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House of Lords Hansard
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Covid-19 Update
16 March 2020
Volume 802

Statement

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My Lords, with the leave of the House, I will now repeat a Statement made in the House of Commons by the Secretary of State for Health. The Statement is as follows:

“Mr Speaker, thank you for allowing me to make a Statement at this time. The coronavirus pandemic is the most serious public health emergency that our nation has faced for a generation. Our goal is to protect life. Our actions have meant that the spread of the virus has slowed in the UK. I pay tribute to the officials at Public Health England and the NHS for their exemplary approach to contact tracing and their work so far. However, the disease is accelerating, and 53 people have sadly now died. Across the whole House, our hearts go out to their families. Our policy is to fight this virus with everything we have.

Last week, my right honourable friend the Chancellor confirmed a £30 billion package of financial firepower, including a £5 billion contingency fund to ensure that the NHS and social care system have the resources that they need. We will give the NHS whatever it needs and we will do whatever it takes. We will get through this by working through our action plan to contain, delay, research and mitigate the virus. That plan has two overriding aims: to protect the NHS by building it up and flattening the curve, and to protect life by safeguarding those who are most vulnerable. We will do the right thing at the right time, based on the best scientific advice.

Earlier, I attended a COBRA meeting, chaired by the Prime Minister, to decide on the next steps in our plan. I can report to the House that we have agreed a very significant step in the actions we are taking from within our plan to control the spread of the disease. These actions will change the ordinary lives of everyone in the country. We appreciate that they are very significant and I understand that people will be concerned. But we have come to the view that they are necessary to save lives and to stop this disease.

First, based on the updated scientific advice, we are today advising that if you or anyone in your home has a high temperature or a new and continuous cough, then you should stay at home for 14 days. If at all possible, you should not go out even to buy food and essentials. Instead you should ask others for assistance with your daily necessities. The exception to this is for exercise. Even then, you should keep at a safe distance from others.

If it is not possible to receive deliveries at home, then you should do what you can to limit your social contact when you leave the house to get supplies. Even if neither you nor anyone in your household have symptoms, there is more that we ask of you. Today we are advising people against all unnecessary social contact with others and all unnecessary travel. We need people to start working from home if they possibly can. We should steer clear of pubs, clubs, cinemas and restaurants. We should only use the NHS when we really need to. This advice is directed at everyone, but it is particularly important for the over-70s, pregnant women and those with some health conditions. It is especially true of London, which the evidence suggests is several weeks ahead of the rest of the country. These measures will be disruptive, but they will save lives.

In a few days’ time—by this coming weekend—we will need to go even further to ensure that those with the most serious health conditions are largely shielded from social contact for around 12 weeks. We want to ensure that this period of maximum shielding coincides with the peak of maximum transmission; and while the risks of transmission at mass gatherings such as sporting events are relatively low, from tomorrow we will be withdrawing our support for mass gatherings. This will free up critical workers we need to deal with the emergency and ensure a consistent approach to social contact.

Secondly, we are increasing our testing capabilities yet further. The UK has tested more people than almost any other major economy outside of China, South Korea and Italy. We have already increased the number of tests to 5,000 a day. This is now on its way up to 10,000 and then radically further.

Thirdly, we are boosting the NHS. Ventilation is mission-critical to treating this disease and we have been buying up ventilation equipment since the start of this crisis, but we need more. Today the Prime Minister hosted a call with the nation’s advanced manufacturers, asking them to join a national effort to produce the ventilators we need. We have set up a dedicated team to do this, and we are hugely encouraged by the scale of the response so far. Later today, the NHS itself will set out the very significant steps it is taking to prepare.

Fourthly, on Thursday, we will introduce to the House the coronavirus emergency Bill. This Bill will give us the powers to keep essential services running at a time when large parts of the workforce may be off sick. Some of these measures will be a very significant departure from the way we do things in peacetime. These are strictly temporary and proportionate, and I hope that many will not have to be used at all. They will only be activated on the basis of scientific advice and will only be in place for as long as is clinically necessary.

Finally, we are ramping up our communications efforts so that people know what steps they need to take to protect themselves, others and the NHS. Tackling coronavirus is a national effort and everyone has a part to play. The more people follow the public health advice, the less need there is to bring in the draconian actions which I am keen to avoid. Of course, we must not forget the simple things we can all do: washing your hands; following the public health advice if you have symptoms; and looking out for the most vulnerable in the community.

The measures I have just outlined are unprecedented in peacetime. We will fight this virus with everything we have. We are in a war against an invisible killer and we have to do everything we can to stop it. I commend this Statement to the House.”

My Lords, that concludes the Statement.

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My Lords, I am very grateful to the Minister for repeating the Statement made by the Secretary of State in another place today. Our thoughts are of course with those affected by coronavirus and the families of the 35 people who have died in the UK and the British citizens who have died overseas.

We understand that the Government’s commitment to ensure the UK’s response to the Covid-19 pandemic is driven by evidence and science, but the Minister must have realised that the public are confused and concerned about the advice that has been given, especially when Governments around the world appear to be receiving and giving their citizens different advice. Surely the answer to this lies with the Government publishing the scientific advice and modelling behind their coronavirus action plan, which would enable experts to analyse, peer review and stress test it.

The Covid-19 pandemic is a global problem that requires Governments to work together. Can the Minister confirm that the UK has access to the evidence and data collected by other affected countries? Does he agree that a global response would give more public confidence? I am not suggesting that the UK is not doing the right thing from our point of view, but it is very important that the public understand why we are doing the things we are doing.

We welcome the update that the Government have already increased the number of tests to 5,000 a day and hope to double this to 10,000. Experts have advised that the most effective way to prevent infections and save lives is breaking the chain of transmission. To do that, you have to test and isolate. The head of the World Health Organization has implored Governments to “test, test, test” and check every suspected case, warning that Governments cannot fight the pandemic blindfolded. Therefore, we are concerned by the Government’s decision that only patients who require hospital admission will be tested for coronavirus. This will mean that only a subset of cases, the most severe, will be identified and we will not know how widespread the infection really is. If our approach is to be science-led, surely data is the key.

The Minister will be aware that NHS workers have also expressed concern about this policy, given that it could lead to staff who do not have coronavirus needlessly self-isolating for seven or 14 days, which would put a further strain on NHS staffing. It could also lead to asymptomatic staff with coronavirus treating frail and vulnerable patients, putting them at further risk. Indeed, there is a petition calling for the prioritisation of testing for NHS staff which currently has over 15,000 signatures. Does the Minister agree that mass testing will allow for valuable insights into the behaviour of this virus? Once testing capacity is increased, will the Government reinstate testing for those suspected of having the virus, prioritising NHS workers, including the cleaners, porters and other essential staff who are needed to keep a hospital running and who play a vital role in infection control? If the Government want to keep key workers at work, they have to make testing available to them. That applies to not only nurses and doctors but teachers and head teachers. It is a nonsense not to do so. Will the Government make tests available to key workers?

Public anxiety has been heightened by Britain seeming to take weaker measures than other countries, confusion over things such as herd immunity and anonymous speculative briefing to the media from government sources. It is unimpressive for the Secretary of State to publish a newspaper article updating us on Covid-19 behind a paywall. It does not smack of a firm communication strategy led by the need for clarity, honesty and reassurance. The Government must provide clear and transparent communication to the public about the steps they are taking to mitigate the impact of this outbreak. This is especially important as the coronavirus curve enters a steeper trajectory, with advice changing rapidly. Just today, the advice has changed for those displaying symptoms to stay at home for 14 days rather that seven. Can the Minister advise us on why the length of time has increased?

We certainly welcome the decision to introduce daily briefings to keep the public informed about what action is being taken to fight the spread of this virus, when certain protocols will be implemented and, perhaps most importantly, why. Will the Government commit to providing clearer guidance for people, including specifying the conditions that may indicate that someone is more susceptible to the effects of Covid-19? The phrase “underlying health conditions” is far too vague and misleading to be helpful, and may cause unnecessary panic and confusion. The NHS website is providing information but I am concerned about how those who are digitally excluded will access it, especially now that they are being advised to socially distance themselves. Will the Government launch a dedicated coronavirus telephone advice line for people? This would be an important source of up-to-date information for many people and would help to alleviate pressure on the 111 service.

Many low and middle-income families will be severely hit by a reduction in income if workplaces shut and they have to take time off sick or need money to respond to the crisis. This morning, Virgin Atlantic asked staff to take eight weeks of unpaid leave over the next three months to help the airline to cope during the pandemic, but that means that those staff will not be eligible for sick pay.

The Prime Minister has now advised everyone to stop non-essential contact with other people by working from home where possible and avoiding pubs, clubs and theatres. Experts have warned that this could push 14 million people who live in poverty into hunger and homelessness, which is why we on these Benches call on the Government to bring forward a package of emergency financial security measures to give people the security and confidence that they need to follow public health advice as part of our collective national endeavour.

The Government have confirmed that the NHS has insufficient ventilators to cope with the number of people who may be admitted to hospital. We certainly welcome the announcement that car makers and defence contractors will be asked to switch production to make medical equipment a national priority. Can the Minister confirm whether it is true that the European Union has passed a regulation so that medical equipment can be exported outside the EU only with special regulatory authority? If true, that would cut us off from a huge number of ventilator manufacturers. What action are the Government taking to increase the number of medical staff who will be trained to deal with respiratory care?

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I too thank the Secretary of State and the Minister for the Statement. I also thank the Prime Minister, the Chief Medical Officer and the Chief Scientific Adviser for the press conference earlier, which laid out the new advice that we will have to take into account. I will come to this at the end of my comments, but I note in particular the advice to people over 70 and with underlying health conditions; I have been asking in your Lordships’ House for specific advice for about six weeks now—at last, it is here. A couple of points of clarification would be useful but it is extremely helpful.

I also thank all NHS and social care staff, public health officials in our local communities and other public servants who are all now working above and beyond even the emergency duty. We on these Benches recognise them across the country in everything they do. Our thoughts are with those who are currently ill and the families of those who have died.

I will not repeat much of what the noble Baroness, Lady Thornton, said, but I want to make the point that the past week has seen a big sea change in attitude among not just the public but many experts who may not be epidemiologists but certainly have an understanding of modelling. It is important to keep them onside by making sure that the modelling is published; I echo the concerns that that has not happened yet, although I note that Chris Whitty said that it would become available in due course.

I share the horror at the Daily Telegraph article being behind a paywall. Notably, some of the largest American newspapers are making every single article on coronavirus free so that the public can access it; I wonder whether we could encourage our newspapers to do the same.

On testing, which seems to be the big issue of the day, I had an email from a friend who has been in a hospital in London with a severe case of coronavirus. That person is recovering now, but it was noticeable that there was an astonishing lack of knowledge on the part of paramedics, NHS 111 and others that breathing difficulties were a symptom. It was assumed that she was having a panic attack, although she had never had one in her life before. It was clear that A&E was completely overwhelmed. There was not enough protective equipment, and the doctor who saw her said that when doctors themselves became sick at their hospitals they were told to self-isolate for seven days but were not being tested, so they did not know whether they were immune or infectious.

The doctor concerned was desperate, and said that testing seemed to be happening only in care homes and in hospital outbreaks. The whole system had been overwhelmed. According to the Health Service Journal, the Department of Health and Social Care has said that the regime is set up to provide testing, but at the moment it is unclear how it will be applied. More and more of the people we are asking to go on to the front line are feeling very exposed.

Moving on to some workforce issues, various airline companies have announced that they are in real trouble; I think everybody understands why. And they are not alone. From these Benches, I express real concern about the Prime Minister’s announcement today, in which he encouraged people not to go to clubs, cinemas, restaurants and theatres. That is likely to mean that many of those businesses will not be able to claim on their insurance, as they could if this was an instruction, as opposed to a guide. Can the Minister tell us why the Prime Minister used that framing? It will cause serious problems for many small businesses.

As for other money issues, it is reported that there is a very large drop in donations to food banks. What will the Government do to ensure that the many thousands of people who rely on food banks will continue to get the support they need, when most people are no longer dropping two or three items into the boxes as they leave the supermarket?

There was some debate recently, involving the House of Commons Library, about sanctions for those attending jobcentres. According to the Library report, Will Quince MP had said that there would be discretion, and that people would not be sanctioned as long as they let the jobcentre know before the appointment. There are two problems there. First, if someone is sick they may not be able to call in and spend the hours it takes on the phone to do that. Secondly, if staff at the DWP are ill, there may not be enough people available to take those messages. Surely during this crisis—the Prime Minister has made it plain how severe it is—sanctions should be stopped for everybody.

Finally, on the advice to the over-70s, I am grateful that Chris Whitty said this afternoon that anybody, adult or child, with an underlying condition, including anybody who had had to have a flu jab, should consider taking action, especially if they have respiratory problems. Can the Minister confirm that and make it clear? I understand that the message about flu jabs has just come down from the website, so I am concerned that there will be confusion. There is no doubt about people who are immunosuppressed, but will he please reassure people who use inhalers—that is certainly one of the categories on the Department of Health and Social Care website—that they will be included?

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My Lords, I thank the noble Baronesses, Lady Thornton and Lady Brinton, for their testing but important questions. Let me go through them systematically. As there were quite a few, I will do it at pace.

I can reassure the Chamber that the CMO has committed to publishing advice. It is extremely complicated, because the models used by SAGE are the result of many different collaborators submitting papers to a central committee, so publishing something simple and robust that can be used by third parties is not as easy as it might initially seem. But that commitment has been made, and we support the commitment to transparency.

In answer to the question from the noble Baroness, Lady Thornton, about other countries’ data, I reassure the Chamber that there is an extremely strong spirit of collaboration between the countries of the world in fighting this virus. The Prime Minister had a G7 call over the weekend, in which there was a very strong commitment by those countries. That will begin a cascade of inclusion to other countries around the world in order to launch a real commitment to combating the virus. That spirit of collaboration is a powerful and encouraging dimension of an otherwise very difficult situation.

Both the noble Baronesses asked about tests: this is a really important question. The tests that we have are, rightly, being concentrated—as the noble Baroness, Lady Brinton, alluded to—on ICU units and care homes. The reason is that it is likely that those who show the most symptoms are also the most infectious. Therefore, the people who are most likely to catch the virus are those who are nearest those who have the strongest symptoms. Those include our healthcare workers, who not only deserve to be protected but need to be, in order to keep our health and social care system working. That is, therefore, where the tests are being focused.

It is also worth saying that, until the end of this week or next week, we are at the very tail end of the winter flu cycle when, if you have a cough or a cold, it could be any number of viruses. However, that is likely to change and, as we go forward, if you do have a cough and a temperature, it will be most likely that you have coronavirus and so the relevance of testing diminishes. None the less, we are working extremely hard to increase the number of tests available and the way in which we test will move to bedside instead of central testing. We hope to be able to develop an at-home test. I believe that there is news of that on the horizon.

The noble Baronesses, Lady Thornton and Lady Brinton, both asked about the media. I reassure the House that the article in the Telegraph was not behind a paywall; it was freely available from 11.20 pm last night. I can confirm that, if any noble Lord has any concerns about it. The Prime Minister has made a commitment to daily updates, in the company of his medical advisers. The public have clearly found that approach reassuring, and it will continue during this important phase of the virus.

The noble Baroness, Lady Thornton, asked about those with underlying health conditions and whether the definitions were clear. The noble Baroness, Lady Brinton, asked about flu jabs and whether those on the flu jab list would be contacted. I reassure both noble Baronesses that those on the flu jab list will be contacted by their GPs within the next few days. Advice will be given and, where necessary, health and care packages put in place for them. Those with underlying health conditions will be contacted by local GPs in order to clarify exactly what kind of risks individuals face.

Both noble Baronesses rightly brought up the question of the economy. This is an area of massive concern, not only to the Government but to everyone whose job and livelihood are threatened by a slowdown in the economy. Without doubt, the recommendation to close clubs, pubs, theatres and all manner of social gatherings will have a profound effect on the economy. The Chancellor has already committed billions of pounds to an economic fund to try to support those industries. Further work is being put into place to ensure that businesses can see this epidemic through.

Those who are homeless or in the gig economy will be the particular focus of measures. We are working extremely hard to change the system of statutory sick pay to include those who would not necessarily be captured by the usual arrangements. That work is still in progress, but we look forward to providing an update when the coronavirus emergency Bill is brought to Parliament on Thursday.

The noble Baronesses, Lady Thornton and Lady Brinton, asked about ventilators. These are clearly the key pieces of equipment that we need to combat the most profound effects of the virus. We have 5,000 in our stock and are working extremely hard to increase that number dramatically. Industry has responded extremely positively. We have been overwhelmed by the response from all parts of industry, from big, established companies to innovators, academics and those with good ideas for how to increase the number of ventilators. We were already in the market many weeks ago and have done a lot to shore up our supplies.

It is entirely right that any number of ventilators will not be any good if you do not have the staff to man them, so we are going about retraining existing clinical staff in how to use them. To give an example, on Saturday I sat next to a surgeon who has found that his operating theatre has been turned into a respiratory support unit. He and his anaesthetist are learning how to work the respirator.

The NHS undoubtedly faces a period of enormous pressure. There is no amount of special pleading that I can do from this Dispatch Box to hide the fact that front-line clinicians and support staff will be under huge pressure. They will take profound personal risks and they are being asked to deliver an important national duty. As I am sure that everyone in the Chamber does, I pay tribute to the work that they have already done and to the work in prospect on the horizon.

Lastly, the noble Baroness, Lady Brinton, asked about food banks. I reassure her that we have a full understanding of the challenge faced by charities—the collapse of not only food donations but financial donations. That is why special provision has been given to DCMS to provide funds for charities, which will play an incredibly important part in many aspects of this national effort, particularly in providing the kind of support to social care needed for those who face an extremely difficult time of loneliness and exclusion as they take the correct decision to socially distance themselves from this virus.

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My Lords, could my noble friend clarify some of the stories about possible future steps that the Government might take, particularly regarding those over 70? There have been some stories about a relatively draconian policy of self-isolation for a very long time that might itself promote certain health problems in those people if the isolation were carried out to that extent. This story appeared in newspapers. On the other hand, we have had the statement by the Chief Medical Officer of Scotland saying that Scotland would not follow such a policy but would be more limited in calling on elderly people to cut back their social contacts by 20% or something like that. Do I take it from today’s Statement that the latter version of the policy is the direction in which we are going?

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My noble friend is entirely right to ask about the exact guidance. I will be clear: everyone in the country is being asked to cut out non-essential social intercourse and to work from home where possible. In the case of over-70s, that is particularly true. If you are over 70, the guidance is very clear: you should take great care of yourself because you are in a very difficult position. Those who have underlying conditions, whether they are over 70 or not, must take particular care of themselves.

As the CMO explained very clearly earlier today, the advice is moving towards those people distancing themselves or even shielding themselves completely from social intercourse. My noble friend Lord Lamont is entirely right that that comes at an enormous cost. Isolation and loneliness will be extremely difficult challenges for those involved. There is a massive mental health issue on the horizon. As a community and as a country, we are going to have to figure out how we come together to provide support for those who have made the entirely right and responsible decision to stay away from society.

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My Lords, can I press the Minister on the question of financial support? In 2013, a parliamentary report stated that taxpayer outlays direct to the banks were £133 billion. People were not told then not to fly or not to go to restaurants, theatres or any kind of hospitality outlets. Now, we hear from the Chancellor that there will be £12 billion: £7 billion support for businesses and £5 billion for the NHS. This is nothing like the scale of financial support that is needed from Governments, either globally or particularly in Britain, to meet the challenge that he has described so eloquently.

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The Government are under no illusions about the size of the challenge. The package announced in the Budget was an initial commitment. Whatever funds are needed will be made available, in particular to support the NHS and our social care but also to support hard-working businesses and those that provide employment and sustenance to the country.

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My Lords, could I tempt the Minister to say a little bit about the antibodies test? Obviously, the test being used at the moment to tell you if you have coronavirus is a swab test. But the one that could make a huge difference to NHS staff would be an antibody test, particularly if it gave one immunity. This could completely transform the workforce and people’s ability to get to work if they had been exposed in the past. Could he say a little more about that?

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The noble Lord has hit upon an essential conundrum of the testing framework. I am not the expert who can give chapter and verse, but my layman’s understanding is that the antibodies test on which he rightly focuses is some way away. The biggest difficulty for testing is knowing who has had the virus but never shown the symptoms. Unfortunately, one of the difficult challenges for our response is not yet having that test; it holds us back, but we are working on it very hard indeed.

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My Lords, my question follows on from the noble Lord’s question on testing. The reason why mass testing is important is that data aids the science, and science aids the response. There are two types of test. One is the PCR—swab—test, which tells you whether you have the coronavirus. On that test, what is the stock level within the NHS and how many more are on order so that rationing will not have to be as narrow as it is at the moment? If the Minister cannot answer that question, could he write to me to let me know? Secondly, on antibody testing, it has been trialled in Singapore, there are certain licences in China and I am aware of at least one biomedical company in Belfast that is producing 20,000 a day. Which companies are the Government in contact with on the antibody test, and when do they expect this test to be available within the NHS? Again, if the Minister cannot answer directly, could he write to me please?

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The noble Lord, Lord Scriven, asks all the right questions. The honest answer is that it is a changing situation. The information that I had on this a week ago has changed even to today. What I can tell you is that there is an enormous global effort going into research in this area. The noble Lord, Lord Scriven, rightly cites the Singapore test, about which we are in touch and keen to find out more. A huge number of offers are incoming to the central co-ordinating committee. An enormous amount of funding and money is coming not just from the UK but from America, Europe and all the major nations trying to crack this. I live in hope that we will be able to do mass testing within the near horizon.

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My Lords, with regard to the preparedness of the NHS, what is the occupancy rate at the moment for adult critical care beds? I understand that figures published on Thursday last week showed them at 83%. What is it now? Secondly, would my noble friend please heed the words of the secretary-general of the Independent Health Professionals Association, who has pointed out the burden and costs of the current IR35 rules on bringing consultants who are currently freelancers back into the NHS, and points to the need for these rules to be suspended at a time when the NHS is going to need to attract these workers back in to provide the care that we need?

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Occupancy rates are changing all the time as we cascade patients from one class of bed to another in order to make room and prioritise those who are hit by the virus. We are doing an enormous amount to expand the capacity of beds—for instance, converting operating theatres into respiratory support units and moving patients into beds where they may be more comfortable. Provisions for IR35 will be made in the coronavirus emergency Bill later this week.

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My Lords, I want to raise the issue of two groups who are particularly vulnerable in terms of social isolation: the deaf elderly and the black and minority ethnic elderly. What assurance can the Minister give the House and the wider community that, in their communication strategy, the Government will take the needs of those two groups into account by signing, in terms of verbal and oral communication, and translation in terms of written?

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The noble Lord is entirely right to ask about this. I am pleased to say that, thanks in part to the advocacy by the deaf community, a signing translator was provided for the briefing from No. 10 Downing Street earlier today. That is a sign that we are listening to those who advocate on behalf of these groups. However, I have to be honest with the Chamber: there are a large number of groups who deserve special treatment, and although we are moving as fast as we can in order to provide the best possible care and service that we can, I cannot pretend that there are going to be tailored packages for each and every vulnerable group in the land. We are just going to have to pull together and do the best that we can under extremely difficult circumstances.

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My Lords, I applaud the fact that the Statement focused on the need to protect the most vulnerable, but many people are hugely financially vulnerable. Does the Minister agree that we need national solidarity to ensure that no one needs to fear losing their roof over their head, having their gas or electricity cut off or not being able to buy the food that they need? Will the proposed Bill include: an end to all benefits sanctions, as the noble Baroness, Lady Brinton, referred to; a suspension of all evictions; an end to the five-week delay for housing benefit; and ensuring that no one’s utility is cut off because they cannot pay the bill? The Minister made particular reference to the homeless. Will provision be made if they need to isolate? If they are ill, will they have safe and appropriate provision? Asylum seekers are people in our community who are very vulnerable with little money. They could contribute if allowed to work. I think we have just seen the first case of the virus in a prison. Will the Bill include special provision to make sure that prisons are safe places in the coronavirus epidemic?

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On prisons, which are clearly an area of grave concern, I reassure the Chamber that guidelines were published earlier today for the management of prison populations and the introduction of cohorting in order to divide those with the virus from the rest of the prison population. On the other questions, I reassure the House that we are alive to the desperate circumstances that some people find themselves in. The financial arrangements being put behind the handling of coronavirus will be generous, and we will not stop supporting those who we love and care for.

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My Lords, I would like to raise with the Minister the question of government language. The second last paragraph of the Statement begins, “We are in a war against an invisible killer”. I understand that a balance has to be struck in ensuring that the public understand the importance of what we are engaged in, but language of that kind can have the effect of causing panic. In particular, may we have an end to the unofficial and unattributed briefings taking place at weekends that give rise to melodramatic headlines, which can only damage public confidence?

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In defence of both the Prime Minister and the Chief Medical Officer, I pay tribute in particular to the Chief Medical Officer and the Government Chief Scientific Adviser for the incredibly measured, considered and transparent way in which they have gone about communications. I bear testimony to the calm and thoughtful advice that has been given to us by the scientific community. We are seeking to share that advice as openly and transparently as we can by having daily briefings from Downing Street, at which both the CMO and GCSA are present.

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My Lords, following the comment of my noble friend Lord Bridges on IR35, which will impose huge costs and burdens on small businesses and entrepreneurs, would it not be sensible for the Government to defer its implementation? More importantly, it is obvious that these measures are going to result in a deep recession in this country. Many good businesses are going to go to the wall, unless they are helped with their cash flow. Declaring an interest as a banker, I know that the banks will want to extend credit to those businesses, but the regulatory rules and the senior managers regime prevent them from doing so. Of course public health is the most important thing, but it is of the utmost importance that the Government enable the banks to provide support for those businesses, and that they recognise that the Budget package, welcome as it is, is a mere flea-bite compared to what is required—and required now.

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My noble friend is entirely right; it is a point well understood in Government. But he does slightly answer his own question, because our priority at this stage is to ensure that the medical and clinical response is right, and that the message gets across to the public about what they can and should do to protect themselves and delay the spread of this virus. I reassure him and the House that the economic impact of this virus is fully understood, and that there will be a full package of measures announced at a later date, once we have got this initial response out of the way.

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My Lords, the UK has withdrawn from the European Medicines Agency without putting anything in its place. This means that no new compound can be registered, licensed and made available for prescription in this country. The new compound might be an antiviral agent effective against coronavirus, or could equally be the vaccine which we are all waiting for. Can the Government tell the House, with urgency, what they are doing about this major gap in the provision of public health in this country?

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I reassure the noble Lord that, as with the response to HIV some years ago, we will not allow any lacuna or gaps in the regulatory arrangements or any delays of the regulatory kind to stand in the way of our response to the virus.

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My Lords, the Minister referred to a recommendation about people not going to pubs, clubs, and theatres. The Society of London Theatre has been instructed to close all theatres by DCMS tonight, and that is now happening. Is it a recommendation, or an instruction? This is important, not just because of behaviour but for insurance purposes in particular.

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The noble Baroness makes an important point. I have received numerous, moving and important communications from those who own, run or support pubs, clubs, theatres and venues in this country. In response, I say that we have moved quickly, as the scientific evidence of this virus has developed quickly. This needs to be addressed by the DCMS; it is not within my purview, but I understand that it will address it.

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Will my noble friend say a word or two about the Bill that is going to come before both Houses of Parliament? Is he effectively saying that those of us who happen to be in our 70s or 80s will not be allowed to take part in that debate, or is this merely advice? Could he also tell me whether there are testing facilities within the Palace of Westminster?

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The Bill will arrive on Thursday and the plan will be published then. In terms of those who wish to attend the House, all I can do is share the advice of the CMO, which is very simple and very clear, but it is down to the choices and decisions of those here as to how they wish to conduct their travel and attendance arrangements.

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My Lords, my noble friend Lady Thornton alluded to some confusion in the Government’s communications over the weekend as to their policy in regard to herd immunity. No doubt the policy is a nuanced one but is it possible for the Minister to state succinctly and definitively what it is? Also, I think the public are finding it hard to understand the Government’s new provisions on eligibility for sick pay and social security. In particular, will he explain what support the Government are giving to self-employed people in low-paid and insecure work who are now being told by the people they normally work for not to come into work and that they will not be paid? How are the Government going to protect them?

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On government priorities I will be really simple and clear. The Government’s priorities are to save lives and to support the NHS. That is our objective and that is what we are throwing our energies into. In terms of sick pay and support for the self-employed, provisions for those have yet to be published, but when they are I look forward to them being discussed.

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My noble friends Lady Brinton and Lady Hamwee have tried to get an answer from the Minister on this question of enabling businesses to claim on their insurance. If they are just advised to close, as I understand it, most of them would not be able to do so, but now we hear from my noble friend Lady Hamwee that DCMS has actually instructed theatres to close—but only theatres. What about restaurants, bars, clubs and everybody else? It does not seem to be a very coherent situation and for the Minister just to say that it is not within his purview to answer this question is frankly not good enough. Could he please give a clear answer as to whether not only theatres but other businesses will be instructed by the Government to close, so as to enable them to claim on their insurance policies?

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As the noble Baroness will be aware, this is a fast-changing situation. I cannot come to this House, in all honesty, and give an account for every single element of the strategy since we have turned around some of these decisions in very quick time. Our focus is on health and on our clinical decisions. When I am able to deliver an answer to that question, I will do it. As soon as I can, I will be glad to write to the noble Baroness.

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I welcome the Prime Minister’s commitment to a daily press conference. It is vital over the difficult weeks and months ahead that people hear directly from him and from the Chief Medical Officer what the Government’s position is. If large numbers of people are either going to have to self-isolate because one of their family is symptomatic or going to have to effectively withdraw from society for four months, a lot more people will need their food delivered to their home. What can the Government do, first to encourage people not to panic and hoard things when it is not necessary to do so, and secondly to allow the supermarkets to scale up their at-home delivery? At the moment, if you register as a new customer, you cannot get a booking for three or four weeks.

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My noble friend Lord Barwell is entirely right. The question of deliveries is an acute concern. There are intense conversations going on on a daily basis between Defra and the food retailers. I understand that there are assurances that there are significant stocks of food and that these are going to be made more available. It is not something that we are currently deeply concerned about. The belief is that as people fill their larders, they will reach a certain point when they will begin backing off the kind of stocking up that they are doing at the moment and it will be possible for those who need it to get those deliveries.

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I am sorry to ask the Minister to return to the issue of closing theatres—and I declare an interest as the deputy chairman of the Royal Shakespeare Company—but reassurance is needed that, by following the instructions or the advice or whatever it is that has been issued, theatres and no doubt other businesses as well are not inadvertently invalidating their insurance arrangements. I understand that the noble Lord finds it difficult to give assurances but I think that one is particularly necessary, not least because it might save the Government some money in the long run.

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The noble Baroness is entirely right. As a trustee of Sadler’s Wells, I understand completely the implications of what she is saying, her point about insurance, and the confusion there might be about what the current status is. I simply cannot answer the question right now. I am not trying to avoid a difficult question; I simply do not have the information. When I do, I will be very happy to write to her and to others who have asked about this.

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My Lords, the Minister has told us several times that the key government priority is to deal with the health crisis of Covid-19. But what work are the Government doing to ensure that the other issues that have been raised, for the self-employed and for small businesses, do not lead to such severe crises that we see an outbreak of suicide because people simply cannot cope and think they do not have a future? It is not only the virus: there needs to be a whole series of decisions around questions that have been raised this evening, to which we have not yet had any answers.

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The noble Baroness is entirely right to be concerned about the holistic challenge we face. We are working hard in different areas to answer each one of those issues as they come along, whether in the area of mental health, social care or the economy and the entertainment sector. Today’s announcement is focused on the clinical response, but I will be glad to answer any questions on specific subjects as they arise.

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My Lords, would driving in a private motor vehicle between one point of self-isolation and another still be within the definition of self-isolation?

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Yes, it would.

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My Lords, will the Government be giving precise advice to agencies dealing with the homeless? Will care workers on zero-hours contracts who need to go into self-isolation be paid by anybody? Are the Government relying on the House of Lords to set the best example in following the Chief Medical Officer’s advice?

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On the provisions for those on zero-hours contracts, that is an area that is particularly knotty and difficult. It is absolutely the focus of the current negotiations on statutory sick pay and other provisions; it is one we care very much about getting right. As for the advice for those in the House of Lords, I cannot repeat the advice of the CMO more times than I have already. I very much hope that everyone will follow it.

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My Lords, based on the models that the Government are using, can the Minister say when he thinks we will reach the peak transmission spike?

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The situation is fluid. The CMO spoke about this in detail at the press conference. He is not speculating or giving an exact date, because the modelling is not as clear as one would hope it to be. However, it will certainly be within weeks, rather than months.

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My Lords, there is a gaping black hole in the economic package announced in response to this crisis. I hope that the Minister has picked up from the repeated questions of noble Lords on all sides that there is acute concern about this. I do not think it is possible to separate the public health emergency from the wider social and economic emergency. People will not go off sick and companies will not be able to give clear guidance to their employees until the Government can answer the questions which have been asked around the Chamber. There is an absence of a clear government policy on sick pay, which is after all the means by which people will survive if they self-diagnose or are diagnosed with this virus. Each day that the Government cannot answer this will lead to more needless spreading of the disease. I know that the noble Lord is the Health Minister and not an Economy Minister, but it is totally unsatisfactory that the Statement gives no clear guidance to the country on the economic aspects. He talked about this being published on Thursday, with the Bill, but that is three days’ time. We are in a massive national emergency; that statement should come tomorrow. Every hour that the Government delay will see the disease spread further, cause needless distress and lead to people going out of business.

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The noble Lord is entirely right in his analysis that getting the social and economic package right is imperative for delivering the social behaviour response to the virus. It is completely understood by the Government that, to get people to abide by the kinds of provisions and recommendations coming from the CMO, there has to be a whole-person solution, and that includes figuring out the money. We understand that and are working on it. We have already altered some of the provisions for statutory sick pay so that people can claim after one day instead of four, which is an important change. We are negotiating with the Treasury, the DWP and other parties on making further changes.

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My Lords, Swansea University today announced its first case of Covid-19. Given that students travel from all other countries to universities—perhaps in greater numbers than to some sporting events—what particular advice will the Government give to universities?

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My noble friend will be reassured to know that guidance for education settings was published a couple of hours ago. This includes advice to universities both on travel and on what to do when someone develops the symptoms of coronavirus. I would be glad to place a copy of this in the Library or send it to any noble Lords who would like to see it.

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My noble friend did not answer the question about the testing facility within the Palace of Westminster.

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The noble Lord is entirely right. To be honest, I do not know the answer to that question, but I would be glad to find it out and write to him with the details.

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As there are five seconds left, may I apologise to the House for having failed to declare my interest as a trustee of a theatre when I asked my question?

House adjourned at 8.47 pm.