Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020 — House of Lords, 2020-12-01
Topic: Health
Lucy Neville-Rolfe (Conservative, Centre-right): My Lords, it is a pleasure to follow the noble Baroness, Lady Watkins of Tavistock, with her nursing expertise and her kind reference to my regret amendment on the Order Paper. This is concerned with SI 1374, which imposes restrictions on gatherings and businesses in England in tiers 1 to 3. I have an interest, living in Wiltshire and working in London, both of which should probably not be in tier 2 at all However, my main interest and the focus of my amendment is in cost-benefit analysis as a powerful driver of good public policy. I first learnt of its merits while at university, studying the case for the Victoria line, which turned out to be so much more beneficial than we expected. I am dismayed that the regulations did not include a regulatory impact assessment outlining, as a minimum, the economic impact of each of the tiers and hence explaining the choices that the Government are proposing. This is apparently because they are "temporary measures". This is a disappointing claim. Inaction on such grounds may have been just about excusable in March, but not now. Worse, the analysis belatedly published yesterday of the health, economic and social effects of Covid-19 and the approach to tiering barely helps at all. A proper cost-benefit analysis—impact assessment, call it what you will—should be guiding the Government’s decisions and should not be cobbled together to placate Parliament after the event All policy decisions in government need to be informed by an analysis of the costs and benefits, which necessarily involves giving both numerical values. Sometimes this is a challenge, but with ingenuity we can ascribe values or a range of values to outcomes based on real-life analogy or widely accepted decisions. We need to measure not only the immediate, first-level effects, but those of a second order. To give an example, if hospital appointments are cancelled because of our Covid policy, we know that there will be problems, including extra deaths from diseases such as cancer and heart disease. This needs to be quantified. The responsible approach is not to ignore or downplay such inevitable consequences of our policy, but to put the costs into the equation Although the Government have not produced a proper analysis of the costs and benefits of their policy, others—distinguished others—have done so. I refer to the paper of August 2020 by Miles, Stedman and Heald. I shall summarise and simplify: they find that the costs of the Government’s policy on lockdown 1 probably amount to between three and 10 times the value of the benefits. Does that not give us some cause to reflect One problem is that the Government have not even claimed to seek the optimum overall outcome. Instead they have, from the start, been fixated on Covid only—the illnesses and deaths it causes, and the impact on bed capacity in the NHS. Of course analysis of the kind I advocate is difficult, but those of us in business or involved in regulation know that it is always worth making estimates and perhaps giving ranges, as the ONS has done for the economy. Its work is summarised in section 7 of the government analysis. It is terrifying: we are looking forward to, at best, flat output by 2025-26 and, at worst, minus 6% compared to the outlook in March. The adverse effects include the destruction of capital and knowledge from business failure, loss of human capital from unemployment and so on. Take restaurants and pubs: they have invested hugely to allow groups of people to dine together, with social distancing, ventilation and contact tracing, yet a cost-benefit analysis appears not to have been done weighing the slight increase in infection in tiers 2 and 3 against the risk of their financial failure. In that case, the response to criticism has been to promise the businesses more money, but that could be a road to fiscal ruin The next category of loss is health outcomes, addressed in part 5 of the analysis. There is much talk of the health system being overwhelmed over the winter but, if true, why have hospitals not been preparing for this since April, building extra capacity, taking on extra staff—as promised in our manifesto—and serving as a beacon of good practice We also need to look at the social effects of Covid policy. There have been some positives in the Government’s approach, such as bubbles for single relatives and the continuation of schools and childcare, which the Minister rightly emphasised. But the list of negatives, all of which need to be costed, gets longer: care home rules leaving desperate children unable to connect with their parents; partners of pregnant women banned from scans; grandparents unable to see their children and grandchildren; the bankrupting of small businessmen in their 50s who are unlikely ever to get work elsewhere; and the special problems for the disabled, as was explained by the noble Baroness, Lady Brinton Finally, we need to consider the money that has been misspent and add that. Top of my list is test, track and trace, and that is £22 billion according to the Treasury spending review and another £15 billion next year. The Government should reflect on the fact that a loyal and committed supporter of theirs is so disappointed in their policies on this vital matter of proper cost-benefit analysis. It is my present intention to divide the House on an amendment with which I think a majority of the House will privately agree.