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Covid-19 Update

Volume 807: debated on Tuesday 3 November 2020

Statement

The following Statement was made in the House of Commons on Monday 2 November.

“With permission, Mr Speaker, I will make a Statement on the measures we must now take to contain the autumn surge of coronavirus, protect our NHS and save lives. On Saturday evening, the Chief Medical Officer and the Chief Scientific Adviser described the remorseless advance of this second wave. The extraordinary efforts being made by millions of people across the country—especially those in very high alert areas—have made a real difference, suppressing the R rate below where it would otherwise have been. But the R is still above one in every part of England—as it is across much of Europe—and the virus is spreading even faster than the reasonable worst-case scenario. There are already more Covid patients in some hospitals now than at the height of the first wave: 2,000 more this Sunday than last Sunday.

While the prevalence of the virus is worse in parts of the north, the doubling time in the south-east and the Midlands is now faster than in the north-west. Even in the south-west, where incidence remains low, current projections mean that it will start to run out of hospital capacity in a matter of weeks. The modelling presented by our scientists suggests that, without action, we could see up to twice as many deaths over the winter as we saw in the first wave.

Faced with these latest figures, there is no alternative but to take further action at a national level. I believe it was right to try every possible option to get the virus under control at a local level, with strong local action and strong local leadership. I reject any suggestion that we are somehow slower in taking measures than our European friends and partners. In fact, we are moving to national measures when the rate both of deaths and infections is lower than they were in, for example, France.

We are engaged as a country in a constant struggle to protect lives and livelihoods, and we must balance the restrictions we introduce against the long-term scars they leave, whether for business and jobs, or our physical and mental health. No one wants to impose measures unless absolutely essential, so it made sense to focus initially on the areas where the disease was surging and not to shut businesses, pubs and restaurants in parts of the country where incidence was low.

I want to thank the millions who have put up with local restrictions, sometimes for months on end. I thank them and the local leaders who have understood the gravity of the position. We will continue so far as possible to adopt a pragmatic and local approach in the months ahead. But we are fighting a disease, and when the data changes course, we must change course too. To those in this House who believe we should resist further national measures, let me spell out the medical and moral disaster we face.

If we allow our health system to be overwhelmed—exactly as the data now suggests—that would not only be a disaster for thousands of Covid patients, because their survival rates would fall, but we would also reach a point where the NHS was no longer there for everyone. The sick would be turned away because there was no room in our hospitals. That sacred principle of care for anyone who needs it, whoever they are and whenever they need it, could be broken for the first time in our lives. Doctors and nurses could be forced to choose which patients to treat, who would live and who would die.

That existential threat to our NHS comes not from focusing too much on coronavirus, but from not focusing enough. If we fail to get coronavirus under control, the sheer weight of demand from Covid patients would deprive others of the care they need. Cancer treatment, heart surgery, other life-saving procedures: all this could be put at risk if we do not get the virus under control. Even though we are so much better prepared than before, with stockpiles of PPE and ventilators, the Nightingales on standby, and 13,000 more nurses than last year, I am afraid that the virus is doubling faster than we could ever conceivably add capacity. Even if we doubled capacity, the gain would be consumed in a single doubling of the virus.

And so on Wednesday the House will vote on regulations which, if passed, will mean that, from Thursday until 2 December in England, people will be permitted to leave home only for specific reasons, including: for education; for work, if you cannot work from home; for exercise and recreation outdoors, with your household or on your own, or with one person from another household or support bubble; for medical reasons, appointments and to escape injury or harm; to shop for food and essentials; and to provide care for vulnerable people, or as a volunteer.

Essential shops will remain open and click-and-collect services will continue, so people do not need to stock up, but I am afraid that non-essential shops, leisure and entertainment venues and the personal care sector will all be closed. Hospitality must close except for takeaway and delivery services. Places of worship can open for individual prayer, funerals and formal childcare, but sadly not for services. However, Remembrance Sunday events can go ahead, provided they are held outside and observe social distancing. Workplaces should stay open where people cannot work from home, for example in construction or manufacturing. Elite sport will also be able to continue.

Single adult households can still form exclusive support bubbles with one other household, and children will still be able to move between homes if their parents are separated. The clinically vulnerable and those over 60 should minimise their contact with others. While we will not ask people to shield again in the same way, the clinically extremely vulnerable should only work from home.

I am truly sorry for the anguish these measures will impose, particularly for businesses that had just got back on their feet—businesses across the country that have gone to such trouble to make themselves Covid-secure, to install Perspex screens and to do the right thing. Each of these actions has helped to bring R down, and their hard work will stand them in good stead, but it is now clear that we must do more together.

The Government will continue to do everything possible to support jobs and livelihoods in the next four weeks, as we have throughout. We protected almost 10 million jobs with furlough, and we are now extending the scheme throughout November. We have already paid out £13.7 billion to help the self-employed, and I can announce today that for November we will double our support from 40% to 80% of trading profits. My right honourable friend the Chancellor will also extend the deadline for applications to the Covid loan schemes, from the end of this month to the end of next, to ensure that small businesses can have access to additional loans if required.

We are not going back to the full-scale lockdown of March and April, and there are ways in which these measures are less prohibitive. We have, for instance, a moral duty to keep schools open now that it is safe to do so, because we must not let this virus damage our children’s futures. Schools, colleges, universities, childcare and early years settings will remain open, and I am pleased that that will command support across the House.

It is also vital that we continue provision for non-Covid healthcare, so people should turn up to use the NHS and to get their scans. They should turn up for appointments and collect treatments.

Let me stress that these restrictions are time-limited. After four weeks, on Wednesday 2 December, they will expire, and we intend to return to a tiered system on a local and regional basis, according to the latest data and trends. The House will have a vote to agree the way forward. We have updated the devolved Administrations on the action we are taking in England, and we will continue to work with them on plans for Christmas and beyond.

While scientists are bleak in their predictions over the short term, they are unanimously optimistic about the medium and long term. If the House asked me, “What is the exit strategy? What is the way out?”, let me be as clear as I can that the way out is to get R down now, to beat this autumn surge and to use this moment to exploit the medical and technical advances we are making to keep it low.

We now have not only much better medication and the prospect of a vaccine, but we have the immediate prospect of many millions of cheap, reliable and rapid-turnaround tests with results in minutes. Trials have already shown that we can help to suppress the disease in hospitals, schools and universities by testing large numbers of NHS workers, children, teachers and students.

These tests, crucially, identify people who are infectious but who do not have symptoms, allowing them immediately to self-isolate and stop the spread of the disease and allowing those who are not infectious to continue as normal. This means that, unlike in the spring, it is possible to keep these institutions open and still stop the spread of the disease.

Over the next few days and weeks we plan a steady but massive expansion in the deployment of these quick-turnaround tests, which we will be manufacturing in this country and applying in an ever-growing number of situations, from helping women to have their partners with them when they are giving birth on labour wards to testing whole towns and even cities. The Army has been brought in to work on the logistics, and the programme will begin in a matter of days. We have dexamethasone, the first validated life-saving treatment for the disease, pioneered in this country. We have the real prospect of a vaccine, as I say, in the first quarter of next year; and we will have ever more sophisticated means of providing virtually instant tests.

I believe that those technical developments, taken together, will enable us to defeat the virus by the spring, as humanity has defeated every other infectious disease, and I am not alone in this optimism. But I cannot pretend that the way ahead is easy or without painful choices for us all, so for the next four weeks I must again ask the people of this country to come together, to protect the NHS and to save many thousands of lives. I commend this Statement to the House.”

My Lords, our procedure at the moment is to assume that Members watched the Prime Minister yesterday when he made his Statement or have read its content. One thing I would say at the outset is that the scale and depth of the crisis mean that mistakes and misjudgments have huge consequences. That weighs heavily on those making decisions, but there is a common national interest in doing all we can to get the right judgments, decisions and policies. When making such difficult decisions, there must be an evidence base behind them, and we must take account of the immediate situation and the longer-term impact on our nation’s collective health and future prosperity. More than that, we must learn from this time and offer hope about the kind of society that we will have post Covid. We are therefore supporting the Government’s proposal, with some questions, but that does not mean that we think the Government have handled it well.

I am not clear what changed between 21 September when SAGE recommended this kind of national lockdown, 13 October when Keir Starmer called on the Government to follow the SAGE advice, and last weekend. On the day when SAGE called for national restrictions, there were 11 deaths and 4,000 confirmed cases. When the Prime Minister made his statement to the nation, there were 326 deaths and more than five times the number of daily infections. That was not unexpected, nor was it inevitable.

The basis for this decision was there in September, when the Government’s own scientists recommended a short circuit-break. That was ignored. It was there again two weeks later as new cases of Covid started to become rife across parts of the north-west and elsewhere, but it was again ignored. It was also there when my right honourable friend the leader of the Opposition, Keir Starmer, suggested nearly three weeks ago that the Government extend the then upcoming school half-term to tackle the spread of the virus head on. At that point, it was not just ignored but ridiculed and attacked. The weekend leak and the rushed press conference, with charts that you could not even read on the TV, must have been precipitated by something else, given that those projections had been available for weeks. Can the noble Baroness tell us what precipitated that announcement?

Given all that, I am surprised that the Prime Minister showed such little humility in his Statement. So many government announcements, such as the world-beating track and trace system and briefings of a vaccine within weeks, have proved to be enthusiastic and exuberant overconfidence. We do not need that; we need realism, honesty and an ongoing evidence-based strategy.

These proposals for a month of national restrictions are not where anybody wants to be. Let us be clear: we all know how difficult and disruptive these restrictions can be, both socially and economically. The Government have taken some action but, as Ministers have acknowledged, there is more to be done for families, individuals and businesses to help them cope now and prepare the nation for the future.

However, there are some things worse than these restrictions. One, as advocated by some, would be to do nothing; the other would be the failure to use this time to test, trace and isolate, and to prepare for a safe route back to a more normal way of living and working. Despite the huge amounts of money involved, fixing test, trace and isolate did not happen over the summer.

We will not be able to eradicate the virus via a mass vaccination programme that will be ready in four weeks, but we must have test, trace and isolate sorted. If we do not do enough tests and get the results back very quickly, we cannot trace. If we do not trace—at present, we are tracing only six out of 10 contacts—we cannot effectively isolate; and if isolation is to be effective, it has to be meaningful, with meaningful support for those in isolation.

I have a few questions for the noble Baroness about the support that is needed. First, I welcome the fact that the Government have pulled their plans to cut support for the self-employed; it is a limited extension to April, but it is to be welcomed. We also welcome the extension of furlough, but this really shows the mismanagement of the issues surrounding governing by leak. The announcement came on the day when furlough was due to end; the Job Support Scheme was meant to start on 1 November. To be eligible, employees must be on an employer’s payroll for a minute before midnight on 30 October. However, people had already been made redundant in the expectation that furlough was going to end. Employers will still be expected to cover pension and national insurance contributions, reflecting the changes made in August, not the scheme in March. Can the noble Baroness confirm that she understands that the Government need to stop these last-minute cliff edges, because they just add to the stress and difficulties for businesses and individuals?

On another related issue, given the plight of the newly unemployed, are the Government now giving any consideration to reinstating their previous bans on rental evictions and home repossessions? Also needed is a winter strategy to help food banks ensure that nobody in our country, including the so-called newly hungry—former middle-class earners—go without the basic provisions they need.

When other areas facing restrictions, including those initiated or imposed by the Government, asked for additional support, they were told in no uncertain terms that it was not available. The Mayor of Liverpool City Region, Steve Rotheram, said that the Government had been “unequivocal” in refusing to provide more than two-thirds of the pay of hospitality workers across the north whose businesses were forced to close under tier 3 measures. The First Minister of Wales, Mark Drakeford, said the Chancellor had rejected his request to pay subsidies for wages when Wales went back into lockdown. He said:

“I got an answer quickly to say that was not possible for a number of technical reasons and so, no.”

Clearly that was not the case with the announcements that have been made now.

Rather than just apportioning blame, this tells us that what is needed is a longer-term strategy to deal with the current situation, and a longer-term exit strategy that tapers support in a way that allows businesses to plan ahead with at least some degree of confidence. We all know that nothing can be said with certainty, but can the noble Baroness confirm whether there is long-term strategic planning for different scenarios at the heart of government decision-making so that the Government and businesses can prepare?

I also want to raise something very specific about the hospitality and retail sectors in the weeks and months ahead. As we know, the festive season over the run-up to Christmas and the break itself in normal times gives a real boost to their income. They need that this year more than ever. However, with Michael Gove indicating that this will go on much longer than four weeks, what advice do the Government have for how those businesses should plan for December? Should they spend money on marketing materials, menus, staging, food orders and extra staffing, because the Government have said this will end on 2 December? If they do all this and we need an extension to the current lockdown, how might the Government support them in dealing with financial losses? I do not expect an answer from the noble Baroness on the details today, but I would like to hear that the Government have factored that in and are planning for that scenario, should it arise—we hope it does not.

We need businesses to survive and people to remain employed in order to prepare for the future. None of us has a crystal ball to predict what will come next, but there are three things that we need to do: trust the public, give them honesty and realistic predictions about what is likely to happen, and give them the support that they and the country deserve.

My Lords, in responding to the Prime Minister’s Statement, there is a great temptation simply to dwell on the Government’s sloth and incompetence in now introducing more draconian measures than they would have been required to do if they had followed SAGE’s advice in late September and introduced a short circuit-breaker lockdown then. If they had done so, many lives would have been saved, many jobs would have been preserved and many businesses, which will now go bust, would have survived.

However, in accepting the lockdown now, the important thing is to look to the future rather than the past. I have three general suggestions. The first is to be more balanced about the evidence. It is extremely difficult for the non-specialist to know exactly what the current trends really foreshadow. For example, at the weekend the Government produced a range of options, including one which spoke of 4,000 deaths a day, yet the projection on which that was based was already a month out of date last Friday and predicted 1,000 deaths a day by the weekend against the 200 that actually happened. Meanwhile, the measures on the ground in Liverpool appear to be working, with the R number now well under one. The Government need to stick to the data on the ground, which justifies the lockdown, as the Liverpool experience shows, but does not justify hyperbolic claims about future levels of deaths.

Secondly, the Government need to be clearer about what happens next. The Prime Minister said yesterday that the lockdown would end

“without a shred of doubt”—[Official Report, Commons, 2/11/20; col. 43.]

on 2 December and that the tiered system would then be reintroduced. However, they are completely unclear about the basis on which decisions on that will be taken. They should set out now the parameters regarding the prevalence of the disease that they intend to follow in making decisions on future restrictions, so that individuals and businesses alike can begin to plan ahead on an informed basis or, at the very least, will know the basis on which the Government intend to take decisions.

Thirdly, the Prime Minister needs to start acting like the Prime Minister of the United Kingdom, not just of England. Frankly, it is ludicrous that the nations of the United Kingdom are so out of step in the timing and content of the restrictions that they have introduced. My colleague Ed Davey suggested recently that the Prime Minister should discuss with the devolved Administrations how to reach a common approach to Christmas. So he should, but he should also, as a matter of course, discuss regularly with them a co-ordinated approach to fighting the disease more generally. Failure to do so will not only cause further confusion but further undermine support for the union itself.

I have a number of specific questions for the Government. First, even where people are contacted by the track and trace system, the proportion who self-isolate is disappointing, with some estimates of compliance as low as 10%. A principal reason for that is the loss of earnings that people suffer if they do. The Government have introduced a scheme for paying those on low incomes in these circumstances but it simply is not working properly. Can the Government ensure that at the point when an individual is told to self-isolate, they are provided with details about how to claim the compensation, with the Government then paying up quickly?

Secondly, will the Government commit now to paying for free school meals during the Christmas period? It is simply unacceptable at this point for them to cut off a lifeline for the poorest children in the country. It is equally unfair for Manchester United fans to expect Marcus Rashford to act as the conscience of the nation as well as perform his day job.

Thirdly, will the Government give some financial certainty now to those sectors that will be unable to operate profitably for some months ahead? In particular, those offering tourist accommodation cannot expect to operate profitably, even if the lockdown is lifted, as hoped, during the winter months. Without further bridging support, many otherwise perfectly profitable businesses will simply not survive. Will the Government now provide a bespoke lifeline for them?

Finally, will they upgrade the carer’s allowance? Yesterday, in response to a question in another place from my colleague Ed Davey, the Prime Minister said that he would “look at” the proposal that the carer’s allowance be upgraded by £20 a week in line with the increase in universal credit. I urge the noble Baroness to give the Prime Minister a nudge to ensure that that happens without delay.

We will discuss the details of the new regulations at some length tomorrow. There are many inconsistencies in them that should be corrected, as the earlier discussion in the House on the opening of churches demonstrated only too clearly.

The Government’s chaotic approach to combating the virus has left people feeling confused, depressed and fearful for the future. The country knows that the Government have to perform an extremely difficult balancing act between combating the disease and permitting economic and social activity to continue. People are sympathetic with them as they face that dilemma. However, that sympathy is wearing pretty thin. People will grudgingly accept this lockdown but if even that grudging acceptance is to be maintained, the Government will need to be more transparent, fair and ahead of the curve than they have been until this point. They simply have to up their game.

I thank the noble Baroness, Lady Smith, and the noble Lord, Lord Newby, for their comments and will attempt to answer their questions. They asked what had changed to mean that we are now looking to introduce these new restrictions. As SAGE said in September in relation to a circuit break, we had to balance the epidemiology against the real damage that lockdowns cause for the economy and people’s mental health, which is something we all acknowledge. We had hoped that the strong local action we were looking to take would get the rates of infection down. It is important to say that the measures have made sure that the R rate is lower than it would have been but, unfortunately, we have seen the rates going up and have exhausted every other tool at our disposal in trying to suppress local outbreaks with local action.

We were presented with national data that we could not ignore. It suggested, for instance, that if we did not take further measures, we could exceed the first wave peak around 20 November, exceed currently available hospital beds around 23 November and exceed surge capacity—capacity freed up from postponing some local hospital services—around 4 December. Data like that meant that the Prime Minister felt that we needed to take further action.

The noble Lord, Lord Newby, mentioned scientific evidence and the data. I should stress that the case for the latest measures was not built around the analysis to which he referred about possible deaths. As I have said to noble Lords on many occasions—I know that everyone is aware of this—a whole series of metrics is involved in these decisions, including the medium-term projections on hospital admissions and daily deaths, as well as the evidence on the ground, which in too many areas, unfortunately, were going in the wrong direction.

The noble Baroness, Lady Smith, and the noble Lord, Lord Newby, talked about the economic support. I am grateful to the noble Baroness for acknowledging the extension of the furlough scheme and some of the other measures we have taken in relation to the self-employed. We have had one of the most comprehensive economic responses of any country, with more than £200 billion of support. She and the noble Lord mentioned sectors that are struggling and need support. I hope that noble Lords will accept that we have moved to try to address the circumstances and support our businesses. We will continue to do that. The noble Lord mentioned the charter and looking at the carers’ allowance. We will of course keep all this under review as we start to see the impact of the latest lockdown as we move towards 2 December.

The new restrictions are being accompanied by additional support through the extension of the furlough scheme, whereby employees receive 80% of their current salary for hours not worked. There is an additional £1.1billion for local authorities to enable them to support businesses in their areas more broadly. We will continue to look at the economic package and there is strategic long-term planning to make sure that we can provide the support needed.

The noble Baroness asked about evictions. From the start of the pandemic, we have provided nearly £1 billion of support by raising the local housing allowance to cover at least 30% of market rents. As she will know, we changed the law to double eviction notice periods from three to six months, allowing someone who is served notice today to stay in their home until May, save for the most serious cases. We will continue to protect renters facing hardship from eviction and set out further details of measures soon.

The noble Lord talked about our relationships with the devolved authorities. I think that there are more similarities than differences in our approaches. For instance, we have all brought in measures at a local and national level to control the virus, mandated closing times for hospitality and brought in social distancing restrictions. We work closely with the devolved Administrations; obviously, the CMOs of the devolved nations talk regularly. However, it is right that they make their own public health assessments and decide what measures they should put in place and are most appropriate.

I assure the noble Lord that we have had hundreds of committee meetings, calls and meetings at official and ministerial levels, and that will continue. We have provided Wales with £4.4 billion of extra funding this year, Scotland with an extra £7.2 billion and Northern Ireland with an extra £2.4 billion through the Barnett guarantee. We are working as a United Kingdom as we tackle this terrible pandemic.

Both the noble Lord and the noble Baroness rightly asked about the end of the current restrictions. As the Prime Minister has said, these measures will be time limited, ending on 2 December, which is when the SIs that we will debate tomorrow will expire. At that point, we will review the restrictions, which will be eased on a regional basis, according to the latest data. Of course, the aim of this action is to get the R number down now, beat this surge and use this opportunity to exploit the medical and technological advances we have made. For instance, I am sure noble Lords have seen the pilot in Liverpool of the mass city testing as well as the better drug treatments that we have and tackling some of the issues we have seen with test and trace.

The R rate is lower as we move into this new phase than it was in March, so we are confident, knowing that the great British public will stick to these rules, that we will have a good reduction in the R rate and that we will be able to come out of these restrictions. I cannot predict what will happen after 2 December, but I assure noble Lords that we will work to make sure that everyone has as much clarity and confidence as they can.

My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers.

My Lords, the Government have a very difficult task indeed, and I ask my question simply in a spirit of inquiry. I am puzzled by the latest graphs, to which the noble Lord, Lord Newby, referred: the four winter scenarios shown to the country by Patrick Vallance on Saturday, showing deaths totalling 4,000 a day. Is this really a realistic possible figure, considering that the previous realistic worst possible case forecast was 800 a day? The daily death rate was 1,000 in the first wave, and this figure is well above the daily death rate of a country like Brazil. Why is the second wave forecast to be so much worse than the first? Was lockdown ineffective and just temporary or is it, as the Deputy Chief Medical Officer suggested yesterday, just in the nature of the virus that the second wave would be worse? If so, why was this not predicted in previous forecasts and why did anyone ever talk about defeating the virus?

I thank my noble friend. I hope that I mentioned, in my response to the noble Lord, Lord Newby—and I should stress this—that I believe the Chief Medical Officer and Chief Scientific Adviser are giving evidence to the Commons Select Committee at the moment to say that the case for the latest measures was not built on the analysis of deaths that the noble Lord mentions. This was not a prediction but just one of the possible worst-case scenarios. As I said, a whole series of other metrics informed the decision as well as the evidence on the ground, which, unfortunately, showed that things were going in the wrong direction. In particular, for instance, the over-60s rate was going up, which correlates with future hospitalisations, and that is still rising. As such, it was a range of measures, and those particular numbers that he mentions were not the reason on which this lockdown, or these proposed measures, have been put forward.

My Lords, the situation facing the country is gravely concerning and we all have a collective responsibility to avoid over- whelming the NHS with the spread of the virus. Churches and faith communities continue to play a crucial role in supporting their local communities. The social and economic support of churches has been estimated at more than £12 billion a year. In my diocese, many churches have offered emergency food and essential supplies to those in desperate need as part of the love your neighbour initiative. It is pleasing, therefore, that the Government have recognised the significance of this contribution by permitting places of worship to continue to offer such essential services during lockdown. I also welcome the provision for private prayer, broadcast and the continuation of funerals.

However the most reverend Primates the Archbishops and the right reverend Prelate the Bishop of London said in their letter to clergy this weekend:

“The sacramental life of the church cannot be seen as an optional extra.”

Access to the sacraments and communal worship are essential to sustain us with much needed hope at this time and to strengthen our commitment to social action. Yet more is needed: people need to be married and not just buried. I am glad to say that we are not exactly in the place where we were in March. Many clergy have worked hard to ensure that places of worship are safe places to be. Today our Archbishops, the Cardinal, the Chief Rabbi and other faith leaders have written to the Prime Minister to say that the continuation of public worship is essential. Will the Minister commit to review the blanket ban? If not, will she publish the evidence used to justify this decision?

Lastly, given the lack of consultation with faith communities before this announcement, can the Minister provide assurances that the Government will consult the churches and other faiths in advance of future decisions such as these?

Of course we recognise that religious practice is of fundamental importance to millions of people across the country. That is why we are enabling individual prayer in places of worship for those who practise that way. We absolutely understand that, for people of faith who take part in communal worship, it will be extremely disappointing news that it cannot continue for the next month, and, of course, it will be difficult for those whose festivals fall during this time. We entirely understand the issue, but we are committed to ensuring that we work collectively to bring the R rate down so that in December we can, we hope, start to get back to normality once we have suppressed the virus, which is what we are all intending to do.

My Lords, I remind noble Lords that this time is meant for questions not statements, which will allow all noble Lords who want to to get in.

My Lords, I draw attention to my registered interests. The lockdown for the coming month in England must achieve a substantial reduction in coronavirus circulation in the community so that hospitals are not overwhelmed by Covid-19 admissions and are able to continue to admit Covid-19 and non-Covid patients requiring urgent and elective care in future. How will Her Majesty’s Government use this one-month period better to prepare our National Health Service and our public health systems to secure these objectives so that further lockdowns will not be necessary?

The noble Lord is absolutely right. Concerns about pressure on the NHS were one of the key drivers behind the decision made as well as the fact that, unfortunately, we are seeing in some areas of the country a small number of non-elective procedures having to be cancelled, and we absolutely do not want that to happen. That is why during this time opticians, pharmacies and GPs will stay open, and we will continue to urge people who need any type of medical opinion, attention or treatment to continue to attend appointments and see professionals. We are ramping up testing capacity. We are providing millions of items of PPE, £3 billion of funding to make sure the Nightingales can provide surge capacity and £300 million to make sure that departments have the funding they need to upgrade ahead of the winter and ensure that the NHS is not overwhelmed.

My Lords, as part of Saturday night’s slide presentation, the Chief Medical Officer and Chief Scientific Adviser made it clear that the Covid-19 hospital admissions rate is the key factor in deciding on a new national lockdown now. Has the bed and ventilator capacity offered by the Nightingale hospitals been taken into account when calculating admission rates compared to the last peak and surge capacity in our NHS?

My Lords, financial support is essential to compliance with lockdown. At the start of the Welsh lockdown, the Government declined the Welsh Government’s request for early access to the job support scheme, despite Wales offering £11 million towards it, and declined a request to widen eligibility for the job retention scheme. Now that the job retention scheme has been extended and includes workers recently made redundant, will support be backdated to 23 October for Wales and be guaranteed for future lockdowns, if needed, in the devolved nations?

As we have made clear, the furlough scheme is a UK-wide scheme, and, as the Prime Minister said, we will always be there for all parts of the UK.

My Lords, can the Minister confirm that local authorities now get sufficient information and data to know where their centres of infection are? Will the Government commit today to working with them to ensure that they have the resources to bear down on those places, whatever they may be, so that they can confidently be prepared to come out of lockdown and to keep on top of that? That means that they will need to be on top of test, track and trace in that more dangerous time after lockdown in particular. Local authorities have shown that they can do track and trace effectively. Why do the Government not work with them in a more trustworthy way and give us all hope that we can get out of lock- down and begin to deal with this virus more effectively?

I entirely agree with the noble Baroness. We are working very closely with local authorities, and they do indeed have significant resources and powers to do local contact tracing. In fact, there are more than 128 local authority contact tracing teams in place around the country, with more to come. I am sure she will be aware of the Liverpool pilot scheme, which we are hoping will be successful and roll out. Everyone living and working in Liverpool will now be offered a Covid test, whether they have symptoms or not. Whole-city testing aims to protect those at highest risk and find asymptomatic cases in order to prevent and reduce transmission in the community, exactly as the noble Baroness said. If this approach works—and we are looking to roll it out—we are hopeful that it will play a significant role in doing exactly what the noble Baroness says in helping to make sure that local authorities and local areas can bear down quickly and effectively on outbreaks within their area.

My Lords, yesterday the Prime Minister, in his characteristic style, said that the same terms would be available to Scotland if it went into lockdown later than England, yet this seems to be have been qualified by Robert Jenrick today, who said that it was a matter for the Chancellor. Scotland is watching to see whether the current restriction levels will bring about a sustained fall in the infection rate or whether more stringent measures will be needed. I am happy to acknowledge the £7.2 billion of additional support provided by the Treasury to Scotland, but we do not want a lockdown just to qualify for furlough, so clarity is needed. Will the same support now being given to England be available to Scotland if it has to follow the same route on a later timescale beyond 2 December?

I am grateful to the noble Lord for acknowledging the £7.2 billion of funding for Scotland. This intervention has saved nearly 1 million jobs in Scotland, which I am sure is very welcome. As we have said, the furlough scheme is a UK-wide scheme, and it will always be there for all parts of the UK.

My Lords, I would like to make a small plea about the NHS. There was a very good statement today from Professor Stephen Powis on the actual position facing the NHS. Accurate information is essential to keeping the confidence of the public, as has been said already today. Sometimes it seems that what is happening in the NHS is slightly cloudy behind a lot of other information—scientific information in particular. Will my noble friend encourage the NHS to go on telling us exactly what is happening within its own front line and make sure that, when it does, it gets properly publicised?

Across the House, we pay tribute to all staff in the health service, from doctors and nurses to cleaners and security, who have done so much over the last few months. I cannot imagine the strain they must be feeling at the moment. Data from the NHS is critical. One of the key things we are trying to do in taking these measures is to ensure that the NHS is not overwhelmed and continues to provide fantastic service, support and care for all members of our society.

My Lords, like other noble Lords, I welcome the reintroduction of schemes put in place during the first lockdown to protect livelihoods. However, thrown into sharp relief is the absence of a shielding programme this time. This puts people with disabilities and others vulnerable to Covid in a difficult position. It makes going to work a choice for them or their employer, with all the risks that entails. It increases financial peril and makes access to appropriate care a greater challenge. Can the noble Baroness explain why, when support programmes to protect livelihoods have been reintroduced, a formal shielding programme to protect lives has not?

We learned from the first lockdown that shielding, as I am sure the noble Baroness is aware, can have a considerable impact on mental health and well-being. That is why we decided, at this stage, not to ask people to shield in the same way again. However, we accept that the clinically extremely vulnerable, in particular, will need to minimise their contact with others and not go to work. We are providing over £32 million of extra funding to enable local authorities to provide support to that group, which needs it, including by helping people to access food and meeting other support needs to enable them to stay at home. We have balanced the experience from the first lockdown and its impacts on mental health and well-being with the decision not to suggest shielding, at this point.

My Lords, I share the view in the Statement that it was right to try every possible option to get the virus under control at the local level. As the Minister reported, there have been some successes there, but we did not make the progress we should have, overall. Unfortunately, political wrangling has not gone down well with the public, who are getting tired of seeing it. If the Government intend, as they state, to adopt a pragmatic and local approach again in the months ahead, is one of the lessons learned that this might be more successful if the Government seek to bring all the political parties, at all levels, into the process? Would the noble Baroness consider a joint plan of action along the lines suggested by her colleague and former Minister, the noble Lord, Lord Bridges of Headley?

The noble Lord is right that we need co-operation locally and nationally. The Liverpool pilot that I mentioned is starting specifically as a local partnership, with central government support. That was requested by the leaders of Liverpool. We hope that we can roll out this model across the country, with the effects that it will have from its ability to find and bear down on the virus locally. It is absolutely about local and national partnership.

My Lords, the tourism and hospitality industries have been thrown into confusion by the latest announcements. Tour operators, conference and events organisers, coach operators and language schools are important components of the travel industry. Will these firms be eligible to claim either the local restrictions support grants or any of the £1.1 billion given to local authorities to support businesses?

Both the pots of money the noble Baroness mentions are under the control of local authorities, and it is entirely up to them to decide which sectors or types of business to support in their area. It is within their gift to provide support, if they have businesses in those sectors, as the money is for them to provide to local businesses, which they know best.

My Lords, does my noble friend agree that we must now plan for several months of constraining transmission of the virus before a vaccine is widely available? Such a plan must mean very limited social contact if we are to keep schools and businesses open and the economy moving, so does she also agree that it will not help to talk of a return to normal any time soon?

I think we are all aware that, as I said, we will review the restrictions on 2 December and look to ease them on a regional basis, according to the latest data. The Chief Scientific Officer has been clear that we will not be going back to normal in four weeks’ time—if we can remember what normal is now. My noble friend is absolutely right: we want to use this time to make sure that we provide the drugs that have proved to be quite effective and, as I said, start new pilots such as the one in Liverpool, so that we are able to bear down in a more effective way. We must use this time to bring the R rate down and make sure that we have the tools available to keep it down, so that we do not have to go back to further national measures such as these if we can avoid them.

My Lords, I have a quick thought, having listened to the Mayor of Liverpool this morning, about not counting into the statistics those who have multiple tests and were shown to be Covid-free first time around. Thinking of the future with hope, will the Government press for an expansion of the no-tariffs WTO pharmaceutical agreement and an acceleration of the implementation of the WTO trade facilitation agreement? What are the Government planning in preparation for a fair and equitable distribution of any Covid vaccine worldwide that leaves a positive legacy on the global trading system, particularly in relation to no tariffs on medical supplies and to efficient, digitised customs and borders?

I hope the noble Viscount will be pleased to know that, last week, we confirmed that we will join the global COVAX initiative, with the aim of expediting the discovery, manufacture and fair distribution of a vaccine to 1 billion people.

Will the Government, at some stage, explain to the country how come we have the same mortality rate per million as the United States, yet while the United States has achieved a 33% growth of GDP quarterly in the third quarter, we are still in a recession? We have protected neither lives nor livelihoods. Can the Government not do better?

I am not sure I heard everything the noble Lord said, so I will go back and check. I think he was talking about the economy, but if I have got that wrong, I apologise. We have put in place one of the most comprehensive economic responses of any country, with more than £200 billion of support. We have protected 12 million jobs through the furlough and self-employed schemes, and we will continue to provide all the support we can to businesses that are struggling at this time.

To regain public confidence after the lockdown in England ends on 2 December, will my noble friend ensure that the Government establish a clear series of trigger points that will determine when an area is required to be placed under restrictions, including the financial support that will be available to devolved Administrations or councils, so that unseemly public arguments with local leaders can be avoided in future?

That is certainly what we will be aiming to do, and there will be a lot of work going on over the next months to make sure that we are in a position to do exactly as the noble Lord says.

My Lords, will my noble friend comment on the data released today by King’s College, which shows new cases plateauing and a slight fall in cases in England, Wales and Scotland, with an R rate of 1.0?

Yes. Part of the reason behind that is that the number of younger people testing positive is falling, particularly among the university student population. Universities should certainly be congratulated on the work they have been doing, but I point out to my noble friend that the over- 60s rate, which then correlates with future hospitalisations, is still rising.

I welcome the more generous level of support to self-employed people announced by the Chancellor, but the 3 million self-employed people who were disqualified from receiving support earlier this year remain so. Given that many of these people are now hungry, as we have seen in Feeding Britain, which I chair, and are having to use food banks for the first time in their lives, will the Minister urgently review the eligibility criteria?

As I have said, we have put in place a comprehensive economic package but the noble Baroness is right that some people have not benefited from certain schemes. The Treasury and the Chancellor and his team always keep this under review and we will continue to look so that we can provide as much support as we can to people at this difficult time.

My Lords, do the Government recognise that it is crucial what they do with the breathing space that this lockdown is providing? In that context, did they listen—as I hope they did—to what our former Prime Minister suggested on the “Today” programme yesterday? He said that we should roll out vaccines as soon as we know they are safe, before we know how effective they are; push out experimental therapeutics as long as they are safe; get a grip on the data confusion that exists; and appoint a Secretary of State for Testing to sort out track and trace, just as Churchill appointed Max Beaverbrook in the Second World War to handle aircraft production.

We have secured early access to 350 million vaccine doses through agreements with six separate vaccine developers, and are investing more than £140 million to make sure that we are ready to manufacture a successful vaccine. We are planning for rollout, making sure that we have adequate transport, PPE and logistical expertise. I assure the noble Lord that, at the forefront of what we are doing, we are working towards making sure that we can take advantage of vaccines when they reach the stage when they can be used.

As we have said, we want track and trace to improve and need faster testing turnaround times. They are improving but I accept that we need to do more. As I have said, the testing pilot in Liverpool is another way in which we hope we will be able to use the time over the next month. By testing a large proportion of a single town or city, more positive cases can be identified and people can be told to self-isolate immediately. The residents and workers of Liverpool will be tested using a combination of existing swab tests and the new lateral flow tests that can turn around results rapidly, within an hour, without needing to be processed in a lab. With all these things together, we will make use of this time to see how much we can roll out so we can really bear down on this in December.

My Lords, I think the Cabinet may come to conclude that national lockdown is not the answer. However, let us look forward. When adopting Covid measures in future, can the Government please set out, in a straightforward way, the expected cost-benefit analysis in numerical terms, including not only the number of delayed Covid deaths and hospital admissions but estimates of the economic costs and the cost in other lives lost, as NHS treatment for other diseases is necessarily limited as a result?

My noble friend is right: we want to be transparent with data and information. Obviously, scientific data and information informing our actions are published on GOV.UK, as are specific relevant findings shared in presentations. I am sure that colleagues across government will take note of what she says.

My Lords, I welcome the Government’s stated intention to mass test. What percentage of the population tested in Liverpool would be considered a success, and are the Government looking at the Slovakian example, where being tested is mandatory for all?

Everyone living and working in Liverpool will now be offered a Covid test, whether they have symptoms or not. Testing will begin this week and, as I mentioned in a previous answer, the pilot is being undertaken at the request of and in close collaboration with local leaders. The aim is to better control the spread of the virus and, as the noble Earl rightly says, gain more data about the number of cases across the city, so that even more targeted action can be taken and people find out the results of their test very quickly. Then they will know to self-isolate and will not perhaps unwittingly spread the virus.

My Lords, the Minister will be aware that many people have relatives, often aged parents, in care homes, and are unable to visit them because of the restrictions imposed. This is causing a great deal of pain. If we can test all the people of Liverpool, as I welcome, could we not have a rigorous testing programme where all people who have relatives in care homes can be tested so that they can visit their relatives, who often have dementia and are very lonely and isolated?

The noble Lord is absolutely right, and this is perhaps one of the most—of so many—heartbreaking situations within this pandemic. He will know that regular testing is now available for all care homes, which includes weekly testing of staff and monthly testing of residents. He is absolutely right—in this pilot in Liverpool the aim is to do this, but then to look at being able to roll out this sort of testing within the NHS and care homes so we can do exactly as he suggests.

House adjourned at 4.51 pm.