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Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Volume 809: debated on Thursday 7 January 2021

Motion to Approve

Moved by

That the Regulations laid before the House on 11 December 2020 be approved.

Relevant document: 40th Report from the Secondary Legislation Scrutiny Committee. Instrument not yet reported by the Joint Committee on Statutory Instruments.

My Lords, today we have more than a million people in Britain infected with Covid. A third are asymptomatic, and most are highly infectious. That is just too many. That is why on Monday the Prime Minister announced a new national lockdown. The measures are tough but necessarily so. They reflect not only the current case rate but the extent of the pressures faced by our health and care system.

We have over 30,000 people with Covid in hospital beds, with over 2,500 people on mechanical ventilation, and based on the infection rates of the last month and the inevitable clinical chain reaction those numbers are set to rise. Yesterday, sadly, the UK reported a further 1,041 people who had died after testing positive in the 28 days previous and, with yesterday recording our highest daily increase since mass testing began, unfortunately it is inevitable that more deaths are on their way. That is why the Government took swift and decisive action this week, introducing a national lockdown and closing schools. We take this action with deep regret—for society and for the economy—but it is necessary to respond to the grave situation that we face.

The SIs we are debating today cover the tiering system introduced following the November national lockdown. Those regulations have been amended five times to extend the geographical reach and to fine-tune the terms, and we are also debating this week’s national lockdown. Overall, these SIs tell the story of our containment of the original strain of the virus, with a tiering system that eventually proved to work. They also cover the subsequent identification of and reaction to a more transmissible strain of the virus that was far more aggressive than anything that had been seen anywhere in the world before.

The New and Emerging Respiratory Virus Threats Advisory Group spelled it out clearly: the new variant demonstrates a 70% increase in transmissibility. This means that successful measures that were previously in place such as tier 3 are no longer enough to reduce the transmission of cases. The new variant makes up around 60% of cases in some parts of England, and that is rising. Since the beginning of December, cases reported per day in the UK have steadily increased, with on average 15,000 reported in the week of the 6 December, 34,000 in the week of 20 December, and a shocking 57,000 in the week to 3 January. This will inevitably lead to more hospital admissions and increased pressure on secondary care over the coming weeks. This is why a national intervention, introduced swiftly, is so necessary, and why the tier 4 measures have been strengthened by the closure of schools.

We are also taking on additional measures to support industry given the further national restrictions. We have announced additional support to the most affected businesses worth £4.6 billion across the UK. This support will help businesses get through this difficult period until spring. We will take further decisions about our economic response to coronavirus and how best to support the economy, businesses and jobs at the Budget on 3 March.

We have aimed to balance the economic impact of greater restrictions on business with measures to protect public health. Implementing a national lockdown with the vaccine rollout will allow the nation to return to some sense of normality and for the economy to bounce back. We have mitigated the short-term impact through financial support schemes to reflect these changes, and will carry on supporting the British public through these tough times.

However, we are not back to the bleak days in March: hope is on the horizon. The rollout of the Pfizer and AstraZeneca vaccines is making excellent progress. We have now vaccinated over 1.1 million people in England and over 1.3 million across the UK. The rollout in care homes started on 16 December, meaning that our most vulnerable as well as vital care staff can be protected.

While the vaccines project is an international collaboration, we should take a moment to recognise the contribution of the British life sciences sector and to reflect that an easy-to-administer, affordable and mass-produced vaccine offers Britain a way out of this disease and will make a huge impact on the global response.

The end is in sight but, until that time, we must all take responsibility for reducing the transmission of the virus, protecting the NHS and saving lives by complying with these restrictions. I know that these measures require a huge sacrifice. They are designed to minimise our social contact, coming at the cost of seeing our friends and family, participating in the hobbies we love and preventing us taking those holidays we desperately look forward to, and the economic cost is high. But this is a price worth paying to help our key workers, who have dedicated themselves for the benefit of others. We owe it to them and to protect the economy from a collapse in confidence and from rolling lockdowns.

The other SI that we are debating today relates to the self-isolation periods for households and is another example of how we have applied what we have learned. We are doing everything we can to identify and isolate the infectious. Between 25 December and 31 December, 346,901 people across the UK tested positive and were told to isolate, and a further 493,573 people were identified as recent close contacts, of which 92.3% were reached and told to self-isolate. This is a massive national effort.

On 14 December, we amended these regulations to make changes to the self-isolation period for households, non-household contacts and international arrivals, reducing it from 14 days to 10. This is based on evidence showing that the likelihood of being infectious as a contact after 10 days is low. To bring our policy in line with other nations in the UK, the 10-day self-isolation countdown begins on the day after exposure, onset of symptoms, or a positive test result.

Before I finish, I will address the question of parliamentary scrutiny. I want to be clear that no one in the Government makes use of these emergency procedures lightly, nor do they do so without the conviction that they are absolutely essential. Unfortunately, as I have set out and as we have seen across recent weeks, urgent action has been required. I know that some of your Lordships may be disappointed that the amendments were made before there was a debate. However, I emphatically reassure them that we remain committed to parliamentary scrutiny. I commend these regulations to the House.

My Lords, I am very grateful to the Minister and declare my interests as a member of the GMC. As we enter lockdown, the NHS finds itself in a critical position, with the four Chief Medical Officers warning that it is at risk of being overwhelmed in parts of the country. This week, NHS Providers has given a sobering analysis of some of the pressures. Indeed, since Christmas Day, the NHS has had 5,000 more Covid in-patients, equivalent to filling 10 hospitals. It also has fewer beds in use than this time last year because of the need for tight infection control to protect patients and staff.

Areas with a high Covid load are suffering from a double whammy of high numbers of Covid patients and high levels of staff absence. Trusts are utilising every last ounce of capacity available and are seeking to maximise the number of patients being safely discharged into community beds and being looked after at home. However, there is understandable concern about the impact of this on already tired and exhausted staff who are now being asked to delay leave, work extra shifts and transfer to new roles, for instance to help in critical care.

I would like to hear from the Minister what plans are under way to try to relieve at least some of the immediate pressure. I have asked him before about the nearly 30,000 additional doctors who were brought on to the GMC’s supplementary list; I know there is an issue around the bureaucracy involved, but is there also an issue of philosophy? Is the NHS, per se, reluctant to use this incredible facility that could be made available? Can he assure me that, as we come out of this critical situation, thought is being given to what support needs to be given to the thousands of staff who will inevitably be scarred and deeply affected by what they have gone through?

We have a national emergency. The number of people catching the virus is rocketing; the NHS is struggling to provide urgent care to all those who require it; and there is the tragedy of early death for so many families. Everyone must do all they can to keep people safe. As difficult as these regulations will be for so many, these Benches support them. We do so with suggestions the Government should listen to and will hopefully take forward. I offer improvements for self-isolation; others will make other suggestions.

We are now vaccinating, but virologists say it is highly likely that we will have to live with the virus for years to come. Fully funded localised test, trace and isolate systems will therefore be important. Changing the number of days for which a person has to self-isolate is totally useless if less than 20% do so. We must deal with the cause of this, which for many is the lack of financial security and support. The present financial support is not enough; SSP works out at £2.59 per hour, and even if a person claims the £500 grant, that still works out as below the rate of the national living wage. What percentage of eligible people apply for and receive the £500 one-off grant for self-isolation?

To improve the numbers of people who self-isolate, the Liberal Democrats request that the Government pay lower-paid people their normal income for the period of isolation, along with a bonus for completing the required days to thank them for doing the right thing. This must be supported by fully funded Covid community teams that are in regular contact with people isolating to offer full practical and well-being support. These two things would give people the security and support to self-isolate. It is a blind spot of the Government and needs to be addressed. They should start to plan and prepare for when we come out of lockdown and not be caught off guard again. With the right government actions and support, it becomes easier for my actions to save your life and for your actions to save mine. That is why self-isolation payments and support must be addressed urgently.

My Lords, I wish to make two points.

Many, including in this House, question the need for and see no benefits in policies related to lockdown. Some believe that the rising rates of infection mean that restrictions to reduce people’s contacts and movement are ineffective in controlling the transmission of the virus. Many factors affect the transmission of the virus, contact between people being the key factor. In the case of the variant that more readily attaches to the ACE2 cells of the host, reducing contact between people is even more important. What matrix do the Government use to assess the effectiveness or otherwise of measures such as lockdown, apart from the decrease in the number of new infections, to inform the public better?

Secondly, on the vaccination strategy, the Government’s ambition is to vaccinate the JCVI’s top four priority groups by mid-February. I commend that, even if the target is not met. The concern voiced in popular and science media is about the proposal to extend the second dose of the vaccine by up to three months, especially for the Pfizer/BioNTech vaccine. Does the Minister agree that the JCVI should publish the scientific data on which this decision is based, for both approved vaccines, to reassure scientists and the public that the dosage regime does not compromise the effectiveness of the vaccines, which I believe to be the case? If he does not have time to answer me today, could he write to me and put a copy in the Library?

My Lords, my awareness of the situation we are in was heightened last night by an email from the care home in which my mother lives informing me that eight residents and six members of staff have tested positive, in a place where they have been remarkably successful at controlling the virus hitherto. It is this new variant; nobody suggests that there are easy answers and we can all feel the Prime Minister’s inner and outer struggles every time he stands to speak.

In these circumstances, these regulations, unwelcome as they may be in some respects, must be agreed and given force. In the equivalent debate in the other place, some were asking for various clear undertakings as to what might happen in particular circumstances in future. All that we have seen hitherto tells us that, while we can and should plan for a range of scenarios, such attempts at certainty are just not realistic. Even with vaccines and the prospect of their effective rollout, we, as a technologically advanced society, are having to live with the reality of our own vulnerability: imperfect knowledge and an inability fully to control our circumstances—things with which people in other places and cultures are more familiar.

In that respect, our societal pride and self-confidence have perhaps been somewhat challenged. It is little wonder that we see a rise in mental health issues, anxiety, doubts about people’s futures and bereavement, in loss of both life and life opportunities. These are not matters that can easily be addressed by, for example, a financial package from the Chancellor. How and by whom does the Minister think these issues in our society might best be addressed?

My Lords, we are repeatedly told that we are in a race against time. It is in fact a race against the virus; presently, the virus, tragically, is winning. This must change. These restrictions may be regrettable but they are necessary and must be persisted with. Will the Government make it clear that a relaxation of restrictions can happen only when the alert level is brought down to three, and not fully relaxed until it is down to two? Even if the most at-risk population is immunised, this will not be 100% effective, and we should maintain social distancing while we drive cases down to the point where test, track and trace can suppress outbreaks.

I want to ask about two issues. First, on the NHS Covid-19 app, we have 20 million-plus downloads and 750,000 QR codes, but how many positive tests are being registered on the app? It should be some 25,000 a day, and we should expect more than 100,000 alerts to be sent out each day. Without them, contact tracing and isolation will miss most of the contacts in public places. Can our app, like those of some other countries, have the option to provide a mobile phone contact number to allow track and trace to follow up those testing positive?

Secondly, we must now maximise the capacity for vaccination, using the military medical support units and community pharmacy. We should not have arrived at the point yesterday where the pharmacy sector was saying that it did not know whether it would be used. Thousands of trained vaccinators are an essential resource. Can my noble friend confirm that they will be integral to our vaccination programme?

My Lords, I will make only two points.

First, if our fellow citizens are being asked to undergo testing and tolerate restrictions, self-isolation, lockdown and so on—I support these measures—how on earth do the Government explain why so many visitors to this country have been able to fly into our airports without testing, self-isolation and lockdown? How do they explain that to people?

Secondly, what consideration is being given to the effect of the restrictive regulations on the terminally ill? Each year, some 225,000 people undergo palliative care in the United Kingdom. Some have only weeks or months to live. To them, every day is like gold dust, yet currently those undergoing such treatment outside hospices are behind some 7 million other people in the queue for vaccinations. Do not the restrictions being placed on that group cry out for a commensurate prioritisation in vaccination?

My Lords, as we debate these regulations—after the event, as ever—we are in the throes of a national emergency the like of which I have not witnessed in my lifetime. We must learn lessons from the handling of the pandemic so far. The overriding need is to act fast, early and with consistency of message. We need to treat the population like grown-ups who prefer to hear it straight, even if the news is bad.

With the new, more aggressive strain of the virus, we are in a race against time, as my honourable friend Munira Wilson said yesterday, and we need a military-style response. Above all, we must introduce a 24/7 vaccination programme, bringing the vaccine to every high street in the country, including on Sundays. We must make maximum use of volunteers for all the nonclinical tasks involved and remove unnecessary barriers to recruitment. Critically, we must make full use of the roughly 11,400 local pharmacies that already administer millions of flu jabs every year. They have the capacity to vaccinate about 1.3 million people each week, which will save the lives, particularly, I suggest, of people who are not registered with a GP. What assurances can the Minister give that this will now happen?

The next few weeks will put huge strain on the mental health of millions, particularly the vulnerable, the marginalised and young people. What assurances can the Minister give that mental health services will be fully resourced and will stay open to respond to the ever-growing mental health need?

Finally, with the number of Covid patients in UK hospitals topping 30,000, and having witnessed the harrowing scenes in last night’s news coverage of the intensive care unit at University College London Hospital, will the Minister say what specific steps the Government are taking to support the mental health needs of front-line health and social care workers who are suffering from exhaustion, burnout and flagging morale? You can only stretch a piece of elastic so far, and many are close to breaking point.

My Lords, given the grim statistics that the Prime Minister outlined in his address on Monday, I fully accept the need for this third lockdown, but I am also clear that it cannot last indefinitely and that we must do everything we can to avoid treading this path again. I share the concerns of many, including my right honourable friend the Prime Minister, over the impact of a third lockdown: on the economy, particularly in retail, hospitality and small businesses; on the education and life chances of our young people; and on the physical and mental well-being of the public, especially those we are asking to shield—something of which I, sadly, have direct personal experience from the first lockdown.

We must therefore find a way out of here, and that must of course be through mass vaccination. I applaud the Government’s efforts in delivering the vaccine so far and in ensuring that more people have been vaccinated here than in the rest of Europe put together, and I strongly support the ambition to have everyone in the top four priority groups vaccinated by mid-February. To achieve that, as other noble Lords have stressed, we need to use every resource at our disposal. That includes the extensive deployment of our Armed Forces, a stripping away of any unnecessary bureaucracy, and ever-more vaccination centres.

In short, we need to act as if we are on a total war footing by running this vaccination programme as a round-the-clock and precise military operation, with the production of the vaccine akin the production of munitions. Ministers and other noble Lords have rightly said that we are in a race against time between the vaccine and the virus. It is not a race that we can afford to lose.

My Lords, I am pleased to contribute to this debate and I hope that it will result in further clarification of the Government’s approach to managing the pandemic over the next two months. There is much concern about the plethora of statutory instruments that have been passed with the aim of containing the virus, and about what appear to be sudden, unexpected changes in geographical tier allocation and guidance restricting the way in which people lead their lives. Are decisions made entirely on the R rate locally, or is it this and other issues, including the estimated risk factors in a local population and the availability of hospital beds for treatment? Research shows that if you want people to comply, you need a straightforward message. Greater transparency about the reasons for changing allocations would, I believe, result in greater adherence to the restrictions.

Nearly every UK citizen wants to do their best to reduce the spread of the virus, but many fail to understand why, for example, they were encouraged to send their children to school on Monday but are now asked to keep them home, seemingly until half term. Can the Minister explain when there will be a review of the current restrictions and whether there will be further attempts to work with the devolved Administrations to get a more joined-up approach across the four countries?

I congratulate the Government on rapidly altering the training requirements for retired healthcare workers wanting to return to assist in vaccination, and I am pleased to report from a Microsoft Teams meeting with the CNO, Ruth May, and Mark Radford from the HEE this morning that there are sufficient permanent and recent volunteers to administer the vaccines for the foreseeable future. However, there remains a need for extra staff to work in clinical areas. Can the Minister confirm that that is the case and tell us what further interventions will be taken to increase the health and social care workforce this year, including intakes in September?

My Lords, I had the privilege of sitting on the Select Committee that looked at the virus. The committee was brilliantly chaired by the noble Lord, Lord Patel, who has already spoken. One thing we heard was that this virus occurred from a mutation and that mutations were likely to be possible in future. The fact is that the more people who are infected in a population, the greater the likelihood of mutation that may be deleterious to human health, and the more treatment that is given to people, the more likely there is to be a mutation, as the virus fights against that treatment.

Of course, people who come from outside your environment—for example, from outside the country—are more likely to bring such mutations in with them. One of the clear issues, which was not properly answered by the noble Baroness, Lady Evans of Bowes Park, earlier today, when she answered the noble Viscount, Lord Waverley, I think, is what we are doing about international travel, a point already raised very ably by my noble friend Lord Reid. It seems to me, looking at the figures for people coming through London airports, that hundreds of thousands of people are coming through on a weekly basis and we are not properly tracking or tracing them. Some of them are being asked if they might like voluntarily to be tested, and of course they have to pay for it. That is clearly nonsense. There should be much stricter controls on people coming into this country, as is happening in other countries. I ask the noble Lord, Lord Bethell, exactly what we are going to do now, because at present the Government do not seem to have a firm policy to do something to make sure that we are not bringing more viruses, which may be mutating in some cases, into this country.

My Lords, I am in isolation due to a contact of mine testing positive. I want to ask six questions. First, are all the Nightingale hospitals now being actively used? Secondly, have Her Majesty’s Government solved the problem with the 25,000 former nurses and doctors who have volunteered their services? Thirdly, as a politician, I am mystified how we can organise a general election involving more than 33 million people voting in five weeks, yet we are having difficulty organising in seven weeks sufficient jabs for 14 million people.

Fourthly, in a pandemic, is there any question of anyone at PHE, the MHRA or anybody else involved in the distribution of this vital jab not working on Sundays? Having done overnight work when I was in commerce, I suggest that people should work overnight if necessary.

Fifthly, will all GP practices be starting this Monday, 11 January, as mine is? Can we be reassured that all will have supplies in time for Monday morning? That is, they will need supplies tomorrow, on Friday.

Lastly, I take a particular interest in care homes, which have done a wonderful job, often on their own. They are now saying that care home staff should be treated the same as NHS staff and allowed to take LFD tests at home, rather than fixing them into their working week. I am most grateful to my noble friend on the Front Bench for the huge effort he has put into this whole programme.

My Lords, last year, we discovered that pandemic planning was inadequate. It was based too much on flu, failed dramatically on PPE and test-and-trace logistics, and dithered for too long before lockdown. If there are any lessons to learn, they are to think the unthinkable, implement at speed and get a grip on logistics. Delay costs lives and, in the end, costs more. That must be programmed in to cut the dither.

Now, vaccine rollout and logistics are slower than hoped, and we are seeing traffic jams and distressed elderly in long queues. With the handling advantages of the Oxford vaccine, it must be a seven-day operation, local and around the clock, where feasible. But why have we only just discovered the excessive red tape around approving vaccinators? We knew the size of the task and that the vaccine was coming, even if not exactly when. Why have local pharmacies not already been lined up and assessed for space and in-and-out arrangements? Each lesser-performing day costs lives, costs the NHS and costs the economy.

The Government have put forward some bold financial support packages, but there are still holes, such as excluding the self-employed and inadequate payments to those who cannot afford to self-isolate. Financial stress induces the rule-breaking that spreads the virus, all the more so after high-profile breaking by people not facing financial hardship. The public health aspect of isolating justifies more support than sick pay, which does not cover everyone. The £500 grant is insufficient and not that well known. These regulations, if anything, came later than they should have. That is a lesson that we will face again, with Covid, we are told, likely to stay around despite vaccination.

My Lords, I too appreciate the seriousness of the situation and how difficult it is for people across the United Kingdom, as we face the pressures of another lockdown. I also appreciate the difficulties faced by the Government in making decisions that have such serious implications for the curtailment of the liberties that people across the United Kingdom have enjoyed. Those who do not have a difficult decision to make can criticise the Government more easily. However, surely the safety and well-being of our citizens are uppermost in our minds. Therefore, it is imperative that we all pull together to ensure that we conquer this Covid virus.

I ask the Minister to confirm that all GPs and community pharmacists will be used to roll out our vaccine. Can we have a 24/7 programme for vaccination, because time is of the essence?

It is one thing to make lockdown restrictions, but we must bear in mind the implications. I therefore ask the Minister what consideration has been given and plans made to prepare for an avalanche of serious mental health problems, which will follow this Covid-19 crisis. With so many being forced into isolation, not only because of personal sickness but because of government restrictions and the depths of despair and loneliness being felt by many across the community, will we not see a serious increase in alcohol and other addictions manifesting, which will need appropriate and professional treatment? Can the Government therefore assure us that appropriate provision is being made to handle the situation?

In my humble opinion, winning the battle against Covid will not end the crisis that we face, but uncover numerous other challenges for society. Government must lead, but it is important that each of us within society does everything in our power to achieve success.

My Lords, as we enter the epic phase of vaccine versus virus, the exemptions in these regulations for elite sportsmen and sportswomen are welcome. The related debate over the timing of their vaccination and that of their entourages has now become a key issue. The president of the International Olympic Committee, Thomas Bach, is to be praised for saying that athletes should not jump the queue in front of those in greater need of vaccination. I agree with him. No one wants to see the world of elite sport given advantage over the most vulnerable in society, namely those most likely to require hospitalisation if they were to contract Covid.

Canadian Richard Pound, who is closely associated with the World Anti-Doping Agency, called overnight for the immediate prioritisation of Canadian athletes in the first wave of vaccinations in his country. He was wrong; “not yet” would have been a more considered view.

Moving through the tiers of those most in need of vaccination, I urge the Government to recognise the pressures that our athletes, both Olympic and Paralympic, are under to qualify for selection for the Games. Selection criteria vary by sport. Some need to qualify soon; others, in the summer. Sport by sport, I urge the Government to work with the Olympic governing bodies to determine the latest possible time it would help Olympic and Paralympic hopefuls to be vaccinated. I believe that they will find that the end of February is broadly the consensual point, but it is vital that this comes after the most vulnerable in society.

In so doing, I hope that the world of international sport also considers the global and not just national socioeconomic inequalities associated with Covid-19. First-world countries will benefit from the vaccine first, with supplies to developing countries lagging significantly behind, some potentially after the Games. While the whole sporting world hopes that the Olympic and Paralympic Games will take place this summer, all involved need to work to ensure that selection processes are fair, that opportunities are taken to optimise performance preparation and that the interest of the world’s athletes is critical, but not more important than the most vulnerable in society.

Today, Health Service Journal published:

“Hospitals, particularly in London and the surrounding areas, are seeing very high and rapidly growing numbers of covid-19 admissions, and are running out of options to free up beds.”

Discharge of patients to care homes has become increasingly difficult, despite beds in many care homes lying empty, as care providers fear repeating the disaster of the spring in the sector, and they are not insured to become Covid-designated homes. Will the Government provide rapid short-term indemnity, such as is provided for the NHS?

Ysbyty’r Seren in Bridgend is the busiest field hospital, operating since mid-October as a step-down unit. Today it has 72 patients. Wales has been about two weeks ahead in this second wave and important virological evidence is emerging. Is experience being sought from Wales for the Nightingale hospitals and is data from all aspects of the pandemic, including genomic testing, being rapidly shared?

Lockdowns have seen a drop in other respiratory infections, such as respiratory syncytial virus, yet sceptics are doing untold damage, endangering the lives of many, including clinical staff who are now exhausted, burnt out, seriously ill with Covid or having to isolate. As the Minister said, the new variant is highly infectious, yet many workplaces, such as factories, food processing plants and schools have remained open without any ventilation system guidance. Will the Government urgently learn from Germany and instigate ventilation guidance, support and certification of ventilation systems, establishing a rapid national standard for machines that lower viral count in the ambient air?

My Lords, I will focus on school education in lockdown. Education has had a poor deal during this crisis. Education is vital for children and young people to thrive and prosper, yet those involved have suffered U-turns—sometimes almost instant—a lack of equipment, and mixed messages about exams and assessments. This has left them confused and distressed.

I ask the Government to put in place a long-term strategy for education, with transparent options if things need to change. They should work with local authorities, unions, parents and children to develop and share a strategy now.

This strategy should include the following. All those working in schools should be vaccinated and treated as a priority. They should have reliable supplies of protective equipment and a safe environment, as they are very special. Testing for all in schools must be established. A broad and balanced curriculum must be maintained and guaranteed as far as possible. Children need not only academic education but structure, routine, socialising, activities such as art, sport and exercise, and the chance to discuss how best to cope in challenging times. Exam assessment systems need to be firm and clear. Families must be guaranteed computer equipment for each child when working at home. Services such as mental health services must be geared up to cope with present and future demand. Where is such a strategy?

Parents also face a crisis. The Government need to listen to parents, who may have the challenge of coping with work, running a household and supporting children who are not at school. Those who cannot work due to childcare commitments must be guaranteed flexible job retention. Confusion and anxiety about the basic needs of children and parents must be addressed urgently by the Government; otherwise, we risk long-term problems in mental health and inequalities, with services that cannot cope.

My Lords, when the noble Lord, Lord Bethell, opened the debate, he was slightly apologetic about parliamentary scrutiny. I do not think that there can be any doubt now that, as long as the Government show courage, transparency and consistency of message, he will get massive support in his work in the fight against this virus.

I will use this short time to put my pressure behind the use of community chemists. We have had a number of vague statements by Ministers that have certainly lacked any “Action This Day”, given that the Royal Pharmaceutical Society and others have made the offer of their facilities. We have already seen and heard anecdotal evidence of how difficult it is for particularly the very elderly to be handled safely by large, often out-of-town centres. Can I have the Minister’s assurance that local pharmacies, particularly those with existing experience of dispensing flu jabs, will be brought into service immediately?

I continue to be worried because the Lord Privy Seal, in answering questions earlier, mentioned that pharmacies might be used where they had capacity to give “significant” doses of vaccine. What does “significant” mean? Another answer was that conversations would be ongoing. The message from all the Benches today, from the noble Lords, Lord Hunt and Lord Lansley, my noble friend Lady Bowles and others, is that it is really “Action This Day” on community pharmacies. It would be absolutely outrageous if that facility was not urgently used.

My Lords, hindsight is a wonderful thing and used wisely I am sure that, with a careful, detailed, objective review, there is much that we will learn from the Government’s handling of this crisis that will better prepare us for future pandemics. My concern, though, is that the knowledge that hindsight brings seems to be currently used only for attacks on a Government trying to deal with a pandemic in unprecedented times. I have no doubt that the Government have made their mistakes, but I do not believe that a different set of Ministers would have dealt with the situation radically differently.

The Government’s strategy of trying to keep the balance between protecting the NHS and minimising the impact on the economy and the nation’s physical and mental health is a challenge beyond all others. There are two areas where I hope we will learn specific lessons and have an agreed framework for the future. Both relate to the fact that any graduated or full lockdown will work only with the support, understanding and, crucially, consent of the population.

The first must be to get an agreed and consistent approach among the four nations of the United Kingdom. Of course I understand the principle of devolved government, but the fact is that differing rules sow confusion and ultimately a distrust of a scientific approach. That is surely to nobody’s advantage.

The second lies in the use of local authority boundaries as tier boundaries. While simple, this has caused enormous challenges in some parts of the country. I live in Gosport, where my wife Caroline Dinenage is Member of Parliament. Her constituency is part Gosport Borough, part Fareham, and was initially split in half between tier 2 and tier 4. This meant that it was fine to have social gatherings on one side of the road but literally not the other. That was impossible to explain to constituents and undermined public confidence in the system.

Boundaries must be drawn somewhere but surely not, where possible, through centres of population. I suggest to the Minister that, if preventing the NHS being overwhelmed is the main objective, perhaps a tiering system based on catchment areas to principal hospitals using postcodes would be an equally simple but more logical approach.

My Lords, I will ask the Minister two slightly uncomfortable questions. First, it is always very important, when one tries to set an example, that we look at ourselves. Does the Minister feel that, in terms of attendance and mask wearing, we in the Chamber and at Westminster are setting the right example? Is there anything we could do better?

My second point is this. I have been reading a book, Breathtaking: Inside the NHS in a Time of Pandemic, by Dr Rachel Clarke. Anybody who read this book would think twice about breaking the rules. I want to go further than the Government in some aspects. For example, the fact that going to a party or organising a party might mean you get a £60 or £500 fine should be seen in the light of the fact that it could cause a porter, a cleaner, a nurse or a doctor to visit not merely ICU but the mortuary. If people thought about this more carefully and the penalties were much more draconian, they would think twice about their behaviour. I am shocked that people might get a fine of £60—a parking meter fine—for going to a party, spreading this pandemic and putting so many lives at risk.

My Lords, here in snowy Cumbria we have lately witnessed a massive increase in cases of the new mutation of the virus, with Carlisle having almost 1,100 cases per 100,000. One reason for this increase is the influx of thousands of visitors who often unwittingly carry coronavirus.

The guidance for the current lockdown urges people not to travel out of their own district. Under the first lockdown there was similar guidance, but there was a critical difference in that it was enshrined in law. This time, unfortunately, this is not the case; it is only guidance. Thus the police cannot, as they did previously, prevent people entering the county, possibly spreading the disease.

Will the Minister consider this particular proposal to enshrine the guidance in law? Doing so would reduce transmission of the virus and save the lives of many thousands of people.

My Lords, it is politically healthy that the UK system has the ability to correct and polish statutory instruments, and that such changes made by government need to secure the approval of both Houses of Parliament. The House of Lords has a useful role in investigating and debating changes to the law made under the affirmative procedure. It is particularly useful that a large number of eminent lawyers sit in the Lords.

The two relevant key instruments currently being addressed reduce the self-isolation period from 14 to 10 days for people in England who have had close contact with someone who has coronavirus. This change also applies to the minimum period of isolation for households switching their support bubbles. The regulations also make changes to the starting date for calculating the isolation period. The Government made the changes following a review by the chief medical officers of the evidence on self-isolating. The regulations shortened the infectious period to 10 days after contact; it was defined as being low, although it was higher than the likelihood of being infectious after 14 days.

The changes to self-isolation period starting points in England were made to bring them in line with the rest of the UK. While there has been some professional questioning of these changes to the regulations, I observe that they have, in the main, been accepted as necessary and appropriate.

My Lords, all the measures covered in the SIs we are debating will amount to nothing if we fail to defend our borders. I will address the points made by the noble Lords, Lord Reid and Lord Winston, about international travellers.

We have a proposed test-to-release scheme that allows passengers to shorten their required isolation period to five days if they take a private Covid-19 test five days after their arrival and receive a negative result. Information provided to the Secondary Legislation Scrutiny Committee by the department stated that

“the protective effect of testing to release international arrivals after 5 days of self-isolation is only marginally less effective than 14 days of self-isolation”.

Public Health England modelling says that the effectiveness of testing after five days is 85%, after eight days 96% and after 10 days 98%—13% more effectiveness if testing is postponed to 10 days after arrival.

The proposal was examined by the committee, which was told that the new approach mirrored that taken by close partners, but no mention was made of the fact that infection rates have been much lower in those countries than in the UK. The committee was also told that our Border Force will be issuing more people with fines if they have not completed the passenger locator forms, the PLFs. However, if they have not completed the form how are they able to be contacted in order to levy the fine? By comparison, all passengers arriving in Australia, whether citizens or travellers from elsewhere, are required to isolate in a hotel, chosen by Australian immigration, for two weeks at their own expense.

We know that the virus has mutated. That is what viruses do, which makes the situation more uncomfortable. We need to be more ready and defend our borders. We cannot take risks. Will the Minister commit to reviewing the evidence and the department’s decision in these matters?

My Lords, I make two points—the first on transmission. As the Minister made clear in his introduction, the SARS-CoV-2 virus is hideously out of control. As scientific knowledge has increased, the importance of aerosol transmission and the key place of the need for ventilation in prevention, and not sharing inside spaces, has becoming increasingly obvious, as the noble Baroness, Lady Finlay of Llandaff, highlighted.

It may not be the Government’s intention but the slogan “hands, face, space” places this crucial issue last on the list and appears to make it of lesser importance. There are people, some of whom I have encountered, who think they are safe if they wear a mask, even in a confined space with a stranger, when the science makes it clear that that is not the case.

Are the Government considering an enhanced, expanded education and publicity campaign to stress the importance of ventilation and not sharing space, perhaps utilising something like the excellent graphics produced by the Spanish newspaper El Pais, which clearly illustrates how the risk of the virus being transmitted in confined spaces is increased, and ways of reducing that risk?

Are the Government also considering rethinking the use of the term “Covid-safe”, particularly when applied to workplaces? Given aerosol transmission, risk can be reduced but not eliminated. Broader understanding of that can make us all safer.

Secondly, I ask about the Government’s long-term plans to provide maximum safety in the period when significant numbers have been vaccinated. Current evidence suggests that the vaccines we now have will not provide sterilising immunity and, therefore, vaccinated individuals will still present an infection risk. What plans are the Government making to redesign spaces and practices, look at ventilation, crowding and practical arrangements in schools, hospitals, prisons and other institutions, and in guidance provided to private companies, to minimise prevalence of the virus? They need to prepare and have a plan that would also make us safer from other infectious agents that we know present a continuing danger in this world scarred by the climate emergency and nature crisis.

My Lords, I have two points and a question. On the borders issue, we do not need to get too worked up about the crossing of borders because, after all, people cross the border from London to Nottingham and places such as that. We need to make sure that the test-and-trace mechanism works.

From time to time in the past year, I have been on the Eurostar. One is not allowed on to the train to come back unless one has filled in the form and it has been registered by the border people. They take a copy of the form and register it. That is a condition of getting on the train. We probably need to tighten up there.

My second point is on vaccines. It is obvious that we should have pharmacies administering them. Do we have enough vaccines? Is the Minister satisfied that the amount being produced will be sufficient to get things done? If he wants to give some encouragement to the Prime Minister, he could say to him that if Britain can manage to vaccinate its people faster than the rest of the EU, he will certainly have seen a result of getting Brexit done because it will make him popular.

My third point is a question. Will the Minister tell me, or write, about the position of dentists and dental surgeries? I read the guidance issued at the end of last year and the priority groups included doctors, dentists and nurses, but are dental nurses included? What is the position of staff in dental surgeries? If they are being left to get their own vaccines, that is not satisfactory.

My Lords, the rules are clear. Those who can work from home must do so. Businesses must do everything that they can to ensure that remote working is made possible. However, there is no doubt that some organisations still prefer to have their staff in the office where they can see them. Some estate agents, for instance, are keeping staff in the office when it is hard to see why that is necessary.

If the Government tell people that they should work from home but employers insist that they travel to the workplace, will they choose to obey the Government or risk disobeying their employer and losing their job? There are penalties for individuals who flout the rules, but can the Minister say what sanctions there are on an employer who puts their staff and the community at risk by insisting that they attend the office?

I echo the question of the noble Lord, Lord Berkeley of Knighton—[Inaudible.] Today, for instance, there are 13 Back-Benchers speaking in this debate from the Chamber, but parliamentary staff have done a remarkable job in ensuring that Peers can work from home. Of course, it is a privilege to debate from the Chamber, but is it essential that so many parliamentarians must work from Westminster?

Finally, on test and trace, could the Minister tell the House just how many people have been traced via the app, and what the average cost of each successful contact is? If he does not have the information to hand, perhaps he could write to me.

My Lords, we are told that by February we are to return to tiered arrangements geared to a national vaccine rollout programme, yet we also learned of discussions over a new tier 5, which could introduce even tougher rules.

Before decisions are taken on tier 5 restrictions, I make a plea: please, please, please listen to calls for mandatory masking. I accept that current rules provide for wider usage than was the case some months ago, yet there is still widespread non-observance of the rules. This is my 18th call since last February. I have repeatedly argued that whereas Governments worldwide are pursuing an enforced mandatory masking policy, we in the UK, in almost splendid isolation, challenge worldwide expert opinion and reject real-teeth legislative intervention. Why not strengthen the law in the tier 5 areas when they come?

I remind the House, according to Worldometer, which monitors the virus in 220 countries worldwide, that the highest corona death rates per million population are in Bulgaria, Slovenia, Bosnia and North Macedonia—all part of the former Soviet bloc. Then we have Belgium, followed by the United Kingdom at 1,121 per million population—fifth place out of 220 countries worldwide. Our stats, updated yesterday, exceed even those of the United States of America.

Our policy has been an unmitigated disaster. As President-elect Biden, in Wilmington, Delaware, put it:

“First, I’ll go to every governor and urge them to mandate mask wearing in their states, and if they refuse, I’ll go to the mayors and county executives and get local mask requirements in place nationwide”.

If only we had such leadership.

For the sake of the health of the nation, listen to those of us who want tougher policies on masking and an end to widespread non-observance.

My Lords, I declare my interest as advising the board of the Dispensing Doctors’ Association, and I would like to focus on the rollout of the vaccinations. Does my noble friend the Minister share my concern that a delivery of over 1,000 vaccines to a rural practice in Suffolk was cancelled at less than a week’s notice? This is happening across the country—in Devon the same as in Suffolk. Dispensing doctors are the ideal vaccinators for the elderly and stand prepared to play their part. Yet notice and certainty of delivery are essential, mindful of the distances and needs of patients in far-flung rural areas to reach the surgery.

It seems that successful vaccination sites are being prevented from getting more vaccines, possibly because they are considered to have successfully vaccinated a greater percentage of patients than neighbouring sites. Yet there are media reports that an internet pharmacy—Pharmacy2U—is to be allowed to vaccinate people in supermarket car parks. Where is the infrastructure to support this? A GP practice wanting to operate vaccinations from a car park would currently be prevented from doing so. Remote NHS management teams seem to be dictating how much can be supplied rather than allowing individual practices to request what they require for their population. Thus, there is no certainty of supply and an inability to plan clinics efficiently and effectively. Those with proven expertise in the provision of vaccinations are being prevented from doing their job.

I also raise the concern that over-65s will not be vaccinated before the middle of February, which appears to be a slippage in timing. Yet this age group is as likely to require hospitalisation as those in the four priority groups. Equally, a change to the date and timing of the second dose of vaccination is not supported by the pilots, on the basis of which regulatory approval was given, and flouts the recommendation of all scientific authority, not least the World Health Organization.

Sorry, I did so, and it went back on mute. I beg your pardon. My Lords, I speak again from the hills of east Lancashire, which are not so sunny today.

The Minister said that we are not back to the grim times of last March, but in this part of the world, and many others in the north, we have never really been out of them, apart from a short time in the middle of summer. The misery, loneliness and debilitating frustration of people such as small shopkeepers in town centres continues.

Vaccination is really the Government’s last chance to show that they can do something competently in this area. My noble friend Lady Bowles of Berkhamsted talked about the logistics and the rollout. In my view, at local level it is very important that the local people involved—the hospitals, GPs, pharmacies and local authorities providing facilities—are able to operate with a degree of flexibility.

Too often we have an attitude in this country of tram lines and tick boxes, and people are not able, and do not feel they are able, to do anything at all that is not on their tick list. Yet if people have the vaccines locally, it is very important that they use them, and that we do not get a situation in which there is a surplus of vaccines in a particular place and people do not turn up to get their vaccination, or there are not enough of the priority categories available. People have to be able to use those vaccines. Every vaccine delivered locally and not used will be a disgrace. I ask the Minister to assure us that people will have the flexibility to use them and to get people vaccinated, right up to 100%.

My Lords, we all look forward to a rapid vaccination of the population and a swift return to normality. But, as the noble Lord, Lord Scriven, said, Covid is likely to remain endemic for many decades to come. That means that improved drugs, care and treatment are necessary, with a view to driving down mortality rates even further than our excellent medical professionals have managed so far.

The British RECOVERY programme—RECOVERY as an acronym—is the world’s largest randomised Covid drugs trial. It has given us dexamethasone as the first drug clinically proven to help reduce deaths from Covid, and it has shown that other drugs thought likely to be useful have had little measurable effect. Results from further trials are likely to come through in coming weeks.

When I raised this topic recently in your Lordships’ House, my noble friend the Minister was generous in saying that the Government saw the importance of better treatment and were investing in it. May I urge him now—amid all the other pressures that he faces—to ensure that government heft and resource go with redoubled effect into supporting the development of new treatments, and to undertake to roll successful drugs out rapidly, even if, by contrast with dexamethasone, they cannot be procured for pennies?

My Lords, it is a pleasure to take part in this debate. The rate of infection is undoubtedly higher now with the ability of the mutated version of the virus to transmit more easily. Control measures have to be put in place and need to be adhered to by all of us—there is a major element of personal responsibility for our own health and the health of our family, friends and communities. As the Minister and other noble Lords have said, the only way out of this Covid dilemma is through the application of vaccines, of which we now have two. I note that the European Medicines Agency has also approved the Moderna vaccine, so I wonder when the UK medicines agency will also approve it.

I have some other questions for the Minister in relation to vaccines. How many doses of each of the vaccines have been ordered for the four parts of the UK, and how many exist in England, Scotland, Wales and Northern Ireland? There have been some suggestions in the media that there are problems in securing sufficient quantities in order to vaccinate all the population. When is it estimated that the vaccine implementation programme will be completed? Will it be by the summer, autumn or winter of 2021? Given that taking the vaccine is down to personal choice, what plans do the Government have to exhort people to take it?

There have been some suggestions that there is a global shortage of glass vials to package up the vaccines, with long waits for safety checks and for ensuring that there are enough vaccinators. Can the Minister assure me on those various areas?

My Lords, these statutory instruments deal with protecting us from the virus—an area where the Government have, as others have said, a record of overpromising and underdelivering. An example is the test and trace scheme, which was hailed by Ministers as world beating but has turned out to be a miserable failure—except of course for some of the friends of those Ministers, who have made a fortune out of it. Maybe the Minister can tell us in his reply where the noble Baroness, Lady Harding, is and what she is up to now.

Now, as many others have said, success in defeating the virus depends on the efficient delivery of the vaccine. I fear that this is beginning to look like another government debacle. Therefore, first—a question asked also by the noble Baroness, Lady Ritchie—can the Minister tell us how many vials of each vaccine have been delivered to each of the three devolved nations? Secondly, when does he expect all the vaccination centres to be operational? Thirdly, when does he expect them to achieve the vaccination of 2 million people each week, as promised? Finally, what will the arrangements be for reporting regularly to both Houses on the progress of the rollout? From the reports of what happened when the Health Secretary visited Bloomsbury today, and from the letter from MPs of all parties in Birmingham, I fear that things are not going quite as well as the Government hoped and that we will fall behind on the delivery of this vaccine, in spite of the bombastic claims of the Prime Minister that we are again world beating.

My Lords, we should be in no doubt about the seriousness of the current situation, so I have no hesitation in supporting these regulations while recognising the grave impact that they will cause for many—financially, physically and mentally. Undoubtedly, lockdown fatigue is pervading the nation, so I commend the Government, and in particular the Prime Minister, for doing whatever is possible to emphasise the gravity of the current situation.

I am afraid that there is still a small minority of our fellow citizens who either unwittingly or deliberately consider that they do not have to conform to these regulations. However, I commend the innate common sense of the majority of our fellow citizens, who are doing what they can, at sometimes considerable personal cost, to try to curb the spread of this pernicious virus and the new variants that we are seeing. I also echo the points made by the noble Baroness, Lady Wheatcroft, that each of us in this House should consider whether attending the Chamber is absolutely essential.

Many groups deserve our gratitude for working beyond the call of duty. I particularly mention the many teachers, such as my eldest son, who are working in a very difficult environment and whose only concern is the education and welfare of their students. They have not been found wanting in these difficult days.

I pay tribute, too, to all those who continue to find innovative ways to keep their businesses afloat as best they can. For example, Balcony Shirts, garment printers in Uxbridge, is once again producing T-shirts and hoodies for those schooling at home with the logo “Home School Class of 2021”. This proved very popular during the last national lockdown with parents and pupils alike—it was a real morale-booster for many. It is also giving a sizeable proportion of the price to the charity Shelter. That is just one of many examples of the invention born of this pandemic.

Let us earnestly hope that if we all do the right thing we may lift these restrictions before 31 March, but we owe it to ourselves and our fellow citizens not to drop our guard until then.

My Lords, there is no doubt that the appearance of this new variant has taken us into a very difficult situation. As welcome as the vaccine is, we have to acknowledge that getting the whole country protected will not be a very quick process. Therefore, the measures that we take, individually and collectively, while we wait to be vaccinated are absolutely key.

I want to ask the Minister two questions. First, what work is going on to reassess the protocols and procedures that have been developed for workplaces, schools, places of worship and so on to ensure that systems which were fit for purpose with the original virus continue to be so with one that is more transmissible?

Secondly, on an individual basis, I acknowledge that this is anecdotal but I am hearing a lot of stories about people who contract Covid and say that they have no idea how they caught it because they have been really careful and have followed all the guidance and procedures. Is any reassessment going on of the sorts of behaviours that many of us have fallen into the habit of adopting? Are those preventive measures still fit for purpose or should we be protecting ourselves and others differently?

Finally, on a different matter, there is a huge role to be played in a vaccine rollout by volunteers, not just as injectors but in a whole range of ways. My plea to the Government is not to rely on a centralised system of the kind we saw last year, as that just does not work. There is a lot of good will but it needs to be harnessed and used locally, because that is where it can be used to best effect.

My Lords, I shall focus my brief remarks on the vaccine—the light at the end of this long and very dark tunnel. The Minister is absolutely right that British science has made an enormous contribution to this, and we should be proud of it. It is also an excellent example of public/private partnership, which I have always believed in. However, there are worries. A lot of noble Lords have concentrated on how we speed up the distribution of the vaccine. I endorse the remarks of the noble Lord, Lord McNally, about the use of community pharmacies. We should not leave them out, and we should go for the fastest-possible distribution.

However, what about manufacturing? What are the supply chain problems that limit the amount of vaccine available? I was very struck by an article in this morning’s Financial Times by Gustav Oertzen, who argued that there is a conflict between the public interest in the widest, quickest-possible distribution of the vaccine and the interests of the pharma companies, which want an extended production schedule over as long a time as possible to ensure a payback on their investment. Do the Government recognise this as a problem? If we are to go on a war footing, as the noble Lord, Lord Caine, put it, do we not have to have an honest dialogue with the pharma companies? Ought we not to think about how to incentivise them to produce things more quickly, and, if necessary, would we be prepared, as in wartime, to be more interventionist and have more direct control?

My Lords, as time for scrutiny is so short, I turn to the main area of hope, which is vaccination. Does my noble friend the Minister agree that this Government are likely to be judged by whether they can manage the rollout of the vaccine effectively? The Prime Minister has more or less committed to vaccinating the highest four tiers by the middle of February. If that timetable is not met, excuses will cut no ice, and experience so far does not indicate that matters are proceeding with the urgent ruthlessness that is required.

Unfortunate bureaucratic obstacles, such as requiring vaccinators to be well versed in diversity, were identified weeks ago. Why were this and other similar obstacles not dealt with at once? Why is there not vaccination seven days a week and up to 24 hours a day? That would not require vaccinators to work seven days a week; there is such a thing as flexible working. There is a race between the virus and the vaccine. The victims include our schoolchildren and their life chances, our economy, those stuck in cramped urban homes and those suffering from cancer and other health conditions, so we must have a more rapid rollout.

The health department’s plan is too slow and centralised. Why did it not start injecting the AstraZeneca vaccine until Monday? Every day matters. We need to bring in the private sector, private doctors and hospitals, and of course private pharmacies, as many have said. These people, who run small businesses, will work day and night and together can deliver millions of doses. They can also charge; many people will be prepared to pay for a dose without affecting the NHS rollout. AstraZeneca has indicated that it could gear up supply. We need to bring in tens of thousands of Army members, some to administer jabs and others to organise them.

We need more action and less self-congratulation. I hope that my noble friend the Minister realises the seriousness of this situation.

My Lords, once again I congratulate Adam Wagner, the human rights barrister, on analysing and explaining all these coronavirus regulations. At the moment, he is perhaps the only person in the country who can make sense of this variety of regulations; he is doing a huge public service.

The tier system was meant to clear things up. It did at first, but now the situation is even more complicated. It is like a jigsaw puzzle but, however much we like jigsaw puzzles, I think we would probably prefer our facts clear and sharp. These regulations affect the life and liberty of every person in the UK; we really need to understand them properly. So do the police, who have to implement them. Instead of being presented with rules that are clear and obvious, we are being presented with a mess of snakes that we cannot untangle. It would be much more coherent if each new piece of legislation, instead of amending previous legislation, simply revoked all the regulations and introduced new ones. That would improve things because, instead of gathering up dozens of snippets and trying to omit or insert bits and bobs all over the place, we would just be able to read it very simply.

I have a particular question for the Minister. I had an email today from a Green Party city councillor in Lancaster, Tim Dant, who had had serious complaints from two local residents about the Government’s U-turn on the Pfizer vaccination programme. Both concerned people in their 80s who had the first dose of the vaccine and were going to have the second one but their appointment was cancelled. Both pointed out that the process of setting up and then cancelling must have been an expensive waste of precious resources, and they are now frustrated and confused about how vulnerable they are to being infected by Covid. Could the Minister please explain that to me?

My Lords, it is absolutely essential that we put the health of our citizens first. The economic impact of the new restrictions is significant. We have to ensure that firms have the cash flow to make it through and that they have a clear line of sight that the support will continue, including the furlough scheme possibly being extended until June. I can say as president of the CBI that British business stands ready to play its full part in the vaccine rollout, increasing massive rapid testing and acting flexibly to support employees, particularly with regard to their mental health.

The vaccines Minister, Nadhim Zahawi, said that 99% of deaths could be stopped by vaccinating the top nine priority groups laid down by the JCVI. The Government have said that there is no shortage of glass vials, for example, and AstraZeneca and Pfizer have said that they can supply vaccines fast enough. The Government have set the target of 13.9 million people to be vaccinated by 15 February, yet the Tony Blair Institute for Global Change recently issued a report saying that the UK could have access to 3 million doses a week by the end of January, 4 million a week by the end of February and 5 million a week by the end of March, so it must have the ability to distribute those. It should be all hands on deck: hospitals, healthcare facilities, car parks, warehouses, offices, everything, including the Armed Forces, which were brilliant with the Nightingale hospitals, and, as I said earlier, businesses—we are all standing by to help.

I want to ask the Minister about airport testing. Nine months after business and the aviation industry were crying out for testing on arrival and before boarding planes, the Prime Minister has finally admitted this week that measures will be brought in. Tests need to be taken 72 hours before departure, as is done in many other countries. Heathrow’s chief executive, John Holland-Kaye, has said that there should be a common international standard. For the first time, Paris has overtaken Heathrow. Let us act on this quickly now.

My Lords, I agree with noble Lords that this is indeed a sombre time, with the highest rate of infection and loss of life and intense pressure on our NHS staff and services. I add my voice to the call for mandatory masking, which must be made freely available. I thank Edmund Yeo for his constant supply of masks, which I have been able to distribute among vulnerable women.

I ask the House’s indulgence to focus today specifically on people of Bangladeshi heritage, who are most excessively affected throughout this pandemic—notwithstanding my respect and concern for all those who have lost their lives or are seriously unwell and facing multiple difficulties as a result of these regulations. Consultant doctor Abdul Mabud Chowdhury was the first GP to lose his life to Covid. His family have continued a commendable campaign for safe practices in the NHS for all staff. Every day, I am notified of friends and neighbours of Bangladeshi heritage struggling with socioeconomic conditions alongside reports of Covid symptoms, self-isolation, hospital admission and, tragically, deaths.

I have spoken repeatedly to the Minister and asked him in this Chamber to explain what he and his department are doing to prevent and mitigate these untold sufferings. Noble Lords will agree that we have made colossal advances in data collection and analysis, or the vaccine simply would not have been developed so rapidly. Given that we have known for many months about the disproportionate impact on people of Bangladeshi heritage, has data has been collected on the numbers of reported Covid infections, particularly with the new variations? How many children are affected and what are their ages? How many are men and how many women, and what are their ages? What underlying conditions do they have? How many are self-isolating and how many infections and deaths are there within specific groups? I am deeply concerned not to see any adequate targeted communications under these extenuating circumstances. Will the Minister undertake to share with me and other noble Lords the Government’s strategy and implementation plan to address these issues as a matter of the gravest urgency?

My Lords, I believe that these measures are necessary. I welcome the fulsome support of opposition parties. The weeks ahead are going to be punctuated by further bouts of depressing news. The more that individuals stick to the guidance and instructions, the better. However, as more and more individuals are vaccinated, as I was nearly four weeks ago, there will be growing interest in how the lockdown rules will be changed or relaxed. The Government have made clear and, indeed, trumpeted the importance of vaccination as the route out of lockdown and the damage being done to the economy and society.

It will soon be essential to announce the relaxation of policy. It will presumably lie somewhere between the two extremes—continuing lockdown for all, including those vaccinated, and permitting those who have been vaccinated to return to normal life—but decisions about when and which parts of the economy and education should be opened up will be complex. This must not be a matter for last-minute announcement and muddle. The need for government guidance is already clear; it needs addressing and announcing now, or as soon as data is available, and, I hope, with an agreed approach by all devolved Administrations. It is for the Government to be seen for once to be on the front foot, ahead of the game, to let us all know—and those vaccinated in particular—when we can play our “get out of jail” card for freedom.

My Lords, I am delighted to follow the noble and gallant Lord, Lord Craig, and I do so with a degree of envy: I long to have my vaccine so that I can come back and be in the Chamber with those who are there now. I spent most of the time when we sat from July almost until Christmas in the Chamber and I miss it. I disagree, gently but firmly, with my noble friends Lord Randall and Lady Wheatcroft: we need an effective Parliament, and that means we need Members in the Chamber. It is essential. Even as we have a hybrid Parliament, which is only a one-dimensional Parliament, there must be Members in the Chamber.

These are dark and difficult times for the House, but I also want to refer to something else. Before he said Prayers today, the right reverend Prelate the Bishop of Rochester said that our thoughts were with those of our parliamentary colleagues in Washington at the moment. Indeed they should be, and we have a wonderful opportunity to demonstrate how democracy really can work, by working together across party. I make an appeal through my noble friend the Minister—and I beg him to pass this on to the Prime Minister—to bring the leader of the Opposition on board. I am not advocating a national Government, much as I would personally like one, but I believe that the leader of the Opposition, who has demonstrated real statesmanship, should be at the table. There should be daily meetings between him and the Prime Minister, and he should be involved in committees such as COBRA. We are fighting this as a society, and it must be a united society—a united nation—and this would do much to achieve that.

My Lords, when vaccines are developed, they go through clinical trials to check on efficacy and any damaging side-effects. What would happen if the same process were applied to lockdowns and other draconian measures? We would have to ask: do they work? Do the serious side-effects outweigh the alleged benefits of keeping Covid at bay? The Government will not be able to answer this, because they have not even asked the questions. Indeed, when one asks such questions, one is often met with a sneer—“Oh, you are one of those lockdown sceptics”—but despite the tragic numbers dying and our being told that the Government have no choice, I do not think that any of us should be cowed into fatalistically accepting the efficacy or morality of this perpetual lockdown strategy. There are always other options.

Scepticism is branded dangerous and irresponsible. Some are even lobbying big tech to censor sceptical questioning, demonised as “misinformation”. If this Government declare that it is illegal to leave one’s home without a reasonable excuse and accumulate a colossal amount of state power, with unintended but devastating collateral damage inflicted on society, it would be irresponsible not to ask sceptical questions. Remember that scepticism, historically, is what has driven scientific progress, medical breakthroughs and radical change. We are urged to listen to medical experts, so let me quote CMO Chris Whitty, speaking at a parliamentary committee last month:

“At a certain point, society, through political leaders, elected Ministers and Parliament, will say that this level of risk is a level of risk that we think it is appropriate to tolerate”.

This is a key debate, moving forward, and I urge the Government to avoid fear-mongering or boosterism, but to have the courage to admit what they know and what they do not know, and make sure they have the means to be held to account. Will the Minister tell us precisely what measure is being used to decide when freedoms will be restored? How can the public know what success looks like if the goalposts change? Is it cases, hospital admissions, deaths, how we deal with so many catching Covid in hospitals, or the numbers of vaccines? What is it that gives us that hope, really?

There seem to be some irrational aspects to this, with 80 year-olds I know demoralised and confused that they have not received even a letter, never mind a jab, and others demoralised that they have not had the second jab. Finally, if the Government can tear up the rulebook on civil liberties, surely they can tear up the rulebook on risk-adverse regulations when it comes to vaccines. It is the only hope. Be brave.

My Lords, the four-tier regulations have been overtaken by the England-wide lockdown. Suddenly, from being in tier 2, we in North Yorkshire found ourselves in lockdown, with so many difficulties and insecurities to cope with. With the devastating news yesterday that 1,000 people died in 24 hours, people are realising how serious the problem has become.

The hope is that vaccination will get on top of this disastrous epidemic. The instructions given when having the Pfizer vaccine are clear:

“You will receive two injections, given 21 days apart. Protection against Covid-19 disease may not be effective until at least seven days after the second dose.”

The Government are now saying that the injections should be given three months apart. This is against the recommendations of the manufacturers and the World Health Organization. Vulnerable elderly people are concerned and confused. What a muddle. Also, many trained medical people have offered to give injections but have been put off by the ridiculous, bureaucratic forms they are asked to sign.

I congratulate the laboratory workers, who are often forgotten, on working so hard in a short time to produce these vaccines, and thank them for doing so. So many people are working, and the volunteers should also be congratulated.

My Lords, yet again we are rubber-stamping regulations imposing draconian restrictions aiming to protect the country in a war that has already caused countless casualties. Despite ever stricter lockdowns, the virus has accelerated. People are not objects that can be put in a box and locked away. Where is the impact assessment on human lives, or a matrix that demonstrates how each element works? Why are we not pulling out all the stops to win this race? Test and trace is not doing the trick. Winter pressures and an ageing population are against us, and serious staff shortages have reduced NHS capacity below normal winter levels, with Nightingales underused. Can my noble friend explain precisely how the Government are removing bureaucratic delays preventing retired NHS staff returning?

It is almost beyond belief that we do not require a negative Covid test before UK entry. The only way forward seems to be vaccination. We keep hearing about delays in training, approvals or distribution logistics, but Israel has managed to get moving much faster than us. Its medical and military operations have left the UK and EU countries lagging behind.

My mother is 88, with COPD, heart problems and other risk factors, but has not been called. All military medical support units, pharmacies, dental staff, first aiders and any others trained in administering injections must be fully mobilised. Also, the virus does not stop spreading at night, so where are the plans for 24/7 vaccinations? Could we consider vaccinating all care home residents through the night in those homes and free up daytime hours for other vulnerable individuals? Medical staff, care home staff and teachers should all be receiving vaccines. We must win this war. We cannot keep halting cancer treatments and other urgent treatments and throwing money at people and businesses that are paralysed by this virus. We have a vaccine, and nothing is more important than doing everything possible to deliver it.

My Lords, many noble Lords have already raised concerns and suggestions about the vaccine roll-out. I invite the Minister, when summing up, to cheer us all up, because we have seen the extraordinary capacity of this country to be world-beating in becoming the first country able to vaccinate people. What are the Government doing to understand where the blockages are? Has he been able to pinpoint what Israel has been doing successfully, with the extraordinary achievements in that country? What can the Government bring in short order to this situation? They have shown that they can act quickly. What will change in the coming weeks to speed this up?

My second question is about the Government’s approach to lockdown once the goal of vaccinating the four most vulnerable groups has been reached, a target set for the middle of February. Hopefully, once that has happened, the pressure on the NHS will be very quickly lessened, because far fewer of those getting the virus will require the same level of hospital treatment. Surely then the R number could remain very high—far above one—yet the pressure be alleviated. Are the Government working on the basis that at that point they will relax these restrictions, start to deal with the huge damage that has been caused by the lockdown, and bring back the benefit of being able to move around freely again?

My Lords, I fully support these regulations to ensure that appropriate steps are taken in the right place to limit the spread of the virus. The places that need especial care are hospitals, particularly intensive care units. What progress has been made to reduce the number of their staff who are very vulnerable to the virus, such as those with type 2 diabetes, high blood pressure and other conditions that are caused by or aggravated by obesity? This measure is difficult with the present staff shortages, which are worsened by illness. Taking the long-term view with the prospect of future pandemics, how much progress has there been with the Prime Minister’s welcome initiative to reduce obesity in the 67% of the population of this country who are in this particular danger?

There is huge support out there for the lockdown, although everyone I know is asking, as am I, why our borders are open, because one thing is certain: if Donald Trump is allowed in during the lockdown, there will be a significant problem for the Government with public opinion.

Looking at the pace at which they are vaccinating, what is Israel doing right that we are not? Can I suggest some reasons to the Minister? My own GP service today is vaccinating for flu but is not allowed to vaccinate for Covid because of new Public Health England rules. I suggest that this is the same reason why pharmacies are not being allowed to vaccinate. It is not because they cannot, since they are vaccinating for flu at the moment, but because of Public Health England rules relating to Covid. I know a nurse, retired after 30 years, who has been re-recruited this week as an assistant and is allowed to vaccinate for flu, but despite that 30 years is not allowed to vaccinate for Covid because of Public Health England rules. Who will get on top of Public Health England? It strikes me that people keep attacking the Government, but the problem I have is with some of the actions of Public Health England, and this demonstrates that. This overcautious approach is delaying and will delay further.

I end not by talking about what is rightly going on with the prioritising of the most elderly and vulnerable, because that is appropriate. In the next stage, I predict that Public Health England will not allow workplaces to vaccinate but will allow the employer to take on the costs, the hassle and the administration. In an area such as the district I live in, 10,000 could be done in a day if they were done in the large workplaces. Then we would really be getting on top of the problem. Which Minister will take on and sort out the bureaucracy from Public Health England?

My Lords, I thank our NHS and care home staff, who are now in the eye of this storm, for all that they do. I agree with other noble Lords about testing at ports and points of entry. Look at the experiences of Australia and New Zealand. It is extraordinary that we have not done this already. I also agree with the noble Lord, Lord Campbell-Savours, about the wearing of masks. We must err far closer to clamping down on this disease and further away from freedom in this regard, and do so very quickly.

Vaccinations are obviously key to all this, and I agree with others who pointed to the experience of Israel. If there is no shortage of supply, and I would encourage the Minister to make clear that there is not, why are we not making more progress than we are currently seeing? We certainly need to use community pharmacists and we should be welcoming volunteers, not making it more difficult for them with some of the extraordinary red tape in the training and questions about deradicalisation and so on. It is monstrous and makes no sense at all.

I hope that the Minister can provide some clarity, disregard his script and tell us why we are not having night clinics and why we are not working at inoculating every day of every week and using every conceivable site for inoculation now? That is what we must do. The nation is crying out for progress on this joint endeavour, standing ready to help in every conceivable way. The Government really need to step up the programme of vaccination, to do so at pace, and to do so now.

My Lords, these regulations are, unfortunately, necessary; we are where we are. I wish to make four brief points in the time available.

First, we require a national mobilisation on a wartime footing, as many noble Peers have said, to accelerate the rollout of vaccines. Israel, as previously mentioned by the noble Lord, Lord Bourne, and others, is doing it 10 times faster than us.

Secondly, due to the extreme virulence of the new strain of Covid-19, we need to immediately engage local pharmacies and the independent sector in the vaccine rollout, as many noble Lords have said in this debate.

Thirdly, we need to avoid vaccine nationalism, as witnessed in France, and use any vaccine which is safe and effective. I fear that the Oxford/AstraZeneca vaccine is simply not effective enough to counter the new strain, especially if restricted to one initial dose.

Fourthly and finally, we should mobilise the Nightingale hospitals but be wary of them being used simply as massive vaccination hubs, which can themselves be a source of infection as large numbers of unvaccinated people travel to and from them. The more vaccination is decentralised and broadened out, the better.

My Lords, the Minister has outlined the severity of this third wave of coronavirus and, with over 1,000 deaths yesterday, it is now all too evident in large parts of the United Kingdom. But I disagree with him, along with my noble friend Lord Greaves, about whether this is less serious than in March. The signs were all there well before Christmas and once again SAGE, with other medical and scientific experts, as well as politicians of all parties, said “Please lock down” before Christmas. Regretfully, once again, our Prime Minister delayed and, despite our wonderful clinicians and support staff, we now see the overwhelming of our NHS in London and the south of the country, with other regions following a few short weeks behind. Today, the Health Service Journal reports that hospitals in the Midlands are likely to be overwhelmed within two weeks. We can see the numbers going up in hospitals all over the country.

All eyes are now on the Government, as vaccines begin to be rolled out. With a more transmissible variant spreading across the country, the infection rate spiralling and hospitals under severe pressure, the Government must use this new lockdown to provide time to roll out vaccine support for those who need it, and to build trust with the public to control the virus, so that we can have a realistic route map back to safety and certainty for the future.

As a nation, we have never sought to vaccinate so many people in such a short time. To ask hospitals, GPs and other health trusts to manage this while they simultaneously try to prevent the NHS being overwhelmed is, frankly, extraordinary and worrying in equal measure, especially in light of the difficulties with barriers to using people such as retired doctors and nurses as vaccinators. Can the Minister say how other volunteers and the military will be used to get to every small town and village in the country to deliver the vaccine 24/7—and I do mean 24/7? If we need to get to 2 million a week before the end of January, and to 30 million to 40 million by Easter, it has to be at that level. It must be available at the most local level and preferably on every high street, whether in a surgery, pharmacy, village or town hall or sports stadium.

So far, all the evidence points to an urban and suburban process, managed by the NHS for the territory it knows, that assumes people have access to private transport. There are reports of people in Cornwall being asked to travel to Bristol for a vaccine, of hundreds of over-80s queueing for hours in the wet and cold to get into surgeries that are too small, and of short-notice delivery cancellations creating chaos and work for hard-pressed NHS staff.

I heard today of a vaccine hub where cars filled with over-80s queued for about 40 minutes beyond the appointment time because there was no space in the car park. Many of the elderly were too frail to even walk from the car park into the centre. Lots of elderly people who seemed cold were shuffling across the car park and then across a road to get into the hub. The wi-fi was down, so registration had to be done on paper, and it was very difficult to socially distance. That all-important 15-minute period of recovery time to check for adverse reaction was in a marquee where the heaters had broken down. The NHS workers and volunteers were all extremely helpful in doing all they could to improve the situation, but the issue was the logistics, including not understanding that elderly people need extra support before and after—as well as when—they receive their injection.

Why is the logistical expertise of the military not being used to its full extent? They demonstrated with the building of the Nightingale hospitals, and then with mass testing in Liverpool, that their expertise is second to none. We need this organisational burden removed from the NHS. Why has Public Health England announced that there will be no deliveries of vaccines on a Sunday? That immediately reduces the capability, when we have plenty of volunteers available to deliver the vaccine into arms. Why are only large pharmacies being used, rather than providing volunteer support to enable them to manage vaccination in small rural areas and villages?

The Minister rightly welcomes the approval of the Oxford/AstraZeneca vaccine as a game-changer but, as my noble friend Lord Scriven has pointed out, the virus will be with us for a long time. Even yesterday, the Prime Minister was still talking about being out of this by the spring. The Government’s communications with the public have been woeful—always trying to give us a bit of good news, which people inevitably cling to when they are worried. Alternatively, the Government have made decisions too late, making people cross and confused, as with the announcement of this lockdown, which once again meant frustration and further exposure to the new variant virus for children, school staff and their families.

We know from epidemiologists that it is likely that we will have future variants and outbreaks, whether small or large, whether here or abroad, for a long time. We must continue to have a full test, trace and isolate system available to respond to this—preferably locally based, as we know that local trace experts and isolation support are much more effective than call centres. Our own data over the last nine months has shown that.

Countries that have implemented successful test, trace and isolate systems have seen fewer cases and far fewer deaths, and built the trust needed to encourage a culture of voluntary compliance with the rules. An isolation policy will work only with effective long-term local test and trace systems, which have to continue to be in place. Yet the Government are silent on how they are to be used, not just during lockdown but after it. Even after many millions of people have received their vaccine, it will still be necessary to keep infection numbers low if we are to lift restrictions successfully and return to normal life. Can the Minister confirm what plans there are to maintain test, trace and isolate for the longer term, so that we do not repeat the problems of the last 10 months? Will the Government look at paying full wages to those on lower incomes who are self-isolating, to help them manage and not leave home?

This morning, I asked the Lord Privy Seal if she could help with the problems faced by care homes, now that insurance for designated Covid settings is almost impossible to get. Without indemnity cover, they cannot take Covid patients; she referred me back to the noble Lord the Minister. NHS Providers is begging the Treasury to help, as hospital beds need to be freed up, but the Treasury is refusing. Please can the Minister take this up with the Chancellor as a matter of extreme urgency to help with this problem, which is not of the care homes’ own making, and which is now blocking beds in hospitals at exactly the time when they need them released at a time of national crisis? Please will he keep me up to date with progress?

On these Benches, we believe that people want to do all they can to bring Covid-19 under control to keep those who they know and love and our communities safe. I ask the Minister: will decisions, messaging and communicating with the public be more honest, timely and realistic? The vast majority of people want to do the right thing. We all need to work together in this national crisis, and together come out of this third national lockdown back into a safe and secure future, where the safety net is in place in case there are future outbreaks.

So, here we are. If the country is weary, I suspect parliamentarians are too. I am trying to work out how many regulations we have done in the last 10 months; perhaps somebody somewhere might be able to tell us. We have four regulations of increasing relevance before us today; all are post implementation. I declare my interest as the non-executive director of a foundation hospital in London.

We on these Benches will support the regulations. We do so while recognising the devastating impact that restrictions will have on our economy, our way of life, our mental health and the well-being of everybody. If we are to restore freedoms for the future and save lives, we all have to behave as if we are infected. I had some sympathy with the noble Lord, Lord Berkeley, when he talked about that because this virus is out of control.

As before, the Government are reacting later than we would have liked. However, unlike before, we now have the vaccines. The Prime Minister did not mention test and trace in his Statement. I would like to know whether this, which was a game-changer for us in the summer, features in the plans for the next six or seven weeks and thereafter. My noble friends Lord Winston and Lord Reid asked this question, as did the noble Baroness, Lady Jolly, and the noble Lord, Lord Mann.

We can only be devastated by the prospect of weeks and weeks—perhaps longer—of people in isolation feeling anxious and lonely. I think that it will be worse this time. I note that the flow of food and gifts to the front line in our hospitals seems slower in appearing this time than in the spring, when the need is actually greater. Our front-line staff are more exhausted and overwhelmed than they were in the spring, as my noble friend Lord Hunt and the noble Lord, Lord Liddle, said.

We can and must rejoice at every care home staff member and resident vaccinated and every older person made safe. We need to focus on getting our unpaid carers vaccinated. I very much welcome the fact that they are now included as priority 6, but there needs to be some discussion about the implementation of that particular priority. We should rejoice when our paid social carers are vaccinated. We have to get clinical NHS workers, auxiliary staff and teaching staff vaccinated as soon as possible. Only when we know they are safe can we breathe more easily.

In the months following the long lockdown last year, 19.6 million prescriptions for antidepressants were issued—a 4% increase on the same period the year before—to more than 6 million people in England, which is the highest number on record. If we are to support lockdown, we need assurances that mental health services will be fully resourced, will stay open and respond to peoples’ needs throughout the lockdown. Can the Minister clarify the conclusion about the amount of funding for mental health created by his right honourable friend the Prime Minister?

The lockdown will have a huge impact on the well-being of our children. The plan to get children safely back to school is a priority, which is why I believe that it is a priority to vaccinate teachers and school staff as soon as we are able. There are thousands of children out of school in overcrowded, cramped accommodation who are unable to access learning properly from home. There are thousands who still do not have access to technology, as my noble friend Lady Massey said. We need to recognise that Covid has exaggerated the inequalities in our society and that we do not want to return to business as usual as this year moves on. We know that there are children at risk of abuse and violence. Many children face the prospect of being locked in their homes with parents who abuse drink and drugs.

Over 62,000 cases were reported in England yesterday —one in 50 have the virus. We know that it is one in 30 of us here in London. There were 3,300 hospitalisations yesterday and it is going up in every region. There were 2,645 people on ventilators and, tragically, over 1,000 died. According to an official briefing given to the capital’s most senior doctors this afternoon, London’s hospitals are less than two weeks from being overwhelmed by Covid in the best-case scenario.

This is a national emergency. The national lockdown is necessary. As my noble friend Lord Foulkes put it —possibly more robustly than I am doing—we should have locked down sooner. The Commons voted this lockdown through on Twelfth Night, yet in the run-up to Christmas, the alarm bells should have been ringing. The Secretary of State reported on the new strain on 14 December. The Prime Minister learned of the rapid spread of the new variant on 18 December. On 21 December, the Chief Scientific Adviser, Sir Patrick Vallance, said that the new strain was everywhere and would rise after the inevitable mixing at Christmas. SAGE met on 22 December and concluded:

“It is highly unlikely that measures with stringency and adherence in line with the measures in England in November … would be sufficient to maintain R below 1 in the presence of the new variant.”

Here we are, two weeks later, with 500,000 infections and 33,000 hospitalisations since 22 December. Why does the Prime Minister, with all the scientific expertise at his disposal and all the power to make a difference, always seem to be the last to grasp what needs to happen? He has not been short of data. He has been short of judgment and, yet again, we are all paying the price.

We will ultimately be released from these restrictions through vaccination. I pay tribute to everyone involved in helping to distribute and administer the 1.3 million vaccine doses so far. It is a great achievement but, as many noble Lords have said, we need to go further and faster if the Prime Minister’s promise that almost 14 million people will be offered the vaccine by mid-February—that is 2 million doses a week—is to be reached. The many solutions offered by noble Lords today need to be taken on board and considered. I did not know that there was the idea that vaccines would not be delivered on a Sunday. How ridiculous is that? I hope the noble Lord will clarify that that is not the case.

Logistics are key to this. From the front line, a doctor’s surgery in the south of England says:

“My group of practices was initially told we would get our first delivery on 28th December. Then 4th Jan. Then 11th Jan. Now we are ‘6th wave’ and it will be 13th, 14th or 15th Jan. We are raring to go, but have no vaccines. WHY?”

In Waverley—in Jeremy Hunt’s constituency—a massive mess-up with the vaccine, which had been outsourced to a company called Procare, meant that 1,100 vaccine appointments were cancelled because there was a manufacturing error and they did not have the vaccine to administer. Of course there will be teething problems, but anecdotal evidence from the debate today suggests that those teething problems are actually quite significant.

How many of the ordered doses have been manufactured? How many have been delivered to the NHS? How many batches are awaiting clearance from the MHRA regulatory clearing process? It would be fantastic to vaccinate 2 million people a week, but we should not limit our ambitions. As other noble Lords have said, we need to scale up to three, five, six million jabs over the next weeks and months.

As my honourable friend Jonathan Ashworth said yesterday, the rule in politics is that it is always better to underpromise and overdeliver, which is certainly a lesson that the Prime Minister needs to learn. Let us hope that 2 million doses is an underpromise and that the Government aim to overdeliver, because would that not be great? Our big target must be to vaccinate more, particularly among NHS staff. Do we have a clear date by which NHS on the front line will receive the vaccine? They need to know. Not only are they exhausted, but it is a matter of morale. They deserve to know when they will be vaccinated.

We support this lockdown today because we know that we have to reduce transmission. That is why we are asking people to stay at home. Not everybody can work from home: there are 10 million key workers in the United Kingdom, of whom only 14% can work from home. Many are low paid and often have to use public transport to get to work in jobs that, by necessity, involve greater social mixing, and they are exposed to risk. Their workplaces need to remain Covid-secure and they need income support if they have to stay at home.

The British public have done so much over the last year and have made great sacrifices. We are a great country, and our people can and will rise to this occasion. All anyone asks is that the Government do the right thing at the right time: make workplaces Covid-secure; vaccinate health workers as soon as possible; introduce decent sick pay and support to isolate; and roll out a mass vaccination programme like we have never seen before. This is a race against time. We will support this lockdown today.

My Lords, we are debating today the 59th regulation in a restriction round—quite a colossal number. They are unfortunate and regrettable, but they are necessary. This Government are committed to making them the best they can be, and I am extremely grateful to noble Lords for their recommendations and suggestions on the restrictions. Let me trot at pace through a few of the recommendations from noble Lords.

Noble Lords are entirely right that money to isolate is an incredibly important element of the effectiveness of isolation. I reassure noble Lords that we are in active dialogue with 314 local authorities to figure out how to make the isolation payments more effective and mobilise charities’ and local authorities’ support for those who need it.

A number of noble Lords brought up travel restrictions. I completely agree with the noble Lords, Lord Winston and Lord Reid, that international travel has been a source of infection for this country in the first and second waves, and continues to be. The prospect of a South African variant that is even more transmissible than the Kent variant puts a spotlight on that threat of infection. That is why we are working on processing new measures, which will be introduced shortly, for pre-flight testing for travellers to Britain, and we look forward to those being announced shortly.

In the meantime, I have to break it to the noble Baroness, Lady Jolly, that test-to-release, which she mentioned, was introduced on 15 December. I get a weekly update on it, and I can reassure her that the evidence to date suggests that the isolation of travellers on test-to-release is much more effective using the testing mechanism than it was on the isolation mechanism. We will probe those figures very carefully, but I am optimistic that that scheme has worked well.

My noble friend Lord Lancaster mentioned the tiering system. It is a grim prospect, but I warn noble Lords that we are unlikely to spring out of this national lockdown straight into the sunny uplands, and a new tiering system will likely be necessary. The right honourable Secretary of State for the Home Office spoke this morning on the radio about the kinds of penalties that she has instructed the police to apply. I reassure the noble Lord, Lord Berkeley, that our approach to the lockdown is effective and implementing all the regulations necessary.

To my noble friend Lady Altmann and to the noble Lord, Lord Foulkes, and others who asked about test and trace, may I just be crystal clear? I sometimes find I am repeating myself on this matter. In the last week of the year, test and trace identified 450,000 people who had Covid and isolated another 350,000 of their contacts. That is an absolutely incredible achievement. No other country has a scheme like it, and it has become repetitive and inaccurate to suggest that it is not making any impact.

The noble Baroness, Lady Thornton, and others asked where community testing might be going. Of course, during a lockdown, the community testing component is not necessary, but I reassure the noble Lord, Lord McNally, and others that we are very committed to it. We are in dialogue with councils at all levels about how they might use community testing, and with schools about once the lockdown is lifted.

A number of noble Lords looked beyond this lockdown to the future. The noble Baronesses, Lady Finlay and Lady Bennett, asked about ventilation and workspaces. That is exactly where our heads are at the moment; we are trying to understand and think through the implications of this pandemic. The reality is that there will be no quick transition. We shall have to think about workplace hygiene. My noble friend Lady Wheatcroft asked how workspaces will have to be reimagined. I very much welcome the suggestions, evidence and recommendations of noble Lords in this area; it is something that both BEIS and DHSC are looking at very closely, and I look forward to updating the House on that.

A number of noble Lords’ questions and comments were about the vaccines, not the regulations. Since that is the hot subject, let me address it directly. I reassure noble Lords that, whatever they may read in the papers about problems and blockages, the rollout of the vaccines is being done at pace. It includes the Army; volunteers are being mobilised, GPs and pharmacies are being recruited and we will hit the numbers that the Prime Minister has committed to. The noble Baroness, Lady Masham, rightly thanked factory workers and others involved in the process of manufacturing and logistical support in supplying these vaccines. It is an incredible process to put together 30 million or 40 million vaccines before the spring at pace in highly delicate, secure and hygienic environments, and to get them to the front line in a way that is temperature-controlled and fulfils the commitment to the MHRA.

Patient safety must be our priority. That is why it is done in a thoughtful fashion. While we are very grateful to BrewDog and others for innovative ideas for how to roll out the vaccine—through the middle of the night and what have you—we must get it right. You cannot jab someone’s arm and inject them with a potent vaccine without being absolutely sure that it is the right person in the right place, the right vaccine and in the right conditions. Getting all those stars aligned requires an enormous logistical process, and we are absolutely determined to get it right. We also must have availability of vaccine. I thank Pfizer and AstraZeneca for the enormous lengths that they have gone to to provide millions of doses of vaccines, but it takes time to deliver. At the moment, it is not the NHS that is the limiting factor but the provision of the vaccines.

To achieve that provision, we will deliver through hospitals, GPs, pharmacies and mass centres. Today, we have 107 hospital sites online, and there will be a further 100 by the end of the week; there are 595 GP-led sites, and there will be a further 180 by the end of the week. The mass centres will be open shortly, and they will have a huge impact on the rollout.

Obviously, the big vaccination centres have hugely more impact than small pharmacies and rural doctors, but that is not to say that those are not being prioritised as well. However, I ask for noble Lords’ consideration: the practical matter of getting a vaccine that has to be temperature controlled and comes in large packs of sometimes up to 1,000 doses to small rural pharmacies, community pharmacies and GP practices in the far-flung parts of Britain is an enormous logistical exercise—we have to balance scale and volume with breadth and the niche interest. I think we are getting it right; we have not forgotten anyone, but there will need to be a little bit of time before we can reach everyone.

A number of noble Lords have talked about cancelled trips to the GPs; I completely recognise and acknowledge those stories. It is true that, sometimes, we have to line people up for appointments, and the delivery of the vaccines, which is an extremely delicate task, has not always proved to be as reliable as we might have hoped. We are seeking to iron that out, and I ask for the forgiveness and forbearance of any pensioners or patients who have had to wait for their vaccine. I reassure noble Lords that, if there are cancelled appointments, it is only because we are trying to make maximum use of the stock of vaccines that we have at the moment.

On the volunteer scheme, I completely and utterly agree with all noble Lords who are frustrated and irritated by the large amount of bureaucracy that this has involved. As the noble Baroness, Lady Watkins, rightly pointed out, we have stamped on some of it, but there is more to do, and I think that there is a lesson to be learned about how the NHS and British Government treat volunteers, and we are making a lot of progress on that already.

To my noble friend Lady Neville-Rolfe and others who asked whether we are using the Army, I say yes we are using the Army.

On dentists, I reassure my noble friend Lord Balfe that all those with direct patient care are prioritised for the vaccine, whether they are dentists or dentists’ assistants.

I do not recognise so well the stories of the noble Baroness, Lady Brinton, about logistical problems, with car parks and freezing GP surgeries. I am on a vibrant WhatsApp group with MPs, and I am deluged with hundreds and hundreds of positive stories of quick, polite and accessible service. I would be very grateful if the noble Baroness would write to me with her anecdote; I would be glad to follow it up.

On therapeutics, I am grateful to my noble friend Lord Moynihan for his quite accurate remarks on the importance not of vaccines but of the therapeutics that can assist in recovery. We are grateful to RECOVERY and REMAP, the two big clinical trial schemes that have proved to be a massive global success—and, without giving the game away, I am hopeful for more good news from that direction shortly.

I remind my noble friend Lord Cormack that, although he may get his vaccine soon, immunity does not necessarily mean sterility. While he himself may take the vaccine and, therefore, be protected from the impact of Covid, he may be the carrier of the virus. To those, like myself and my noble friend Lady Penn, who are not candidates for the priority list for the vaccine, we would be extremely wary of anyone who has had the vaccine but is still a carrier of the virus. That is a really important policy point that we will have to wrestle with in months ahead.

I reassure the noble Lord, Lord Truscott, that the Oxford vaccine is extremely good, and just as good as all the others.

Lastly, on the NHS, I completely agree with all those noble Lords who pointed out that the second, or potentially the third, time round is tougher for the NHS: there are mental health issues and capacity issues, and there is the sheer miserableness of being back on the front line again. I live opposite University College London Hospital; the sound of the ambulances arriving through the night wakes me all the time. It used to be once or twice a night, but it has been a dozen times a night for the last month, which is a sombre reminder for me, personally, of the front-line experience of those who work in the NHS. I profoundly thank all those who are spending a tough winter looking after those with Covid and other conditions. We are working hard to get volunteers to support the front line, but I acknowledge that that has been slower than perhaps expected. Some £15 million has been allocated for mental health support for those in the NHS, but more can and should be done, and we are consistently working on it.

By way of winding up, I say that these restrictions are extremely regrettable. The noble Baroness, Lady Fox, demonstrates her anger and frustration; I do not really agree with much of what she says, but the emotional frustration she shares is well expressed, I think. However, I cannot hide from the Chamber that the new variants that have developed in Kent, South Africa and elsewhere present a tough challenge for all of us. We have learned an enormous amount about how to contain the virus and we have a huge amount of hope from the vaccine, but we have a long way to go.

Motion agreed.