Health Protection (Coronavirus, Local COVID-19 Alert Level) (Medium) (England) Regulations 2020 - Motion to Approve

– in the House of Lords at 5:40 pm on 14 October 2020.

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Lord Bethell:

Moved by Lord Bethell

That the Regulations laid before the House on 12 October be approved.

Instrument not yet reported by the Joint Committee on Statutory Instruments

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

My Lords, it is a disappointing fact that the rate of Covid-19 infections is rising rapidly across the UK. The ONS estimates that one in every 240 people in England had the virus between 25 September and 1 October and that the number of those who are infected is doubling every seven to 12 days. The scientific advice is clear that the disease is currently growing exponentially. To combat this, the new local Covid alert level framework standardises many of the restrictions that will be in place, making it easier for people to understand them and comply with them. As I have said throughout these debates, the new approach will be simple and constructive. I take this opportunity to thank local leaders who have engaged with the Government over the weeks and months as we have developed this system.

The Government will continue to work with local leaders to decide changes to alert levels. Decisions will be made based on a number of factors, including the rate of transmission, how quickly it is changing and the effectiveness of current interventions. The regulations we are discussing implement the restrictions known as local Covid alert level “medium”. They reflect the current national measures and are the minimum level of restrictions in place across England.

The restrictions on gatherings seek to slow down transmission by reducing social contact. They include the rule of six. This gathering limit, which includes numerous exemptions, strikes a balance between reducing social contact, allowing socialising to continue and minimising negative social and economic impacts. Additionally, a limit of six provides a clear message to the public to emphasise social distance. The rule of six means that, unless an exemption applies, nobody can gather in a group of more than six individuals, indoors or outdoors, unless everyone is from the same household or the group is made up of two households that are part of the same support bubble, or the individual is part of a smaller group attending a larger gathering being held in a public outdoor space. The organiser of the gathering must also have carried out a risk assessment and must take all reasonable measures to limit the risk of transmission of the coronavirus.

As I have described, there are exemptions from the rule of six. For instance, we are concerned about mental health, which is why we have legislated for support bubbles to help those most at risk of becoming isolated. There are also exemptions for work or voluntary purposes, education and training, formal childcare and providing care to vulnerable people, and there are exemptions for specific life events: weddings, civil partnerships, and funerals and commemorative events following a person’s death such as wakes, which are subject to a 15-person limit. As I explained earlier, allowing higher limits for these events balances the need of people to recognise significant life events while still minimising the spread of the virus.

The restrictions include measures for business. In the first debate, I outlined much of the evidence from SAGE, PHE and other studies which demonstrate that hospitality venues pose a high transmission risk. Therefore, these regulations require the closure of hospitality and some leisure venues, including takeaways, from 10 o’clock in the evening to 5 o’clock the following morning, except for delivery or collection during that period, as long as the order is placed remotely—for example, online or by phone. This, again, is to reduce the likelihood of people not adhering to social distancing rules, as compliance is often affected by alcohol consumption. The regulations also mandate table service if alcohol is served on the premises. Customers are required to be seated when they order their food and drink, which is then served to them. The business should take all reasonable steps to ensure that customers remain seated to consume it. If no alcohol is served, customers can order at a counter, but the business should take all reasonable steps to ensure that the customer remains seated while consuming the food or drink on the premises.

On business closures, the regulations close down nightclubs, dance halls, discos and other venues which open at night, have a dance floor or provide music, whether live or recorded, for dancing. This is because such businesses and services pose a much higher transmission risk and cannot currently be opened safely. We continue to work with representatives from these industries and business sectors to develop options to facilitate a safe way for them to reopen. The Government recognise the importance of these industries and have committed to a world-leading £1.57 billion rescue package to help them weather the impact of the pandemic.

The regulations create offences punishable by fines and provide for the issuing of fixed penalty notices. For individuals, the first offence carries a £200 penalty, which is halved if paid within 14 days, and the fine doubles for every subsequent offence up to a maximum of £6,400. For businesses and services, the first offence is £1,000, followed by £2,000, £4,000 and then £10,000 for every offence committed thereafter.

I reiterate that the Government express their profound thanks to the vast majority of people who have made huge sacrifices through this pandemic and will continue to do the right thing and follow the rules. However, to protect public health it is important that police have appropriate powers to deal with those who break the rules.

I once again express my thanks to noble Lords for their valuable contributions to this debate and the two earlier debates and for challenging us to do better in this vital area of public policy. I believe that we have met the bar set for us in these debates and that these regulations are proportionate and necessary to protect the public from the spread of coronavirus and to prevent a second national lockdown. I beg to move.

Photo of Baroness Donaghy Baroness Donaghy Chair, EU Services Sub-Committee, Chair, EU Services Sub-Committee 5:47, 14 October 2020

I thank the Minister for his clear explanation of this statutory instrument, which is the lowest level including the rule of six and the 10 pm curfew for bars and clubs. As I said earlier, as a former licensee, I understand the business reasons for opening, if only for a more limited period, but common sense says that it could be the worst of all worlds. This statutory instrument shows the stark divide between north and south on any Covid map. I appreciate the difficult job the Government have to do. I have been critical of the Government’s poor relationship with local government leaders. The Local Government Association’s reaction to the three-tier proposal has been fairly positive—I should declare, incidentally, that I am not a vice-president of the Local Government Association. It has said that the new system will make it easier to follow the rules. It also urges that the system allow local councillors and public health experts to respond to specific causes of spikes in infections in their area. It referred to the additional pressure on already overstretched council budgets. What assurances can the Minister give that local expertise will be used and that sufficient funding will be available for councils to carry out their vital tasks?

Reference has been made throughout today’s debates to the publication of the SAGE minutes of 20 September, which advised the Government to ban all contact within the home by members of other households, to close all bars, restaurants and other venues, and that all university and college teaching be online unless face-to-face teaching is absolutely necessary. The contrast between the advice of SAGE and the Government’s delayed reaction—22 days later—could not be greater. We have “very high”, “high” and “medium”. I am assuming the SAGE advice would be “sky high”. Those who say that a total lockdown would be a disaster miss the point. It is all disastrous. It is a question of disaster management and clear strategy.

Turning to the issue of probity, how can the Minister prove that the public money being spent on test and trace, IT systems, testing the provision of PPE and testing laboratories fulfils all the requirements of public procurement? In his answer, he referred to the huge amount of work being done on auditing, checking and supervising contracts. He said that the Cabinet Office provided a huge amount of analysis and challenge in checking against delivery of the products and services involved, yet we still get reports of companies being given contracts without proper tendering processes. What information can the Minister give us on the actual results of those Cabinet Office checks on the delivery of those products and services? It ought to be public knowledge.

I said in the past that I was uncomfortable dealing with retrospective and sometimes contradictory SIs—but, like most of us, I have gone along with it because it is important to try to work together. Now Labour’s previous support has been thrown in its face by the Prime Minister, who is saying that we are the ones doing the U-turns. I do not detect that kind of combative aggressiveness in the Minister, but I would appreciate his acknowledgement that Labour has up to today been as strong a supporter as he could ask for in supporting these statutory instruments.

Photo of Baroness Bakewell of Hardington Mandeville Baroness Bakewell of Hardington Mandeville Liberal Democrat Lords Spokesperson (Environment, Food and Rural Affairs) 5:51, 14 October 2020

My Lords, I begin by extending my congratulations and sympathy to the Minister, the noble Lord, Lord Bethell, on his patience and stamina in dealing with the numerous questions and debates that Covid-19 has generated. Having to answer in three separate debates on the same subject on the same day seems above the call of duty.

I am lucky to live in Somerset, which has a very low R rate and is on the medium alert level. My London accommodation is also on a medium alert level. I get regular emails from the council on what is happening and how it is tackling the issues. I just hope that going backwards and forwards to Somerset does not jeopardise Somerset’s R rate. At this stage, I should probably declare my interest as a vice-president of the LGA.

I have read the instrument—No. 1103—and the Explanatory Memorandum, and I have a number of questions. Paragraph (2) of Regulation 2—headed “Interpretation”—states:

“For the purposes of these Regulations, references to a ‘local authority’ include references to a county council.”

Can the Minister clarify whether this means that all councils, districts and unitaries, are covered by this? On further reading, it is obvious that local authorities will have a very big part to play in protecting and maintaining their areas at medium level.

The dashboards circulated this morning are extremely useful but do not give quite the level of detail that is contained in the instrument. Residential care is open to visitors but subject to care provider guidance. On the radio this morning, there were some heart-rending stories of relatives who have loved ones with dementia not now being able to visit, whereas previously they had visited daily. Those with dementia are particularly hard hit; they do not understand what is happening and why they appear to be being punished. Their loneliness and isolation are more than they can bear. Would the Government consider working with the residential care sector to provide guidelines to allow those suffering from dementia greater safe access to their relatives?

I am somewhat confused by the paragraph on linked households; other noble Lords have referred to this. I may not be the only one in the country who is confused. The paragraph states that a household of one adult and children under 18 may link with another household. However, there is no limit on the number of adults or children who may be in the second household. Can the Minister say how this fits in with the rule of six, either indoors or outdoors? Why can the first household not have two adults and no children in it?

Lastly, I want to touch on the plight of young people who have fallen on the wrong side of the law. Services to young people are at an all-time low and the restriction on gatherings hits young people very hard. I note that workplace canteens are exempt from the restrictions, as are canteens in criminal justice accommodation, which includes young offender institutions. It is essential that young people should be able to at least socialise with their peers in this setting at mealtimes. Are visits from relatives allowed at young offender institutions, or do they fall under the same restrictions that exist in residential care homes? Isolating young people from their family support network is not likely to change the behaviour that brought them into the criminal justice system in the first place.

Broadly, I support the introduction of these three instruments, but I fear that they may be a little too late to deal with the second wave of infections that is overtaking our country.

Photo of Lord Bilimoria Lord Bilimoria Crossbench 5:56, 14 October 2020

My Lords, a second national lockdown would be devastating for our economy, so it is right to prioritise bringing infections under control. Business supports the simplification of Covid rules with the three tiers of restrictions. But this remains very tough news for thousands of firms that have done so much to keep customers and employees safe.

Now that clear rules are in place, good, open communication is essential. Businesses in the worst-affected areas have too often had to plan on rumour or react to things at the last minute. This can be solved with a more collaborative approach between businesses, central government and local government. Restoring a sense of national unity is critical for tackling the virus and, to maintain confidence and compliance, the Government must show more of its evidence base for new restrictions.

One example of this would be the 10 pm curfew for restaurants, bars and pubs. I have asked this question before, but can the Minister provide us with the evidence that the curfew is necessary? I have heard that only 5% of new infections come from the hospitality sector and, when wearing my business hat, I have heard from my trade that only 10% of drinking takes place after 10 pm.

To protect jobs, we should keep financial support under review and in lock-step with the severity of the restrictions. I pay tribute to the Chancellor, who has continually listened when we have asked for more help, and iterated and adapted and avoided cliff edges. For that, I know that business is very grateful. But ultimately, mass rapid testing must really ramp up if we are to prevent a second wave from further harming economic growth.

I know the Minister and I appreciate his hard work and dedication. I know that I sound like a stuck record, but I will say this: we get updates on normal testing, with the target of 500,000, but what about the LAMP boxes that can be rolled out? We could have something like a ventilator challenge to have them manufactured; British manufacturing would come to the fore. We could really ramp up their use in airports, schools, factories and offices. Similarly, we could have mass testing with pregnancy-type tests; they may not be as accurate as PCR tests, but with a triage-type approach combining them with LAMP and existing testing, we could really be on top of the virus.

Business wants to work with the Government on support during these restrictions. The CBI, of which I am president, has proposed a six-point action plan. Business wants to see the following: increased visibility and awareness of the data trigger points used in decision-making; ensuring that decisions are communicated at the right time to the right people; clarity of message on what people can do and on changes to what they cannot do; communication of who is in charge of the lockdown, with a go-to person accessible to businesses who can provide information; stepping up test and trace efforts; and a framework which recognises that local lockdowns will impact local economies differently, with improved support for businesses and people where staff absences are due to self-isolation rules, a clear mechanism for channelling funding quickly by local authorities, and any such support made easily accessible to local firms.

Photo of Baroness Andrews Baroness Andrews Deputy Chairman of Committees, Deputy Speaker (Lords), Chair, Common Frameworks Scrutiny Committee, Chair, Common Frameworks Scrutiny Committee 6:00, 14 October 2020

My Lords, in the time available, I want to ask the Minister a number of questions about this SI and the decision to leave so much of the country designated as “medium” level, but I join other noble Lords in saying how much we appreciate the Minister’s very hard work, stamina and patience on this series of SIs.

It seems that the “medium” level areas are precisely those where there is still a marginal chance that lessons can be learned, and early and swift action can be taken to prevent escalation. One of the most perverse and unwelcome outcomes of how this disease has developed is that, as the WHO said recently, it thrives on poverty and poor housing, and “exasperates inequalities”. One of the very worst things that could happen would be for this already divided country to be driven further apart because those traditional post-industrial communities of the north and west, the Midlands, south Wales and Scotland were to suffer disproportionately. We are certainly not all in this together at the moment, but I sense that it is only a matter of time before we are. Large areas of the country designated at the lowest tier also contain large poor urban communities, where the pandemic takes a fierce hold.

That is why I say, “Thank God for the leadership of the local authorities.” They have stepped up magnificently to protect and provide for their local communities. The most effective thing that the Government could do is to listen more closely and act more swiftly on the advice they are getting from local authorities. They are still not in the driving seat when it comes to NHS Test and Trace, but they need to be. London is the outstanding case in point. Infections are now rising above 100 in 100,000 in several boroughs. The Mayor of London is urging the Government not to wait four weeks, until London has caught up with the worst scenario in the north, but to act now to break the circuit of infection. What is the Government’s response to this? Is the Prime Minister talking to the mayor? Why delay when, as surely as night follows day, and as the Deputy Chief Medical Officer has said, the evidence is that there will be a predictable exponential increase in infection and eventually in hospitalisations. What is the Government’s strategy to deal with London in all its diversity?

Turning to more general questions about the decisions to leave most of the country designated as “medium” level, how is risk defined in those areas so designated? Is there any differentiation within these areas? What are the ranges of the R number? What modelling is being done by SAGE or other groups, and at what level, to establish transmission routes or speed of transmission from areas of high infection to areas of low infection? What advice are the Government giving public health leaders in the south-eastern region, for example, about what they might expect and what they should be preparing for? Given that there are many universities in the south-east, what assessment have the Government made of likely sites for the spread of infection? What advice is now being given to universities across those areas, especially on testing? What precise trigger point would escalate the decision to move regions to tier 2? Which pillars of the Covid-testing strategy are informing these decisions? Given that SAGE has confirmed that the NHS Test and Trace system is having a marginal effect on areas with the highest rates of infection, what evidence is there that it is having a more effective impact, in terms of contact tracing, on areas of medium risk? Have the Government assessed the relative advantages of a Serco track and trace system over those of local authorities?

We are all shocked by the resistance that the Government showed to SAGE advice three weeks ago. Now we are told that the Government might be considering a circuit-breaker. I beg of them not to dither any more, because I predict that we will be here in a few weeks’ time debating a temporary lockdown. The tragedy is that we will have wasted weeks, when we could have saved lives in the process.

Photo of Lord Dholakia Lord Dholakia Co-Deputy Leader of the Liberal Democrat Peers 6:05, 14 October 2020

My Lords, the reality is that the number of cases of Covid has quadrupled in the last three weeks, and there are now more people in hospitals with Covid than there were when we went into lockdown on 23 March—and deaths are already rising. All the optimism about a vaccine and winning the battle against Covid has become a distant future, and the reality has to be accepted: the virus is here to stay for a while.

I shall concentrate on some of the issues facing us. It is not to ignore the situation in very high-risk areas, but the tier system fails to address issues in other areas. There is a commonality between all three tiers. No one is immune from the spread of this virus; we cannot afford to take our eyes off the areas classified as “medium”, and great care must be taken to ensure that factors that affect the other tiers are as relevant in groups where intensity is less obvious. We do so at our own peril.

There has often been confusion in how we have handled this issue. We are told that our action relates to, and is guided by, science. That sounds hollow when we now know that scientific opinion offered a few weeks ago, including actions that should be taken, was ignored. Consultation with communities was narrowly confined, and the local population hardly featured in any outcome of the decisions taken.

I give one example. I live in a village which has no shops, no station and no post office—nothing of that sort. The nearest supermarket is about seven miles away. We have one facility, which is the local pub, the Labouring Man, and I declare an interest as I frequently visit it. It is owned by Martyn Brand, who converted his shop into a grocery shop overnight when the crisis became obvious. I hate to think what would have happened to the village had that facility not been available to local people. A number of noble Lords have talked about closing hospitality businesses at 10 pm. We have to be careful about how that affects small places in many rural areas.

At the best of times, the Government’s message is confusing. We must remember that the population has paid a very heavy price for the action taken so far. We are now expecting even more from them. They will oblige if there is absolute clarity in the message that comes from the top. This has not been the case. It is here that I want to thank local radio stations, provincial newspapers and ethnic papers, which have been at the forefront. They have probed statements for clarity and highlighted issues affecting local communities, care homes, business and the hospitality industry. Communities are better informed not because of the Government but because of how they have highlighted the fight against the virus.

In conclusion, let us not forget the plight of those at the wrong end of this issue, who fit in all three tiers that we have talked about. These include single mothers living in limited accommodation and victims of domestic violence, which is on the increase because of isolation. Unemployment is on the increase, and test and trace has been so poor—and there are many other factors. These will not go away, and action is necessary on all fronts.

We value the award of honours to those who have excelled in their contribution, and I am delighted that so many from minority communities featured on the last list. Their contribution in providing care has been unique. Many have provided food and help where appropriate. If there is one positive message from the present crisis, it is that we are more united now than we have ever been.

Photo of Viscount Eccles Viscount Eccles Conservative 6:09, 14 October 2020

My Lords, in expressing my gratitude to my noble friend on the Front Bench, I reflect that in this very complicated situation it cannot always be easy to convey the messages that go from this House to the other end of the Corridor. Messages are coming from a multitude of directions, and we must be very grateful for my noble friend’s diligence and persistence and for the calm presentations that he makes to us in this House.

This virus is, regrettably, proving to be very efficient. What assumptions can we reasonably make? There are not many, but perhaps there are two. The first is that it will be here for a long time, and the second is that it is almost certain that it will cause excess deaths, although of course some of them, equally regrettably, will probably be due to other, more conventional reasons because of the burden laid on our institutions—notably, the NHS.

At the same time, the social, economic and financial effects are huge, and they have been discussed many times in this House. They go all the way from the national debt to the individuals who decline to self-isolate for their own reasons, some of which are very compelling.

Therefore, a balance needs to be struck, with a comprehensive approach to how we deal with the future. In approaching that, it is very welcome that the Government have made the greater involvement of local institutions—local government, the NHS and Public Health England, to which I would add charities and local groups—a part of the programme. However, at the moment it is described as “working with”, and I am not sure that that is yet an adequate way of approaching local involvement. The nearer the action, the greater the knowledge of what is happening and of the people to whom it is happening and their circumstances. Indeed, I would say that our best chance of controlling, reducing or suppressing this virus lies with individual behaviour. Knowledge of what is happening is growing all the time and people’s response to that is critical.

However, I come back to these regulations and the others that we have considered today. They all need to be reviewed in 28 days. The 28th day is 11 November—a date of some significance. I think that this House and the public need to know more about the criteria that will be applied to those reviews—the assessment that has been made and how the balance, with all the competing matters that face us, is being approached and reached. May we please have some days before 11 November to debate the matter?

Photo of Lord Robertson of Port Ellen Lord Robertson of Port Ellen Labour 6:13, 14 October 2020

My Lords, I join other noble Lords in congratulating the Minister on his fortitude and, indeed, his patience in dealing with all these regulations. Of course, they are all to do with enforcement, whether through self-discipline or the force of law, and that is extremely important. I think that the problem for this Government is that, with the internal market Bill coming up and raising the whole question of the rule of law, they have a dilemma on their hands. I wonder whether the Minister has seen the words of the noble and learned Lord, Lord Neuberger, the former President of the Supreme Court, who last week made this point:

“What moral authority does the government have in expecting people to obey these laws if it itself is announcing that it intends to break its obligations under international law?”

Is that not a fatal weakening of the Government’s authority in this situation?

I want to ask a couple of questions but also to underline the fact that all this should be about track and trace: it is fundamental in the detection of and dealing with the crisis we face. The SAGE report makes it clear that the low level of engagement and the delays in testing were hindering the system’s success. It is scathing about the Government in that regard.

I ask three brief questions of the Minister. First, is what Sky is reporting today true: that private sector consultants are being paid £7,000 a day on the track and trace system? Secondly, can he explain to me and the House how a company called PPE Medpro, incorporated with a share capital of £100 in May this year, received a non-compete contract for PPE in the health service of £110 million? Finally, when will the Government get around to making the app available in England compatible with the one in Scotland? As somebody who travels between the two nations, I find that I cannot get my NHS app to work in London because it is overruled by the one I have on my phone from Scotland. The Prime Minister was asked that today by Wendy Chamberlain, the Liberal Democrat chief whip, and it seemed to come as news to him. Can the Minister give an answer today as to when that ridiculous situation will be resolved?

Photo of Lord Rooker Lord Rooker Labour 6:17, 14 October 2020

My Lords, two days ago, the Prime Minister sent us all a circular letter following his Statement. It had two enclosures, one of which was a chart of the local Covid alert levels. It is in three colours, so it is fairly simple. I have one question about one issue. In the description column, it lists “youth clubs and activities”. Under each level—medium, high and very high—it simply says in each column: “permitted”. I would like to know what is permitted and what is the evidence that youth clubs and activities are actually taking place? I get the impression that they are not, yet, clearly, under each of the regulations, they are permitted. Do the Government have any further information about that?

The Minister said in the previous debate that the system of government is such that we have all got to know each other better. I can guarantee that for the first six months of the outbreak of this pandemic, the words “environmental health officer” never crossed the lips of a Minister. Those 3,000-plus people are the unsung heroes of this country. They know how to check on disease control and other matters, but they were never used because they are public sector.

The Minister also said, very interestingly, that it is now superspreading events that are the problem. That puts the kibosh on the approval of the noble Baroness, Lady Harding, of the Cheltenham Festival, does it not? We need to go back and look at that: those events did cause problems. My only question about SAGE and the minutes of 21 September is not about the detail, it is why on earth, when the Prime Minister made his statement on Monday, he never referred to the fact that the SAGE minutes were going to be published. He must have known that. All he had to was mention it and simply say, “We have looked at it, but we are doing this.” That would have stopped all the rows and accusations about his judgment, but he failed to mention it, although he knew all about it.

On local authorities, the previous debate was about tier 2 and this is about the rest. It is true that the city of Birmingham, which I referred to before, is abounded by the local authorities in the West Midlands conurbation. But it is also abounded by Staffordshire, Warwickshire and Worcestershire and all are encompassed in the travel-to-work areas. Looking at the way the tiers have been drawn up, it looks as though the refusal to use travel-to-work areas may be an Achilles heel.

My final question is again to help the Minister because he is the one who raised this, not me. He boasted about 310,000 swabs a day and I asked him how many people were involved in those swabs. He did not answer, or even refer to his own boast. Yet in his own weekly statistics for NHS Test and Trace in England, as published by his department, those for the latest week of 24 to 30 September clearly state on page 41 in Annex A—it is the same annex every week—that the number of people tested totalled 588,895. That is 84,127 a day and the figure was less than the week before, so the testing system is not working. That is why we do not have a trusted system. Until it is working and the boasts of 500,000 being tested are made a reality—and how many people that involves—people will not trust the system or the Government.

Photo of Baroness Uddin Baroness Uddin Non-affiliated 6:21, 14 October 2020

My Lords, it is a real privilege to follow my noble friends Lord Robertson and Lord Rooker. Tiered approaches may seem fit for the purpose now, as we deal with differing rates in admissions across the country and across boroughs in London. However, it has to be said that the rapid rate of government announcements has caused manic confusion among the general public. I agree with the noble Lord, Lord Bilimoria, that clarity in message is critical. Even in areas described as medium risk, there is a deepening fear that we are about to hit a catastrophic health crisis without sufficient financial measures for significant numbers of our citizens—vulnerable citizens and communities. I have some general questions for the Minister and I look forward to his consideration and responses.

What specific measures are in place to protect front-line staff with protected characteristics? Will the Government assure this House that, unlike in the first few weeks and months, front-line staff of minority heritage will not be pushed into Covid management without safeguarding their well-being? I am citing many who lost their loved ones during the first outbreak. Given that we know people of minority heritage continue to be at risk of ending up in ICU admissions, will the Government ensure that those doing test and trace door to door have proficiency in the languages for the populations there? What additional resources will be given to areas in the middle tier to prevent them going to the more critical grade?

We also know that families with disabled children who have learning disabilities and autism, and their carers, have experienced adverse impacts in services and their mental well-being. What plans and resources are in place to meet the upcoming needs for services to ensure that we meet our obligations on human rights and equal rights? I have asked this question before and it has not been answered. What protocols exist to ensure that parents and carers of people with learning disabilities and autism can be with their loved ones, should they wish to be, when members of their families end up in hospital for treatment? I would really like to be written to if it is not possible to answer this. What protocols exist and are they being issued as guidelines to all front-line services?

Some of the exemptions are applicable to people with disabilities who are able to participate in games, outside and indoors. I understand the sentiment in ensuring that activities and provisions on playing sport are available to them. Are we not overlooking the need to safeguard the health and protection of the groups of people who have until now been shielding?

Are the criteria for shifting at-risk areas in the medium category to a higher grade being communicated to local authorities in advance so that they can prepare sufficiently, and will adequate extra resources be made available to cities and regions, whatever their political leadership?

Finally, boroughs such as Tower Hamlets and Newham have seen incredible levels of infection and admissions, which now include young people and children. What consideration is being given to ensure that we do not airbrush children out of the danger zone, as we seem to be doing?

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

As the noble Lord, Lord Berkeley, has withdrawn, I call the noble Baroness, Lady Jolly.

Photo of Baroness Jolly Baroness Jolly Liberal Democrat 6:26, 14 October 2020

My Lords, this has been a good debate, with more questions for the Minister about various concerns of noble Lords. It must seem to him like a never-ending SI marathon—and of course we all know there will be more.

Our Government have abandoned their attempts to control the spread of SARS-CoV-2 by means of piecemeal local regulations and have introduced a three-tier approach across England, with legal restrictions varying according to government-defined tiers. Tier 1 areas are referred to as medium restriction areas, with tier 2 high and tier 3 very high.

This third SI covers the majority of England and is the basis of those SIs that we have already heard debated. It is the least restrictive, repeating the rule of six and its attendant exceptions and outlining business restrictions in hospitality and leisure venues, the closing times of hospitality businesses and closures of such leisure venues which are deemed to have a higher transmission risk. Those SIs that have already been debated have covered this and more. We understand that lockdowns are not popular, that our economy is stretched towards breaking, and in some cases it has broken, but what is really at issue here is science, evidence and expertise.

What seems a long time ago—over six months—we went into our first lockdown; it was originally for three weeks, but became four months. We adapted to home working, school children at home too, parts of local economies failing, and clapping for carers on Thursdays. We came out of lockdown and things became a new normal. However, there was much concern over a second peak and, in an open letter to the BMJ, a number of health leaders called on UK politicians to conduct

“a rapid and forward looking assessment” to assess how prepared the nation was for a potential second round of infections. The letter read:

“The job now is not only to deal urgently with the wide-ranging impacts of the first phase of the pandemic, but to ensure that the country is adequately prepared to contain a second phase.”

It added:

“While the future shape of the pandemic in the UK is hard to predict, the available evidence indicates that local flare ups are increasingly likely and a second wave a real risk. Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain.”

Will the Minister outline what measures were put in place as a result of that letter or, if he does not know that, what lessons were learned from the first wave, what preparations are now in place for the second wave, and whether the Government feel confident that lessons were learned?

One area of failure, which many Peers have mentioned in today’s debate, was the test, track and isolate system. The technology did not instantly deliver—from the mobile app to the appointment system for testing. We have heard many examples this afternoon. Media coverage of call centre staff failing to track and trace sent all the wrong messages. If this has not already been rectified, any lockdown we find ourselves in must be used for getting this fixed.

Many local authorities requested that they should be sent into their own neighbourhoods to carry out track and trace on their own patches. Could the Minister explain why that did not happen from the beginning? They had local expertise and knowledge and were used to doing it. What was the Government’s objection to using these local experts?

I am alarmed that, while we have a Cabinet with very few scientists, we have a group of experts whose job it is to advise the Prime Minister. SAGE, headed by the Chief Scientific Adviser, Patrick Vallance, and Chief Medical Officer, Chris Whitty, provides scientific and technical advice to support government decision-makers during emergencies. That is what it does, and the minutes of its meetings make fascinating reading. We all want to put Covid behind us as soon as possible, so why would the Prime Minister either ignore the advice given to him by these experts or not ask them in the first place? Why would he ask us to follow measures that his chief advisers felt were not good enough?

Today we spent four and a half hours debating a suite of measures across England that are designed to set us right for Christmas. The case for a short circuit break is clear. The Government’s test, trace and isolate system is utterly failing to help them to get a grip on this second wave, leaving us with few other options. The country has made enormous sacrifices to try to contain the pandemic, and people will be rightly appalled to read that the Government have once again ignored the best scientific advice and wasted the sacrifices that everyone has made. The Prime Minister has made little effort to explain how his Government will get a grip on the rising cases, so that we have a chance of coming out of these restrictions. Until the Prime Minister fixes the test and trace system, people will continue to face lockdown as a result of this incompetence. Of course, we all understand that the economy is important, but lives are important too. I hope that in the near and mid future, No. 10 keeps that in mind.

Photo of Baroness Thornton Baroness Thornton Shadow Spokesperson (Health) 6:32, 14 October 2020

I thank the Minister for his explanation of this SI and indeed of the others. I compliment him, as other noble Lords have been doing, on—I do not know what the word is; “sturdiness” is not quite right—his resilience under fire, apart from anything else.

In many ways, this might be the most important SI before us today because it concerns the whole of the rest of the country, which is subject to restrictions that we are all very familiar with and know about. The success of combating the virus will depend in part on those restrictions being adhered to by the rest of the country, so that communities do not move into the next tier. As the Minister said, coronavirus cases are increasing at a terrifying rate.

I want to ask particularly about London. While it seemed that lockdowns were happening mostly in the north, it now seems that London might be heading towards one. Indeed the mayor, Sadiq Khan, has been pressing the Government to put in tougher restrictions in the capital for some time, such as a ban on households mixing. I echo what other noble Lords, including my noble friend Lady Andrews, have said: why are the Government hesitating?

All London’s 32 boroughs have been placed on the Government’s official watch list, which highlights that they are areas of concern, but some are more concerning than others. Eight London boroughs are above the infection rate threshold of 100 per 100,000. Ealing is 136.9; Richmond is 133.3; Redbridge is 124.5. Some of those rates are higher than those for boroughs and cities that are already included in the second tier. This is an important issue because London has very diverse communities and some very poor ones. One of London’s great strengths and, in these days of Covid, vulnerabilities, is how mixed it is and how large its BAME communities are. We have already lost too many BAME fellow citizens, particularly those who work for the NHS. London has not been spared any of that.

Compared to London, Doncaster has an infection rate of 136.9 per 100,000 and is currently in the high tier. Leicester went into lockdown on 30 June with an infection rate of 135 per 100,000. My honourable friend Jonathan Ashworth has asked why the city of Leicester is in tier 2 with restrictions, yet Charnwood—the constituency of Edward Argar MP—where the infection rate is 150 per 100,00, is not. Why are North East Derbyshire, where the rate is 164, or Barrow, where it is 277, not in that tier? There are questions about why other areas have not been included.

Sadiq Khan says that across our city

“the average over the last 7 days is about 90 per 100,000. All the indicators that I have: hospital admissions, ICU occupancy, the numbers of older people with cases, the prevalence of the disease, the positivity, are all going in the wrong direction. Which means, I’m afraid it’s inevitable over the course of the next few days London will have passed a trigger point”.

Is that correct? When was the Mayor of London invited to a COBRA meeting? Have conversations happened at a senior level with the leading citizen of our capital city, as they should have?

As my noble friend Lady Donaghy said in her pertinent questions, we are very concerned about probity. At some point, there has to be a reckoning of the governance of the contracts that the Government have given during this pandemic. My noble friend Lord Robertson underlined that point, in relation to track and trace. My noble friend Lord Rooker also raised the issue, with his usual tenacity. My noble friend Lady Andrews asked the Minister the key question which has been asked all afternoon. I am not sure that I have heard an answer yet. Why did the Government ignore the advice they were given on 21 September?

On a lighter note, the Minister referred to “the rose garden”. My noble friend Lady Donaghy asks whether he means the rose garden at the White House in Washington or the one that Dominic Cummings occupied in Downing Street?

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

I thank noble Lords for a detailed and illuminating debate which focused, quite rightly, on the interplay between the local picture and the national one. If these restrictions are about one thing, they are about trying to make focused, local lockdown work, so that we can avoid another great, clunking, national lockdown, which would come at enormous social and economic cost. We have seen some incredibly impactful local lockdowns work in Swindon—it was an intervention there, rather than a lockdown—Luton, Leicester and other cities. We are determined to try to make these work.

Getting them to work, as the noble Baroness, Lady Donaghy, rightly said, totally depends on getting the interplay between national and local government right. I am grateful to her for reminding us that the LGA has welcomed these restrictions and the spirit of partnership between local and national government.

In response to the noble Baroness, Lady Donaghy, yes, we absolutely want to work with and deploy the expertise of local authorities. We also absolutely need to back major restrictions with the money to support those communities—the charities and civic institutions, the businesses that are hard hit and the individuals whose jobs are put at risk or who need to stand down. I reiterate the sentiments of the noble Lord, Lord Dholakia, who said we will end up more united than we have ever been. I would really like to dwell on that positive sentiment.

To reassure the noble Lord, Lord Rooker, environmental health officers have been part of our thinking from the very beginning, and reminding us of that has been central to these debates. We spoke about this in some detail in the debate on the “very high” restrictions so I will not repeat myself, but we have put in a huge quantity of resources. We now have 1,000 tier 1 central tracers and 90 contract tracing partnerships, and we have doubled the number of local protection teams. In answer to the noble Baroness, Lady Jolly, local partnerships are absolutely central to our response to Covid.

In response to the noble Baronesses, Lady Thornton and Lady Andrews, the situation in London is very much on our mind. We are in daily, if not more frequent, contact with Sadiq Khan, who has made his sentiments very clear. The encouraging thing is that with these restrictions, and the other investments we have made over the last months, we very much have a shared platform of data on which we can make joint decisions informed by the latest information—information which in no way existed in February, March and April. Talk of data in those days was wishful thinking rather than practical. With these restrictions we have a structure for applying local lockdowns, and we have a much stronger spirit of partnership between national and local government.

The noble Baroness, Lady Andrews, talked about exit strategies, which is a critical question. We have local Covid plans in place in every local authority, and these plans govern the response of the local authority and create a template for the response to the epidemic. These restrictions give a new poignancy to those plans and a new importance to the exit component. Only by working collaboratively with the communities in those local areas will the kind of behavioural changes and containment strategies that can lead to exit really work.

The noble Lord, Lord Robertson, asked about Scottish interoperability. I completely share his frustration, but it is an aspect of the mobile phone app phenomenon that they tend to interfere with each other. We are working with the Irish, Welsh and Scottish DAs to bring about the kind of interoperable nirvana of which he dreams. We hope to introduce a new version shortly.

I would be very glad to write to the noble Baroness, Lady Uddin, with the protocols for those caring for the vulnerable. Those protocols exist and I would be glad to share with her a link to them.

To answer the noble Lord, Lord Rooker, youth clubs are open. There are extremely detailed guidelines for making them Covid-safe; that is the only way in which young people can mix together in those youth clubs. Again, I would be very glad to share those guidelines with him if that would be helpful.

Towards the noble Lord, Lord Bilimoria, I feel a degree of resentment. I thought that I was the country’s leading evangelist and advocate for mass testing, the power of surveillance and innovative technologies such as LAMP and lateral flows, but it seems that the noble Lord has stolen my crown, because he is absolutely the No. 1 evangelist for them. I applaud wholeheartedly his sentiments on that matter.

I am genuinely touched by the kind comments that people have made about these debates and my contributions to them. They are really important; there is a huge amount of them—nor do I think they will stop any time soon. I am glad that this debate is happening on the day that these SIs have been brought into force, which brings a new relevancy to it. I extend my thanks to my opposite numbers: to the rota of spokespeople on the Lib Dem Bench and to the noble Baroness, Lady Thornton, for her enormous stamina. She has been in lock-step with me all the way, and I am grateful to her both for her insightfulness and for the collaborative way in which she has gone about these debates. I extend my thanks also to the Whip, my noble friend Lady Penn, who has been a huge support and demonstrated massive stamina.

My noble friend Lord Eccles asked about the relevancy of these debates. They are absolutely relevant. There are instances where what has been said in this Chamber has been carried into the decision-making and discussions of policy as it has happened. On masks and face coverings, on the importance of sharing data with local authorities, on issues around shielding and communications to the vulnerable, on the role of local infection control and the directors of public health, on the entire areas of social care and mental health and on the impact of restrictions on the economy, noble Lords have expressed clear, insightful and well-informed views and wisdom, and those views have been shared in the decision-making process. It has been a demonstration of this Chamber at its very best.

Motion agreed.