Considered in Grand Committee
That the Grand Committee do consider the Health Protection (Coronavirus) Regulations 2020.
Relevant document: 5th Report from the Secondary Legislation Scrutiny Committee
My Lords, in the time available to me, I would like to remind your Lordships of the level of seriousness with which we should address the level of Covid-19 and the context for the Government’s response. I will then explain the workings of the regulations in detail and how they fit into our wider strategy for addressing the outbreak.
On 31 December 2019, Chinese authorities notified the World Health Organization of an outbreak of pneumonia in Wuhan City, which was then classified as a new disease, Covid-19. On 30 January 2020, the WHO declared the outbreak of Covid-19 a public health emergency of international concern.
Based on current evidence, the main symptoms of Covid-19 are a cough, high temperature and, in severe cases, shortness of breath. It is a new virus, so there is a lack of immunity in the population and, as yet, no effective vaccine. This means that Covid-19 has the potential to spread extensively in the population.
As expected, case numbers are increasing, but the UK remains well prepared for such outbreaks. As of 9 am on 9 March 2020, 24,960 people had been tested in the UK, of whom 24,641 were confirmed as negative and 311 were confirmed as positive.
Although our knowledge is growing by the day, much remains unknown. The four UK Chief Medical Officers have made it clear that the disease currently presents a moderate risk to the public, but that planning and preparation for the potential of a more widespread outbreak is sensible. As the Prime Minister has made clear, there could be a very significant increase in the number of cases of coronavirus in the UK.
Tackling Covid-19 requires a robust, integrated and proportionate response. On Tuesday 3 March, the Prime Minister introduced the UK’s coronavirus action plan, providing the public with information on what the Government have done and on their plans to tackle the coronavirus outbreak.
The Government’s approach to tackling Covid-19 can be summarised in four phases: contain, delay, research and mitigate. The Government have focused hard over the past weeks on the containment phase, taking precautionary measures to limit the spread of the virus as much as possible. A crucial aspect of that is ensuring that people who are contacts of known cases or are considered to be at high risk of infection are isolated from others for a period of time, ensuring that they cannot infect others but can readily access help if they fall ill.
However, we have been acutely aware that there are important gaps in our public health legislation that could potentially undermine the success of this policy. It was to address these gaps that the Secretary of State for Health and Social Care laid an instrument before Parliament on 10 February 2020 and made a Statement in the other place on 11 February 2020 about that action. My noble friend Lady Blackwood repeated the Secretary of State’s Statement about the instrument in this House and answered questions at the time.
The regulations provide the power to screen, isolate and detain those at risk of spreading Covid-19 and, if necessary, to keep them isolated for a period of time. The powers are proportionate—they include a number of important safeguards to ensure that all actions are proportionate. Importantly, the regulations apply only in respect of Covid-19 and have a sunset period of two years from the date of coming into force.
Clear statutory tests are set out in the regulations to ensure that the imposition of requirements on restriction, including that of detention and isolation, must always be proportionate and necessary. There is a right of appeal to the magistrates’ court against the imposition of any requirements. There are also clear checks on detention, such as a requirement for any detention lasting over 14 days to be reviewed as soon as is practicable, and subsequently every 24 hours, by the Secretary of State.
Although the regulations provide powers to impose restrictions on groups, the powers are proportionate to what is sought to be achieved. For example, each person in the group would have to be believed to be infected or potentially infected and to be at risk of infecting others, or to have arrived on the same conveyance from the same infected area. That analysis will be considered for each individual.
These regulations will help us to slow down transmission of the virus and make it easier for NHS and public health staff to do their jobs. While the risk that Covid-19 poses to the public remains moderate, the new regulations are essential to ensure that the Government remain suitably prepared to contain the spread of the virus for as long as possible.
I would like to explain in detail the powers in the regulations for the benefit of the Committee. The powers can be used by different designated individuals depending on what is most appropriate for the circumstance. A Part 2 order is an order that a justice of the peace can make under the Public Health (Control of Disease) Act 1984. These are powers to order health measures in relation to persons, things or premises such as isolation, detention and quarantine. This regime continues to apply as it always did. The regulations do not impact on the current ability of local authorities to apply for orders under the Part 2A order regime.
The Government have taken steps to introduce these regulations in addition to the existing legal framework, as this made it difficult to take appropriate action in advance of an individual becoming unwell, even if there was a strong suspicion that they could be incubating and spreading disease. Secondly, so-called Part 2 orders, which enable restrictions on individuals on public health grounds, could be applied only by local authorities. This potentially undermined a more uniform approach to disease control and meant that the Secretary of State was reliant on others for the timeliness and effectiveness of those critical public health measures. Thirdly, the existing legislation has limited enforcement powers, making it more difficult in practice to deal with people who are trying to evade public health precautions or regimes or who do not follow advice or the conditions that are set.
It is important to note that the regulations are appropriate to the containment stage of the outbreak. Regulation 3 places stringent requirements on when the regulations can apply. First, the Secretary of State must declare that the incidence or transmission of coronavirus constitutes a serious and imminent threat to public health. Secondly, the incidence or transmission of the virus must be at such a point that the regulations may reasonably be considered effective in preventing its further transmission. These are important safeguards. If the declaration of a threat were revoked, the regulations would cease to apply.
Regulation 4 sets out that the Secretary of State or a registered public health consultant may require that someone is detained for screening and assessment either if they reasonably believe that the person is or may be infected with coronavirus and may infect or contaminate others or if that person has arrived in England from an infected area.
Regulation 5 permits them to impose various restrictions to ensure that screening and assessment can take place and to impose further restrictions or requirements as considered necessary for the purposes of removing or reducing the risk of infecting or contaminating others. Regulation 6 outlines in more detail what screening may involve, while Regulation 7 sets out further restrictions which may be applied, including restrictions on travel, activities and contact with others.
Regulation 8 covers the isolation of persons who are or who are suspected to be infected with coronavirus, while Regulation 9 sets out safeguards such as a duty on the Secretary of State to have regard to the well-being of anyone detained, and to review any continued detention over a 14-day period. Again, these are important safeguards when imposing restrictions on individuals.
Regulation 10 relates to the application of the provisions to groups. Regulation 11 enables a registered public health consultant or the Secretary of State to apply for a Part 2A order, which currently can be applied for only by a local authority. Regulation 12 covers appeals, while Regulations 13 and 14 enable police constables to enforce detention requirements or to initiate detention if they have reasonable grounds to suspect that someone is, or may be, infected with coronavirus. It is important to note that they must as far as reasonably practicable consult a registered public health consultant before taking action in relation to initial detention, and must have regard to any guidance from Public Health England. Regulation 15 covers offences, while Regulation 16 sets out that the regulations are subject to sunsetting two years from the date of commencement.
The regulations apply only to England; health is a devolved matter, therefore we continue to consult with the devolved Administrations regarding appropriate measures for any individuals who may return directly to Wales, Scotland and Northern Ireland. That includes options in primary legislation that would cover the entirety of the UK.
These regulations therefore enable the Government to take the necessary steps to minimise onward transmission from individuals who are or may be infected or contaminated with coronavirus and ensure that these are proportionate and effective. While we expect the vast majority of individuals to comply with public health advice without the need for legal enforcement, it is important that we remain suitably prepared for all eventualities. Given the seriousness of the threat posed by Covid-19, the regulations are a reasonable and necessary part of our strategy to protect the public. The Government will conduct a lessons-learned review in line with previous incidents and infectious disease outbreaks.
I take this opportunity to thank all our NHS, Public Health England and other front-line staff, including those on the borders, who are working so tirelessly on the response to Covid-19. Thanks to all their efforts, the Government, the NHS and other front-line responders are well prepared to respond to Covid-19. I also use this opportunity in Committee to thank the public for their pragmatic and sensible response to the situation to date. We must continue to take that approach to ensure public safety and refrain from panic and disinformation. As the Secretary of State for Health and Social Care has said, dealing with this disease is a marathon, not a sprint. We will be guided by the science and the advice of the Chief Medical Officers. We will continue to do everything that is effective to tackle this virus and keep people safe, and the regulations are an important element of that work.
As a final and important reminder, all of us—including noble Lords—can take actions to support the Government’s response that are simple but effective, such as washing hands and catching coughs and sneezes in a tissue. These and other precautions, including these regulations, are a necessary and proportionate response to protect public health. I commend these regulations to the House and beg to move.
My Lords, I thank the Minister for that comprehensive explanation of the order. When I started to read the policy background, it all came flooding back to me, having sat in his position in 2008 dealing with amendments put forward to modernise the legal framework for health protection and considering what powers were needed. My first question, therefore, is, why is the 2008 Act not sufficient to cover the eventuality of this virus, when these regulations relate to the 1984 Act? It is just a technical, anorak-type question and I am interested to know the answer.
I have given the Minister notice of my other questions, the first being about the differing legal structures in the United Kingdom, particularly between England and Scotland. Where are the regulations being considered? Are they being considered? Have they already been adopted by the devolved Administrations?
Echoing the brief discussion we just had in the Chamber, a further question relates to when this becomes a serious and imminent threat. In our scrutiny, we need always to focus on whether the orders and the Bill about to come before us give too much power or just enough power to a Secretary of State.
The statutory instrument refers throughout to detention or isolation. Can the Minister explain the difference between them? Is detention where somebody is arrested and detained, and isolation where they stay in their home? What would compel them to do that? I would like that to be unpicked.
Will the measure add significantly to the workload of magistrates’ courts? Has some estimate been made of that, and will it be properly funded?
My next question is about police involvement if people will not take the precautions required of them by law. Can we be assured that the police will be protected appropriately if they have to be involved in arresting or detaining people? That goes for other people involved in incarceration of any sort, because prisons and so on are contained environments that pose their own questions and dangers.
Finally, given that we do not know how long the coronavirus outbreak will last and what will happen, is two years too long a time for these regulations? Would not one year be more sensible?
My Lords, I thank the Minister for his detailed explanation of the regulations. I too have warned him in advance of an area on which I want to focus.
In general, we are content with the principles and are reassured that the Government have made it plain that the measures are a last resort when people will not co-operate and public health is seriously at risk. The points that we are raising are more about the detail of how things will work.
Reference was made to consistency across the four devolved nations. On a previous Statement, I asked whether there might be a “Gretna Green” benefit to belting over the border. I still want reassurance that there will not be variation between the devolved nations. Can the Minister inform the Grand Committee about discussions going on with the three devolved nations to ensure consistency and to prevent people trying to dash over a border, whether it is towards Gretna Green, across to Northern Ireland or into Wales?
My main point comes back to the question asked by the noble Baroness, Lady Thornton, about why the 2008 Act is not enough on its own. My focus today is very much on what happened in coalition regarding the Health and Social Care Act and the moving of directors of public health into local authorities. My concern is that some directors of public health have been told that they do not qualify as public health officers. Under “Interpretation”, Regulation 2(1)(d) defines a public health officer as
“a registered public health consultant or a person working within Public Health England”.
That is important because, in Regulation 4, it is that person as defined in the recitals who is able to effect the order. I just want to check that, given the document that was republished and updated in January this year—Directors of Public Health in Local Government— which makes it plain right from the start that this is a joint appointment. It says that a director of public health must be
“jointly appointed with the Secretary of State of the Department of Health and Social Care (in practice, Public Health England)”
and local government, and among their statutory duties are
“exercising their local authority’s functions in planning for, and responding to, emergencies that present a risk to the public’s health.”
Paragraph 4.5 of that document says that they must be registered with the General Medical Council, the General Dental Council or the UK Public Health Register, meaning that they are qualified and have to maintain that qualification with all the validations and re-examinations required.
Therefore, my question to the Minister is as follows: directors of public health resided inside Public Health England less than five years ago, but because they are no longer in Public Health England, why do they now suddenly no longer qualify? If it is a misunderstanding in Public Health England, please can we have public reassurance about that? If it is due to a lacuna in the legislation, clearly we cannot deal with that through these regulations but we happen to have a handy Bill coming along in the next couple of weeks in which we could perhaps make that clear. From the conversations that I have been having with directors of public health around the country, it seems that they are, as one would expect, heavily involved with both the health side and the community side. The key stakeholders—such as the fire services, the Courts Service, the police, the Prison Service, universities and those involved in education—are absolutely vital in dealing with matters where members of the public or organisations refuse to follow the rules relating to identification, quarantine and isolation.
My Lords, as I understand it, this is the first opportunity that we have had, outside of UQs and Statements, to fully debate this whole issue. I want to speak at a little greater length on this matter because I think that we are entering a crisis which perhaps we have underestimated at this stage.
As I understand it, these regulations apply where the Secretary of State makes a declaration that the incidence or transmission of coronavirus constitutes a serious and imminent threat to public health, and that the incidence of coronavirus is at such a point that the measures outlined may reasonably be considered as an effective means of preventing the further transmission of coronavirus. I will argue in my contribution that, prior to the use of regulations, advice should be given in the form of information—far more information than is available at the moment to the public—to help individuals avoid contamination and infection.
Before I start, I need to declare an interest. Some years ago, I had surgery on my lung to remove a tumour, leaving me with half a lung and with COPD on the remaining two lobes. As a result, I have major breathing difficulties. I also want to make it clear that I am not speaking only on behalf of myself; I approach this whole debate as one among the many hundreds of thousands who are in the vulnerable group described as “persons with pre-existing conditions”. Before moving to the thrust of my case—on the provision of information, which is what I want to concentrate on—I want to make three points.
First, the use of the terms coronavirus and Covid-19 is unhelpful and confusing. We need single-term terminology in the public debate. Secondly, repeating the statement that masks are of little value and are no defence, which we hear repeatedly on television, is irresponsible. Masks protect others from infection by those who are unaware that they are carriers. If they are so ineffective, why are doctors, nurses, health assistants, virus-testing personnel, ambulancemen, laboratory assistants, research chemists, health professionals generally and even undertakers worldwide all wearing masks, as can be seen on every television screen in the country, every day and every night on every new bulletin?
Thirdly, I am curious about the statistics on mortality rates, particularly among the elderly. The way this debate is being presented, it is as if 1%, 2% or 3% of those who are stricken with this condition may die, but that confuses groups of people, including the elderly and the young. I understand that the real figure for people in the 70 to 80-plus age group is appropriately 15%, which is substantially more. We need clarification on that.
In my view, the public should ignore the advice on masks and follow the practice of health professionals. I understand that this mistaken advice is being given to avoid panic among the wider population. It will do the reverse, as such advice emphasises in the public mind the distinction between the no-panic case from government and the reality of the practice of healthcare professionals on the ground in the real world that they can see on television every evening.
I turn to the provision of information. The best way to secure public co-operation in the avoidance of infection is to provide authoritative information. That is the story behind the calls for freedom of information legislation in the late 1980s. I was at the heart of that debate in the Commons, and our mantra was “information influences conduct”. To avoid infection, we need information from authoritative sources that is regularly updated as more information is made available to government. When the public have confidence in the scale of transparency and the source of the information, individuals are more likely to act responsibly. Apart from providing information, the state can do only so much, as is the case with the National Health Service and local authorities. The less information it provides, the less it will influence conduct. The less it provides, the more the fake news merchants will dominate the debate and the more they will influence public reaction and conduct. Inadequate and confused messages from government will lead only to a mix of panic on one hand and resigned inertia on the other. We need more than “Wash your hands, cough and dispose and do not touch your face”. It is simply not enough. If you provide more information, the public will make far more realistic assessments of the actions that they need to take. The terms contain, delay, research and mitigate are important, but they are meaningless to Joe Public. In fact the public will not even know what they mean. As contain morphs into delay and further morphing goes on, the message will become even more confused and obscure. The public want authoritative messages and updated and detailed information on where the dangers lie, in particular to elderly groups.
I have spoken to a number of people in my former constituency over the past week, and I will now set out what I believe the public want to learn and know. These are questions being asked by the vulnerable groups; they want authoritative information and answers.
We are told that the research money has been increased to £40 million. Reuters put out a very interesting article the other day. It reported:
“A global coalition set up to fight epidemic diseases issued a call on Friday for $2 billion … to support the development of a vaccine against the new coronavirus that is causing COVID-19 infections around the world. Describing the outbreak as an ‘unprecedented threat in terms of its global impact’, the Coalition for Epidemic Preparedness Innovations (CEPI) said that while containment measures would help slow the spread, a vaccine was key to longer-term control … ‘It is critical that we ... invest in the development of a vaccine that will prevent people from getting sick.’ … But on Friday it said these funds would be fully allocated by the end of March. ‘Without immediate additional financial contributions the vaccine programs we have begun will not be able to progress and ultimately will not deliver the vaccines that the world needs’.”
Those were the comments of Mr Hatchett, CEPI’s chief executive. On Friday, the British Government announced another £20 million of additional funding. The total is now £40 million or £50 million; I am not absolutely sure about the final figure. The point is that the budget is insufficient. What pressure are we putting on other countries to contribute to this budget to make sure that it meets the demands of those people who believe that it is necessary if a vaccine can be found in the foreseeable future?
Further, is the virus affected by temperature? We read all sorts of things on the internet. If so, at what temperature is it destroyed? That is the first question on my list of questions about the detail.
Should a vulnerable, at-risk person use public transport, be it a train, Tube train or taxi? The public are asking these questions. Should the elderly be using these facilities?
Can the virus survive any of the following circumstances: a hot drink; water; fruit juice; milk; beer or wine; a drink with a high alcohol content; an ice cream; a burger; takeaway food; or a restaurant meal? In each case, what is the lifespan of the virus? Again, the public are asking these questions, each of which should be answered separately.
What general information do we have on the lifespan of the virus? Can a fish, bird, animal or any other species catch the virus? The internet is full of explanations from people who cannot be described as authoritative sources for this information. Of course, the reference behind that is to pets. To what extent can a pet potentially be dangerous?
Can disposable polyurethane gloves be reused following washing? If so, in what fluids? Tens of millions of them are being sold on the internet. The question is, will they be effective if they are used more than once in contaminated circumstances? Will they wash in hot water? I know that these questions may seem naive to some but they are the kind of questions being asked by the general public.
Can a pair of gloves, whether they be made of fabric, leather, plastic or another daily wear material, pass on the virus? If so, can the gloves be decontaminated and reused? Can a simple face mask made of plastic be used repeatedly? Can it be washed for reuse? Is there a difference in terms of efficacy between a single-fabric face mask and a filter mask? I have two such masks here. The question is, are they in any way of use in the circumstances I described at the beginning of my contribution?
What antiviral substances are effective in killing the virus? Also, what substances are ineffective? Is there a base alcohol requirement in any decontaminant? Can the virus survive on any of the following inanimate items and, if so, for how long? Again, we have seen material on the internet, but we have nothing authoritatively on whether and how long the virus can survive on: a light switch; a newspaper; a piece of correspondence; a letter; a fabric, such as clothing; furniture; metal items; glass; a milk bottle; a plastic container; a piece of china; cutlery; a coin; a bank note; plastic packaging on food; a cash machine; a computer; a mobile phone keypad; a handle; handles on public transport, such as on a Tube train; a handkerchief; a toilet seat; a toilet chain; a towel; or a petrol pump nozzle. There is no authoritative information on these items, and we are getting into a dangerous period.
I have listed some of the items that I have been asked about—and there are more. The public will want clear advice and individual answers that identify the likelihood of contamination for each listed item and, crucially, the length of time that the virus could survive under such inanimate item headings.
What advice can be given on the possible contamination of food, such as cold meat, cooked fish and poultry, raw meat and fish, fresh vegetables and salads, fruit, cheese, and spreads, including butter? It might be that the process of vacuum packing affects contamination one way or another—who knows?
Will the Government publish the stats on the age of persons, which I referred to before, who fall under the following categories: in hospital care and deceased—which I referred to before?
Finally, is Worldometer a good source of information? It seems to be the primary source for the public of information on this matter on the internet.
In conclusion, I fully understand that to some, many of my questions may appear to be simplistic, naive and an indicator of my own ignorance. Such criticism is of no concern to me. These questions will stand the test of time. There are 67 million people in the United Kingdom, and these are the kinds of questions many of them are already asking on the internet and in public meetings. We are Parliament and it is our role to secure answers on these from the Government. I do not expect answers to them today, but only after they have been fully considered. I hope that they are made public and are widely circulated to counter misinformation. I can only repeat that, when the public are told the full truth and given the full information in an authoritative form, they will respond positively and constructively. Until that happens, there will be nothing but panic, confusion, upset, frustration and, in some cases, dangerous indifference, particularly among the elderly and the vulnerable groups, who are the focus of my contribution today.
My Lords, first, I apologise to the Committee that I came in late. The business proceeded slightly faster than I realised, but I am most grateful to noble Lords for allowing me to intervene briefly.
The comments made by the noble Lord, Lord Campbell-Savours, clearly illustrated the need for messaging out to the public. One of the difficulties is that the answers to many of his questions are just not known scientifically. It is a range of probabilities only; the way the virus behaves on different surfaces and with different substances is different. The infectivity may vary with the viral load to the individual as well as the individual’s own immune system. That makes it really complicated in terms of defining. You cannot give a false sense of security to people by saying, “Well, you are fit and well, and your immune system is okay”, because those people may become very ill, particularly if they have a large viral load. We saw that with the Chinese doctor who initially highlighted the problem. Tragically, he died.
I take this opportunity to ask a few questions. This order refers to Public Health England but we have devolved Administrations, and Public Health Wales and Public Health Scotland operate differently. Some aspects of this statutory instrument concern the police and justice, yet the Ministry of Justice and its overarching responsibilities are not devolved, so there is a difficult interface between the devolved and non-devolved competencies. Can the Minister provide some reassurance on the daily round-table consultations that are going on to make sure that decision-making is absolutely seamless and that the devolved Governments are taking forward—and, I hope, mirroring—such legislation so that we do not end up with different systems operating across what are effectively artificial borders? In areas such as Shropshire, there is a huge amount of cross-border flow between England and Wales. Linked to that, can the Minister clarify that equipment, and its distribution to where it is needed, is also part of the consideration of the protection of the public so that we do not have an outcry if one part of the country cannot access equipment as well as another?
Testing is difficult: it is a complex and finite resource, and it takes some hours to run the test. A lot of the public do not understand that it is not like a pregnancy test; it is not a quick dip and a quick answer. With such a finite resource, will the Minister clarify where the governance sits for the management of negative results? One of my anxieties is that people may have a false sense of security from a negative result, because they may get the infection the day after it and subsequently become positive. Although it is helpful to confirm positive cases, a negative result does not mean that you are not going to get the coronavirus infection further down the road.
Linked to the cross-border issues, can the Minister also confirm that the use of beds and the availability of things such as ITU beds and ECMO are being considered across the whole country? I worry that difficult decisions are going to have to be made and it will be very important to have clear standards against which to make them. If it looks as if we are becoming like Italy, that will certainly more than stretch services to the limit; it will take them beyond it.
Will we need additional statutory instruments for the reregistration of people with healthcare professional qualifications of any sort? If so, when will we see them? I was rather hoping that it might be today. This relates to my earlier question about registration on specialist registers. Is the GMC working to find alternative ways of putting those who have completed training on the specialist register without bringing them all together in an exam hall, which seems to be an unwise move when their competencies have already been assessed through training?
That concludes my questions, but I thank the Minister for his clarity, for explaining things really well, for answering questions on the Floor of the House and for answering unanswerable questions with such honesty. It is terribly important that he and those advising him try to be very clear and open about the things that we do not know.
My Lords, I will start by talking about two matters that are not central to the regulations but which are important pieces of context. I thank the noble Lord, Lord Campbell-Savours, for his incredibly candid and heartfelt comments, which none of us here could help but be moved by. I would also like to express sympathy for his personal situation. We all know friends, relatives and people who are in a vulnerable position. While the CMO’s advice is that for a lot of us the virus does not present a huge risk, for some people it does. That cannot but be on their mind and we think about them a lot, so I am grateful to the noble Lord for bringing that message of seriousness and his personal testimony.
I will also address directly the noble Lord’s questions. I am afraid that I cannot answer the important technical questions he asked; I am grateful for his appreciation of that fact. However, I reassure the Committee that our approach is to seek to be as transparent as we possibly can be. In answer to the noble Lord’s question, there is a daily update on the PHE website, where all the figures that we know and can prove are published—they go up at 1.45 pm every afternoon. That is a serious matter, and we are looking at ways of making that a more easily accessible dashboard with a deeper set of numbers that you can look at locally; we could then publish as reasonable and proportionate an amount of figures as possible while keeping secure the anonymity of those involved.
The other part of our approach comes very much from the spirit of the CMO himself, whom many of your Lordships will have met. He is an enlightened character who is extremely committed to evidence-based policy recommendations. We all plague him with questions much along the same lines as those the noble Lord, Lord Campbell-Savours, asked, seeking from him reassurances about particular technical questions. He is able to speculate and to say, “Maybe this or maybe that, but I can’t give you any clear reassurance on that because there is no data on it”.
One of the things about trying to preserve the pact with the public that our decision-making is supported by evidence is to avoid going into the kind of tempting speculation that the situation draws you into. There is temptation there, but, as a cardinal rule, we have to apply a self-restraining ordinance on trying to give people the answers and the speculation that, emotionally, they naturally want. The questions of the noble Lord, Lord Campbell-Savours, are exactly right, and I reassure him that battalions of scientists are trying to get to the bottom of those answers. Lots of evidence is being worked up, and I believe that answers to many of those questions will be forthcoming. However, until they have the sign-off from the scientists, it is not right for us to indulge in speculation. That is the foundation of our approach, which I mentioned earlier. Although it is incredibly frustrating, from a public policy point of view it is the right approach. However, I will try to address just a couple of the questions that the noble Lord asked, without falling into my self-defined bear trap.
The noble Lord, Lord Campbell-Savours, asked about masks. Broadly speaking, except for the most comprehensive hazmat suits that cover you from head to toe, masks are mainly used to limit the number of germs that you emit rather than that you consume. I think we are all interested in the work going on in Taiwan, where all schoolchildren wear masks, not to protect them from the germs but to try to stop them infecting the people next to them. That is an interesting insight, but it is not the approach that the CMO has recommended.
On the delicate issue of mortality rates, I completely sympathise with the noble Lord’s point that there is wild speculation on these numbers, and it would be fantastic to have a more reliable set of figures. I will say only that it is extremely difficult to know mortality rates, because you simply do not know how many people have the virus in the first place. Large numbers of people are infected and infectious but completely asymptomatic and never go near a test kit, so we cannot know what the mortality rate is at any age. I recommend that the noble Lord treats all mortality rates data with great suspicion. It is not the way we are guiding ourselves.
On the coalition on vaccines, the noble Lord is entirely right that substantial resources will be needed to mobilise a usable vaccine around the globe. However, the advice we have is that creating a vaccine for a completely new virus will take longer than the cycle of this virus through the population. While that work is being done, and the Government are supporting it as a matter of urgency, it will not provide a quick or easy answer to our situation.
A lot of the public have asked about pets. It is important. We are aware of reports that a pet dog whose owner tested positive reportedly contracted a low-level infection. Those reports are causing a lot of concern, but the WHO says that there is currently no evidence that pet animals can transmit the disease to humans and the story has been greeted with scepticism by scientists I have met—but we do not have scientific evidence on that.
All noble Lords asked about the devolved Administrations. I shall clarify two things because there is an important point here. The regulations are for England only. We are working extremely closely with the devolved Administrations. There is an extremely good spirit and an extremely collaborative approach. We do not see an administrative or policy issue at the moment. The Secretary of State and the Prime Minister have made it clear that a coronavirus Bill is being considered and one of the matters that could be considered in such a Bill, were it to be introduced, might be the formalisation of these regulations to bring them into line across the four nations. I cannot give cast-iron reassurances on this because we have not published the Bill. It has not been through the process, but we are very conscious of this issue. It is a big priority, and I reassure the Committee that the conversations with the devolved Administrations are working very well and we are hopeful that a solution to this obvious lacuna will be addressed.
The noble Baroness, Lady Brinton, asked about directors of public health. I know that she is concerned about them. The public health consultants who are described in the regulations are members of a register that is run and controlled by Public Health England. They are not the same as directors of public health. I completely understand that there is an argument to be made that perhaps they could or should be directors of public health, but that is not how the regulations are currently drafted. Instead, they are people who are on the register. If the noble Baroness would like to know more about that register, I would be happy to send her details and perhaps a link to where the details can be found.
In the past they have been on that register, and the big concern is the move from one department to another. If I am being told that that is not the case, that is not the feedback I am getting from directors of public health. As the Minister knows, I have other concerns about the relationship between Public Health England and directors of public health, which is why I asked for clarification.
I completely understand the point of clarification. If there is information available on what proportion of directors of public health are also public health consultants, we will share it with the noble Baroness. However, the way that the regulations are drafted at the moment means that the powers in the regulations are held not by directors of public health but by public health consultants.
I am sorry to interrupt the Minister again but the point is not about the register kept by Public Health England. My point concerns the definition of public health consultant—I am afraid that Hansard now has the relevant document, otherwise I would quote from it—and most directors of public health have to do that qualification because the job description, which is in the statutory guidance, says that they must be registered. That is my problem, and I know that it is clearly a problem for some of them as well. There is a bigger issue here. Should this become a pandemic and we see a large spike in numbers, we will need everyone qualified in public health to be able to do this, and there seems to be a problem in excluding the people at the heart of managing coronavirus within their wider communities.
The noble Baroness makes a very reasonable point. My understanding is that this decision was made not on a personnel basis but on an administrative basis. We are seeking to restrict the number of people who are able to execute these potentially quite serious powers. Having a list of available people is a legally clear and responsible way of doing things, but creating a new administrative definition goes beyond the powers of these regulations. However, I have already taken on board the noble Baroness’s points about the role of directors of public health in this epidemic. Those points have been listened to and are being followed up, and I will continue the dialogue that we already have in place on that.
The noble Baroness, Lady Thornton, asked why the 2008 powers are not sufficient. The answer is that it is mainly for practical reasons. The 2008 Section 2A powers give local councils powers but mobilising local councils to do things, sometimes at the weekend, sometimes at ports where they are not necessarily administratively present and sometimes overnight, is administratively a challenge. We found that in practice during the containment at Arrowe Park, it was really Public Health England officials on the ground who dealt with the situation and who needed these powers both in their back pocket and in their administration of the situation. That is why we have sought to do this. It is fair to say that a lessons-learned review is expected in the years to come and this will be the kind of issue that we will look at again.
The noble Baroness, Lady Thornton, asked what the difference is between detention and isolation. Although I do not have the legal definitions in front of me, my understanding is that isolation can be in someone’s house—literally holding them away from the rest of society—whereas detention involves confining someone to a place that they cannot leave, such as a police cell or a jail. Both are covered in these regulations. It is worth saying that you could, for instance, seek to isolate someone in a hotel room near the Arrowe Park facility and that would be covered.
The noble Baroness also asked about magistrates’ courts. I reassure her that MoJ colleagues were fully consulted on this and they did not see a problem. The objective was to try to create a low bar for an appeal to make the appeal process as easy and accessible as possible, recognising that these are very serious powers and we want to make them as sensitive as possible. In terms of police involvement and whether the police would wear suitable suits, they absolutely would. Police officials are highly protective of their workforce. Public Health England is working closely with the police to ensure that they have both the guidelines and the kit necessary to protect the workforce.
On the term of the regulations, I agree with the noble Baroness that two years is longer than we hope or pray this virus will continue. However, the advice from the CMO was that we cannot necessarily plan for that. Viruses sometimes last longer than expected; they can create multiple strains, and it may take time to have the lessons-learned review and to bring in new powers. That said, it is also possible that a coronavirus Bill that overtakes these regulations will be brought to the House later this month and the sunset clauses would necessarily be included in that.
Will the Minister reconsider something that he said to me? He said that he could not answer many of the questions that I asked. Almost all of them were to do with contamination, and virologists can answer them—I am told by a virologist that they can all be answered; we went very carefully through them. Can the Minister take each of the questions that I asked and answer them individually on the basis that virologists will be able to give him the information that he requires?
The noble Lord, Lord Campbell-Savours, is entirely right to press me on this. I should be honest: obviously, I am not a doctor. However, we have arranged for another briefing from the Chief Medical Officer in Room G at 4 pm tomorrow. He is the epidemiologist who can convey to the noble Lord both the extent and limits of current understanding of the virus. I have sat with him sufficiently long to have the impression that a lot of speculation, guidelines and history are associated with such viruses that we might reasonably apply to this one. However, its behaviours are not fully understood. Although the genome is broken, we do not fully understand its genetic makeup. The advice from the CMO generally is to hold back on pretending to understand things that are not yet fully explored.
I say to my noble friend that I would not use the internet as my source of information on any of these issues. I would use the BBC, which has been running extra programmes—in fact, I have just received an email from the head of the World Service listing all the extra programmes that the BBC is producing which will give us lots of advice. Its website is useful. I want to put it on the record to my noble friend that I would steer clear of those sorts of discussions on the internet and look at the BBC’s websites.
The great majority of the British population will not go into some of the technical areas that my noble friend would go into. That is why I am trying to find a single source of information for people to be able to go to which is authoritative and gives answers, with the latest information and knowledge available, on each of the questions I have asked. I persist in believing that the Government should arrange for this information to be made part of the public debate, because it would be helpful to everyone concerned.
I understand the point and will take it back to the department.
The noble Baroness, Lady Finlay, asked about testing. She is entirely right to focus on that, because we are at the stage of the cycle when questions about testing are very much on our minds. She asked where we were focusing our testing. The most important area for testing is those people who are most vulnerable but who might have the virus. She is entirely right that someone who tests negative today may well test positive tomorrow. Where that is most dangerous is within hospitals. Hospitals are centres of infection. It is one reason why, if you phone 111, they recommend that you do not go to your hospital or your GP. Therefore, testing within hospitals is where we are focusing our resources.
I reassure the noble Baroness, Lady Finlay, that we are moving incredibly quickly to increase capacity of ECMO beds. There will be a huge amount of pressure —we cannot hide that—but those most in need are being prioritised. Training is going on to support those with the technical knowledge of how to run the equipment and purchasing is going on to create new kit.
On reregistration of clinical professionals, all the concerns raised in Committee and in the Chamber about the provenance of people seeking to reregister are fully understood. Provision is being made to make sure that criminal record checks and competence checks are in place. However, these remain incredibly valuable and skilled people who can support us, so we are determined to mobilise them if possible.
I referred to difficult decisions possibly being made. Can the Minister reassure the Committee that the Government are working with the heads of all the royal colleges—particularly their ethics committees—to make sure that unified guidance is going out to commissions across all the disciplines? Unfortunately, the different colleges have at times a tendency to work in their own silo, but this will be across all of them. It will have to go across the professions, rather than across the individual trusts and internal organisations. Therefore, a round table or regular consultation with them to make sure they all give the same messages is important, and it would reassure the public.
The noble Baroness, Lady Finlay, makes an important point. The CMO currently has a weekly call with all the presidents or relevant members of the royal colleges, and there is an incredibly energetic interface between officials at PHE and the colleges. New guidance is being drafted at the moment. As our understanding of the epidemic increases so the CMO’s certainty and confidence about the advice he is giving will be clearer. We are therefore seeking to publish really good guidance for employers, voluntary organisations and all the groups who need it. The CMO also works closely with the CMOs of the other three nations, and I understand that is an incredibly healthy and productive relationship. It has served very well to ensure that the devolved authorities are fully involved in decision-making and that there is transparency on key issues such as ethics, which the noble Baroness was right to mention.
Committee adjourned at 6.03 pm.