My Lords, I very much agree with what the Minister said about the importance of self-isolation. I note that emphasis is given in the winter plan to the importance of isolation in relation to breaking transmissions. The issue I have is that there is a proportion of the population who find self-isolation very difficult, and there are legitimate reasons for that. I have been studying TUC research, which shows that 24% of low-paid workers say they cannot afford to take time off for sickness, as opposed to 6% of high-paid workers. It reckons that only 35% of low-paid workers get full sick pay, as opposed to 80% of high-paid workers, defined as those earning more than £50,000 per annum. Statutory sick pay is only £96.35, less than any other OECD country. It is reckoned that 72% of low-paid workers cannot work from home, compared with 20% of high-paid workers.
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The Minister may respond by saying, “Ah, but we have a self-isolation payment scheme”, and we do, but my understanding is that 34% of applications to councils are being rejected because councils are worried about running out of funds. In areas with a high proportion of low-paid workers who cannot work from home, the approval rate is even lower. Do the Government recognise that we have a serious problem here? If we have to tighten self-isolation rules again—indeed, even under the current, voluntary system—will this be addressed?
I relate this to work by SAGE in interpreting differential health outcomes among minority-ethnic groups in the first and second waves. As it pointed out,
“all minority ethnic groups … have been at higher risk of mortality”
during the pandemic, but there is
“a particular intensity in this pattern of differential mortality among Bangladeshi and Pakistani groups”.
They
“suffer severe, debilitating underlying conditions at a younger age and more often than other minority ethnic groups due to health inequalities. They are more likely to have two or more health conditions that interact to produce greater risk of death from Covid”.
A number of factors provide some explanation, including:
“Practical difficulties of access … to … NHS Track and Trace services due to … site locations, difficulties taking time off … for testing”,
and real fear of
“loss of livelihood if required to self-isolate”,
as I have mentioned.
As SAGE said at the time:
“Furlough, self-employment and business support schemes have helped thriving businesses and better-off self-employed people the most, rather than those in the most hard pressed situations”.
It concluded:
“Unaffordability of taking unpaid time off, or concerns about the effect of absences on job security”
will need to be tackled. How is this to be tackled?
I will comment on the removal of the requirement on children to self-isolate when they have had close contact with a person who has tested positive. The Government argue:
“At present those under 18 are unable to be vaccinated”—
that has obviously changed since the regulations were published—
“but have experienced a significant impact on their social and educational development as well as their physical and mental health through having to self-isolate. Removing the requirement to self-isolate will significantly improve a range of outcomes for this cohort.”
I do not disagree with that at all, but have our schools, in particular, been made as safe as possible? Recently, Independent SAGE pointed out that many of the recommendations it made about schools more than a year ago are still “highly relevant” today,
“including advice on bubbles, distancing, ventilation, testing and support for staff and students, particularly students from deprived communities.”
As it says, not enough progress has been made.
I am glad to see that on page 18 of the winter plan there is a section on ventilation where the Government lay out five ways in which they are going to
“support improved ventilation in key settings”.
They refer to the public sector estate and evidence an initiative in 30 Bradford schools. Will they go further? At the moment, my understanding is that many schools are very concerned about the lack of ventilation equipment. They will not always be able to afford the cost of sorting this out, which sometimes can be very high. It goes with the territory: having removed the requirement on children to self-isolate, which I fully understand, surely we need to do more in relation to school ventilation. I know we will come to debate the winter plan later in the week, but one of my questions is whether there will be some resource available to help schools improve ventilation.