Private Notice Question
We continue to see Covid-19 case rates and hospitalisations rise in all age groups, with the largest increases in hospitalisations and ICU admissions in those aged 75 and older. A large proportion of those hospitalised are admitted for reasons other than Covid. However, Covid is identified due to the increase in case rates in the community and the high rates of testing in hospital, including among those with no respiratory symptoms. Current data does not point to cases becoming more severe.
My Lords, with a stark rise in infections, many people—particularly the clinically vulnerable, carers and older people—are feeling anxious, yet the Government have been noticeably silent, perhaps being somewhat distracted. We might be through the worst of Covid but evidently it has not gone away; individuals, organisation and businesses still want guidance. I have two questions for the Minister. Are the Government planning any campaigns, perhaps involving scientists and others, to highlight current risks and to encourage the take up of booster jabs? Are there plans to reintroduce mandatory mask wearing in hospitals, which the chair of the JCVI considers sensible?
I have to strongly disagree with the noble Baroness when she says that the Government are doing nothing. We are reliant on the UKHSA, which monitors rates and gives us advice, along with the JCVI. In my briefing from the UKHSA, it said it is continuing to monitor cases. As many noble Lords will remember, when we announced the living with Covid strategy we said that we are always ready to stand up measures should case rates rise so much that our health system was under pressure. We managed to break the link between infections and hospitalisations and hospitalisations and death; if that gets out of control then of course we will stand up the measures that we had previously.
The noble Lord will be aware of the different balances and trade-offs that the Government have to consider. At one stage, I think we spent £2 billion in a short period on testing, and a number of people in the health system said that surely that money would be better spent elsewhere, given the backlog due to lockdown. It is always a difficult trade-off on where you spend the money. At the moment, there are people who are still eligible for free tests: certain social and healthcare workers, and also people visiting and some carers. All this will continue to be monitored. Should the number of cases spiral out of control, clearly we would look to reintroduce free testing at some stage, should that be needed.
My noble friend raises a very important question. We are waiting for advice from the JCVI, coming later this week, on the autumn programme. There have been various reports, but we are waiting for confirmation of whether it will be the existing cohort of 75 and over, 70 and over, or whether it will be given to wider groups. That is being considered and will be announced later this week.
My Lords, the Minister mentioned £2 billion being spent in a month on Covid tests, which includes PCR tests as well. What proportion of that £2 billion was spent on lateral flow tests? If necessary, looking down the road to this winter, are the Government prepared with vaccines, free lateral flow tests for businesses and citizens, and the antiviral programme? Are we ready just in case?
We continue to monitor the situation. The Secretary of State and I have regular meetings with the UKHSA, which tells us about the various issues of concern. Noble Lords will know about the outbreak of monkeypox in certain communities and the discovery of the polio vaccine in sewage, though not leading to cases. Clearly, we constantly talk about Covid cases. We are monitoring numbers, and the UKHSA looks at the ONS numbers as well. We are planning for the autumn, but we also have plans should the number of infections start leading to hospitalisations and possibly deaths.
My Lords, my noble friend Lady Merron is absolutely right: this appears to be creeping up on the Government unawares. The level is going up and is particularly high in Scotland. The last time around, there was a lot of confusion, because different reactions were evident in Scotland, Wales, Northern Ireland and England. In order to deal with this quickly and in a co-ordinated way, can I ask the Minister to get together the Chief Medical Officers of all four countries as quickly as possible to come up with a plan?
I am sure the noble Lord will have been in meetings with the devolved Administrations; sometimes they want to go their own way. For example, when we reduced some of the measures in England, the devolved Administrations were sceptical of what we had done. When the data showed that the measures left in place in Scotland were no more effective than us removing some of those restrictions, it demonstrated exactly why, although we talk to the devolved Administrations all the time, we also respect the devolved settlements. We have to agree to disagree at times.
My Lords, does my noble friend agree that we have lived with flu all our lives? I completely agree with his assertion that if this illness is not proving more deadly than illnesses we have lived with for a long time, what would be the purpose of upsetting the economic recovery and causing so much extra cost to the public purse—unless, as he rightly says, serious hospitalisation cases and deaths were to increase suddenly?
My noble friend makes a very important point. You always have to look at these things in the round and you have to look at the trade-offs. Many noble Lords will recognise that, when we went into lockdown, there were build-ups in many parts of the NHS backlog and an increase in people suffering from mental health issues—the numbers were even larger than they were before—so clearly, we have to look at this as a trade-off. We have a living with Covid strategy. We constantly get updated by the UKHSA, which is looking at all this data. We are ready to stand up should we need to.
My Lords, the recent welcome inroads into NHS waiting lists are now being reversed. What plans do the Government have to ensure that, as Covid pressures mount, over the winter in particular, crucial NHS services and diagnoses are sustained—particularly, for example, early diagnoses of cancers?
The noble and gallant Lord makes a very important point: we have to continue with the living with Covid strategy, and keep an eye on the Covid cases, but also be aware that we need to clear the backlog, and that people have missed appointments. One of the things we are doing is looking more at diagnostics. Many noble Lords will be aware that about 80% of the waiting list is people waiting for diagnosis. Of those waiting for surgery, about 80% of them do not need to stay overnight in hospital. We want to make sure that we get the right balance between monitoring what is going on with Covid and at the same time clearing the backlog.
My Lords, I declare my interest as in the register as a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust. Following on from the last two questions, last year, the Government awarded £6 billion extra to the NHS to deal with Covid cost pressures. There was an assumption that there would be no Covid in the NHS by June, and all funding stopped. In the light of rising cases and the issues caused by the pressures, will the Government reinstate NHS Covid money? If not, this will eat into the day-to-day budgets of our NHS.
As I said, we are keeping everything under review. We called our strategy Living with Covid-19 as opposed to “We’ve Got Over Covid-19” because we knew it could come back at any time. We have seen that, with the omicron variant, some medication is less effective. We continue to monitor that, and we are ready to stand up the measures that may be needed if the number of cases dictates that, on the advice of the JCVI and the UKHSA.
We are finding that vaccination is clearly the best way to break the link between catching Covid and hospitalisation. Sadly, a large part of our population still has not been vaccinated. Even with the third booster, 80% of that age group have come forward but 20% of the older age group still have not done so. We are trying to target groups that have not yet been vaccinated to make sure that we offer them the best protection possible.
Undoubtedly there will be an inquiry; in fact, the Government announced that there would be one. There will also be lots of independent inquiries and academics writing about what different countries got right and got wrong. When speaking to my friends who are Health Ministers in other countries, we all say that, looking back, there are things that we could have done differently, in various ways, if we had had that knowledge. But we also have to be very careful about the fallacy of hindsight, and of saying that we would have acted differently had we been in that situation. We can learn from hindsight, and we need to make sure that we do so for future pandemics.
My Lords, will the Minister take up the offer made by the noble Lord, Lord Foulkes, of a meeting of the four chief medical officers of the regions and nations of the UK to explore further possibilities and solutions in relation to Covid? Only last week in Northern Ireland I heard two separate virologists indicating that to reduce the advisory limit for self-isolation to five days was a dangerous precedent because many people in that group would remain positive, thereby spreading Covid in their local area. In view of that and the rising levels of Covid and other respiratory viruses, will the Minister immediately talk to his ministerial colleagues and set up such a meeting?
One of the things we do in the Department of Health and Social Care is to have regular meetings with our counterparts in the devolved Administrations—all the Ministers do. The noble Lord, Lord Foulkes, shakes his head, but I can tell him that we regularly have meetings with the devolved Administrations. I commit to go back to the department and see who is next due to have a meeting with their devolved counterparts, and ask whether we can put Covid on the agenda.
Does the Minister agree that his dismissal of hindsight is one of the most useless ways of looking at this? Surely with continuing infection like this, hindsight is really important, and we should be looking all the time to see how we can change our practice.
I was making the point that there is the benefit of hindsight but also the fallacy of hindsight. The benefit is that we learn from mistakes we made in the past. We learn from previous actions what worked and did not work, particularly in a local context. Some of my friends in other countries tell me that what we did in England may not necessarily have worked in their country, and vice versa. There is also the fallacy of hindsight, when people say that in the same situation, 18 months or two years ago, they would have done something completely different with the information we had then. That is what is known in social sciences as the fallacy of hindsight.
My Lords, I just want to be clear about something. One mistake we made before was not paying attention earlier to predictive modelling from the NHS. Are we sitting on any information that we are getting from the NHS now about what exponential rate may occur in this virus? Please can the Minister reassure me on that.
We rely on data from the UK Health Security Agency. It monitors this, and looks at ONS data, data on hospitalisations and the capacity of the NHS to absorb the increase in patient numbers if there is one. That is where we take our advice from and that is what would trigger future action, should it be needed.
My Lords, I confirm that there is anxiety about the rise in Covid cases, but less about the virus itself than a worry that politicians might reintroduce some of the over-the-top restrictions that led to such collateral damage during the past two years. Hindsight or not, I make the point that people are nervous. Very specifically, will the Minister comment on the fact that, for example, some care homes are using the rise in Covid cases to lock down homes and carry on restricting visits with relatives—which we now know is damaging the mental and physical health of so many elderly care home residents, who suffered so inhumanely, not from Covid but from our response to it? Will he encourage those care homes to open up and be a bit more confident?
I start by paying tribute to the noble Baroness for her championing of civil liberties issues and making sure there was a debate on them. I will, with pleasure, take back her point on care homes to my ministerial colleagues who are in charge of social care.