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Public Health

Volume 705: debated on Tuesday 14 December 2021

[Relevant documents: First Special Report of the Joint Committee on Statutory Instruments, Rule of Law Themes from COVID-19 Regulations, HC 600 and the Government Response, HC 774; Fourth Report of the Justice Committee, Covid-19 and the criminal law, HC 71.]

The Business of the House (Today) motion just agreed to by the House provides for the motions on the four statutory instruments on today’s Order Paper, each relating to public health, to be debated together until 6.30 pm. At the end of the debate, the Deputy Speaker will call the Minister to move each motion formally and will put the Question on each motion separately. I hope that that clarifies the situation for the House.

I beg to move,

That the Health Protection (Coronavirus, Wearing of Face Coverings) (England) (Amendment) Regulations 2021 (SI, 2021, No. 1400), dated 9 December 2021, a copy of which was laid before this House on 9 December, be approved.

With this we will take the following motions:

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021 (SI, 2021, No. 1415), dated 13 December 2021, a copy of which was laid before this House on 13 December, be approved.

That the Health Protection (Coronavirus, Restrictions) (Entry to Venues and Events) (England) Regulations 2021 (SI, 2021, No. 1416), dated 13 December 2021, a copy of which was laid before this House on 13 December, be approved.

That the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021, which were laid before this House on 9 November, be approved.

The covid-19 pandemic has caused upheaval across the world, forcing Governments everywhere to wrestle with how to keep their citizens safe while protecting the liberties that we all hold dear. We have learned a lot from our experience and the experience of others, and of course we are still learning. But we can take huge pride that thanks to the defences that we have built, so much of this year has been a year of recovery. We have enjoyed greater freedom than at any time during the pandemic so far. Thanks to the rapid progress of our vaccination programme, our investment in treatments and our decision to open up during the warmer summer months, we are in a far stronger position than we were last winter.

But even as I stood at this Dispatch Box back in July to announce the major milestone of taking step 4 in our road map, I said that

“we know that the greatest risk to the progress we have made is the possibility of another new variant, especially one that can escape immunity and puncture the protective wall of our vaccination programme”.—[Official Report, 12 July 2021; Vol. 699, c. 22.]

We have always known that variants have the potential to knock us off our course, and we have built the capacity to identify and respond to those that pose a threat.

The vast majority of new variants present no risk whatsoever. Since the summer, there have been hundreds of new variants, but only one of them—omicron—has been designated a variant of concern. For example, just last month, I updated the House from this Dispatch Box on AY.4.2, a new form of the delta variant, which preliminary analysis showed at that time might be more infectious. I said then that we would keep it under review, and that is what we did—and we took no action.

But omicron is a grave threat. We acted early to slow its spread, strengthening our testing regime and placing 11 countries on the travel red list, but despite those swift steps, the data over the past few days has shown more cause for concern. I would like to reinforce to the House today—to all hon. Members—why omicron represents such a risk to the progress that we have all made so far together.

I am listening carefully to the Secretary of State’s comments and am grateful that he has brought these measures before the House. I asked him yesterday whether he would give a commitment at the Dispatch Box to recall the House if the Government had to bring further measures in other than those being proposed today, so that we could be involved on behalf of our constituents in making that decision. He kindly agreed to take that matter away and discuss it with the Prime Minister. Is he able now, at the Dispatch Box, to commit that if the Government were to take further measures to deal with omicron during the recess, they would recall the House of Commons so that we are able to have all the evidence and participate in taking those decisions on behalf of the constituents we represent?

I of course understand the importance of my right hon. Friend’s question; as he said, he asked it yesterday and, understandably, has asked it again today. I hope he will understand that I am not able to give that commitment alone; it would not be a decision for me and my Department alone, but I know the Government would consider it together seriously.

Might the Secretary of State consider going a little further? Since the data is changing all the time—almost by the minute—it is inconceivable that in a week’s time and a week after that we will be in the same place that we are in today. This House needs to consider the information available to it in near real time, so will he go away and consider whether it would be appropriate now to ensure that the House is able to consider these matters for sure next week and the week after that?

I will consider that. My right hon. Friend is right to point out that this is a fast-moving situation and it is right that the Government continue to monitor it and respond when necessary, but I hope my right hon. Friend will agree that right here and now the matter being debated and the regulation before the House is the best possible response that can be given by this Parliament today.

I am grateful to the Secretary of State for giving way. If he is going to consider those matters will he also consider the following issue? The virus spreads if people are not able to isolate, so will he think about addressing the issue of statutory sick pay, and in particular spreading the scope of SSP and raising it to a proper rate so that people can isolate and therefore not spread the virus and not end up in our hospitals?

The hon. Gentleman will know that some measures are already in place such as the ability to get sick pay from day one and that there are hardship funds, but I understand the hon. Gentleman’s question: he asked us to look at that further and we will do so. All these matters are under review.

No, I will take an intervention from the hon. Gentleman later.

I want to turn now to some of the things we have learned about the new variant. This is a fast-moving situation and in the last week we have been able to determine the following things with a high degree of confidence. First, omicron is more transmissible than the delta variant. We can see that the growth in omicron cases here in the UK is now mirroring the rapid increase in South Africa, and the current observed doubling time is around every two days. Although yesterday we reported that there were 4,713 confirmed cases of omicron in the UK, the UK Health Security Agency estimate for the number of daily infections was 42 times higher at 200,000. Scientists have never seen a covid-19 variant capable of spreading so rapidly, so we have to look at what we can do to slow omicron’s advance.

The Secretary of State is making a strong point about exactly why we need to do far more to address the threat of omicron, but does he accept that the Government’s mixed messaging has been incredibly unhelpful? Telling people that a tsunami of omicron is on the way but at the same time saying we can go on partying absolutely undermines that message. Will he have the moral courage to say that we actually do need to reduce our social contacts, and will he make it possible for people to do that both with the sick pay we have already talked about and by ensuring businesses get the financial support they need if fewer people are going into their premises?

What I think we need to do are the measures that are in front of the House today, and I hope the House will support them. I think those are the most important measures we can take right now.

But has the Secretary of State seen the statement from Dr Angelique Coetzee, the head of the South African Medical Association, today? She says that the Government’s measures on lockdown may be counterproductive, that omicron is a mild form of covid-19 that will have huge benefits for herd immunity and protection, and that delaying its spread may give time for more virulent and pathogenic variants to take hold and cause more deaths in the UK.

First, I think my hon. Friend, if I heard him correctly, talked about the “Government’s measures on lockdown”. I am not sure where he has seen these measures on lockdown, because they are certainly not being presented by this Government here today. On whether the omicron variant is milder, I will come to that issue very shortly.

Building on the point from my hon. Friend the Member for North West Leicestershire (Andrew Bridgen), which my right hon. Friend says he is about to expand on, the question is: when will we know whether omicron gives severe or mild disease? If it is mild, how quickly could the decision be made that this would be an advantage to get rid of delta and to get herd immunity while it does not create strong disease?

If my right hon. Friend will allow me, I am about to come to precisely the point he raises.

The second thing about omicron that I want to share is that, although we do not yet have a complete picture of its severity, even if its severity is significantly lower, the much higher transmissibility of omicron means that it still has the potential to overwhelm the NHS. Let us take the current observed doubling time of two years—[Interruption.] Sorry. Let us take the current doubling time of two days. If, for argument’s sake, omicron is only half as severe as delta, after the lag between cases and hospitalisations has taken effect, that would buy us only two days before omicron hospitalisations reach the same level as for delta.

I will do so later.

In England, 10 people are confirmed to have been hospitalised with the omicron variant. I know that some hon. Members have said that, because confirmed hospitalisations from omicron are low, we do not need to act, but it is the fact that omicron hospitalisations are low that means now is the best time to act. We have seen during previous waves—we have already seen this—that the lag between infections and hospitalisations is about two weeks. When infections are rising so quickly, we are likely to see a substantial rise in hospitalisations before any measure starts to have an impact, so there really is no time to lose.

I understand the nuanced point that my right hon. Friend is making, but on the forecasts, does he accept that many academics have doubted the previous forecasts, describing them as “hysterical”, “substantially inflated”, “consistently overconfident”, “lurid” and “severely flawed”? We have had a problem with inaccurate forecasts. Does he accept that point?

Yes, I absolutely accept that point. With previous variants of covid, we have seen forecasts and estimates—whether from academics, think-tanks or others—that have been completely off the mark, but all I would say, gently, to my hon. Friend and other hon. Members is that, just because several forecasts in the past have been wrong, it does not mean that every estimate or forecast is always wrong. I hope my hon. Friend will note that.

My right hon. Friend talks about hospitalisations and the danger they may cause to the NHS, but will he reflect on the fact that it is not just hospitalisations but the length of stay in hospitals that determines how many beds are occupied? Evidence from South Africa suggests not only that there are fewer hospitalisations, but that people are in hospital for a much shorter time. Is that reflected in his calculations?

Yes, I can confirm that to my right hon. Friend. First, he is absolutely right to make that point. Of course it is not just about individuals entering hospital but about how many days they are likely to stay in hospital. I believe that for the delta variant an individual stays, on average, about nine days in hospital. If that was cut to five or six days, of course it would help with capacity. First, we cannot assume that, because what we are seeing in terms of the impact in South Africa is that hospitalisations there are rising rapidly; there are hundreds of people in intensive care units and on ventilators. It is hard to completely read that across, given that the average age of the South African population is about 27. I hope he would agree that, as with the point I just made on severity, even if the hospital stay is half of what it is at the moment, the rate at which this thing is growing—and if it continues to grow at that rate—means that that benefit could be cancelled out in two days.

The Secretary of State is facing a lot of criticism from behind him, but he should be assured that on these Benches we absolutely recognise the dangers of the variant before him. Does he accept, however, that having come in to his post saying that the end of restrictions was “irreversible”, he has created an expectation that he is going to constantly ignore the scientific advice, which is why he is facing so much disappointment from those behind him now?

The hon. Gentleman may have heard earlier, when I started my remarks, that I talked about what I said at this Dispatch Box in July and, specifically, about the risk of a vaccine-escape variant. I do want to talk about the vaccines and this variant—

I am grateful, and I think my views on this are pretty well understood. Given the case the Secretary of State is setting out, one thing I am puzzled by is why he is only going as far as he is. Will he explain to us why, in his estimation, the measures he is taking are equal to the situation that he is describing?

That is a very fair question, as always from my hon. Friend. In the measures we are setting out, we are taking into account the very best advice we are being given—this includes making sure that we are not just listening to every piece of advice or every forecast we are seeing. He will recall that back in the summer had we listened to some of the advice we were receiving we would not have opened up in the way we did. So we are taking account of the advice, deciding whether it should influence our decision making and then coming to a balanced and proportionate response: the measures I have talked of and, for example, increasing the booster programme, which I will turn to in a moment too.

I must make some progress, but I will take further interventions in a moment. I wish to talk about the importance of what we have learned about omicron and the vaccines. Vaccines have proven to be highly effective against previous variants, such as the alpha and delta variants. That has weakened the link between cases, and hospitalisations and deaths, and it has allowed us to reopen our country once more. But recent analysis from the UK Health Security Agency has shown that two doses of a vaccine provide much lower levels of protection against symptomatic infection from omicron when compared with the delta variant. More encouragingly, effectiveness rose considerably in the early period after a booster dose, providing about 70% to 75% protection against symptomatic infection. This data starkly shows the importance of booster doses and why we are working so hard to get many more boosters into arms. I will say more about that in just a moment. Our strategy is to take proportionate action now, to come down hard on this virus and strengthen our defences, rather than waiting until it is too late.

Surely the whole point is that we cannot be complacent and assume that this likely huge increase in infections is all going to result in very mild symptoms. What the Government are doing, therefore, is taking modest steps to ensure that if that does not happen, we will be prepared. Will he promise that if this situation does not materialise, he will be able to relax again?

We all want to relax. I wish I was more relaxed now than I already am. My hon. Friend is absolutely right on that, and I agree with him.

I appreciate that this is an escalating situation which needs urgent attention, but the fact is that if we are enabling social mixing, that is the very context in which we will see transmission, as we did with delta last December. Will the Secretary of State review these measures, as it seems that the statutory instruments before us today are already out of date?

It is of course important that we keep measures under review, but, for the reasons I gave earlier, I will continue to present this set of measures to the House. They strike the right balance and are a proportionate response.

My right hon. Friend may be interested to learn that Dr Angelique Coetzee gave evidence to the Science and Technology Committee this morning, and, rather contrary to her piece in the Daily Mail, she actually endorsed what the Government are doing. She said that the boosters were definitely the absolute priority, but she also referred to masks and avoiding mixing. When asked specifically about the covid pass proposals, she said that they sounded like a proportionate response to the requirements of the situation.

I thank my hon. Friend for sharing that with the House. I think it is important to hear that support from South African experts too.

We are all, of course, concerned to hear that plan C measures are already being discussed, and I should be grateful if my right hon. Friend could lay that to rest. However, I want to raise the question of hospitalisations. There is a difference between people who have been hospitalised with omicron and those who have hospitalised from omicron. Will my right hon. Friend tell us what he knows about those cases? How many people have been admitted to hospital for other reasons, and how many have arrived in hospital because they are seriously ill with omicron?

What I can tell my right hon. Friend is that there are approximately 6,000 people in English hospitals who have tested positive for covid, and of those—I have shared information like this with the House before, because I was determined to obtain it when I first became Health Secretary—approximately 80% are there because of covid symptoms, while about a fifth are there for other reasons, but were tested for covid and happened to have it. I hope that that is helpful to my right hon. Friend.

I really must press the Secretary of State on this issue, on behalf of workers in my constituency and across the country, particularly low-paid workers. Why are the Government not offering us a vote today on whether to increase sick pay to real living wage levels? We cannot have a situation in which the Government are making the case that this matter is so serious—which it is—while forcing low-paid workers to choose between food on the table and self-isolating to protect the rest of the community.

Where I agree with the hon. Gentleman is on the importance of using measures to support people. Support is already there, but I recognise from the way in which he phrased his question that he thinks there should be more support. I understand that we have a difference of view on that, but it is something we keep under review.

When I announced our autumn and winter plan to the House in September, I explained that we would hold measures in reserve in case the NHS was likely to come under unsustainable pressure and stop being able to provide the treatment that we want all our constituents to receive. Yesterday NHS England announced that it would return to its highest level of emergency preparedness, incident level 4, and unfortunately there is now a real risk that the exponential rise in omicron cases will translate into a spike in hospital admissions and threaten to overwhelm the NHS.

We have done so much to boost the capacity of the NHS. Over the past year we have increased the number of doctors by 5,000 and the number of nurses by almost 10,000, and we have expanded the number of beds available, but we have also had to put in place measures for infection control which have limited that capacity, and there are already more than 6,000 covid-19 patients in hospital beds in England.

Despite the progress that we have made, the NHS will never have an unlimited number of beds, or an unlimited number of people to look after people in those beds. If we think that capacity risks being breached, we simply have to step in, because we know what that would mean in practice for both covid and non-covid care. It would mean one of the hon. Gentleman’s constituents, maybe a child, is in a car crash and is in need of emergency care, and the NHS has to make difficult decisions about who deserves treatment and who does not. Now, I know that some hon. Members think that this is merely hypothetical, but it is not. We have seen health services around the world become overwhelmed by covid-19 and we cannot allow that to happen here.

I am extremely grateful to the Health Secretary for mentioning frontline NHS staff. The all-party parliamentary group on coronavirus had a hearing this morning where we heard that staff are suffering moral injury because they are having to make exactly the decisions he outlined. The other thing we heard is that there is a worrying suggestion that omicron may be worse for children than delta. What assessment has he made of that risk? What is his plan for children to protect them against this deadly new wave?

First, I very much agree with the hon. Lady about the phenomenal work everyone in the NHS has been doing at all times, but especially over the past two years during this pandemic. They could not have delivered more. On her question about children and omicron, I am afraid we do not have any evidence on that yet that I have seen. We take the impact of omicron very seriously—I hope she can see that—and we will keep that under review.

I will take some interventions in a moment, but I want to just finish this section.

We are also giving the NHS more time to put boosters in arms. I can assure the House that we will not waste a single second in doing that. We have already given more booster doses than anywhere else in Europe and 44% of the people in this country over the age of 18 have already been boosted. However, the recent data showing the importance of booster doses for our fight against omicron has highlighted the need to go even faster. Yesterday, I set out to the House how we are bringing forward the target we set ourselves, so that everyone who is eligible and aged 18 and over in England will be offered the chance to get their booster dose before the new year. This is a new national mission: a race between the virus and the vaccine to get as many people protected as soon as possible.

Just as we embark on this huge logistical endeavour in the short term, we are also looking at the long term. We have already signed contracts to buy a total of 114 million extra doses of future-proof vaccines that will help our country’s vaccination programme over the next two years. The deals we have struck will give us the earliest access to modified vaccines to combat omicron and future variants of concern should we need them.

The Secretary of State is absolutely right. I am overjoyed that boosters are the key to getting the country out of this issue. I have raised, over the past couple of weeks and last week in PMQs, the issue of the 15-minute wait post-Pfizer. I wonder if the Medicines and Healthcare products Regulatory Agency or the Joint Committee on Vaccination and Immunisation have come to a conclusion on that, because that would free up a huge amount of capacity when it comes to delivering the boosters?

My hon. Friend did raise that point yesterday. It is being looked at very urgently. I am sure he will agree that if it is done, it should be done in a safe way that our regulators are happy with. I can confidently say that I expect an urgent update later today as soon as I leave this Chamber.

I entirely agree with what my right hon. Friend said about the pressure on the NHS and the difficult problems that will occur if we have unvaccinated people blocking ICU beds. As he said, however, variants come along. He is making the case that, even if symptoms are only mild there will be exponential growth of cases in hospitals. What is the plan going forward? There is a set of measures today to deal with the situation now—fair enough—but if this is going to keep happening, how do we avoid being sat here in three months’ time, five months’ time or six months’ time debating the same thing? What is the plan?

That is a very fair question. I will say more about that in a moment, but I point my right hon. Friend to one of the things I have just mentioned, which is better and better vaccines. In the future, we will have poly-variant vaccines. Because of the orders we have already placed, we are at the front of the queue for such vaccines.

Has the Secretary of State noticed, as I have, the view that omicron may have originated in Africa in an immunosuppressed sufferer of HIV, where these viruses can mutate much faster than they would under other circumstances? Does he agree that the best way of dealing with this is to get vaccines into as many people in Africa as possible and to ensure that HIV/AIDS sufferers are given access to the proper treatment?

There is lots of speculation on how omicron may have originated. I will not add to that speculation now, but I agree with the hon. Lady’s general point, which is a powerful point, about the need to get more vaccines to people in developing countries, whether in Africa, Asia or elsewhere. We can be proud of what the UK has already done—more than 20 million vaccines delivered through COVAX or directly, and almost another 10 million on the way. We are completely committed to meet our target of 100 million vaccine donations by June 2022.

Order. Just before the Secretary of State makes further progress, it is absolutely right that he should be taking a lot of interventions—there are a lot of questions to be asked—but people who have already made one intervention should not be making a second or a third intervention and certainly not if they also wish to be called to speak later in the day. I have too many people who wish to speak and there is not going to be enough time for everybody. Be sure—if you keep intervening, you do not get to speak. Let us have a little consideration for others.

I shall indulge my hon. Friend the Member for North West Leicestershire (Andrew Bridgen) because he is going to be really short.

The Secretary of State knows that I have been short all my life. He said earlier that the average age in South Africa was 27.5 years. I fear that he may have mis-spoken or been badly advised. In fact, the median age in South Africa is 27.5 and the comparative median age in the UK is 40.5—not radically different.

I am pleased that I took that intervention because I do not want people to think in the way my hon. Friend has suggested. I have to disagree with him. There is a big difference between those two ages, and the last time I looked the median can be described as an average. But I am pleased that he shared that because it highlights my point.

I do need to plough on, but I will take some interventions a bit later.

For the reasons that I have set out, I believe that the responsible decision is to move to plan B in England, drawing on the measures that we have held in contingency to give more time to get those boosters into arms. These are not steps that we would take lightly. I firmly believe in individual liberty and that curbs should be placed on our freedoms only in the gravest of circumstances. Not only that, but I am, of course, mindful of the costs that restrictions can bring to the nation’s health, to our education and to the economy. So it is vital that we act early and we act in a proportionate way, doing whatever we can to build our defences and to preserve greater freedom for the long term. I am confident that these measures are balanced and proportionate, and that they still leave us with far fewer restrictions than are in place in most countries in Europe. I can assure the House that we will keep reviewing the measures that we have put in place and we will not keep them in place for a day longer than we have to.

Specifically on the regulations, given the regulation on refusal of entry, the small number of venues and the large number of exemptions and the lack of protection for double-vaccinated people, why not make it a necessity for everybody to show a lateral flow test, rather than showing double vaccination?

If my hon. Friend allows me, I will come to that point shortly.

I said a moment ago that we will not keep measures in place for a moment longer than we need to. For example, now that there is community transmission of omicron in the UK and that omicron has spread so widely across the world, the travel red list is less effective in slowing the incursion of omicron from abroad, so I can announce today that, while we will maintain our temporary testing measures for international travel, we will be removing all 11 countries from the travel red list, effective from 4 tomorrow morning.

I wish to turn to the details of some of the regulations before the House. Regulation No. 1400 proposes extending the use of face coverings. In October, UKHSA published an updated review of the evidence on the effectiveness of face coverings and concluded that there is good evidence that they can help to reduce the spread of covid-19 when worn in the community. The regulation proposes extending the legal requirement to most indoor settings, including theatres and cinemas. They are not required in places where it would not be practical—for example, in hospitality settings such as cafés, restaurants, pubs, nightclubs or other dance venues, or in exercise facilities such as gyms.

Regulation No. 1416 would mean that anyone over 18 would need to show a negative lateral flow test to get into a limited number of higher-risk settings, unless they were double vaccinated. As I announced to the House yesterday, however, in the light of new data on how vaccines respond to omicron, our intention is that boosters will be required instead of two doses as soon as all adults have had a reasonable chance to get their booster jab.

I thank the Secretary of State for being so generous in taking interventions. Does he agree that, if we are to get on the front foot in tackling the pandemic, we have to acknowledge that it is like our house being on fire and dealing with just one room rather than the rest of the house? Surely the TRIPS waiver, which gives other countries across the developing world and beyond the ability to produce the vaccine themselves, to increase the supply at a cost-effective rate and to stop big pharma from excessively profiteering, is the way to get on to the front foot in vaccinating the rest of the world and ensure that new variants do not continue to flourish.

As I said in response to an earlier question, in terms of getting vaccines to the developing world, donations through COVAX and bilateral donations are important. I must strongly but respectfully disagree, however, with the hon. Gentleman’s suggestion that waiving intellectual property and patent rights will help. That will not help. That will undermine the world’s ability to deal with the pandemic, because it will remove the incentive for pharmaceutical companies to develop these valuable drugs in the first place.

I need to make some progress.

As I announced to the House yesterday, in the light of new data on how vaccines respond to omicron, our intention is that boosters will be required instead of two doses as soon as all adults have had a reasonable chance to get their booster jab. I reinforce to hon. Members that the proposal on getting a negative result from a lateral flow test, or not having to do so if you are double vaccinated, is not a vaccine passport.

It is really important to me, as a point of principle, that people have a range of different routes to show how they are eligible, and that is what is before the House today. Those options include showing proof of a negative test for the last 48 hours, proof of vaccination, proof of a medical examination, or evidence of participation in a clinical trial. The regulations cover a small number of settings that present particular risk.

My right hon. Friend knows that I am completely against vaccine passports and mandatory vaccinations. Can he confirm that lateral flow tests will always be used? That would allay my fears and those of my constituents that we are creating a two-tier system with mandatory passports. If lateral flow tests are always used, everyone can have access to all parts of our society.

I can give my hon. Friend that confirmation and I am happy to make that really clear. It is vital that there is always an option for a lateral flow test. I would not support a vaccine-only option.

In terms of providing proof of a negative lateral flow test, is that possible for someone who does not have access to the internet or a phone? What is the evidentiary requirement?

Lateral flow tests are available for everyone. The vast majority of people will have access to phones or through other ways. Once people have taken the lateral flow test and registered the result, perhaps with the help of someone in their family or a friend, they can get printed proof of that by using the 119 service. If there are other ways to improve that, of course we will, but we have found that that is available to the vast majority of people, including those who might not be as familiar with technology.

A vaccine passport with a lateral flow test alternative is still a vaccine passport. We have seen the use of vaccine passports in other parts of the country, in Scotland and in Wales. What difference have they made to the transmission of omicron in those parts of the country?

I will come to that specifically in a moment, but again I have to stress that this is not a vaccine passport. If the right hon. Gentleman wants to see a vaccine passport, he can do that in Scotland or he can go to France or some other countries. The measure is an attempt to reduce risk from covid in a high-risk venue. It is sensible and proportionate and provides several options and flexibilities.

I must make some progress. I will take some interventions later.

The regulations—statutory instrument No. 1416—cover a small number of settings that present a particular risk: venues such as nightclubs, indoor events with 500 or more attendees likely to stand and move around, outdoor events with 4,000 or more attendees likely to stand and move around, and all events with 10,000 or more attendees. Those measures come into force tomorrow. We have given a week’s notice of those changes so that venues have time to put arrangements in place. I am pleased that many venues are already using the measures.

We cannot eliminate the risk of covid-19—that is simply not possible, nor should it be tried—but we can reduce it. The proposals offer a pragmatic way of doing that. Under them, people can either show a negative lateral flow test result, meaning that they are less likely to be infectious, or they can be double jabbed, which means that they are less likely to become severely unwell if they are exposed to covid-19.

Many of my constituents have contacted me concerned that the measures today are the first step in further restrictions on social gatherings and businesses. Will my right hon. Friend assure them that that is not the case and that, if we can rescind the measures before 26 January, we will?

I think that what I am about to say will give my hon. Friend that assurance. The plans will make high-risk environments safer than they would otherwise be, but all the regulations will be reviewed by 5 January and sunset on 26 January. I emphasise in response to her question that they sunset on 26 January and that even if the Government wanted to do something different and change matters in some way, we would have to come back to the House and seek its approval.

The Secretary of State is right that the regulations do not provide for vaccine passports. Conservative Back Benchers and the Liberal Democrats are completely wrong about that. I warmly welcome what he said about abolishing the red list. Will he now release all those people who are currently incarcerated in so-called quarantine hotels in inhumane conditions in this country? Will he also get rid of the other extra restrictions he introduced only two weeks ago to try to keep the omicron variant out when it is already here?

The point about managed quarantine and those people who are already in it is important. I am told that the practice in the past was to require them to complete their quarantine period, but I understand the importance of the point. I have asked for urgent advice about what that means. I hope to add to that very soon.

One of the things we know about omicron is the significant genetic mutations and changes that have happened to the spike protein. This morning, at the Science and Technology Committee, Kate Bingham, the Government’s vaccine tsar, said that the Government’s decision to pull the plug on the Valneva contract was mistaken. Will the Secretary of State make a commitment today to revisit that, given the specific technologies that exist with a whole-virus vaccine, which Ms Bingham described as “having the edge” over other vaccines, and which would help the distribution of vaccines to the rest of the world?

I think the hon. Gentleman will understand that when the Government make decisions on vaccines they take expert advice, most of which comes from the JCVI. We always listen carefully to that advice to make a final decision, but it is coming on a number of occasions and is constantly kept under review.

Referring back to the point made by the right hon. Member for Exeter (Mr Bradshaw), it is crazy that people who have been in self-isolation are going to have to remain there due to the 11 countries that have not been removed from the red list. Surely they should not only be released from their incarceration but reimbursed for the astronomical amount of fees they have had to pay.

I am very persuaded by what my hon. Friend says. I would love to stand here right now and just say that that is the case, but there are some issues that need to be resolved, and they are urgently being looked at. I hope that we can say something more on this as a Government, even as early as today. I do understand what he said, for exactly the reasons that he said it, including on reimbursement.

As well as the new measures we are proposing, we are restoring freedoms too, drawing on the defences that we have already built. At the end of last month, this House passed regulations requiring all close contacts of a suspected or confirmed omicron case to self-isolate for 10 days, but given the increasing dominance of omicron, this approach no longer makes sense for public health purposes and nor is it sustainable for the economy. So we are drawing on the testing capacity that we have built to create a new system of daily testing for covid contacts that has started today. Instead of close contacts of confirmed cases or suspected cases having to self-isolate, all vaccinated contacts, irrespective of whether the contact was with an omicron case, will be asked to take lateral flow tests every day for seven days. Regulation No. 1415 allows us to put this plan into action by revoking the omicron-specific provisions for self-isolation.

The Secretary of State knows that I welcome that. The isolation regs that we passed two weeks ago that I did not support were sinister, and well done to him for getting rid of that. On test and release, though, he will know that many of our constituents—many of mine have contacted me to say this—cannot, for love nor money, get hold of lateral flow tests right now. Could he update the House on whether this problem has been resolved?

My hon. Friend will understand that there has been a huge surge in demand for lateral flow tests, perfectly understandably of course. The situation at present is that the warehouses of the UKHSA have plenty of stock, but the distribution channel has been limited, although it has added to that significantly in recent days, including building on the channels it has with Royal Mail, Amazon and other suppliers, and also opening up more access points other than direct ordering online so that people can pick up tests from far more pharmacies, for example, than they currently can. It is being worked on, and whatever the current situation is, it will be improved very, very quickly. I hope that reassures my hon. Friend.

The Secretary of State is making some vital points about testing and self-isolation, but yesterday I raised a point with him about PCR testing that I would like to come back to. Although the supply of lateral flow tests is important, so is the PCR testing, which is a more reliable gold standard. Today there was a point when it was reported on social media that there were no PCR testing slots available in any region of England. Yesterday I asked him if he would authorise each director of public health across the country to have a float stock of 500 PCR tests they can use to disrupt covid outbreaks and to slow the transmission of omicron. This is a really important point. Only nine directors of public health have that float stock at the moment. Will he take this vital step and authorise it for all the other directors of public health?

We are, as the hon. Lady would imagine, working very closely with directors of public health throughout England, whether on testing or other areas. On PCR testing capacity specifically, capacity is usually roughly 600,000 a day, but it is already being expanded to about 800,000 a day, and it will be further expanded. It is important for hon. Members to know that testing is released at different times of day, so if someone checks the system and a test is not available, it might be available in their local area in the next couple of hours—it is not just a day-by-day process. As the process is surged, tests will become much more easily available. It is also important to remind people whenever one can that a PCR test should be used only if someone has symptoms; otherwise, lateral flow tests should be deployed.

Finally, I turn to measures to help keep the health and care system safe for the long term by making vaccination a condition of deployment for more health and social care settings. Across the UK, the overwhelming majority of us have made the positive choice to accept the offer of a vaccination against covid-19, and 91% of NHS staff have already had two doses, but we need that figure to go even higher. Uptake rates vary among health and care organisations and across the country; despite the incredible effort to boost uptake across the country, approximately 94,000 NHS staff are still unvaccinated. It is critical to patient safety that health and care staff get the jab to protect some of the most vulnerable people who are in their care and keep the NHS workforce strong in the wake of omicron.

We made vaccination against covid-19 a condition of deployment in care homes from 11 November this year. Contrary to what some people feared, we are not aware of any care home closures in which vaccination as a condition of deployment has been the primary cause. The regulations that we are putting before the House today will extend that requirement to health and other social care settings.

The Secretary of State pointed out that the capacity of the health service is important and should not be breached. If 9% of staff to date have decided not to be vaccinated and will presumably stick with that decision, how does he expect that that will not reduce the capacity of the health service in future? Is it not a fact that there are already many people staying in hospital because a care home cannot be facilitated owing to lack of staff?

The right hon. Gentleman asks a fair question. I will answer precisely that question in just a moment.

We know that the vaccines are only 33% effective at reducing omicron infection. We know that the reduction of infectiousness falls dramatically—to zero after 12 weeks, in the case of AstraZeneca. What does the Secretary of State view as better for protecting people from infection: daily lateral flow tests or vaccination?

I think both have a role to play. In the NHS and in social care, there is very frequent testing—lateral flow testing, in the case of the NHS, and often PCR testing—but I think vaccination has a role to play. At this point in time, many people still have two doses; that is rapidly changing. When they have a third dose or their booster dose, that gives them an even higher degree of protection.

I draw attention to my entry on the Register of Members’ Financial Interests. The Secretary of State is making a very clear argument for the need to do something; he talks about how a very small proportion of a much larger number of cases could overwhelm the NHS in the way that a larger proportion of a much smaller number of cases might not. However, we know that the NHS has a huge backlog of people awaiting diagnostic and operative procedures. What evidence does he have that mandating vaccines for NHS staff will help? Given that we know that vaccination does not particularly reduce transmission, and given what he has said about the importance of choice, why does he not think that it would be reasonable to offer medical staff and nursing staff the option of daily testing instead of vaccination, should they make that choice?

In coming to this decision, we held an extensive consultation with thousands of responses. Importantly, we also consulted with the NHS itself; as I shall touch on in a moment, it has weighed up the decision. My hon. Friend is right if she is suggesting that there may be some people who choose to leave the NHS rather than stay and be vaccinated—that is a choice for them to make, but there is also an issue of patient safety. That is also the view of the NHS. As I said in response to my right hon. Friend the Member for Haltemprice and Howden (Mr Davis), testing can be used alongside, but vaccinations help as well.

I want to talk about settings.

Order. Let us allow the Secretary of State to finish his speech. He has some important information to put before the House, and I now want to hear that information.

The settings to which this measure would apply include, of course, NHS hospitals, and GP and dental practices, regardless of whether a provider is publicly or privately funded. Anyone working in health or social care activities regulated by the Care Quality Commission will need to be vaccinated against covid-19 if their role will involve direct contact with patients, apart from a few limited exemptions—for example, for medical reasons. The definition of “fully vaccinated” is currently two doses, but we are keeping this under review, and of course I urge everyone who works in the NHS and social care to get their boosters too.

As we have just heard, concerns have been raised about the impact of the measures on the workforce, especially during these winter months, although even before the pandemic workplace policies were in place requiring the hepatitis B vaccine for those who have to perform certain clinical procedures. We are already allowing a 12-week grace period to give people the chance to make the positive choice to get protected, and we are aiming to start enforcing these requirements from 1 April next year—subject, of course, to the will of the House.

If a member of the NHS decides that they do not want to be vaccinated, will they be given a redundancy payment; and if not, why not? But if they are and that is the policy, how much would it cost the NHS, and would that be a good use of taxpayers’ money?

I believe that it would not be classed as redundancy because it would not be redundancy; that job would not have become redundant. If an individual chooses not to get vaccinated, that is of course a decision for them to make. The way in which this should be, and no doubt will be, implemented by the NHS is that getting vaccinated should always be a positive choice. The NHS has put in place a number of methods to try to provide the information that people want to share, including through one-to-one consultations and providing more information especially for those who may have received misinformation. The outcome when a similar measure was implemented for care homes was that many staff—when provided with the right, positive information —chose to be vaccinated, rather than to leave their jobs.

Order. The Secretary of State is right; he must make progress, as other people need to speak now. Please let us allow the Secretary of State to conclude his speech.

Thank you, Madam Deputy Speaker.

Today, the chief executive of NHS England has written to me, reinforcing the importance of getting the jab in the interests of patient and staff safety. I will be placing a copy of this letter in the Libraries of both Houses today. Despite the concerns that some people have raised, I am pleased to say that we have already seen a net increase of more than 55,000 NHS staff vaccinated with a first dose since we consulted on the policy in September.

Although I firmly believe that these measures are a proportionate way of protecting those at greatest risk, I know that hon. Members have questions about whether we would extend them further. Let me say clearly to the House today—once and for all—that although we have seen plans for universal mandatory vaccination in some countries in Europe, I will never support them in this country. I firmly believe that getting vaccinated should be a positive decision. I assure the House that the Government have no intention of extending the condition of deployment to any other workforces or of introducing mandatory vaccination more widely.

The regulations that we are debating today are not measures that any of us would like to be putting in place, but they are measures that the situation demands, because when the facts change, our response must change too. As we look ahead to a winter with omicron in our midst, the measures before the House today will fortify our national defences and guard the gains that we have all made against this deadly virus. I commend these regulations to the House.

Before I call the shadow Secretary of State, it might be helpful for the House to know there will be an immediate time limit of five minutes on Back-Bench speeches, which will reduce later in the afternoon.

I begin by acknowledging that there are sincere and deeply held views on both sides of this debate and, indeed, on both sides of the House. I respect those who take a different view from the one I will be outlining on behalf of the Opposition, but we owe it to our country to have a debate worthy of the finest traditions of this House.

In the light of comments made in recent days by at least one Conservative MP comparing these measures to the situation in Germany during the 1930s, it should not be for me, as shadow Secretary of State, to point out that we are not living in the 1930s and that the Secretary of State and his team are not Nazis. On their shoulders rest the health of our nation and the responsibility to protect our NHS. Indeed, it is a responsibility we all share. They need our support, and they are owed better treatment than they have received from some on their own side in recent days and even this afternoon.

No matter how dysfunctional the Conservative party has become, the country can rely on Labour. We will act in the national interest, as we have throughout the pandemic, by putting public health before party politics and supporting the motions under consideration this afternoon. We do not do so lightly. Throughout the pandemic we have asked the British people to make big sacrifices to support the national effort against coronavirus—sacrifices that have impacted on lives, livelihoods and liberties. Whenever this House considers such measures, we owe it to the British people to explain why they are necessary. We believe these measure are a necessary response to the omicron threat, necessary to protect ourselves, necessary to protect the ones we love and necessary to protect our NHS.

We cannot yet be sure about the severity of the omicron variant, but we can be certain it is spreading, and spreading fast—faster than any other variant. Even if a smaller proportion of omicron victims are hospitalised, the rapid advance of the virus through the population could see large numbers of people admitted to hospital during the months in which the NHS is under greatest pressure. There should be no complacency about this. The winter months present the greatest pressures on the NHS in any normal year and, as we know, this is far from a normal year. The NHS is contending with winter pressures, a serious backlog, the delta variant and now the omicron variant. When people invoke the story of the boy who cried wolf, of the warnings that came before but never materialised, they should remember that, in the end, there was a wolf.

Many of the challenges facing the NHS are understandable, given the unprecedented challenges of the covid-19 pandemic, but we have to be honest and acknowledge that confronting these challenges has been made much harder because we went into the pandemic with NHS waiting lists at a record 4.5 million, 100,000 staff vacancies and 112,000 vacancies in social care. It is not just that the Government did not fix the roof while the sun was shining; they dismantled the roof and removed the floorboards.

Now the NHS is locked in a race against time: a race against the fastest variant of covid-19 we have seen to date and a race to get as many people boosted as possible before the end of this month. The Opposition support the Government in that task, and let me say on behalf of all of us in the Labour party to every NHS worker, every GP, every pharmacist, every public health official in local government, every member of our armed forces and every volunteer stepping up to meet this enormous task that we are with them 100%. If anyone can do it, they can.

Can the hon. Gentleman explain why the Labour party did not support mandatory vaccinations for care workers but has changed its mind for NHS workers?

I will outline our position on that, but the hon. Gentleman will have to be patient because I will come on to that later in my speech.

We need to buy the NHS and its helpers some time. The measures put forward for consideration today are an attempt to do just that by slowing the spread of the virus whilst trying to protect Christmas so that people can enjoy the festive season safely, by limiting our interactions in the workplace, by wearing face coverings in settings where the virus finds it easier to spread, by testing before we attend large indoor gatherings, and by getting behind the booster roll-out to ensure that everyone is protected.

My hon. Friend is absolutely right that we are all very conscious of how important this time of year is to the hospitality sector, but does he agree that the greatest threat to the hospitality sector is not restrictions of the type that are before us today, but the sense that the virus is out of control, and widespread cancellations across the sector? So these restrictions enable the hospitality sector to survive in this really difficult time, but also enable us to take proportionate steps to ensure that the spike does not get out of control.

I wholeheartedly agree with my hon. Friend. Indeed, one of our primary reasons for supporting the measures for consideration today is that we on the Labour Benches support business, and we want to support it through a particularly difficult time, when normally trading would be at its busiest.

The goal in the end must of course be to learn to live with the virus. That means effective vaccination, antiviral treatments, and public health measures that have minimal impacts on our lives, our jobs and our businesses. So let me take each of the measures in turn and explain why Labour supports them, and no doubt take interventions.

First, on mask wearing, no one enjoys wearing a mask—I certainly do not, but it is nothing compared with the costs that more draconian restrictions have on our lives, livelihoods and liberties. Masks are simply a price worth paying for our freedom to go out and live our lives during this pandemic. They are proven to be effective, and not only that, but in times of rising infections, when people are feeling increasingly cautious, it is vital to our economy that people feel safe boarding a busy bus or entering a crowded theatre. In our view, the Government should never have got rid of the requirement to wear masks in those settings, but we know why they did. We have counted, in recent weeks, hon. Members on the Government Benches not wearing masks. I am glad to see that compliance has risen somewhat considerably. We know that the Prime Minister no longer has the authority to lead his own party, but I am grateful that Members on the Government Benches have at least listened to their Health Secretary.

Turning to the vaccine pass, and testing to enter nightclubs and large events, I welcome the fact that the Government have listened to representations from Labour and responded. The Labour party has argued consistently against vaccine passports and insisted on people having the option of showing a negative test. Further, we argued that such passes should not be required for access to essential services. On both counts the Government have listened and amended the proposals, and we can support the measure before us today. It is not a vaccine passport. It is, in effect, a default requirement to show a negative test to enter venues where the virus is most likely to spread, with an opt-out available to those with an NHS covid pass.

My hon. Friend makes a very good point on that. Is not the reality that if we did not introduce these measures there would be a danger that our night-time economy—pubs, venues and other events—would have to shut completely? So this pass is actually a pass for freedom to allow us to continue to enjoy activities that otherwise would be shut down, and the libertarians opposite should be welcoming it, not bemoaning it.

I wholeheartedly agree with my hon. Friend. Let me be clear: we in the Labour party support this approach because we support British business. This is about giving people the confidence to go out and about despite the presence of omicron.

I thank the shadow Secretary of State for giving way. I wonder whether he shares my concern about reports over the past couple of days that there has been an absence, or a lack, of lateral flow devices to be sent out for testing. What is also alarming is the lack of support for the domestic diagnostics market and the manufacturers in this country of lateral flow devices that are much more accurate and reliable and superior to the current Government lateral flow devices. If these devices are to make a difference, we must have the best quality devices in place.

I agree with the hon. Gentleman. Of course, in order for this measure to work as effectively as we would wish, there has to be an adequate supply of lateral flow tests. I heard what the Secretary of State said yesterday about the availability of testing, but it is no good if the tests are in the warehouse; they need to be available to people where they need them, when they need them. We have had supply issues and those really do need to be resolved, not least in the light of other measures, which I will come to shortly.

Does the shadow Secretary of State not accept that rather than giving confidence to people, these measures, and the background against which they have been introduced, have actually reduced confidence? We have predictions of 75,000 deaths and we are telling people that they cannot go to venues unless they have certain tests; the experience in Northern Ireland is that the hospitality industry has already lost millions of pounds in orders coming up to the Christmas period because people are afraid to go out.

I will say to the right hon. Gentleman that it is my understanding from dispatches from the shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle)—of course, Northern Ireland is ahead of England on this—that he had a perfectly nice time out last night enjoying the best hospitality that the people of Northern Ireland have to offer. I think people are drawing confidence from this. Let me also say that we should draw on the experience of other countries. Look at countries with strict covid passport rules, such as Italy, France and Denmark; all have seen their retail and recreation sectors fare far better than those here in the UK because there has been consistency and confidence.

With passes and lateral flow tests, venues can operate at 100% capacity, punters can be confident that they are safe to attend and enjoy themselves, at this time of year the show goes on, and everyone stays in a job. Without these measures, with rising infections and more hospitalisations, we would risk seeing the Government forced to impose more draconian measures on these sectors, shutting down our cultural sector and collapsing the economy once again. I think we should be confident about this.

Let me address the tension—it is a reasonable question —in the message that people should work from home if they can but that they can go out. I make no apology for trying to safeguard social interactions between people, their families and their friends at Christmas time. I also make no apology whatsoever for supporting our hospitality industry, which has been battered by the pandemic and which enjoys our support—our confident support, our full-throated support, and our support at the table and the bar in the coming days.

Can we take it from that that the hon. Gentleman is in favour of extending the certification, or vaccine passport, to all venues?

For now, we think the Government have struck the right balance. The measure is limited to nightclubs and larger venues. However, as the Secretary of State knows, we listen to the chief medical officer, we listen to the chief scientific adviser, we listen to the scientific advisory group for emergencies, we listen to the NHS and we make decisions based on evidence. If ever the Government want to come forward with further proposals, we will consider them in a genuinely bipartisan way and we will act in what we believe to be the national interest. I do not think anyone would expect less of us.

With the covid passes, there is the option of using a lateral flow test or double vaccination. Does the hon. Member recognise that double vaccination, which many people will use, gives a very false sense of security? We know that someone can be vaccinated and still transmit. Most of the people we know getting covid at the moment have already been vaccinated. Double vaccination is not very effective, and it will give a real false sense of security.

I think the hon. Member should look at the evidence from our friends on the continent, which is that this approach not only works in giving people confidence to go out and enjoy themselves, but encourages people to take up vaccination. On that basis, I think the Liberal Democrats ought to reconsider their position.

The shadow Secretary of State has obviously spoken to lots of people and he is really concerned about transmission. Could he tell the House the Labour party’s view on how much transmission is reduced by two vaccinations?

I direct the hon. Member to the SAGE advice, which is that there is some evidence—I would not put it any stronger than that—on the reduction of transmission. As I say, our primary reason for supporting the measure is to give people the confidence to continue to access hospitality and an added incentive to take up vaccination. On both those tests, our friends on the continent have shown us a better, effective way forward. I dare Government Members to suggest that France, for example, given its history and culture, is not a country that values liberty strongly.

Let me move on, because I must make progress. For the passes to work, people must be able to access tests easily and readily. We cannot continue with the situation in which tests are out of stock and unavailable to the public who are required to take them—not if covid passes are required to work and not if close contacts of covid cases are to be able to take the daily tests required. This morning, the Government’s website showed PCR tests unavailable throughout England, and the only region where lateral flow tests are available today is the south-east. We need immediately to resolve such technical issues and the practical issues of test delivery. The measure on daily testing is the one measure that seems to have united the House in agreement, so the Secretary of State really needs to get a grip and ensure we have access to the tests we need.

On the flexibility to work from home, we have called for workers to be given that flexibility for months and we support the guidance for them to do so where possible. I have addressed the contradiction in respect of people working from home and going out to Christmas parties. We want to protect people’s ability to enjoy Christmas safely this year, which is one of the key arguments for the measure. By limiting people’s interactions at work without disrupting their ability to do their work, we thereby lower contacts and infections and hope to preserve people’s ability to go ahead with the social interactions that they cherish most at this time of year.

As the Prime Minister rather clumsily and unhelpfully tried last week to open a “national conversation” on mandatory vaccinations for the country at large, I wish to make it crystal clear that we do not support mandatory vaccinations in general. I welcome what the Secretary of State has said this afternoon—not the first time he has had to clean up the Prime Minister’s mess. We believe the vaccine is safe and effective and that everyone should choose to have it. I cannot give any stronger endorsement than to say that I have had my first two jabs and will be having my booster on Thursday. I would not take the vaccine or recommend it to others unless I believed it was safe.

I recognise that mandatory vaccination for NHS staff is a difficult issue for colleagues from all parties and in our NHS, but the NHS has asked us for it, patients want it and we are persuaded that the threat of omicron makes it even more important for staff to be vaccinated to protect themselves and to protect the public they serve.

I draw the House’s attention to my declaration, as a practising NHS doctor, in the Register of Members’ Financial Interests.

I commend the hon. Gentleman for the consensual way he is approaching today’s debate and for the many points he has made with which I agree. On mandatory vaccinations for NHS staff, before I could train in medicine I had to have a Bacillus Calmette-Guérin injection for tuberculosis and a hepatitis injection; otherwise, I could not have practised medicine. It was about protecting my patients. It is the duty of all healthcare professionals to put their patients first, which is why it is absolutely right that they should have mandatory covid vaccinations. Does the hon. Gentleman agree?

I strongly endorse what the hon. Gentleman said. Infection control is going to be a real challenge this winter because of the nature of the omicron variant. By ensuring that the NHS workforce is fully vaccinated, we will protect not only patients but staff, who already put themselves in harm’s way enough. As the hon. Gentleman, who speaks with real knowledge and expertise, said, this is not a new precedent: NHS staff are already required to inoculate themselves against other diseases. It is a professional duty. The NHS clearly believes that the April deadline gives sufficient time to persuade the workforce to protect themselves, their patients and their loved ones without there being an exodus of staff.

I supported the requirement for people working with vulnerable people in care homes to be vaccinated or, if they would not be vaccinated, to be removed from direct contact with vulnerable people. Can the hon. Gentleman tell me—I did not get a chance to ask the Secretary of State—whether this proposal for members of the NHS who have not been vaccinated will affect only frontline staff who interact with the vulnerable, or whether it will apply to people throughout the NHS who might have no contact with the vulnerable? That will affect the way I cast my vote today.

I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.

My hon. Friend is handling his speech in just the right way. There is a balance of rights here, and patients have a right to be treated by staff who are fully vaccinated to protect them. I have a constituent who is clinically extremely vulnerable. She contacted me to say that she was not willing to go to her necessary hospital appointments once she realised that the hospital staff were not fully vaccinated. Does my hon. Friend agree that we have to think of that pretty large number of clinically extremely vulnerable people in this country?

My hon. Friend is absolutely right.

We have heard the arguments in outline: this is about protecting staff and patients; it is not a new precedent; and there is a professional obligation, which makes it slightly different from the experience in the social care workforce. I will come on to talk about what the Government need to do. Those are broadly the arguments—

If the hon. Gentleman just lets me make this point, I will certainly give way.

Those are broadly the arguments, but I would ask Members on both sides of the House to think about those NHS staff who go to work every day feeling unsafe because their colleagues are not vaccinated. If that is not persuasive enough, I ask them to think about how they would feel if a loved one were treated in a clinical setting or care home by an unvaccinated member of staff through whom they contracted covid and, with it, serious illness or worse. If I lost a loved one through serious illness in those circumstances, I am not sure that I would be very forgiving about the decisions made by Members of this House.

I appreciate the point that the hon. Gentleman is making, but that is not what the results of the survey of NHS staff in the healthcare and social care workforce found, which was that 55% of people in the NHS were against this proposal. How does he respond to that?

I have no doubt whatsoever that opinion in the workforce is divided. I do not dispute that, and it is divided partly because people resent the mandate. Ultimately, however, it comes down to this. It is not just about the broad arguments I have outlined or the specific cases we might be confronted with without this protection; we have to ask whether we as a House think it is acceptable for people working in health and social care, who have a duty of care to their patients, to say, “I am making a choice to put them at greater risk. I am working against the very principles that encouraged me to sign up to my vocation in the first place.” That is why, on balance, I think it is the right measure, but I will come on to talk about the way in which we need to take the workforce with us and what we need to do ahead of April.

My hon. Friend is setting out his response to these proposals with great care. On the vexed issue of mandatory vaccinations, does he acknowledge that 97% of those in my trust have been properly vaccinated and that a significant proportion of the remaining 3% are new starters making their journey towards proper vaccination? It is therefore not that clear. We have heard the responses from the British Medical Association, Unison, the Royal College of Nursing, Unite, the Chartered Society of Physiotherapy, the GMB and the Royal College of General Practitioners, who are opposed to making vaccination mandatory and prefer persuasion to coercion. Does he not think that we should be adopting that approach?

That is a helpful intervention from my hon. Friend. Let me be clear: I absolutely acknowledge the views that have been put forward by the royal colleges and by staff trade unions. Government ought to take them seriously and work heavily with them in this next phase, where there is still a window for persuasion. I also point the Government to the success that the Welsh Labour Government have had in persuading the workforce; there is much to learn and time available, and we have to work in a spirit of partnership.

I will say more about that in a just a moment, because the hon. Member for North Dorset (Simon Hoare), at the back, has been very patient.

I am grateful to the shadow Secretary of State for giving way. May I endorse and welcome what he said at the start of his speech with regard to comments about the Nazis? I called that out yesterday and he was right to do so at the Dispatch Box. I was looking through my inbox from the start of the pandemic and lockdown, and almost every person working in the care sector or the NHS in my constituency was saying, perfectly legitimately, “When the vaccine is available, we must be at the front of the queue, because we are dealing with the vulnerable and it is our duty to get vaccinated.” I do not think that has changed, and I think he is absolutely right, as is the Secretary of State, to say that those caring for the most vulnerable in society should, to try to reduce the risk that they face, be vaccinated.

I agree with the hon. Gentleman. We have a big effort to boost the booster this month and we have to boost the workforce as well, and make sure that people are supported.

This is a difficult decision—two Members from the same region—but my hon. Friend the Member for Liverpool, Riverside (Kim Johnson), right in the corner, has been very patient, so I will give way to her. I will then come to my hon. Friend the Member for Wallasey (Dame Angela Eagle).

I appreciate my hon. Friend giving way. He is making an excellent speech; however, the British Medical Association has identified some serious concerns about mandatory vaccines—the fact that we have a chronically under-staffed NHS. Does he believe that this policy is likely to have a significant impact and cause more harm than good?

That is such an important point, and I am grateful to my hon. Friend for making it. There is a reassurance I would like to offer her and a call to action that I would like to issue to the Government. The reassurance is that there were concerns about what would happen to the social care workforce, which very much influenced Labour’s position on that statutory instrument at the time, but we did not see the collapse in the social care workforce that was warned of and there was lots of evidence that there was a positive impact on take-up.

I say to the Secretary of State and his team that if they are asking the health and social care workforce to do their duty as professionals, the Government must show greater respect to their professional voice and experience—on pay, conditions and workload. It is often said that the NHS runs on goodwill, so I would like to see the Government showing greater goodwill in return and engaging with the royal colleges and staff trade unions, not just on the plan for vaccine roll-out to their members, but on the debate about the future of our health and social care systems and the big workforce challenge.

On vaccinations, there is still precious time to do the work on persuasion. I have met the trade unions in recent days, including a great meeting with Unison yesterday—I should declare that I am a member of Unison. Unison had some really helpful advice and practical feedback about the kind of conversations with occupational health that are making a big impact in giving staff the confidence to choose to take the vaccine well ahead of the deadline. Of course we would much rather persuasion than compulsion.

In St Helens, 99% of care home staff are vaccinated, and at Whiston Hospital, the best one in the country, 91% have had the first vaccine, 89% the second vaccine and 64% the booster. That has all been done with persuasion, not with the threat of the sack. These people are in a vocation. It is not just a job to them; they believe in the patients. We must not get to the stage where we are threatening people. The GPs have even been involved in persuading the care home staff. Everyone has been involved for some considerable time and that is the way to do it—

Order. Let me just make this clear: more than 40 people wish to speak this afternoon and if people make interventions, it is simply not fair on those at the end of the list who will be trying to speak later on. The hon. Lady is only one of many. The shadow Secretary of State is being very fair, as was the Secretary of State, in answering all the questions, but I must ask people to be reasonable.

It may have been a speech rather than an intervention, Madam Deputy Speaker, but I thought it was a very good one, and I welcome what my hon. Friend has said.

Will my hon. Friend acknowledge that anti-vaxxers are using vicious and very effective psychological propaganda to upset and worry people who may be vaccine hesitant, particularly about issues with fertility, whether the vaccine is halal and all those things? Does he agree with me that the Government should do much more to counter this very vicious and damaging propaganda?

I wholeheartedly agree with my hon. Friend. This comes back to the point I made about the Government engaging with the staff trade unions and the royal colleges. Whatever their policy position on having mandatory vaccination, the Secretary of State will find in them willing allies who want to help the Government to persuade colleagues to engage with them and to deal with some of these dangerous conspiracy theories that are knocking public confidence, and creating real fear and anxiety entirely without basis. When the Minister for the Cabinet Office concludes later, I hope that he will set out how the Government plan to engage and that he will give an undertaking to work with the staff trade unions and the royal colleges, because that would do so much to achieve the objectives that we all share, but also to raise morale in the workforce, who often feel that they are slogging their guts out for the Government, but do not get the hearing they deserve.

The hon. Gentleman is making a very good speech, and I apologise for interrupting him, but on a point of science, will he just accept that he has got it a little bit wrong? Someone having the vaccine does not stop them spreading it; it just makes it much less likely that it will harm them badly. Someone can have the vaccine and still spread it, and to imply otherwise is just wrong.

The hon. Gentleman has called repeatedly from a sedentary position that I do not know the science, but I have said nothing of any sort to contradict the points he has just made.

With respect to Conservative Members, particularly those who oppose these measures, what they are missing is that it is indisputable that the booster does provide greater protection than the first and second jabs, that vaccination—full stop—provides better protection, and that if we are talking about NHS pressures and workforce pressures, the biggest danger is that the virus sweeps through the health and social care workforce, knocks a load of people out in the middle of the busiest period for the NHS, and then the system topples over. I do not know why it has to be explained again and again to Conservative Members that the objective is to protect the NHS and to stop it toppling over at a critical time. The points about the severity of the virus and the efficacy of the vaccine in preventing transmission or serious illness are largely secondary. We know that the virus is spreading, and doing so rapidly, and we know that if it rips through the health and social care workforce, that is the biggest risk to the NHS—that is what will topple it over. Conservative Members’ constituents will not thank them one bit if they allow that to happen.

My hon. Friend is making an excellent speech and putting his case very forcefully. On the issue of coercion versus persuasion and involving trade unions and the royal colleges in NHS managers taking the staff with them, what was not respected by the Secretary of State when he was asked about redundancies is that this is a retrospective change in people’s terms and conditions, and even people who are vaccinated will be resistant to the change being imposed upon them. We have to go forward carefully and take the staff with us. Will my hon. Friend urge the Government to work with the royal colleges and trade unions to take this forward?

My hon. Friend makes such an important point. Going back to the staff surveys, particularly given that the overwhelming majority of staff are vaccinated, it is not that they do not want their colleagues to be vaccinated, but that they have concerns about the way in which the Government are going about this. We accepted from the Government and from NHS England a very clear view that omicron has raised the stakes in this regard, which has had a big bearing on our position. It is very difficult for me and my colleagues on the Labour Benches to put ourselves in a position that is on the other side of the argument from the NHS and from the public, but the point about engagement is really important. The Government must work with and take the workforce with them. It is not good enough for us to just clap for the NHS, or clap for carers; we must work in partnership with them and respect that these are people who have given their lives to public service and caring for others. They do care. They will instinctively be on the right side, but they just need some persuasion, some patience and genuine engagement and that is where the Government have gone slightly wrong.

My hon. Friend started off his speech in an excellent way and has got better as he has gone through it. I say that, but I will almost certainly not be in the same Lobby as him on some of the votes this evening. There is a general point to the specific point that he is making on vaccines, which is that the Government should be clear, explicit and transparent on every issue that they raise if they want to take with them people who are not just worried about vaccines but worried about this whole affair. Repeatedly, the Government have refused to do a cost-benefit analysis on the impact of their policies. We have before us now a number of statutory instruments without impact assessments. Does he agree that that information should be available?

Let me say to my hon. Friend that, in his intervention, he started off well, dipped in the middle and then got better at the end. He made some absolutely fair points about impact assessments and transparency. In fact, I can see the Vaccines Minister waving impact assessments at me, so I am sure that she will make them available to my hon. Friend.

It comes back, as we have discussed at various points today and previously in relation to these sorts of restrictions and measures—it is how I began, and will begin to close, my contribution—to how we really cannot be complacent when it comes to public support, public compliance and public consent for the measures that we are considering. We know that we have asked so much of the British people and they have played their part. We also know that recent events have dented their trust and confidence and their willingness to comply, because they have seen No.10 saying one thing and doing another. That makes it even more important that, when we discuss measures that impact on people’s lives, livelihoods and liberties, we have these sorts of exchanges, look over the evidence rigorously, test each other’s assumptions and come to a conclusion.

With some of the exchanges that we have heard today, people across the country on both sides of these arguments can at least take some reassurance from the fact that, when these matters are under consideration, we do take them seriously. The Government could do a little better sometimes on bringing measures forward in advance of their implementation and on setting out the rationale and argument, and not just assuming that, because measures have been supported by the public previously, they will be supported today. I think we have public support for the measures under consideration this afternoon, but we should not be complacent about it. That is why it is right that we spend so much time exploring these issues.

My hon. Friend is making a very important point: we need to make decisions on the evidence that is available. Does he agree that having the debate today and passing these measures tonight is urgent? We have heard that the doubling rate of omicron is shortening. If we are to protect the public, our families, our communities, and the NHS in the run-up to Christmas and beyond, these measures need to pass today.

I agree with my hon. Friend, and particularly in this city. The reproduction rate of this virus is shortening every day and the numbers that the Secretary of State set out in his opening remarks should concentrate minds before people walk through the Division Lobby this afternoon. Fun though it might be to see the Government in hot water and struggling in votes, it is not in the national interest and that should be the thing at the forefront of our minds.

Does the hon. Gentleman agree that one thing that will reassure Members across the House is a commitment from the Government at the Dispatch Box that, if further restrictions were to come into play, a vote will be had in this House?

I agree with the hon. Lady. I appreciate that she is a newer Member of the House but I dare say she watched our proceedings before being elected, and we cannot have spent so much time talking about parliamentary sovereignty only to then throw it out of the window in the next Parliament, so her point is well made. The shadow public health Minister, my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), and I have already agreed: he will bring the dinner, I will bring the pudding, and we will see if the Commons shop is doing crackers on discount if we meet over Christmas.

Finally, and seriously, we think there are areas where the Government can go further without impacting on people’s lives, livelihoods and liberties and should do so. On ventilation in schools, young people have borne the brunt of this pandemic and we owe it to them, to their education and to the staff who support them to make sure that their schools are properly ventilated. They cannot wait until October next year for a review to be published; we need action now. In winding up, can the Minister for the Cabinet Office say something about that? On jabs for young people, the Christmas holidays seem to us to be an ideal time to get young people vaccinated, so when do the Government think we can see action on that front?

Finally, on statutory sick pay, as we have heard very powerfully from my hon. Friends, there are people out there who are forced to choose between doing the right thing by their families and doing the right thing by public health because they simply cannot afford to isolate at home. So we again implore the Government to act by making sure that higher statutory sick pay is available to people immediately so that they can afford to do the right thing.

We have not played games with these votes: we are not exploiting the divisions in the Conservative party to inflict defeat on the Government for the sake of scoring political points. The threat facing the country is too serious and Labour takes our duty to the country seriously. The Tories may be in disarray but the public can rely on Labour to keep the country safe, to do the right thing and to support these measures today, and we trust the British people to do the same.

I think the House will want to acknowledge the power of the speech that the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), has just given. We wish his predecessor well. One thing we can say about the hon. Gentleman is that his voice carries very well around this Chamber.

The Government are right to ask for support for these regulations. I am glad the Opposition will in general be supporting them, and I will do so as well. If the public health risk increases, we must ask what changes to regulations are proportionate and appropriate.

It may have been missed by some who have written to me, but some of the regulations are relaxations; others are not. The regulations are intended to make sure that some places can stay open if people abide by sensible precautions.

One constituent who has written to me today says he and his family and many of his friends will not go to places of public congregation because too many people are not vaccinated or showing they are not infected by the virus. That may be a minority view expressed, but I think it is one that is held in the hearts and minds of many of our constituents.

To those who have said an impact assessment has not been made, I say that it has and it has been published; those who invigilate assessments do not think it is adequate, but that is a side point. Annex B on pages 54 and 55 shows the proportion of people by age in the national health service who have been vaccinated.

We must recognise that one reason why half of those who are unvaccinated are aged under 40 is that the opportunity for vaccination came later for them than for those who are older. But if they do not think it matters to them, I would say to them that it does, for the reasons that our hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), the practising doctor, gave. When caring for people who are vulnerable—obviously, people in medical care are, in the same way as those in social care—the most we can do to protect ourselves also has the impact of protecting them. If in doubt, get the protection that the vaccine and the booster give.

I was going to make a rather longer speech, but I will stop now because many hon. Members want to contribute, many of whom will disagree with me. I will respect what they have to say, but I will say very clearly that I back the Government in these regulations.

As you know, Madam Deputy Speaker, I was trying to help you with the intervention by withdrawing from the list, but I am grateful to be on top of the list for the Labour Benches.

I agree with my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer) the Leader of the Opposition when he says that the Prime Minister is a threat to public health. I think that that is absolutely right. I draw a different conclusion from my hon. Friends on the Labour Front Bench on how we should respond: not by being irresponsible but by taking a look at the way the Government have dealt with the whole of the covid crisis from the very beginning to what they continue to do.

I am a member of the Science and Technology Committee. Together with the Health and Social Care Committee we produced a 150-page report. I hope that right hon. and hon. Members have had the time to read it. They may not agree with its conclusions, but it contains very valuable information. The key point, which a lot of the press missed, was not that the Government followed the science on the issue but that they got into a groupthink with the scientific advisers and did not challenge them. They assumed that science was something handed down on tablets of stone, whereas it is not. It is a process and it needs challenging by those of us who have responsibility in this House for making laws and policies, and by other scientists. We seem to be repeating that process.

My Committee had as a witness this morning Susan Hopkins. Let me say that at best—if I can use a word somebody else used—the advice we were getting from her as an adviser was opaque. The information we were getting was opaque when it should be transparent. This time last week, the Deputy Prime Minister stood up and said there was no plan to go to plan B. Some 36 hours later, we were starting plan B. Why was that? What was the scientific advice given?

We were told fairly definitively that no such advice was given to change the view. What changed the view was that the Prime Minister was in a state of crisis and under pressure from his own Back Benchers and everybody else. That is not a sensible way to make decisions. It is not a sensible way to make decisions to put forward statutory instruments that say—the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup) was waving a sheet about, which may or may not have been the impact assessment—that no impact assessment has been done.

I have in my hand the impact assessment for vaccination as a condition of deployment in health and care providers—I was not able to get in earlier. I feel confident that the Front Benchers will know that the estimate is that 88,000 people will leave the health sector, 73,000 will leave the NHS, 15,000 will leave the independent health sector, and 35,000 workers will leave domiciliary care. Does the hon. Gentleman agree that that is reason enough to vote against imposing this on the nation?

That is very interesting. It is also interesting that papers circulated by the Vote Office said there was no impact assessment. That does not impress me.

The point I was just about to make—I do not know if other hon. and right hon. Members have noticed this—is that the 355-page Act passed at the start of the epidemic, the Coronavirus Act 2020, is barely being used. The Government could have used the Civil Contingencies Act 2004 to bring in some of the restrictions that they have placed—maybe necessarily, maybe unnecessarily—on people’s freedoms. The difference between the 2004 Act and the Public Health (Control of Disease) Act 1984 is quite simply that much less scrutiny is available under the latter. Once regulations are passed, if there is not a sunset clause, they last. The Government should not be rewarded for unnecessarily using tough authoritarian legislation when other legislation was available that would have allowed more scrutiny.

The Government have refused to give information. My hon. Friend the Member for Ilford North (Wes Streeting) began his speech by saying that different people have different views and weigh the factors of civil liberties and health in different ways. That is absolutely right, but the Government will not tell us the costs and benefits of their policies. We now know that three quarters of a million people have failed to be tested for cancer. This is not a win-win situation. Cancer patients who are yet to be tested will eventually die because of the decisions being taken, because services are not available; some people will die of covid.

To come to the right decisions, this House needs all the information available, but it is not coming from the NHS and it is not coming from Government Ministers. That is why I will not give the Prime Minister the benefit of my support for the way he has arranged to respond to this covid crisis.

On a typical winter’s day, between 200 and 350 people will die of flu. Do we hide behind our masks? Do we lurk at home, working from home? Do we demand that people provide their bona fides before going to a venue? Do we require people to be vaccinated as a condition of keeping their jobs?

The question whether the measures before the House today are proportionate comes down to a matter of opinion. Do we take seriously some of the extraordinary extrapolations that we have been given, particularly given the previous record? The fact is that those are things that might take place, and we have to balance them against the known costs and damage to enterprise, economy and society.

In the end, it comes down to a matter of opinion—a matter of our prejudice. Typically, we are capable of organising our lives and making those decisions for ourselves. We decide what our risk appetite is and what we are or are not prepared to encounter. Notwithstanding the carnage on our roads, which is certainly killing more people than covid at the moment, some of us still decide to drive. It is a matter of opinion.

It comes down to letting loose the dogs of war—getting the fear factor into it and getting the officials, the members of SAGE, Independent SAGE and SPI-M and all those who speak in their private capacity out there twisting the fear lever. What about the Health Protection Agency? What Stalinist minds thought up that nomenclature? Get them out there, twisting the fear button, and by and large you will get the reaction that you want: people will crave more enforcement and fiercer measures to protect them from the great danger that is out there. Let hospitality be just collateral damage—let the industry endure the deluge of cancellations at what should be its most productive time. That is the situation that we have delivered.

The Government, having administered this Ministry of fear, are absolutely complicit with their officials and organisations who have designed and delivered it. In doing so, they have abandoned any principle of social democracy or liberal democracy, absolutely beyond anything that we have endured in recent living memory, in the history of this pandemic. As a consequence, having abandoned what might have been their ideology, they are rudderless and so much more at risk of the opinions and predictions of the advisers to whom they are in hock.

I have just come from a meeting of the all-party parliamentary group on coronavirus. We were given a shocking set of presentations, about which the hon. Member for Oxford West and Abingdon (Layla Moran) will say more shortly.

I want to bring three key messages from that meeting of scientists and NHS professionals. The NHS is already beyond full stretch, and some said that it was at breaking point. They pointed out that we are not South Africa, which started its omicron wave from a low level of cases. We are starting it on top of a rising number of delta cases, so we have to get transmission rates down now. The focus on vaccinations alone, although they are vital, will not be enough. We have to focus on a range of other measures such as ventilation in schools, as other hon. Members have mentioned, and the big issue of limiting social contact.

We need to be honest and to have consistent and clear messaging about the need to reduce social contact. There is a direct relationship between the number of contacts that we have and the spread of infection. Giving guidance to work from home while still giving the green light to Christmas parties is, as the professor of primary care in Oxford suggests, akin to giving people advice to wash their hands after a meal but not after going to the toilet. We are all dreading the prospect of not seeing loved ones again at Christmas, but that is exactly the direction in which we are heading unless the Government show some leadership and tell us the unwelcome truth that we might not like to hear.

The hon. Lady and I share a hospital trust. She will know that that hospital is being overwhelmed at the moment not by covid cases or covid pressure but by cases of non-covid illness that have been neglected during lockdown and by the inability to release people who are medically fit for discharge. Is it not correct that, as it stands, those are the real pressures on the health service, not a torrent of covid cases coming in?

That may well be the case now, but I do not see why that is an argument against needing to get coronavirus cases down. If transmission rates go up on the trajectory that we are being told they will, we can be sure that there will be massive pressure on our hospitals and NHS trusts. I do not disagree with the hon. Gentleman’s point, but it is not a criticism of my argument. It is precisely because of the multiple pressures on our hospital system that we need to get transmission rates of omicron and delta down. That is why I want the Government to get rid of the disincentives that are built into the system and that stop people being able to self-isolate when they need to. Why do we still not have better sick pay for self-isolation? Why do we not have better support for our businesses? If there is going to be reduced social contact, as there needs to be, we know that has an impact, particularly on the hospitality sector.

We need VAT reductions to be extended beyond April, when they are due to end. We need businesses to be offered grants to help them through the next difficult weeks and to be given flexibility on paying back covid loans. My constituency is already feeling the impact of omicron, and the hospitality sector is extremely worried. Why can we not tell it, for example, that there will be extended and expanded business relief, with the Government ensuring that local councils do not lose even more funding? There should also be a proper support scheme for the self-employed who, as we know, play such a key part in our economy but were utterly left out of previous support mechanisms.

I regret that the Government have given MPs less than 24 hours to analyse the statutory instruments before us. Frankly, they have not advanced the scientific case for them. A Public Administration and Constitutional Affairs Committee inquiry earlier this year concluded that the Government had not made a robust case for vaccine passports, and I have not heard anything today that has persuaded me otherwise.

Although I recognise the civil liberty arguments on the measures, with which I have sympathy, my bigger concern comes from the strong body of evidence on the impact of vaccine passports on vaccination rates. That evidence makes it clear that, although they can accelerate take-up rates among those inclined towards vaccination, they also entrench opposition among those who are hesitant.

As Professor Stephen Reicher has said, people not getting vaccinated is not a cognitive problem—it is not that they do not understand the issues—but a social problem. People are not getting vaccinated because of a lack of trust, and trying to force them into it, either through vaccine passports or through mandatory vaccinations in some settings, compounds that mistrust, as does berating them or “othering” them. If we want more people to be vaccinated—and believe me, I absolutely do—that is the bottom line, but we have to build the sense that vaccination is being done for the community, not to it. It is for the common good. Behavioural science clearly indicates that coercion undermines the relationships we need to build and the respect we must show one another in order to increase vaccination rates, and we do everyone a massive disservice by ignoring that science.

I want to end by saying a few words about the wider global situation that we face. It is supremely reckless to have so catastrophically neglected vaccination in poorer countries, and it is extremely reckless of our Government to refuse to support the waiver on trade-related aspects of intellectual property rights at the World Trade Organisation. As Winnie Byanyima, executive director of UNAIDS, has said,

“Omicron is with us because we have failed to vaccinate the world.”

The Government should absolutely be changing their position on that TRIPS waiver: they should not be blocking it. The virus will be with us for years and years to come, and it will mutate into other viruses and variants unless we treat this as a global crisis, not just a crisis here at home. I beg the Government to look at the evidence, to look at what works, and to move forward on that basis.

Let me begin by saying a word about the vaccine programme and issuing a plea to Ministers.

It is important that, with the emergence of omicron, we do not accidentally underplay the success of the vaccine programme to date. We know that vaccines will generate a number of immune responses—the production of neutralising antibodies, the production of marker antibodies, and a T-cell response—and, although with omicron a booster dose is required to bring about the level of neutralising antibodies that we saw following our response of two doses to the delta variant, the whole programme gives both individual and community protection; and we are starting from a very different place from the place where we were with the delta variant.

It is very important for us to encourage people, especially young people, to get their second dose. May I make a plea that we stop hearing from Ministers the phrase “two doses don’t work, three doses do”? I think that it is undermining the Government’s own programme. May I also make a plea that we drop this constant reference to the doubling time of the current variant? The fact that the measured doubling has been two days in the very early stages is no measure whatsoever that that is something that we will see in the future. If it doubled every day, the whole population would be affected in nine days. This is not modelling; it is simple extrapolation, which does not contribute to a sensible debate on the subject.

When it comes to the proposals before us today, lawmakers need to look at several elements. Are these measures necessary, are they proportionate, are they enforceable and will they be effective? Let me begin with the 10-day quarantine, which was a bad measure to begin with. It was disproportionate and it was likely to bring about a recurrence of the “pingdemic”, so I am glad that it is being dropped. However, the point made by the right hon. Member for Exeter (Mr Bradshaw) is a key one which must be answered by the Government. If having the red list is pointless and if enforced 10-day quarantine is pointless, why are some people still in enforced 10-day quarantine? It is incumbent on the Government, having abandoned the policy, to let those people go free, otherwise I fear that the Government may face legal action.

The right hon. Gentleman is making a very important point. Some Welsh rugby players who had covid in South Africa did 10 days’ quarantine there and are halfway through quarantine in England, and they are now being told that they must complete the whole of the quarantine period. When the position is as illogical as that, it brings the whole thing into dispute.

I absolutely agree, and what we do not require is more advice from Ministers on this subject; we require decisions from Ministers on this subject.

I also want to raise the issue of masks. I receive letters, as I imagine all Members do, from people who say, “There is no point in wearing masks because they do not stop transmission.” I assume that those people would not like their surgeons to wear masks during a surgical procedure. This is nonsense: mask wearing is a common-sense thing for us to do if it reduces transmission to some degree. It is a minor inconvenience to the vast majority of people and it is a sensible measure for the Government to introduce, and I therefore support it.

I cannot say the same for the Government’s covid passport. I do not believe it passes the necessity test, and I think the good working of the insurance industry and the availability of civil remedy in the courts are enough to drive the behaviour of venues towards sensible public health policy. We, as a Government, should not be creating criminal offences unnecessarily. I worry about enforcement and penalties in a system that is already overloaded. There is no evidence from Scotland or elsewhere that covid passports actually work. France was mentioned earlier, and there are more than twice as many people in hospital with covid in France than in the United Kingdom.

I have given way once. I am conscious that colleagues want to speak, so I will not give way again.

I assume the lateral flow tests will have to be externally validated, which will add a cost to anyone who wants to go to one of these venues. That will not be the help to the hospitality industry that has been suggested by the Secretary of State and the shadow Secretary of State.

When compulsory vaccination was introduced for care workers, many hon. Members took the view that it was the thin end of the wedge, but we were assured that it would be care workers and no one else. Now it is all NHS workers, with a few exemptions. The ground for compulsory vaccination is that these staff will be working with vulnerable members of the public. Well, so will the police and some retail and post office workers. Where does it stop?

The hon. Member for Blackley and Broughton (Graham Stringer) made the valid point that this is a retrospective change to the terms and conditions of people who already work in the NHS, and it is likely that we will lose staff as a consequence. This is completely unnecessary when more than 91% of NHS staff have already volunteered to be vaccinated. It is disproportionate and illogical, and I do not believe it will be effective. If the logic of the Government’s position on covid passports is that people must be given a choice between being vaccinated and getting a daily lateral flow test, why does that not operate in the health service, too? The lack of logic in many of these measures diminishes support for the Government’s case.

I end on a positive note. Many of these measures are relatively small beer compared with what we can achieve through the booster campaign, so it is essential that the one message we leave the House with tonight is that every one of us has a duty to say to every one of our constituents, “Go out, get immunised and get a booster. That is the best way you can help yourself, your family, your community and wider public health.” If there is to be unanimity in the House at this time of year, that is surely the message that must resonate.

Having had the dubious pleasure of spending an inordinate amount of time in various Committee Rooms over the past 18 months to scrutinise regulations introduced by the Government as part of their response to the pandemic, I must confess that I have had withdrawal symptoms following the reshuffle, so I am pleased to have the opportunity to speak on these regulations today.

I am sorry to say that, on too many occasions, regulations were debated well after they came into force, so it is positive that at last we seem to be getting into the habit of having debates and votes before regulations become law. I would not want that to be seen as a ringing endorsement of the Government’s approach to parliamentary scrutiny, as two of these sets of regulations were published only at 3 pm yesterday, less than 24 hours before this debate began. I know things move quickly, but some of these regulations have been the subject of consultation for many months. There is no excuse for their being dropped in at the last minute.

The decision to reveal the precise detail of these regulations at the last minute has probably generated more opposition than is warranted. I have had many representations from constituents about the entry to venues regulations on the basis that they represent a compulsory vaccine passport. Let us be clear that they do not. A negative test taken in the 48 hours before entry can be used as an alternative, which addresses many of the legitimate concerns that have been raised with me about civil liberties and discrimination. I am pleased that my party’s persistence in pushing for a negative test as an alternative has been accepted, because it gives me enough confidence to support these regulations.

Across the House, many of us have been calling for greater transparency from the Government. The more we hear from the chief medical officer, the more concerning it is. If the Government had been more transparent up front, I am sure there would be greater support across the House.

Indeed. If we look at what has happened in Wales, there has been a similar system for some time, which seems to be working reasonably well. People have been required to produce tests when travelling abroad and several venues in England have been doing that on a voluntary basis. It is not the slide into dystopia that some people fear, but the situation has not been aided by the Government not being as up front as they should about what the regulations mean. Many people already routinely take lateral flow tests before they go out.

However, there are some outstanding questions and concerns. There is no doubt that some constituents feel that the regulations are the start of a slippery slope and that we will soon have to show vaccination papers to get in anywhere. I will be clear: I do not support such a move. Given that the Government cannot even bring themselves to mandate wearing face coverings in pubs, I would be surprised if they moved in that direction, but I want confirmation when the Minister winds up that the Government are not planning any extensions to where the regulations will operate. We also need a clearer explanation of where the line is drawn and to which venues the regulations apply. Do places such as this, which fall into the definition of a public hall indoors with 500 or more people who stand up and move around, come within the ambit of the regulations? My reading suggests that they do. If we want to gain the public’s confidence, we should show that the rules apply to us equally.

Another concern that has rightly been raised is whether a charge will be introduced at some point to obtain lateral flow tests. That would obviously undermine tests as an alternative to showing vaccine status. Charging people to obtain tests would be an absolute disaster from a public health perspective. That goes way beyond the remit of the regulations, but I hope we can get confirmation from the Minister that there are no plans to charge for tests.

The Government need to do rather better at setting out what they consider the cost of the regulations to be to businesses. Again, I note there has been no impact assessment for the entry regulations. Who will pick up the cost of enforcing them? There is nothing I can see about supporting businesses to check people, let alone providing resources to local authorities, which are meant to enforce the regulations.

What will be the position if there is a national shortage of tests? We are told that there are tens of millions of them but, as we know, there are challenges in getting them out to the people who need them. In those circumstances, will the regulations be suspended, or will people be pushed down the vaccination route?

That said, the evidential burden for a negative test seems particularly broad. I think that will assist in reducing the burden on businesses, but it also increases the risk of fraudulent tests doing the rounds. That would undermine the whole point of the regulations. We do not want the worst of all worlds: an expensive bureaucratic system that does not actually help reduce transmission because it is not properly enforced.

Regarding the vaccination of NHS staff, there is plenty of evidence to suggest that a small but significant proportion of covid admissions is the result of people acquiring the infection in hospital. I have seen figures to suggest that it has been as high as 15% to 20% of all covid admissions, although once staff started to receive the vaccination, the figure dropped dramatically. There is therefore evidence to show that the regulations will have an impact on covid admissions and the wider pressure on the NHS. I know it is difficult, but on balance, the regulations should be supported.

However, that should not be the end of the story. We have had a workforce crisis for years. Covid has accelerated cases of burnout and only a few weeks ago, the Government passed up the opportunity to grasp the nettle by refusing to implement a long-term workforce strategy. That is why we need an awful lot more work on the regulations.

The Government have an uphill struggle to earn people’s trust and explain why they consider the proposals necessary, to convince the public that what is before us will be the limit of restrictions and that we will not be talking about extensions or changes at some point in the future. Judging by the comments of many Conservative Members, the Government have failed to persuade a number of their Back Benchers, so it is little wonder that we are all being bombarded by emails from our constituents expressing concern. That exposes the wider truth that the Government have vacated the space where leadership should be. They are compromised by their own failure to follow the rules, riddled with internal disagreements about the route ahead and unable to provide the authority to persuade a sceptical public that the measures are needed.

Here we are again, and this time, two weeks on, the concept of “learn to live with covid” is as dead as anything I know. In July, we were told many, many times from the Dispatch Box, and from the podium in No. 10, that we were on an irreversible road map to freedom. Do we all remember that? I thought it was an unwise hostage to fortune when it was said, and so it has proved.

When I vote tonight, I will consider the legislation before us. I completely agree with the hon. Member for Ellesmere Port and Neston (Justin Madders) that it should have been published long before this, less than 24 hours before the debate. That is why I did not tell anybody in the media how I was going to vote today—because I am rather old-fashioned and like to actually read the legislation before I decide how I am going to vote. I wish those on the official Opposition Front Bench had done the same. I look at the legislation and I also look at the intention behind it, so what is the intention here? Is it to stop omicron? Is it to slow the spread? That is clearly not happening now, so I guess the question we then have to ask is whether these four SIs are going to do that. Working from home is not in an SI; it is guidance. We are told that people need to work from home where they can, but they can meet the very same people in the pub that evening and every evening. Is that going to slow the spread? I do not think so.

I abstained on the SI on mask-wearing two weeks ago and I will do so again this evening. I have no issue with wearing a mask. It does not impact on my life or on my freedoms. Many of my constituents have been wearing masks in plenty of situations, indoors and out, for a long time throughout the pandemic. I think it is a bit of a crutch, but if people believe that it makes them safer, that is fine. In many ways, it is an instrument of people feeling they are safe. Today’s SI says that we have to wear a mask in certain shops but not in pubs or in restaurants, and some of the exemptions make a mockery of it, but I will not stand in its way.

On the covid passport, if we were to put aside the practicalities and the moral arguments, which I do not, and many of my constituents writing to me certainly do not, then a vaccine still does not stop people getting this and passing it on. Professor Whitty said to MPs on a call this lunchtime that there is a minimal impact on transmission with regard to all our vaccines.

Last Wednesday, when the Secretary of State made his late-night statement, I expected him to bring forward a devastating piece of science that basically said, “The drugs don’t work.” That is not what he said; he said that we are moving to plan B on the basis of some modelling. We have SAGE’s gloomy predictions and yet a confirmation that vaccines do work with two jabs, even better with a booster. I completely agree. Today we have a study that says that the Pfizer vaccine has 70% efficacy against the omicron variant. Last Wednesday’s statement should have been about the national booster effort that was announced in the live TV broadcast on Sunday night. I cannot say how many of my constituents have contacted me furious at the frightening nature of that broadcast that sent their children off to bed terrified.

If we truly mean the “learn to live with covid” mantra that we continue to hear, the booster campaign is 100% where our focus should be. We should be focusing on an ongoing plan to keep immunity high. We probably need a new primary care infrastructure, because “panic stations and cancel all else” is not a plan. Yesterday I spoke to three of the four primary care networks that cover my constituency. They are going to do their absolute everything to offer the booster to all eligible over-18s by the end of this month, but it will be really difficult. They are scrabbling around for venues in the week of Christmas. This is not the long-term thinking that we need.

I am ambivalent about regulation No. 1400 on face coverings and I will not stand in its way. On isolation moving to tests, I will support that if there is a Division, although I suspect there will not be. However, if people cannot get the lateral flow tests, as they have not been able to today and yesterday, as I raised in an intervention on the Secretary of State, then we get the pingdemic anyway, so we need to sort that supply out. I will not support the vaccine passport because it crosses a Rubicon. Italy began in exactly this way saying that it was all about providing lateral flow tests, and I think it will move, and move quite quickly. On the mandating of health staff, I will support that to be consistent with the mandating of vaccines in the care sector. If you work in the health service, working with vulnerable people, surely you have to believe in science above all else, and there is a precedent because of hepatitis B. So it is a mixed bag for me: I will support some of the measures before us today but not others.

We all know that the NHS is facing one of the toughest winters in living memory; not only is covid a very real threat, but we are also facing a potentially tough flu season. The Liberal Democrats will be supporting the statutory instruments on face coverings and self-isolation, but let us be clear: the Government should never have scrapped the use of masks on 19 July. Their obsession with removing all precautions in one go had far more to do with party management than it did with public health. We have all made tough sacrifices throughout the pandemic, and asking people to wear masks on public transport would have been a very small ask with a very large pay-off. We also support the working from home guidance, for which we have been calling for some time.

Today we are discussing the plan B protections to reduce the spread of this disease, but there have been rumours overnight that the Government are also working on a possible plan C. It has been reported that the UK Health Security Agency has privately advised the Government that “stringent national measures” will need to be imposed by 18 December—in just four days’ time. This drip, drip of information is causing huge uncertainty and anxiety. We need clarity and we need it now. The British public are haunted by Christmas past. We know that that last-minute U-turn meant that many people ended up spending Christmas on their own last year. With just days to go, we need the Government to come clean and tell us what omicron means for Christmas this year.

We Liberal Democrats welcome the ambition of 1 million jabs a day, and we sincerely hope that it makes up for the complacency around the booster scheme over the last few months, but the way in which the target was announced, with no scrutiny and no details, was a real insult to all those who were left to scramble to pull a plan together on Monday morning. The idea that NHS staff, GPs and their staff, local authorities, the military—none of them—had been given any prior warning of the announcement is extraordinary, and highlights the Government’s complete lack of planning. The idea that those people, whom we are now asking to vaccinate millions, were an afterthought is shocking. But here we are. As always, our NHS, the GPs and their staff, local authorities, the military and volunteers are stepping up, and as a country we are grateful.

The Government still have not made a commitment this afternoon that if they bring in more protections of any kind, this House will have the opportunity to scrutinise them, so I want to get a few points on the record right now. If the Government are considering any further protections, they must support small businesses and our high streets. Hospitality businesses are experiencing unprecedented cancellation rates for this festive period, and they were experiencing them even before the latest protections were announced. Hospitality is technically allowed to stay open, but all of the mood music is telling people not to go, which is causing a huge problem. We have therefore called on the Government several times to call and convene an urgent hospitality summit in order to see what support businesses need right now.

If there are further restrictions, we must also look after people’s mental health. We need supported isolation, not lone self-isolation. There must be financial and practical support for those with caring duties and for those who live alone—and for our schools. Our children have suffered so much. It was months ago that the Liberal Democrats called on the Government to ensure that there was an air purifier in every single classroom in England, but we are still nowhere near that.

Finally, for all these measures to work, there must be trust in the Government. With that in mind, what we need now from the Prime Minister and his Cabinet is the truth. Will the Government come clean about Christmas, or will we see another last-minute U-turn that ruins the Christmas holiday and is too late to alleviate pressure on the NHS? I sincerely hope that it is the first.

Over the past year I have supported some covid measures and voted against others. With that in mind, my constituents may be struggling with the logic of my voting record, but I believe it is straightforward and I hope to exemplify why that is the case.

Where the measures have felt disproportionate to the wider harm, I have voted against their introduction. An example was putting the constituency in differing tiers when hospital admissions were low. Where the hospitals could not cope, I did support lockdowns as proportionate in those dramatic circumstances.

Where the wording of measures felt contrary to the aims they sought to deliver, I voted against their introduction. The 10 pm curfew was a good example of that; everyone piled out of the pub and on to public transport, and the Government eventually conceded, and reversed. That was the same concept that led me to vote against last week’s self-isolation regulations. I could not understand why, when omicron was going to become the dominant variant, we were requiring people to self-isolate; it would have led to a pingdemic. I am glad that the Government are reversing that today and I will gladly support that regulation.

As for the other three, my thoughts are as follows. For face coverings, I voted for the same outcome for retail and public transport last week. I do not want to see face coverings become a permanent feature and I do not want to see them reintroduced in the classroom, but for a limited period of time, in a settings reference, it feels right to me to extend the scope. On NHS workers being vaccinated, I voted for the same outcome for the social care workforce, and will do so again. We know that getting vaccinated reduced the delta transmission rate by 60%. We also know that patients who get vaccinated are not completely protected from serious illness or death. Surely, if care is in the DNA, it is not unreasonable to expect vaccination to be an entry point. If NHS workers believe that their own choices come before the safety of their patients, or if they do not believe that the NHS is about working for covid and working for vaccines, or that the evidence on those is true, I question if they are in the right profession.

For vaccine certification at larger venues, I am genuinely perplexed about the outrage at, at worst, showing paperwork. Last month, I got asked for my passport when I came back into the country. I have to show evidence of purchase when I watch a football match. I was also delighted to be asked for ID showing my age when I wanted to buy a beer, only a month back. What is the issue in temporarily asking someone to evidence vaccination, or a negative lateral flow test, for certain venues? If it keeps people safe, and in jobs because we do not have to put more draconian restrictions on events and hospitality, I am happy to oblige.

The impact of the omicron variant is not known. What we do know is that the doubling rate is two to three days; for delta it was seven days. In South Africa, where the variant emerged, the hospitalisation rate is now rising. Yes, the vaccination rate is lower in South Africa. However, it is also their summer, they have a higher level of antibodies from natural infection, and the average age is 13 years lower than in the UK. These restrictions are limited in time and scope. I ask myself, “What is it that I will not be able to do tomorrow that I could do last week?” The answer is, absolutely nothing. A little more face-mask-wearing. A little more admin to go to the football. If you are an NHS worker and are not going to vaccinate, there are a record number of jobs available for you to work somewhere else.

There is a larger issue at play, which I find infuriating. Over 80% of my constituents have got themselves vaccinated. They are keeping themselves and their communities safe. They are minimising their own impact on the NHS. There are a small minority who are not playing by the same rules, and have the temerity to lecture me on freedom. Let me tell them this: their freedom to remain unvaccinated and then do as they choose is reducing the freedoms of those who have done the right thing for themselves and the wider community.

As a Conservative, I believe that rights are not absolute: they have to come with responsibilities. Being a cavalier for freedoms is what we were sent to this place to be. Being cavalier about the health of the public is contrary to that principle. With that in mind, I will be supporting these proportionate and limited measures this evening.

Given time, I will concentrate my comments on mandatory vaccinations for NHS staff. I find myself really torn on this emotive subject, and I also find myself trying to apply logic to what is quickly becoming an illogical argument from the Government Benches. If it is really about patient safety, the Government should already have identified workers in the NHS who are still unvaccinated and have been working with them to alleviate fears and concerns and remove barriers. The Secretary of State should explain to the House why it is acceptable for those in the NHS who remain unvaccinated to work on the frontline to assist with the omicron crisis but, come 1 April, to be dismissed. Quite frankly, it makes no sense.

Comparisons have been drawn with the requirement for NHS staff to be vaccinated against hepatitis B. The reality is that chapter 12 of the Public Health England Green Book, which provides the latest information on vaccines and vaccinations, states:

“Hepatitis B vaccination is recommended for healthcare workers who may have direct contact with patients’ blood or blood-stained body fluids.”

It is not the law. The Government proposal will see these workers work around the clock during the next few weeks and months, only to be dismissed on 1 April if they do not succumb to mandatory vaccination.

Does my hon. Friend agree that if these measures will come into force at the beginning of April and the parties concerned are to participate in a framework agreement for their roll-out, there is an ideal opportunity for those parties to work through how they may be implemented? By rushing the measures today, we are being robbed of that opportunity, despite the noises from the British Medical Association, the unions and the royal colleges.

I thank my hon. Friend for that excellent point, which I agree with wholeheartedly.

The workers I am talking about are the workers who worked around the clock at the start of the pandemic, despite having inadequate personal protective equipment, because they were putting the nation first. They are the workers who will continue to work around the clock over Christmas and the new year. In an institution that is built on consent between patient and clinician, the Government are ripping up the rulebook to suit their own ends, while at the same time we are seeing the 17th reorganisation of the NHS since 1993.

We clapped for our care workers and NHS staff on a Thursday, and they will get us through the latest crisis over Christmas and the new year. But now the Government, who ripped up the rulebook last Christmas while the rest of us obeyed the rules, sacrificing seeing our loved ones—some in their final moments—are going to dismiss workers in April. And all this while No. 10 and the Department for Education not only had Christmas parties but told this House and the nation that they did not. The message is inconsistent and makes no sense.

We are told to trust the Government, but it is increasingly concerning that they are reviewing the Human Rights Act and want to replace it. We should be very afraid, because this could be a sign of things to come from a Government and a Prime Minister who believe they are above the law. Even worse, if they do not like the law and it does not serve their purpose any more, they will rip it up and start again until they get the policy or the outcome they want, irrespective of civil liberties or economic damage.

The right to choose, particularly when it comes to our own bodies, is something we should all take very seriously. I implore everyone to get vaccinated and boosted to protect themselves and others, but the Government have set a precedent that should worry every citizen. For the first time ever, we have seen the profession of care workers singled out; they have had conditions attached to their employment status that were never there to begin with.

There is so much that the Government could do in the weeks and months ahead, from constructive negotiations with the trade unions, which remain opposed to mandatory vaccinations, to ensuring that local authorities and health services have the resources and capacity required to deliver the ambitious daily targets for boosters, and that statutory sick pay is set at the Living Wage Foundation rate. Most importantly, they could follow the rules themselves, to give the public confidence that any measures introduced are proportionate and necessary.

Before entering this place, I represented care workers, NHS staff and public servants, many of whom are now my constituents. I take very seriously my responsibility to ensure that their voices are heard, while trying to balance that with the unprecedented situation before us and the importance of public health. I think we can do just that by consensus rather than compulsion.

I implore the Government to pause on the issue of mandatory vaccinations, withdraw the relevant statutory instrument and work on the issue with the trade unions, the Labour party and all those in the House who offer cross-party support. The Secretary of State himself has said that we have seen an increase in vaccination rates since the start of the consultation. Please, remove the SI and let us work together to get the country vaccinated.

I draw the House’s attention to my entry in the Register of Members’ Financial Interests: I am a doctor and vaccinator.

Statutory instruments Nos. 1400, 1415 and 1416 are without question relatively modest, certainly by comparison with the restrictions that currently apply in similar jurisdictions, and it is a very good thing that they will fall on 26 January. Nevertheless, I urge Ministers to think about the rapidity with which the evidence is changing. Currently, the evidence from South Africa is relatively positive: I am particularly impressed by the fact that mean hospitalisation in this particular wave is 2.8 days—it was previously eight days with the beta variant predominant in South Africa, whereas we have had delta, which is worse. From that, we can deduce, because it is the same population with the same demographic issues, that this variant is relatively mild. That has to be our working hypothesis, but we really do not know. We are struggling for evidence and the evidence appears to be evolving by the day. It seems to me unreasonable for the public to see their representatives leave this place for two weeks when they would expect us to be here to hold the Government to account on a real-time basis, which would require the House to sit next week and the following week, inconvenient though that may be for a lot of colleagues. I urge Ministers to give that some thought so that we could consider, for example, the advice on working from home that is currently having a significant impact on sectors of the economy.

SI No. 1415 is permissive, for which I congratulate the Government. I welcome it, and it should avoid another pingdemic. The advice about taking a lateral flow test for seven days is sensible, but only if, of course, lateral flow tests are available. I have heard that they are not available today in my constituency and hope that Ministers will attend to the issue as best they can.

I cannot get too excited about statutory instrument No. 1400, on face coverings. The best evidence published last month in The BMJ’s meta-analysis suggested that the wearing of masks had some effect on transmission, so it is the least we can do to wear the wretched things. The measure extends the list of venues that require people to wear a mask, but as we have all seen—those of us who use public transport and shops—the prevalence of mask wearing has increased in any event, thanks to the good sense and good will of the British people. We should encourage that at all times.

Statutory instrument No. 1416, on access to venues, starts to get a bit more sticky. The Secretary of State’s workmanlike recasting of vaccine certificates as an alternative to a negative lateral flow test yesterday was very helpful, but it was not helped terribly much by the remarks attributed to the chief medical officer earlier today that seemed to suggest that protection against transmission for vaccinated people is rather less than many of us had previously hoped. That did nothing to advance the case that the Government are trying to make, but I am more relaxed about that particular SI now.

I am slightly concerned about the SI on regulated activities. If a recent negative lateral flow test is okay under SI No. 1416 and, to an extent, SI No. 1415, why is it not okay for healthcare workers? With respect to my colleagues, the difference between the BCG and hepatitis B vaccines for those in the national health service who perform exposure-prone procedures and the situation we are discussing here is that there is an alternative to demonstrate that a healthcare worker poses no threat to their patients: a lateral flow test conducted very recently. It seems to me that, given the Regulatory Policy Committee’s damning assessment of the measure and the likelihood that as a result we will lose quite a few people in a health and care system that can scarcely afford to lose people, we need to look at alternatives to keep people in, not least because even the vaccinated will feel the pressure of some of their unvaccinated colleagues leaving. This could be something of a perfect storm in the winter months, and I hope Ministers will look again at whether we can have lateral flow testing—on a daily basis if we like, as I have had when I have been jabbing—as an alternative to insisting on vaccination.

I ask Ministers please to examine the issue of quarantine hotels and the requirement to bang people up. That is completely untenable, given the change in advice. I am surprised that Treasury lawyers have not already been advising Ministers that it is not appropriate, and I suspect there will be a wall of cases if those people are kept locked up when they should be released, in accordance with Ministers’ very welcome announcement today on the red list.

I rise to focus, in the short time available, on statutory instrument No. 1416, on entry to venues and the issue of compulsory vaccines. It feels as though I have been around this block before, because just over a decade ago I was the Minister responsible for identity cards and passports in the last Labour Government, yet I share concerns about health data being routinely required in order to access services.

When we dealt with identity cards, we were clear that they were about verifying identity, with no health information included, despite some groups lobbying to have health information on those cards. No immigration status information was to be on them, although many of my constituents and people up and down the country, do have cards with their immigration status on, which they are happy to have to prove their rights. There was other lobbying to include things such as veteran status on cards, but the Labour Government pushed back hard on those points and there was absolutely no requirement in law to have an ID card to access any public service.

That is very important, because tonight’s proposal does not require people to show their vaccine status in order to access a public service. It is about accessing optional large events, where they could be a spreader. In addition, ID cards were on a statutory basis, with a raft of underpinning law to make sure that we had a clear basis for them, and they were long-term. They were debated at length, including twice in this House, because the general election of 2005 interrupted the process.

Let us be clear that a covid vaccine status document or app is a temporary measure—it expires. I have just had my booster, but had I not done so it would have been a moot point as to how long my second vaccine would still give me the status that I require. The Secretary of State has said that that booster will be required, once it is rolled out, on that pass in order for it to be valid. It is not required in order to access any public service. That is an important step, because if we were to go down that route, we would need to get this on to a statutory footing. I hope we never get to that point, but we do not know what is going to happen with coronavirus. As it stands, we have not had a version that will kill our children, and thank God for that, but we know that this is not yet over. At this stage, there is no proposal for a permanent covid pass and therefore there is no need for this to have a statutory footing, because we hope this is something that will run into the stand.

We are also talking about a health treatment here. When I present my pass, it tells the person nothing other than my name and my date of birth; sadly, people will have probably worked out that I am no longer 21, and I do not really mind about that. If that information is needed in order to get into a venue, I am prepared to make that choice. It is a compromise, because of what happens if we do not do this. The data will show that although even vaccinated people can catch covid and spread it, this reduces it, and the booster reduces it further.

For sceptics, let me say that 100% safety would mean a lockdown or closing down hospitality venues, events, workplaces and schools—no one wants that. So this is not a perfect solution to stop spreading omicron or any variant of the virus, but it protects our hospitality industries and events. Even though they are still hit, it protects them from complete closure. This approach of temporary and near universal coverage, limited information required to be presented and no requirement for venues to hold copies of our data is a proportionate response. It is a responsible thing to support each other. Individual freedom, as outlined by the hon. Member for Bexhill and Battle (Huw Merriman), cannot be at the expense of wider freedoms; we do have that responsibility with that freedom.

I wish to touch on compulsory vaccines for health workers, and I congratulate my hon. Friend the Member for Ilford North (Wes Streeting) on his tour de force on that. I am concerned about pushing people forcibly to have a vaccine, but we should never have got to this point. We should rely on reliable information and education to ensure that we do not get to the point where people have to be forced. Of course, we cannot force someone to have a vaccine, so the consequences for a health worker are immense. Ultimately, for those health workers on the frontline supporting their patients, vaccination will have to be a requirement for the job, because the risk of spreading the virus or of sickness across the health service because staff are not protected would cripple our health service. Reluctantly, therefore, I have moved to the point where, having voted against it in the past, I will support the measure tonight. Spreading a virus that makes us ill, kills us and puts pressure on the NHS is not something that NHS workers can be a part of, but NHS England must work hard to convince and support people and to get rid of the disinformation about the danger of vaccines.

Let me start with a few words about the big picture. My hon. Friend the Member for Winchester (Steve Brine) put this very well. We know that covid is going to be with us forever, and we know that we are going to have variants forever. The chief scientific adviser has told us that, and I agree with him. There are many people who think that we will just have to wait a bit and it will all be over, but that is not happening. We have to be realistic about what we are facing, and according to Jeremy Farrar, we are facing this challenge as probably the best protected country in the world through vaccination.

This was effectively the first big test for the Government: how do we deal with a variant of concern in a very well vaccinated population? I am disappointed that we have quickly gone into panic and emergency mode, with late Sunday night broadcasts—not in the House of Commons where questions can be asked—scaring people witless. For example, they have been told that two doses give them no protection, which is not true. Two doses provide weakened protection from omicron against infection, but they still provide good protection against serious disease. I am concerned that many people out there who have had two doses and who are perhaps vulnerable now feel that they have no protection. That is simply not correct. If this is the first test, I do not think we are doing very well.

The data from South Africa that we heard this morning in the Science and Technology Committee showed that we still have good protection against severe disease from two doses of Pfizer, but it has gone down from 93% to 70% for hospitalisation. That is four times the risk of hospitalisation.

I have seen that, and I look forward to the information from the UK. The point I have been making in my constant repetition about the House sitting next week or the week after or being recalled—my right hon. Friend the Member for South West Wiltshire (Dr Murrison) also mentioned this—is that we are learning new information every day, and when we get that information, we might need to make different decisions. The House needs to be involved in those decisions; they should not simply be made by Ministers by decree. I repeat that point, and I do not understand why Ministers will not give us that assurance. It would build a lot of trust and good will among colleagues, and I do not understand why they will not give that commitment.

These decisions have significant economic and social impacts, as well as impacts on the NHS’s ability to deliver non-covid treatments. My hon. Friend the Member for Winchester has already pointed out that the NHS is going to scrap a whole load of elective surgeries and consultations with GPs in order to get boosters delivered. That might be the right decision, but I do not think that a proper balancing is taking place. Goodness knows how long it is going to take us to recover from the creation of this new backlog over the coming months. If the Government’s fears, as set out by the Secretary of State, are confirmed in any way, what is the exit strategy? What approach are they going to take to ensure that we do not face on-and-off seasonal restrictions forever? That is a serious question, and it has been raised by other colleagues. We need an economy that functions, people need to build lives that can function and the NHS needs to be able to function and deliver all the other healthcare we require.

Let me turn briefly to plan B. I am happy to support the measures on self-isolation. I simply note that, two weeks ago when we were asked to vote to restrict them, I voted against that. Two weeks later, the Government have agreed that I was right to do so, because they are effectively revoking those earlier measures. I will leave that thought with colleagues for when they decide whether they wish to listen to the advice of Ministers or others.

On vaccine passports, the Government’s plan B makes it very clear that Ministers’ preference is for vaccine-only passports. The only reason why tests have been incorporated is to buy or secure the support of the Opposition. That is the only reason. Ministers’ preference in writing is for vaccine-only certificates, so we know what they would like to do if they could get away with it.

The Secretary of State also made some commitments about not supporting mandatory vaccination for the entire population. The only reason that needed to be said is that, two weeks ago, the Prime Minister put on the table the whole concept of mandatory vaccination and talked about having a “national conversation” about it. All I say is that, if Ministers wish to build trust and good will, they need to be careful about what they say. They should not fling these very troubling concepts around without thinking about them. Words have consequences, both in terms of what happens in the real world and of the trust that needs to be built with Members of Parliament and the public.

What is proposed for vaccine passports is very limited, but that was the case everywhere they were introduced around the world. Everywhere they have been introduced, they have been extended. In Wales, for example, where Labour is in power, they have been extended in terms of the venues to which they apply, so anyone who thinks that Ministers will stick to what is currently on the Order Paper are, I am afraid, kidding themselves.

The final thing I say to colleagues is this: the vote on vaccine passports is not just about the regulations on the Order Paper; it signals how we wish to treat this House, how we wish to be treated on behalf of our constituents, and the direction of travel and the approach. If my colleagues wish to send the Government a clear signal that they need to rethink their approach, then, certainly on vaccine passports, they should vote against them. Send the Government a clear message that we can do better. There is a better way, and we should send that message today.

The past week has been tumultuous. We are about to go off on our Christmas break. The only positive thing that has emerged from party-gate is that it took Boris Johnson—[Interruption.] I do apologise. It took the Prime Minister potentially being on the front pages of all the newspapers on Monday morning to come out in favour of a different approach to plan B. I can only say thank goodness for party-gate. Had that not happened, I wonder how much longer we would have waited for the Government to act. The reason why that matters is that, every single step of the way through this pandemic, the longer we have waited, the worse things have got. The sooner we act, the less we have to act and the better the benefits.

This morning, the all-party group on coronavirus heard from the experts, many of whom advise the Government, and from people who represent frontline NHS workers. We wanted them to answer simple questions: “What is going on?” “Tell us about omicron.” Also, “Is it enough?” On omicron itself, the news is startling. Two-day doubling is quite scary. Even if all the population had boosters today, because it takes 12 days, more or less, for a person to develop immunity and become protected, the numbers would increase by 60 times. That is why the two-day doubling matters. It is true that when we get that booster immunity in place, the time of doubling will increase, which is a good thing, because we want to reduce that peak. My concern is that we have not gone fast enough soon enough.

Let us look at evidence from places such as Denmark and South Africa. Much has been made of South Africa, but it is true to say that our populations are not directly comparable. There are some things of which we need to take heed. For example, just this morning, there has been new evidence to suggest that omicron affects young children more than delta. It takes tiny percentages of children getting sick for us to start seeing them following through into hospital admissions. We should remember that children are, as yet, unvaccinated; they have no protection at all. So the first plea I make to Ministers is where is the plan for children? It needs to go beyond hoping that they are going to be okay, because it would seem that this variant is potentially a threat. I will send Ministers the evidence I have seen, which is sincerely alarming, and I hope they take it seriously.

The other thing we see from Denmark is the shape of these curves. I know that this is hard to show when talking, but for the benefit of Hansard, the blue line is delta and the red line is omicron. This is data coming from Denmark, and I will post it on Twitter if people want to look at it. However, for the benefit of Hansard, the blue line looks like a gentle slope and the red line looks like a hockey stick, and that is deeply alarming. So what do the Government need to do? They have gone from plan A to plan B, and they are considering, once they get plan B through, moving from B to C. I was a teacher before, and if that was happening to a student of mine, I would get the parents in and get them to have a chat, because we need to go from B to B-plus.

What does B-plus mean? It is the booster—absolutely, it is the booster—but we have to recognise that between now and then it is not enough. We need to ventilate our public spaces. We need to provide support for social care, because unblocking those beds in the NHS requires extra support in social care. We need to ensure that test, trace and isolate works, which means allowing people to get tested—we have seen issues with that already—but we also need to help them to isolate. We need to limit mixing, and if people will not do it themselves, the Government need to act. We also need to bear in mind the effect of long covid in all of this. If there are huge numbers of people who already have it, many more are going to have that. So I urge the Government: do not hesitate, act quickly, please do not curb Christmas, and go from B to B-plus now so that we can enjoy the holiday ahead.

Whenever this House passes legislation, it is essential that it is effective, evidence-based and logical, and it needs to have broad public support. What I see in front of us today with regard to plan B delivers on virtually none of these items. Indeed, if I look on social media and in my constituency email inbox or just have general conversation with others, it is clear that the measures before us are being treated with strong suspicion of a wider agenda, partly because they simply will not deliver on their supposed intentions.

Sadly, the Labour party will be supporting the Government today as legislation passes to introduce vaccine passports for the first time in this country, so it will fall to Conservative Back Benchers to be the only people who are subjecting these proposals to any sort of scrutiny. No doubt Her Majesty’s loyal Opposition would also like to take part in the discussions on proposals for mandatory vaccination, given the fact that they have supported every one of the Government’s lockdown proposals. Indeed, they have demanded longer and stronger lockdowns than we have had.

It would be remiss of me not to highlight the risk to the NHS that both vaccine passports and mandatory vaccination would bring. Vaccine passports tell those unconvinced of the science or those who for health reasons cannot take the vaccine that they are second-class citizens: they must show their papers or be banished. Mandatory vaccination would take these things a step further, effectively imprisoning anyone who does not agree with the status quo. All these measures are being considered or may be taken to protect our NHS.

There is all this fixation on the vaccine status of health and care workers, yet we know from the science that vaccination does not prevent transmission of the virus, so why are we going to put tens of thousands of people out of a job at a point when the NHS itself is going to be stretched to the limit and, may I add, when their vaccination status makes them little more or less dangerous to the people they work with or work for if they are tested daily?

Indeed, the best protection of all is actually to have had the virus and then to have recovered. The scientific evidence shows that someone is probably 10 to 20 times less likely to be reinfected if they have already had and have recovered from the virus than if they are double vaccinated, yet the many thousands of individuals in key worker roles who have had and have recovered from the virus but refuse to have the vaccine will actually lose their jobs at a key time. It is an inconsistency.

Turning to the question of the necessity of these restrictions, there have undoubtedly been far fewer deaths due to the omicron variant in South Africa despite its having been prevalent for four months and having replaced other variants that were more deadly in various ways. All the evidence we are hearing is that omicron is a milder form of covid with fewer cases of serious disease, fewer hospitalisations and, thankfully, far fewer deaths.

In my view, the most dangerous epidemic sweeping the world and our country is an epidemic of fear. It has seriously damaged mental health and particularly damaged the mental health of our young people. It must end.

I rise to express my serious concerns about the principle of mandatory vaccination, not for any ideological reasons but because it will have the contrary effect to that intended and therefore is wrong.

My concerns are first and foremost for public safety and also patient safety. That is the analysis I bring; having worked in the NHS for 20 years as a clinician, that is drilled into us from day one. The Government’s lack of strategy in managing this pandemic is astounding and they must understand that we need to get ahead of the virus in order to lock it down, as opposed to locking people, and their futures, down. A lack of consistency also continually comes through their policies. They cannot have it both ways; there must be one approach that carries that thread of containing the virus. They cannot say to one venue that they are are going to lock it down but tell another venue it has all the freedoms it needs, because that simply does not work; in fact, it is dangerous, and therefore the Government need to get a grip.

The very people we revered—who just a year ago we were clapping and calling our heroes—are the very people who are now exhausted, traumatised and frightened, and the legislation before us will sack them. For two decades I was their colleague and I know the dedication, compassion and care they give to their patients; I was their trade union leader and I know their professionalism and the sacrifice they give for the people they care for. I will not undermine that trusted relationship, which is absolutely essential in delivering healthcare in our country, and I will not ride roughshod over Labour’s NHS constitution, which pledges to assist people to participate fully in their own healthcare decisions and to support them in decision making. I will not turn my back on working people, and I will never forget my roots and those I served alongside. While the Prime Minister partied, NHS workers put on layers of personal protective equipment and fought for lives. That is what those in the NHS do: you make sacrifices and while traumatised you just keep going.

My Friend’s excellent work as a trade union leader in the NHS is well understood. She is speaking on behalf of NHS workers; has she any idea how many will be affected by this totally wrong attempt to force vaccinations and passports on people?

I am grateful to my hon. Friend for making that intervention and he makes a point I wanted to make myself. The Government’s estimate on that in their impact assessment is 123,000, and even in the best-case scenario 62,000 will lose their jobs, which the NHS simply cannot afford.

I apologise. I know my hon. Friend knows about care and health workers so she knows how dedicated they are; they have a vocation. Does my hon. Friend agree that the Government can and should stop going too far? Let us not break the trust between patient and worker and between Government. Let us go down the route, which has been proven to work, of persuasion and education, and ask them and work with them to distil the fear.

I thank my hon. Friend, who represents her constituents so well. There is an alternative path and we can take it today. We know that the Prime Minister is allowing people to go to pubs and clubs unmasked, while he is sacking NHS staff who are wearing full PPE and testing. Some 93% of NHS staff are vaccinated; figures from the Office for National Statistics show that 4% of people are vaccine-hesitant, which rises to 21% among minoritised communities. As 22.1% of NHS staff are from minoritised communities, the regulations will target black workers. In fact, 26.8% of workers of mixed race are not vaccinated; that is in the Government’s impact assessment, which also gives the figures for black workers. The regulations therefore indirectly discriminate against black workers.

Unvaccinated staff are frightened. On Friday, I spoke to someone in my constituency who has worked for the NHS for 16 years. Her father had a vaccine. His heart stopped. Miraculously, NHS workers brought him back to life; he is now in a critical condition. She is frightened. She tests; she wears PPE; she has sacrificed everything. She will be sacked.

I want all NHS and care staff to have vaccine counselling and education with a qualified practitioner who holds the right competencies so that concerns can be explored, not with line managers, who just do not have the competencies. I want everyone to be vaccinated—I cannot stress that enough—but I want to win the trust of staff, not push them further away, as the Government’s approach will. In York, where we have focused on those trusted conversations, we have seen 99% of our social care staff vaccinated. It just shows what works and what makes the difference.

We do not want to push people further away. We want to bring them in, win their trust and win their confidence, because we will have to ask more from our health and care staff as things get harder—we certainly will if there are fewer people to deliver the service. Let us do what works—enforcement never does. The regulations are vaccine-illiterate.

If 123,000 people lose their job in the midst of a health and care crisis, it will be catastrophic, not least as people are starting to hand in their notice now. Why go through another tough winter of trauma when we do not have to? The regulations will make it worse. We know that two vaccines, or even three, will reduce transmission of the virus, so get your jabs! But they will not stop transmission, so let us move to better PPE, FFP3 masks, daily testing and better biosecurity. Rather than pushing the regulations today, I urge the Government to go away and come back to the House with a plan for us to vote on in January. That is good governance and the way forward.

As a trade unionist, I am not prepared to be complicit in the sacking of our NHS and care staff. Trade unionists fight for working people; we are never complicit in writing their P45. As a trade unionist, I came to this place to fight for working people. I therefore urge that we change course and put staff and the care that they have for their patients first.