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Covid 19: Winter Plan

Volume 808: debated on Tuesday 24 November 2020


The following Statement was made in the House of Commons on Monday 23 November.

“With permission, Mr Speaker, I will make a Statement on the Government’s Covid winter plan. For the first time since this wretched virus took hold, we can see a route out of the pandemic. The breakthroughs in treatment, testing and vaccines mean that the scientific cavalry is now in sight, and we know in our hearts that next year we will succeed. By the spring, these advances should reduce the need for the restrictions we have endured in 2020 and make the whole concept of a Covid lockdown redundant.

When that moment comes, it will have been made possible by the sacrifices of millions across the UK. I am acutely conscious that no other peacetime Prime Minister has asked so much of the British people, and just as our country has risen to every previous trial, so it has responded this time, and I am deeply grateful. But the hard truth is that we are not there yet. First, we must get through winter without the virus spreading out of control and squandering our hard-won gains, at exactly the time when the burden on our NHS is always greatest. Our winter plan is designed to carry us safely to spring.

In recent weeks, families and businesses in England have, once again, steadfastly observed nationwide restrictions, and they have managed to slow the growth of new cases and ease the worst pressures on our NHS. I can therefore confirm that national restrictions in England will end on 2 December, and they will not be renewed. From next Wednesday people will be able to leave their home for any purpose and meet others in outdoor public spaces, subject to the rule of six; collective worship, weddings and outdoor sports can resume; and shops, personal care, gyms and the wider leisure sector can reopen.

But without sensible precautions, we would risk the virus escalating into a winter or new year surge. The incidence of the disease is, alas, still widespread in many areas, so we will not replace national measures with a free for all, the status quo ante Covid. We are going to go back instead to a regional, tiered approach, applying the toughest measures where Covid is most prevalent. While the previous local tiers cut the R number, they were not quite enough to reduce it below 1, so the scientific advice, I am afraid, is that, as we come out, our tiers need to be made tougher.

In particular, in tier 1 people should work from home wherever possible. In tier 2, alcohol may be served in hospitality settings only as part of a substantial meal. In tier 3, indoor entertainment, hotels and other accommodation will have to close, along with all forms of hospitality, except for delivery and takeaways. I am very sorry, obviously, for the unavoidable hardship that this will cause for business owners who have already endured so much disruption this year.

Unlike the previous arrangements, tiers will now be a uniform set of rules—that is to say, we will not have negotiations on additional measures with each region. We have learned from experience that there are some things we can do differently. We are, therefore, going to change the 10 pm closing time for hospitality so that it is last orders at 10 pm, with closing at 11 pm. In tiers 1 or 2, spectator sports and business events will be free to resume inside and outside—with capacity limits and social distancing—providing more consistency with indoor performances in theatres and concert halls. We will also strengthen the enforcement ability of local authorities, including specially trained officers and new powers to close down premises that pose a risk to public health.

Later this week—on Thursday, I hope—we will announce which areas will fall into which tier, based on analysis of cases in all age groups, especially the over-60s; the rate by which cases are rising or falling; the percentage of those tested in a local population who have Covid; and the current and projected pressures on the NHS. I am sorry to say that we expect that more regions will fall—at least temporarily—into higher levels than before, but by using these tougher tiers and using rapid turnaround tests on an ever greater scale to drive R below 1 and keep it there, it should be possible for areas to move down the tiering scale to lower levels of restrictions.

By maintaining the pressure on the virus, we can also enable people to see more of their family and friends over Christmas. I cannot say that Christmas will be normal this year, but in a period of adversity, time spent with loved ones is even more precious for people of all faiths and none. We all want some kind of Christmas—we need it and we certainly feel we deserve it—but what we do not want is to throw caution to the winds and allow the virus to flare up once again, forcing us all back into lockdown in January.

So, to allow families to come together, while minimising the risk, we are working with the devolved Administrations on a special, time-limited Christmas dispensation, embracing the whole of the United Kingdom and reflecting the ties of kinship across our islands. The virus will obviously not grant us a Christmas truce—it does not know that it is Christmas—and families will need to make a careful judgment about the risk of visiting elderly relatives. We will be publishing guidance for those who are clinically extremely vulnerable on how to manage the risks in each tier, as well as over Christmas.

As we work to suppress the virus with these local tiers, two scientific breakthroughs will ultimately make these restrictions obsolete. As soon as a vaccine is approved, we will dispense it as quickly as possible. But given that that cannot be done immediately, we will simultaneously use rapid-turnaround testing—lateral flow testing—that gives results within 30 minutes, to identify those without symptoms so they can isolate and avoid transmission. We are beginning to deploy these tests in our NHS and in care homes in England, so people will once again be able to hug and hold hands with loved ones instead of waving at them through a window. By the end of the year, this will allow every care home resident to have two visitors, who can be tested twice a week.

Care workers looking after people in their own homes will be offered weekly tests from today. From next month, weekly tests will also be available to staff in prisons and food manufacturing, and those delivering and administering Covid vaccines. We are also, as the House knows, using testing to help schools and universities to stay open. Testing will enable students to know they can go home safely for Christmas, and back from home to university.

There is another way of using these rapid tests, and that is to follow the example of Liverpool, where in the last two and a half weeks over 200,000 people have taken part in community testing, contributing to a substantial fall in infections. Together with NHS Test and Trace and our fantastic Armed Forces, we will now launch a major community testing programme, offering all local authorities in tier 3 areas in England a six-week surge of testing. The system is untried and there are many unknowns, but if it works, we should be able to offer those who test negative the prospect of fewer restrictions—for example, meeting up in certain places with others who have also tested negative. Those towns and regions that engage in community testing will have a much greater chance of easing the tiering rules they currently endure.

We will also use daily testing to ease another restriction that has impinged on many lives. We will seek to end automatic isolation for close contacts of those who are found positive. Beginning in Liverpool later this week, contacts who are tested every day for a week will need to isolate only if they themselves test positive. If successful, this approach will be extended across the health system next month, and to the whole of England from January. Of course, we are working with the devolved Administrations to ensure that Wales, Scotland and Northern Ireland also benefit, as they should and will, from these advances in rapid testing.

Clearly, the most hopeful advance of all is how vaccines are now edging ever closer to liberating us from the virus, demonstrating emphatically that this is not a pandemic without end. We can take great heart from today’s news, which has the makings of a wonderful British scientific achievement. The vaccine developed with astonishing speed by the University of Oxford and AstraZeneca is now one of three capable of delivering a period of immunity. We do not yet know when any will be ready and licensed, but we have ordered 100 million doses of the Oxford vaccine and over 350 million in total—more than enough for everyone in the UK, the Crown dependencies and the overseas territories. The NHS is preparing a nationwide immunisation programme, ready next month, the like of which we have never witnessed.

Mr Speaker, 2020 has been, in many ways, a tragic year when so many have lost loved ones and faced financial ruin, and this will still be a hard winter. Christmas cannot be normal and there is a long road to spring, but we have turned a corner and the escape route is in sight. We must hold out against the virus until testing and vaccines come to our rescue and reduce the need for restrictions. Everyone can help speed up the arrival of that moment by continuing to follow the rules, getting tested and self-isolating when instructed, remembering ‘hands, face, space’, and pulling together for one final push to the spring, when we have every reason to hope and believe that the achievements of our scientists will finally lift the shadow of this virus.

I commend this Statement to the House.”

My Lords, this has been a year in which everyone, at home and abroad, has seen their lives change, some irrevocably. There is now huge excitement about the development of vaccines to tackle Covid. We have seen extraordinary human endeavour to bring about this remarkable achievement and I hope we will find an appropriate way to honour those scientists and their teams.

There is now a sense of optimism that life will, at some point in the foreseeable future, start to return to normal—I see smiles all round. But the road that leads to that normality is not going to be easy; until a vaccine or vaccines can be successfully rolled out, the actions and preventive measures we take will make a real difference in containing the virus. No one likes lockdowns or welcomes greater restrictions. We know that they are not pain-free but, if done properly alongside other measures, they are essential in containing the virus and reducing the R rate. So it is obvious that we cannot let up on wearing masks, on washing hands or on social distancing. The mistakes made on test, trace and isolate must be replaced by an effective system across the whole country.

I appreciate that the finer details will not be available until Thursday, but I hope that the Leader will be able to respond today to some of the broader questions, including on the long-term implications and plans. I want to ask first about regional tiers, because she will be aware of the concerns about the effectiveness of the previous tier system. Rather than one tier preventing movement into a higher tier, it seemed that tier 2 was in fact a route into tier 3 and that there was no clarity around the exit strategy. I understand that the plans to be announced on Thursday will be different, but I hope that we will have far greater clarity. It is crucial that we have clear guidelines relating to when regions go into a particular tier and what their route out is. Can the Leader assure us that such detail will be made available when Parliament is updated this week?

The other lesson learned previously was that measures are at their most effective when there is local co-operation. My understanding is that the new restrictions will apply in a uniform manner. Can the Leader provide any clarity about what that means for local engagement? Clearly, there must be urgent improvements in test, trace and isolate, along with support for those who have to isolate. Will this be managed locally or nationally? Importantly, can she confirm that any new contracts will be awarded on proven competence?

On Wednesday 9 September, the Prime Minister said that life could be back to normal by Christmas. That was overly optimistic and it jarred with the view of the Chief Medical Officer, Chris Whitty, who, speaking alongside him, cautioned that our difficulties would last until the spring. Mr Johnson now recognises that Christmas will not be the same this year—certainly, no mistletoe. Nevertheless, it is a time for family and friends, of all faiths and none, to come together. I welcome that the Government are consulting with the devolved Governments to plan a UK-wide approach. The Statement refers to a special time-limited dispensation. It would be helpful if the Leader could provide some details on that today. Where are the discussions at now, and what is the nature of the agreement being sought with the devolved Administrations?

Earlier this month, the noble Baroness, Lady Harding, as the head of test and trace, told the Commons Health and Social Care Committee that she could not have been expected to predict the surge in cases when students returned to university. But risks can be foreseen, and when foreseen they can be mitigated. The Chief Medical Officer has been clear that lifting restrictions over Christmas brings some risks. Most people will be well aware of them and will want to do all they can to minimise them, to share quality time with friends and family.

What modelling and planning have been done to understand and gauge the likely levels of infection post Christmas? Based on that evidence, will some groups—whether determined by age, health or some other criteria—expect to be advised that the personal risk to them is higher? If the Government have not estimated or modelled that level of risk, have SAGE or anyone else been tasked to do so? If so, can the Leader say when we expect that additional advice to be made public? If no such modelling is planned, will the dispensation from the rules apply equally to everybody? She will understand that the advice to care homes will be particularly important.

Following the Transport Secretary’s warning about having to book trains early and limited capacity, has there been any discussion with train and coach companies about capacity and ticket prices, to ensure that travellers are protected?

On financial support into the longer term, the Prime Minister made it pretty clear yesterday that we will have to expect some level of restrictions until early spring and perhaps Easter. I appreciate that the Leader might not be armed with anything too detailed today, but I would like some real insight into the strategic preparations now being made within government for the first few months of next year. If she can give some assurances that lessons, positive and negative—what was good, what was bad, what worked and what did not—have been learned from the past nine months, that might help us all get through the next four or five. Can she give us a steer on how the Government plan to support, compensate and encourage and give some examples, particularly for freelance workers and the self-employed, who currently fall outside the existing support schemes?

Companies in the hospitality and entertainment sectors must feel they have had a rollover of bad luck, as each lockdown and set of restrictions not only put paid to their activities as businesses but completely undermined their planning for a return to normality. Sectors such as the travel sector have traditionally been reliant on advance bookings and are now suffering the additional impact of people feeling uncertain about the future and risking the losses that come with cancellations. Similar questions are relevant for other sectors. The point I am making is that viable businesses need support now if they are to survive and be part of the post-Covid recovery, and they tell us that what they need most is certainty.

As a broader point across all this, what planning is taking place within government that will offer reassurance that there is a clear, thought-out path through what has been a truly awful period for everyone, leading into the end of the pandemic and perhaps a rather more hopeful future?

My Lords, this is the most positive Statement the Prime Minister has been able to give since March, as we now have the real prospect of effective mass vaccination against coronavirus, which offers a route—of whatever length—back to normality. Huge congratulations are due to the team in Oxford and the other groups which produced the vaccine in record times. Reading accounts of how this has been achieved, I see that the key improvement on normal practice has been a willingness to work outside the normal silos in which scientists and others usually work. I hope this lesson will be learned for future vaccines, other areas of scientific research and public policy more generally.

There will no doubt be valid discussions about which groups other than those in care homes and the elderly should have priority on vaccine programmes, but the experience of the flu vaccination programme earlier this autumn should give us all some confidence that the programme can be undertaken speedily and effectively. I have one question about the vaccination programme. Do the Government intend that all those who receive the vaccine will get a vaccination certificate? One can certainly see many attractions of this, not least in that, if it were part of an international agreement to recognise such certificates, it could facilitate the return to greater normality in international travel, with the attendant benefits for the airline and tourism sectors.

The Statement sets out four criteria against which decisions on the placing of regions into tiers will be based and says that the tiering will be reviewed on a fortnightly basis. Can the noble Baroness clarify how that will work? The Prime Minister said yesterday that there will be a uniform approach, but the Health Secretary said it would depend on local circumstances. Which is it to be?

It is clear that, in tier 3 areas, the hospitality sector will continue to be very badly hit. Obviously, I understand the need for that, but will the Government look at additional, narrowly targeted support for this sector so that, when the toughest restrictions are lifted, there is still a hospitality sector able to reopen?

The Statement says that another £7 billion will be allocated to the test and trace system, bringing the total spend on this to some £22 billion—a huge sum which is, for example, greater than the total cost of Crossrail. I do not think that a single person believes that this has been money well spent so far. I hope that the new rapid tests will prove effective, but unless people who should get tested actually do so and then self-isolate if necessary, they will be ineffective. Equally, unless the tracking system also works, the money will be wasted. On all those grounds, the system to date has underperformed, to put it kindly.

In Liverpool, although the headline number of people tested is high, in the most deprived areas the take-up has been only 4% of residents. How do the Government aim to tackle this particular take-up problem? The proportion of people who self-isolate when asked to do so is still abysmally low. This is in no small measure due to the financial costs of doing so. There is of course the grant of £500 per week theoretically available so that those on low pay can be compensated for isolating. However, this is subject to so many conditions that, at the moment, apparently some 80% of all applications are rejected—this from a Government who have shown no such rigour when doling out PPE contracts worth millions of pounds. Will the Government now urgently recast the £500 scheme so that it can be accessed by those who need it?

Finally, I have a very specific question, of which I have given the noble Baroness prior notice. Page 24 of the winter plan document states that places of worship will be allowed to reopen but that there will be limits, depending on the tier, on the number of people with whom congregants can “interact”. Can the noble Baroness explain what “interact” means in this context, given that before the lockdown people were required to socially distance, wear masks and certainly not touch each other? Does it mean that there will be more or less “interaction” in churches now than there was a month ago?

I thank the noble Lord and the noble Baroness for their questions. We have published our winter plan, the aim of which is to take us through to spring. I will first answer a few questions on the tier system, which both the noble Baroness and the noble Lord touched on.

We have adapted our tiers in this plan on evidence that gives us the best chance to control the virus, developing community testing with scientific advice from national advisers and local directors of public health. The noble Baroness is right: these tiers are designed to reduce and keep the R below 1 and to support areas moving down tiers. That is the aim of where we are going. I will move on to vaccines, mass testing and other elements that we think will play an important part as we move towards the spring and, I hope, some kind of normality.

The noble Lord and the noble Baroness are absolutely right. To provide clarity and consistency, all tier restrictions have been standardised and will not be negotiated locally—so that is tiers 1, 2 and 3. Both asked about decisions on moving out of tiers. Decisions on the areas that go in and out of tiers will be based on a range of indicators, including: case detection rates in all age groups; case detection rates in the over-60s; the rate at which cases are rising or falling; the positivity rate—so the number of positive cases detected as a percentage of tests taken; and pressure on the NHS, including current and projected occupancy. Tiering allocations will be reviewed every 14 days, so there is a process and range of measures that will be published around which decisions will be made. While we appreciate that people would like to see firm thresholds, because areas and localities are different we will need to take into account local factors as well, but the indicators that I mentioned are key ones.

The noble Baroness rightly asked about local engagement on the basis that there is now some consistency among tiers. Absolutely, there will be local engagement. In particular, we will offer local authorities in tier 3 areas the opportunity to participate in a new community asymptomatic testing programme to help to find people who have the virus but do not show symptoms. Local authority directors of public health will be able to select their own approaches for delivering tests and priority testing targets and, as the noble Lord said, we hope that will mean that there is proper targeting of local areas, and some of the issues around take-up that he mentioned can be addressed through this local programme.

The programme will involve a six-week surge of testing capability to enable regular testing to be rolled out to the community in a way that works for the local authority with support from national government, including sufficient test supply, funding to cover support set-up costs and staffing test sites and support for extra contact tracing to break up clusters before they become outbreaks. That is where the additional funding that the noble Lord mentioned for test and trace will be focused.

The noble Baroness asked about contracts, and I can only reassure her that we will, of course, follow all the proper processes, procedures and oversights in awarding any future contracts.

In relation to Christmas, just as we came in discussions finished with the devolved Administrations, and they have reached some conclusions. Between 23 and 27 December, up to three households will be able to join together to form an exclusive Christmas bubble. The noble Baroness rightly asked about the clinically extremely vulnerable. Everyone must continue to take personal responsibility for spreading the virus and protecting their loved ones. For someone who is clinically extremely vulnerable, forming a Christmas bubble carries additional risk, but it will be a personal choice. People should take all precautions, including maintaining social distance from those they do not live with at all times, and they should consider seeing their bubble outside, where the risks are lower—but that will be a personal choice for people.

From 23 to 27 December, travel will be permitted between tiers and nations for the purposes of joining a Christmas bubble. People coming to or from Northern Ireland—and I see the noble Lord sitting there—will be permitted to travel a day either side of 23 and 27 December. I am sure there will be further information coming out, but that has come hot off the press.

In relation to care homes, we have launched testing pilots across 20 care homes, using PCR and the new rapid turnaround tests to allow up to two specific visitors to take two tests a week so they can do indoor visits to residents, including some physical contact. We intend to roll out this approach in a phased way across December, because we have made a commitment to provide tests to enable care home residents to have two visitors tested twice a week.

The noble Baroness and the noble Lord asked about vaccines, which is a key part of our route out by spring, we hope. It is about a combination of the mass testing that I have talked about and, obviously, the improved therapeutics that we have, which are having an impact when people are in hospital, but also vaccines. We anticipate that a number of safe and effective vaccines will be available in 2021, and we have taken steps to ensure that the UK has access to them. As everyone will know, we have agreements with seven separate vaccine developers, but we accept that the shift will not happen overnight, which is why spring is the timescale that we are looking towards.

The noble Lord, Lord Newby, asked about a vaccination certificate. I am not aware of that, but I will take that issue back and raise it. I reassure him that an enormous amount of preparation is taking place to make sure that we have adequate provision, transport, PPE and logistical experts to ensure that the rollout is successful. As he rightly says, the NHS is working from a great base—every year for the flu vaccine we have to roll out a vaccination programme, so we are starting from a good base.

I will attempt to answer the question from the noble Lord, Lord Newby, on interaction in places of worship. Social distancing rules should continue to be followed within places of worship, including during communal worship, which can of course now take place in all three tiers. That means that in areas under tier 1 restrictions, people should attend only in groups of up to six—the rule of six—and in tiers 2 and 3, people must not mix outside their household or household bubble. People should stay socially distanced. There should be closer distance only when absolutely essential to enable a faith practice to be carried out—for example, contact with a faith leader—and time spent in such contact should be kept to an absolute minimum.

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, I draw attention to my declared interests. In his Statement in the other place, the Prime Minister made reference to the imminent initiation of a mass vaccination programme for the UK population. Have Her Majesty’s Government considered creating a prospective research cohort from among the millions of citizens who will be vaccinated in the early months of this programme? This would facilitate individual follow-up and invaluable data collection, better inform our understanding of pandemic epidemiology and provide invaluable insights into the future development of novel vaccine platforms.

I thank the noble Lord for his question, and I also pay tribute to all the fantastic work that has been done in relation to the vaccinations. Indeed, obviously a lot of research and testing has been done to develop the vaccines. We will certainly learn from that as we roll out the vaccination programme, and from his very useful comments and observations about things we may consider. I am very happy to take that back to the department of health, which I am sure will be considering these things and talking to experts, such as himself, throughout the industry to make sure that we roll out this programme as effectively as possible.

Mindful that we live in one of the richest nations on earth, that we have one of the best healthcare systems, some of the most brilliant scientists and pharmaceutical companies, and that they have developed the best Covid vaccine to date, will my noble friend reaffirm the commitment made at the G20 summit last weekend to ensure fair and affordable access to the vaccine for the vast majority of the world, who are not nearly as fortunate as we are yet whose need is just as great?

I am very happy to provide that reassurance to my noble friend. We are absolutely committed to ensuring rapid and equitable access to safe and effective vaccines, therapeutics and diagnostics, and we have committed up to £829 million of ODA to this. We have announced up to £500 million to the COVAX advanced market commitment, supporting 92 low and lower-middle income countries to gain access to a vaccine.

The right reverend Prelate the Bishop of St Albans has withdrawn, so I now call the noble Lord, Lord Knight of Weymouth.

My Lords, with regard to the Minister’s news regarding us being able to have up to three households together at Christmas, does the rule of six still apply and, if not, what will be the limit on people celebrating together? I spoke in the debate on the regulations to put us into lockdown, and asked the noble Lord, Lord Bethell, about the nonsense of children being able to play with their friends bubbling with them in school but not play with the same children out of school. He said he would definitely look into it, but since then I have heard nothing. Can I ask the Minister to please urgently pursue this? Whatever tier we are to move into next week, please can the Government ensure that children have this right to play with their school bubble-mates after school and at weekends?

As I said, the decisions on Christmas have just been made, so I probably do not have full information. As I said, between 23 and 27 December, up to three households will be able to join together to form an exclusive Christmas bubble. Everyone can be in one bubble only and cannot change that bubble during this time period. The bubble will be able to spend time together in private homes, attend places of worship or meet in a public outdoor place. Beyond this, people should follow the local restrictions in the area in which they are staying. I will speak to my noble friend Lord Bethell about the noble Lord’s other question.

My Lords, I echo the plaudits of my noble friend Lord Newby for the team in Oxford that developed a viable, stable, successful and inexpensive vaccine. Does the noble Baroness have any clear idea when the vaccination programme will start? Will it start all across England at the same time? Who will be responsible for carrying out the vaccinations? How many will be trained to do this? They do not need to be clinicians.

On behaviour in churches, can congregations now sing?

Moving to testing, last month, in round figures, of the 315,000 people who were identified as having come into close contact with someone who tested positive, only 60% were reached and asked to self-isolate, and that figure was little changed from the record low of the previous month. It means that 126,000 people with coronavirus were not contacted and, therefore, were not isolating and so were infecting others. Are the Government are satisfied with this? We have had months to make this more effective. Why can we not do better?

Well, there will be further guidance on carol singing, I am assured, so the noble Baroness can keep an eye out for that.

On vaccines, obviously the safety of the public comes first. A Covid vaccine will be approved for use only once it has met robust standards. In relation to the Pfizer/BioNTech vaccine, the Health Secretary has asked the MHRA to begin its assessment of this vaccine, and Pfizer/BioNTech has begun supplying data to the MHRA. But it is an entirely independent process, so that will be done in time. As I have said, we anticipate a number of safe and effective vaccines available in 2021.

My Lords, I welcome this approach, particularly to care home testing, but have concerns in relation to SI 1292, which came into force on 17 November to provide an exemption from travel restrictions to allow poultry workers into the UK to assist with turkey slaughter. Many are coming from eastern European countries experiencing high levels of Covid-19 infection. I understand that testing and other requirements are based on individual workers showing coronavirus symptoms. Could the noble Baroness the Leader of the House explain why there are no plans for routine testing of these workers to protect public health, as there is the potential for asymptomatic transmission from these workers? Has the Department for Transport undertaken a thorough review of this situation, together with the Department of Health? Could the noble Baroness inform us on this issue and investigate it if she is unable to answer at this time?

What I can say is that this is one of the areas in which the mass testing programme rollout can be used. For instance, local authority directors of public health may wish to roll out one of their programmes to higher-risk industries, for instance. Those are exactly the kinds of situations where local authorities may wish to use this programme to deal with the very issues that the noble Baroness set out.

My Lords, at great personal cost, as well as social and financial cost to the country, millions have now had Covid and therefore have antibodies. I am indeed one of them. Significant savings can be made by excluding anyone who has contracted the disease in, say, the last six months, from needlessly being traced, tested or required to isolate, including after returning from abroad. So what has been decided about such people and where they should come in the pecking order for vaccination?

In relation to the pecking order, as my noble friend said, for the vaccination, it will be for the independent Joint Committee on Vaccination and Immunisation to advise the Government on which vaccine should be used and what the priority groups are—and the committee has indeed issued some interim advice on this already.

Another initiative that we are launching which will, to a degree, help to address my noble friend’s points going forward, is the plan to introduce frequent testing as an alternative to the need to self-isolate for people who have had close contact with someone who has had Covid. The contacts would have regular tests during an isolation period and would have to self-isolate only if they tested positive.

My Lords, 18% of those for whom self-employment makes up at least half their income are ineligible for the Self-employment Income Support Scheme, while 38% of those with any self-employment income are still ineligible. When will the Government address this wrong? Secondly, can the Government publish a list of businesses that have received subsidies through the Coronavirus Job Retention Scheme?

We have put in place one of the world’s most comprehensive economic responses, backed by over £200 billion, to protect jobs, incomes and businesses throughout this period and beyond the pandemic. Our support for the self-employed has been more comprehensive and generous than almost any other country’s, with around £13.5 billion for over 2.5 million people.

First, as the father of three young boys, I associate myself with the comments of the noble Lord, Lord Knight, about children being able to meet with other children from their school bubble, who they work with every day, outside the school. It is critical to their socialisation and enjoyment of the coming weeks.

More specifically, it only takes walking down the high street to see how many businesses have shut over the last months—permanently, not just for lockdown. Hospitality businesses are at enormous risk of long-term closure now if they are not able to operate during the critical weeks up to Christmas. Will the Government extend specific support beyond that already being given to them, as they will be required to miss their most important trading time?

I completely accept and acknowledge the difficulty for hospitality businesses in particular over the past few months. As the noble Lord is aware, we have provided a comprehensive array of economic support packages, through the furlough scheme, grants to businesses forced to close as a result of the restrictions, business rate relief and the extension of various schemes. We are cognisant of this and will continue to support the hospitality sector. To get all businesses back on their feet, we want to find the pathway out of this pandemic. With vaccines, mass testing and improved therapeutics, I hope we are getting towards that, so that businesses can start to open and return to some sense of normality, which we and they all want.

The agreement of a UK-wide approach to Christmas rules is welcome. Will a UK-wide approach also be sought for the distribution and allocation of vaccines? Do the Government agree that, after prioritising key NHS and care workers, it is preferable that those who contribute to economic recovery and growth, and education, are prioritised over the more elderly, who have successfully kept free from the virus by isolation?

I reassure the noble and gallant Lord that a vaccine will be deployed across the whole UK. We are working closely with the devolved Administrations to ensure that it is deployed fairly. As I mentioned, the independent Joint Committee on Vaccination and Immunisation will advise on which vaccines should be used and what the priority groups are. The initial advice is that the vaccine should first be given to care home residents and staff, followed by people over 80 and health and social care workers, and then the rest of the population in order of age and risk.

I thank the noble Baroness for the Statement. The Prime Minister said that the scientific cavalry is now in sight. Can I be assured that the squadrons of cavalry will all arrive on the battlefields of the United Kingdom together, so that care home workers, clinical staff and all the rest will be vaccinated and have access to rapid testing at roughly the same time?

I hope that I have made it clear that we are working very closely with the devolved Administrations to make sure that these programmes and vaccines are rolled out. Obviously, the mass testing programme in England is the only testing programme, but we will be working with all the devolved Administrations to make sure that they have access to the tests and vaccines they need in order that we can all move forward together and, I hope, see some light at the end of the tunnel come the spring.

My Lords, this is a moment of hope. One hopeful thing that caught my eye in the Government’s White Paper was paragraph 79, which sets out a plan to legislate by the end of this year, requiring care home providers to restrict all but essential movement of staff between settings. This is very desirable, but does the noble Baroness accept that these movements are in part because of the scandalous pay and conditions of people working in the care sector, their need to combine several part-time jobs and their poverty, which makes them reluctant to isolate? Will the legislation proposed by the end of the year include a statutory framework to improve pay and conditions in the care sector, and will the Government consult the trade unions on it?

The noble Lord is right in the sense that one issue that care homes have faced is the movement of staff who work in a number of them. We have extended the infection control fund and ring-fenced over £1 billion to support social care providers, exactly to help ensure that workers do not have to go between care homes. We have also made over £4.6 billion available to help local authorities respond to the pressures caused by the pandemic in key services such as adult social care. So we are very cognisant of the issues that he has raised.

The Prime Minister likened the work of Oxford and other universities to the cavalry riding to the rescue over the hill. Two years ago, Oxford attracted more European funding than any other academic institution in the Union, much of which we will lose as we move into the EEC. Will the Government make good these losses? Our universities defend us from disease, feed us, and find ways of tackling climate change and cybercrime, but they are run by much-derided public servants, many from overseas. They are motivated by finding answers to problems. University research must be financed, staff must receive reasonable salaries or they will go elsewhere, and in many cases they will need visas. Will the Leader of the House speak up for these university staff, who are not well paid, so that they are supported in their work and are available to deal with more challenging problems ahead?

I am very happy to again pay tribute, as the noble Baroness, the noble Lord and others have done, to the fantastic scientists who have worked on these vaccines and indeed who work across universities. I very much hope that the exciting developments we have seen at Oxford and other universities will encourage young people to think about this work as a career. It is incredibly impressive and challenging work, and I hope that some of the coverage and interest in it will encourage more people to think about it as a career, ensuring that we continue to have fantastic scientists working in this country.

My Lords, we rejoice at the wonderful news of the Oxford-AstraZeneca vaccine. However, in the meantime, does the noble Baroness agree that a six-week mass, rapid and affordable lateral flow antigen testing surge could be a game-changer? Now that these tests will be manufactured in the UK at very low cost—perhaps even as low as £3—do the Government agree that they should be freely distributed to enable as much of the population as possible to self-test regularly? This would reduce the R rate rapidly, within weeks, and, in the words of the Prime Minister, would be the boxing glove that truly pummels the virus.

I agree with the noble Lord, and that is exactly why we are offering all local authorities in tier 3 areas the opportunity to participate in the sort of programme that he has suggested. It will be called the kick out Covid testing challenge and will build on the positive results from the Liverpool pilot.

My Lords, my noble friend will be aware of the risks associated with large numbers of students returning home in the run-up to Christmas, and of course in some cases travelling between higher tier areas to lower tier homes. Will she ensure that the Government will work with universities so that all of them provide two tests for each student to ensure that they return home only when they have a negative test result that is immediately available?

I can certainly reassure my noble friend that we are working closely with universities. As he will know, between 3 and 9 December, students will be allowed to travel home on staggered departure dates set by universities. Tests will be offered to as many students as possible before they travel home for Christmas, targeted using a range of factors, including local prevalence rates, whether a testing history is already available, and the percentage of high-risk students in each institution.

I thank the Leader of the House for repeating the Statement. I assume that an estimate has been made of the extra people who will be killed in January as a result of this crazy five-day three-family rule. What is it? I have just watched Professor Sridhar at Edinburgh University advise on the Channel 4 news programme: “Don’t travel. Don’t put your family at risk. Why throw away the gains of the past few weeks?” Does the Leader agree?

Regardless of faith, Christmas is a time when family and friends come together. It has been an incredibly difficult year for everyone, and time with loved ones is very important. We have been very clear about the rules and we have also been clear that it is for people and families to make judgments about how comfortable they feel in terms of the importance of seeing loved ones with regard to their vulnerability. However, I personally would say no to stopping people seeing family for Christmas. I would prefer to see my family, but obviously I will have to make judgments with them about how comfortable we feel, and I think that that is quite important.

My Lords, I am reminded of the line from the poem,

“If winter comes, can Spring be far behind?”

It seems that this is the Government’s last chance to get things right on a lot more testing and distribution of the vaccines. The Royal Blackburn Hospital reports that despite the fact that the number of infections in east Lancashire has started to go down at last, it has twice as many Covid cases in hospital as it had in the spring. That is putting huge pressure on all its services.

I asked about the Nightingale hospitals in a recent Question and was told that each Nightingale team has been developing a clinical model that can be scaled up as and when additional capacity is required. Why are we not using the Nightingale facilities in places like Manchester and Harrogate to relieve the pressure on hospitals like Blackburn?

The NHS Medical Director has made it clear that the NHS has carefully planned to make sure that we can deal with additional demand using, as the noble Lord has rightly said, the mobilisation of the Nightingale hospitals and through partnerships with the independent sector. They will ensure that this is rolled out as and when it is needed. I am sure that they will be cognisant of the situation in Blackburn and will be monitoring it very carefully.

My Lords, will the noble Baroness kindly clarify further her response to the noble Lord, Lord Newby? Do the Government plan to relax international travel restrictions to allow for air travel over the Christmas and new year period on the proviso that compliance is upheld in the country of destination? More generally, do the Government anticipate accepting negative test results within any 72-hour criteria being allowed towards the proposed five-day criteria when that test has been taken at an overseas clinic?

On travel over Christmas under the new tier system, people will be permitted to travel abroad, but those in tier 3 areas are being advised to avoid leaving the area for any reason other than work, education or caring responsibilities. The noble Lord may be aware that from 15 December, passengers arriving in England from countries not featured on the travel corridor list will have the option to take a private test after five days of self-isolation with a negative result, releasing them from the need for self-isolation.

I thank my noble friend for her response on Christmas—that it is a matter for all families to make educated judgments on their own risk. This is a much better way of leading the British people through a crisis. Given that there is strong evidence that infections peaked in the UK in the weeks before the lockdown in March due to voluntary action, in the weeks before the current lockdown nationally, and in most regions across all tiers—1, 2 and 3—due to the changing community perceptions of the virus, what intention do Her Majesty’s Government have to pivot to a strategy of public health messaging to improve adherence and enable voluntary, as opposed to mandatory, measures that empower citizens to take responsibility for their own health and the health of their families and communities?

Well, I assure my noble friend that the legal consistency of the new tiers—as I said, they are now standardised—will be complemented by targeted communications and public health campaigns to inform and influence behaviours to strengthen the sense of personal responsibility in behaviours that will be important to combat the spread of the virus over the winter, together with using local mass testing programmes, with local knowledge about how to encourage people to use them. All that will lead to the kinds of conversations and messaging that my noble friend talks about.

My Lords, does the noble Baroness agree that the public health campaigns she just referred to need also to be targeted at people over uptake of vaccines? Is she concerned about the rise in anti-vaccine sentiment? A UCL survey recently showed that, while 78% of people were willing to get the vaccine, only half considered themselves “very likely to”, with 10% saying that they were “very unlikely to”. There is pernicious anti-vaccine sentiment around. What action will the Government take to deal with it?

We have a central government unit that will be working on this, but also DCMS is working very closely with social media platforms to help identify false claims, exactly as the noble Lord said, about both the virus and the vaccine and, where necessary, promoting authoritative sources of information in their place. I assure the noble Lord that we are very cognisant of these issues and are working hard to make sure that the rollout of the national vaccination plan is accompanied by a public health strategy and message to make sure that people understand that we will always put the safety of the public first, and that any vaccine that is approved will have gone through an incredibly rigorous process to pass that hurdle, as the noble Lord will well know.

My Lords, it is very encouraging news that vaccines will be available in 2021—a remarkable feat. We should all congratulate Oxford, which is not only supplying 100 million vaccines to our Government but is doing so on a not-for-profit basis. Is Pfizer, the supplier of the first vaccine to be announced, which is supplying us with 40 million doses, doing so on the same basis? More importantly, deal or no deal, as the Pfizer vaccine is, I believe, coming from Belgium, will there be import duties or tariffs?

Well, we have secured more than 40 million doses of the Pfizer vaccine, as my noble friend rightly said, which is enough for about a third of our population, and in total we have secured early access to more than 355 million doses through a portfolio of promising new vaccines—so we are very well placed to take advantage of both the Pfizer and Oxford vaccines, which have now reached the stages they have, and other vaccines that will hopefully follow through on the back of their success.

As it is very usual for couples, whether or not they have children, but particularly when they do, to split their time at Christmas by visiting in turn the homes of their respective parents, is there any possibility that the grand easing of restrictions will stretch enough to include such behaviour, which is so highly valued by the elderly and the very young alike?

As I have said, there was a COBRA meeting this afternoon with the devolved Administrations, and details of the decisions made were released just before we came into the Chamber, so I am afraid the only information I have is the information I provided earlier, which is that between 23 and 27 December up to three households will be able to join together to form an exclusive Christmas bubble.

Does my noble friend agree that all three vaccines are fine examples of the benefits of genetic modification? If she is happy to have them injected into her body, as I am, why do we still not allow the planting of genetically modified potatoes in our fields?

I would be very happy to have the vaccine injected into my body. I will let my noble friend eat his genetically modified potatoes, but I look forward to sharing a meal with him once again when he returns to the House once we are through this crisis.

House adjourned at 7.50 pm.