tests available to Londoners for at least the last four days, and probably much longer, can the Minister say what belief we should have in the statistics for the prevalence of the virus in the country, and in particular in London? Furthermore, the Health Secretary—when he was not blaming the public for the shortage of available tests—did admit that there were problems with a couple of contracts. Could the Minister explain what those problems are and why, according to the Health Secretary, it will take a couple of weeks to sort them out?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, the statistics on prevalence are provided by the ONS. They were published yesterday and today—both the ONS and REACT figures. I would be happy to share links to those publications with my noble friend. Regarding the troubled contracts, I do not know the quotation to which she alludes but if she would like to correspond with me, I would be glad to try to figure it out.

Sitting suspended.