Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021 - Motion to Approve

Part of the debate – in the House of Lords at 1:00 pm on 15th December 2021.

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Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care 1:00 pm, 15th December 2021

I start by thanking noble Lords for their valuable contributions to this debate. They showed the very best of debate in this place, in the range of views covered—some political, some scientific and some challenging the Government on constitutional issues. This demonstrates the importance of these discussions and I welcome all contributions, whether or not I agree with them. That is the purpose of debate and discussion.

I remind some of my noble friends behind me and other noble Lords why we have acted now and gone to plan B. We want to slow the spread of the virus, after looking at the replication rate; we want to buy time for more people, especially the older and more vulnerable, to get their booster dose; and we want to give our experts crucial time to gather and understand the data about omicron.

Noble Lords, and indeed noble friends, look at the experience of South Africa. As the noble Lord, Lord Birt, and others have said, its experience is different. It has a younger population, with an average age of about 29, when our average age is in the mid to high 40s. Given our experience at the beginning of the Covid pandemic, when a disproportionate number of older people died, surely it is right that we collect data to make sure that the most vulnerable people are safe before we go forward.

I turn to some specific points raised by noble Lords. As I said, my noble friend Lord Robathan asked about the data from Africa, which we will continue to monitor. We will monitor whether it is different or milder here.

The noble Baroness, Lady Bennett, mentioned the risk of exponential growth and I thank her for making that point. We do not want to see waiting times and patient numbers starting to overwhelm hospitals. By the time we had waited for exact data, it might be too late. The noble Lord, Lord Davies, rightly spoke about the limited data available. I assure the House that we will continue to review the data as it comes in.

As we have looked at the response, we have always tried to strike the right balance and act in a proportionate way. We have looked at the scientific evidence, including evidence from different scientists—they have not always agreed. We have looked at the differences within the health profession and at the concerns about lockdown and the effect of some of the restrictions on the mental health of our nation. We have also looked at the unintended consequences, including all the operations and diagnoses that have been delayed. I admit that it has been a difficult balance and that, whatever we do and whichever way we come down, we will always have critics—rightly so—but we have tried to get the balance right.

My noble friends Lord Robathan and Lady Foster raised concerns about the restrictions on social services, elective care, hospitality and the wider economy. Elective care recovery remains a priority and I have previously announced increased investment in tackling the backlog and waiting lists. As I have said previously, between 70% and 80% of those on waiting lists are waiting for diagnoses, rather than surgery. Of those waiting for surgery, about 80% do not need to stay overnight as their surgery can be completed without an overnight stay.

We need to protect our health service from the pressures caused by the new variant of Covid-19 and prioritise vaccinations and urgent appointments. My noble friend Lord Robathan and the noble Baroness, Lady Fox, asked why we are taking action now. On Sunday, the UK’s Chief Medical Officer increased the UK alert level from 3 to 4 because of the rise in cases and because the doubling rate is every couple of days. That is why it is right to act now, while we collect more data.

My noble friend Lord Dobbs asked several questions about cases of the omicron variant in the UK. While the number of hospitalisations and deaths from omicron may not seem troubling to some now in comparison with previous waves, the measures we have implemented to stem hospitalisations and deaths have been introduced to make sure that we do not overwhelm our health service.

The noble Lord, Lord Scriven, asked about the value of vaccine or test certification in the light of omicron. This is why it is so important that everyone gets boosted now and why my right honourable friend the Secretary of State set out that boosters will be included in the definition of a full course of vaccination once all adults have had the opportunity to get the jab. For now, the definition remains at two doses, but once a sufficient proportion of the population has had the booster vaccine, it will move to three. Vaccine effectiveness is likely to be higher for preventing severe rather than mild disease and, of course, it continues to be vital in relation to the high levels of delta cases which continue to circulate.

I say to the noble Baroness, Lady Fox, that certification is not a vaccine passport. We believe it is important that everyone has the option to access settings and that is why, alongside vaccination, a recent test from within 48 hours and medical or clinical trial exemptions will also be accepted.

My noble friend Lord Robathan asked about evidence on the effectiveness of face coverings. Evidence from the UK Health Security Agency respiratory evidence panel suggests that all types of face coverings are, to some extent, effective in reducing transmission of Covid-19, through a combination of source control and protection for the wearer. According to SAGE, face coverings are likely to reduce transmission through all routes by partially reducing the emission of and/or exposure to the full range of aerosols and droplets that carry the virus, including those that remain airborne and those that deposit on surfaces.

The noble Baroness, Lady Walmsley, and the noble Lord, Lord Scriven, raised the issue of compliance with regulations concerning face coverings. When face coverings were previously mandatory, our assessment showed that compliance was high. We are grateful for the public’s willingness to comply with the rules, which help to keep everybody safe, and expect similarly high levels of compliance as the public get used to these new requirements. Turning to enforcement, the police can enforce the law and issue fixed penalty notices. This includes the British Transport Police, who work and operate on the railways.

The noble Baroness, Lady Walmsley, also queried the value of certification. Introducing vaccine or test certification will help reduce risks in associated settings when compared with no intervention. It has been correctly stated that a negative test result provides some assurance that the individual is not infectious when the test is taken and for a short time afterwards. However, vaccine effectiveness is likely to be higher for preventing severe rather than mild disease for omicron and of course continues to be vital in response to the high level of delta cases.

The noble Baroness, Lady Walmsley, asked about compliance and enforcement of daily testing. I hear her concerns. To implement daily testing for contacts as quickly as possible, we have taken a pragmatic approach. As in all these things, we have once again to address a balance, but we strongly advise that people follow the advice to take daily lateral flow tests. Noble Lords will agree that most people will want to do the right thing to protect their loved ones and communities, with peer pressure from friends and family to help manage the pandemic so we can all live as normal a life as possible.

The noble Lord, Lord Bilimoria, rightly noted the importance of lateral flow tests in our pandemic response and the latest evidence of the efficacy of oral antivirals. The UK was the first country in the world to approve a Covid-19 antiviral; we are now also the first to begin rolling out oral antivirals in the community. UK patients have been receiving molnupiravir through a new national study called PANORAMIC, which opened on 8 December. I strongly encourage all eligible patients to sign up for this national study, to help the UK once again gather more data on how antivirals work in a predominantly vaccinated population.

The noble Baroness, Lady Walmsley, and the noble Lord, Lord Rooker, raised concerns about testing capacity in the face of increased demand. I reassure the House that there is no shortage of lateral flow tests. The issue has been one of distribution. I was in a meeting earlier this week with my right honourable friend the Secretary of State; he said that we have the numbers and the orders, we just have to make sure that we get them out everywhere. Everyone who needs a lateral flow test will be able to collect them at a local pharmacy, at some community sites and at some schools and colleges. Tests should become available for delivery every few hours. We are issuing record numbers of rapid test kits to people in zones across the country and are urgently working to expand our delivery capacity and improve distribution to the right places.

The noble Lord, Lord Rooker, my noble friend Lord Robathan and the noble Baroness, Lady Fox, asked what the Government are doing to protect the health service, not only in the context of Covid. The Government are committed to giving the NHS what it needs. In previous pronouncements in this place, I have gone into details on some of the investment into the new UK-wide health and social care levy, which provides £23 billion for the NHS, so I will not go into further detail on it here.

I echo the thanks of the noble Baroness, Lady Bennett, to the noble Lord, Lord Thomas, for his moving words and the importance of these measures in protecting the most vulnerable in our society. The noble Lord, Lord Fowler, spoke eloquently about the expertise of scientific advisers and their invaluable input throughout the pandemic, based on his own experience of championing treatments for AIDS over many years. I completely agree with the noble Lord and thank him for his advice. If he is ever tempted to jump back on to our Benches, he would be more than welcome—I am not sure I have done him any favours there.

The noble Baroness, Lady Hayman, spoke about the importance of this legislation given the balance between the threat posed by the virus and the threat to disruption of NHS services. I agree that we must balance these things; each of us may see that balance differently, and we must make a decision based on the balance of different factors. We will not all come to the same conclusions, but I hope noble Lords will acknowledge that we try our best to get the balance right—we may not always get it right, but we try.

I also thank noble Lords for their incisive, impassioned contributions to this and previous debates on other Covid-19 legislation. It would be remiss of me not to reply to the noble Baroness, Lady Brinton, on the immunosuppressed and shielding. The decision to end shielding was based on there being far more available information on the virus and what makes individuals more or less vulnerable. I hope I can give her and some of the charities we are talking to more information at our meeting tomorrow. I am grateful to Jonathan Van-Tam for making himself available for that meeting to discuss these issues, and I will make sure that noble Lords are aware of it.

On ventilation, as raised by the noble Baronesses, Lady Bennett, Lady Brinton and Lady Thornton, we have provided CO2 monitors to state-funded education settings. We continue to look at ventilation in education, from not only air units but open windows. However, we also understand, as many noble Lords have said, the pressures of lockdown and restrictions on children. We have seen an increase in mental health issues among the very youngest, as among those of many other ages. We understand that that is all part of the decision when getting the balance right.

A number of noble Lords spoke about freedom, including my noble friend Lord Hannan and the noble Baronesses, Lady Fox and Lady Hayman. With freedom comes responsibility. I shall be honest and say that I am someone who has been described as a libertarian or a classical liberal, and I quite often use the word “freedom”—but I have to ask a question of my noble friends who think that these measures impinge on their freedom. I believe that we should be allowed to do what we want as long as we do not impinge on the freedom or the rights of others, and do not engage in or advocate violence against individuals, their family or their property—but I fail to see what liberty is impinged on by the requirement to wear a mask. Is it the liberty for me to breathe on other people, and is it really such a bad thing if we impinge on that liberty?

So let us get away from the textbooks and look at it pragmatically. Let us get the balance right. I understand that many noble Lords will see some of the measures as impinging on freedom, but let us put this in context. Many noble Lords have spoken about freedom, but it does not include the right to spread the virus if you have it, and I hope that we all understand that with freedom comes responsibility.

I thank noble Lords for demonstrating the wisdom that exists right across this House and I hope that, despite the many reservations that have rightly been raised, they can support these measures today. I commend the regulations to the House.

Motion agreed.