The Secretary of State for Health and Social Care (Matt Hancock)
I beg to move,
That this House has considered covid-19.
This global pandemic calls on us all to make the best judgments that we can on behalf of our nation. This disease attacks us all because we are human, and it is only by coming together as humanity that we can solve it. It is a communitarian disease that passes from person to person among those who are closest to each other, and it is as a community that we must tackle it. The virus raises profound questions for each Member of this House, too, representing our constituencies as we do, to make the best judgments that we can in the face of uncertainty, immense challenge and with great weights on each side of the scales, in the best interests of the nation that we serve.
We have heard today from the Prime Minister of the grave steps on which the House will vote on Wednesday. We know of the real impact that those steps will have on so many lives and livelihoods. We know the hardships that would be faced and the jobs lost, and we cannot save them all, but the alternative of not acting would be so much worse.
When faced with such a deadly adversary, we cannot stand aside and let it spread unchecked through our communities when we know the devastation it would cause, not just to the NHS and not only in the mounting death toll, but I firmly believe the impact on our economy would be worse too. The devastation that the virus would wreak if unchecked would impact the NHS’s ability to treat covid and non-covid patients. For all those who need treatment in the NHS right now, the action we propose will help to ensure that the NHS has what it needs to give them the world-class care that we have all come to expect.
Ian Paisley (North Antrim) (DUP)
I applaud the congratulations that the Secretary of State has already extended to NHS workers. What message does he have for my constituent, Faye McDonnell, a student nurse? Will she be paid during this crisis? Will my other constituent, Kirsten Doran, a theatre nurse, be paid the increase in pay and fair pay that nurses are campaigning for?
Matt Hancock
Of course the NHS in Northern Ireland is the responsibility of the Administration there. I know of the issues around nurses’ pay, which has been the subject of much interest. I will not go into the individual details, but I recognise the case that the hon. Gentleman rightly makes on behalf of his constituents. We in this House support the staff of the NHS across the UK—in all four nations in all four parts of the NHS.
Across the UK, however, the case is the same. For people who need NHS treatment now, whether it is for covid or any other condition, the best course of action is to suppress the virus. Partly because of that, I therefore believe that the only strategy a responsible Government can take is to suppress the virus and support the economy, education and the NHS as much as possible until science can come to our rescue.
Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
We are undoubtedly in a serious situation, and I am sure that the Secretary of State agrees that we need to take political gamesmanship out of the debate. Considering the measures and the month-long lockdown that have been announced for England, does he share my concern at the actions of some of his colleagues in Wales who have worked the whole situation up into a political frenzy with regard to the ongoing lockdown in my country?
Matt Hancock
The hon. Gentleman invites me to get involved in political controversy in Wales while rejecting the principle of getting involved in political controversy. Having thought about it, on balance, I am going to sidestep that particular political controversy. As it happens, I strongly think that the public expect us to work together in the national interest, and that is what we propose to do.
A crucial part of that national interest is protecting the most vulnerable. When coronavirus spreads rapidly, it reaches all parts. Many of the most vulnerable can live only with care and support from those outside their home, or live in multigenerational households. We must protect the most vulnerable from the disease, and we will, with renewed shielding advice and support for care homes, but we cannot rely on that alone.
There is no quick fix to this pandemic; there is no silver bullet. What makes this fight so tough is that the virus thrives on all the things that make life worth living, such as the joy of social contact and the communal events that give us so much happiness and fulfilment, but we must persevere together to get it under control.
Mr Mark Harper (Forest of Dean) (Con)
One of the key things that we will depend on after the lockdown is over—assuming that the House gives its support—is a really effective contact tracing system. The Secretary of State knows as well as I do that, in the last couple of weeks, the system has been reaching only 48% of the contacts of those who have tested positive. The Scientific Advisory Group for Emergencies says that for the system to be effective, it needs to reach 80%. In the 28 days of lockdown, what specific steps will he take to get it to 80%?
Matt Hancock
My right hon Friend is right; I was going to come on to that issue. Of course the contact tracing system needs to contact as many people as it can. The figures that he refers to include a huge array of different types of contact. I will update the House on the improvements that we have seen in contact tracing, including an increase in the absolute number of people who have been contacted and in the proportion.
We absolutely need the proportion to go up. A critical part of that is people’s engagement with the contact tracing system, as well as the system itself. Some of the proportion who are not reached are not reached because their contact details are not given. It is quite hard to blame the people who work in NHS Test and Trace, who are working so hard on it, for that particular reason. It is important to go into the details of why a particular contact is not made and try to improve all those details. That work is ongoing, but I accept the challenge.
Munira Wilson (Twickenham) (LD)
As well as boosting contact tracing rates, which are absolutely critical, I hope the Secretary of State will address the issues with the app that have been revealed this weekend; it has not been contacting people who should have been contacted. Self-isolation is also important. The Prime Minister admitted today—he finally acknowledged—that self-isolation rates are far too low, but we have heard nothing about what steps are to be put in place. We need carrots, not sticks—support and incentives for people to self-isolate. The Secretary of State mentioned multigenerational households; there are many overcrowded households, particularly in inner cities, and therefore high-risk people who cannot self-isolate at home. Has he given any consideration to setting up self-isolation support facilities that those people can go to?
Matt Hancock
Of course, self-isolation following contact or following a positive test, or in quarantine from abroad, is absolutely critical, and we have brought in measures to improve self-isolation, such as the £500 payment and strengthening the enforcement around it, and we are always looking for what we can do to strengthen self-isolation; the Prime Minister was absolutely right in what he said earlier, and there is a huge amount of work under way on it.
Rachael Maskell (York Central) (Lab/Co-op)
Two weeks ago, I asked the Health Secretary about the button that was meant to be on the app to release a reference code for people to claim the £500. The Health Secretary specifically came to the Dispatch Box to say that they just needed to press that button. That button does not exist—it did not exist then and it still does not exist today—so why did he make that intervention and how is he going to rectify the situation so people can claim that £500?
Matt Hancock
Yes, the button is coming; it is in development. The hon. Member for Twickenham (Munira Wilson), who made the previous intervention, also spoke about the app. There was an upgrade to the app towards the end of last week, and I want to put on record my thanks to the app team, who have done such a great job in improving the app by, as the hon. Member for Twickenham said, improving the targeting so that more people are targeted and more people get the message. The app is also now getting fewer false positives so people can have more confidence that if they are contacted by the app and told to isolate, they need to do so. The button will come.
Rushanara Ali (Bethnal Green and Bow) (Lab)
People up and down the country made enormous sacrifices during the first lockdown, and they were promised a world-beating contact, test and trace system. Some £12 billion has been spent on Serco to provide that. In areas such as mine with high levels of deprivation, health inequalities and high numbers of vulnerable people, people are already dying, and we do not have an effective testing and tracing system. So, given where we are, may I appeal to the Secretary of State to make resources available to areas where we have the local capacity to do testing and tracing, to help improve the system as quickly as possible in this lockdown?
Matt Hancock
Yes, as we have discussed many times, that is happening—absolutely—and it is the link between the national and the local that is the solution here. I will come on to testing in more detail later because I have some new things to say about it. In the meantime, the other thing we need to do, of course, is make sure that for this second peak—the second wave—we do all we can to support those institutions that are helping us through it, and first among those is, of course, the NHS.
The NHS is better prepared for this second wave, and I want to thank the NHS and everybody who works in it for their efforts over the past few months to ensure that we are better prepared. We know infinitely more things about coronavirus now than we knew as the first wave hit. Our Nightingale hospitals, for instance, stand ready and are being restarted in the parts of the country that need them. The independent sector has stepped up to the mark to help us work through the backlog of the vital elective operations and to help keep going with elective operations, even through this second peak. We have hired more staff, with 13,700 more nurses and 7,800 more doctors. We have provided £3 billion of extra funding across health and social care. Personal protective equipment is widely and freely available, and infection control procedures have been significantly strengthened, based on better understanding of transmission of the virus, including aerosol as well as droplet and fomite transmission.
Dr Luke Evans (Bosworth) (Con)
I am glad to hear that preparations are under way. I have had several emails from constituents in Bosworth who are worried about their routine operations; their follow-up might be lost. They remember what happened in the last lockdown, when they were not able to get that follow-up. Can my right hon. Friend confirm that all NHS appointments will be going ahead as best they can?
Matt Hancock
Yes, absolutely, and my hon. Friend makes a critical point. If in Bosworth someone is waiting for an operation on the NHS, they are more likely to get it if we keep the virus suppressed—in fact, if we keep it down, they will get that operation and we will get it done. Unfortunately, in the parts of the country where things have got too high, non-urgent, non-cancer elective operations have had to be cancelled. That demonstrates that, both for covid and non-covid health reasons, it is better to keep the virus suppressed.
I was halfway through my long list of the things that the NHS has been doing to prepare over the summer. At the moment, we are delivering 159 A&E upgrades; as far as I know, that is the biggest number of concurrent upgrades to emergency care in the NHS’s history. We have radically expanded telemedicine in primary and outpatient care. We are introducing 111 First, with an expanded 111 service to help people get the care that they need.
The NHS has learned how to treat covid patients better too, of course: not just by discovering treatments such as dexamethasone, in which the NHS played a critical part, but by improving clinical techniques—earlier oxygenation and later ventilation, for instance. As a result, our rate of hospital-acquired infection is down and the number of people who survive covid in hospital is up. We have been able to set an explicit goal that all cancer treatment should continue throughout this second wave, which speaks precisely to the point that my hon. Friend the Member for Bosworth (Dr Evans) made.
But even with this expanded NHS and with the better treatments, the extra investment and the brilliance of the whole NHS team, who have done and learned so much about the virus and worked so hard to prepare—even with all that—and even if the NHS were twice as big as it is now, it could not cope, and no health service could, if the virus continued to grow as it is now. We must control the virus, to protect the NHS and ensure that it is always there, to treat patients with covid and patients with all other conditions.
Mr Steve Baker (Wycombe) (Con)
One of the wonderful things that my right hon. Friend has done is make available so much data. I am looking at the case data for Liverpool, and there it is—daily cases by specimen date. Thank goodness the number is now falling, and on a seven-day basis, again, it is falling. I am just wondering why now anyone in Liverpool would say anything other than that the Government’s previous strategy is now working. Why on earth, then, would people in other areas that are not even as badly off as Liverpool—or indeed Manchester, where the cases seem to be stabilising—want to see an even tighter lockdown?
Matt Hancock
Unfortunately, in Liverpool the overall case rate includes a very high peak among students. The over-60s case rate, which is also published on the same website, shows a flattening, but a flattening at a very high level, such that Liverpool University Hospitals NHS Foundation Trust has already had to cancel non-urgent, non-cancer elective activity.
The danger of a plateauing at a high level, as the chief medical officer set out, is that if the rate starts to go up again, we are already under significant pressure in the NHS in Liverpool. The same argument goes for Tyneside, where again the overall case rate appears to be coming down, which is good news. The number among the over-60s, however, is flattening, again at a very high level, and in other parts of the country, including areas in tier 3, the numbers were going up.
It is not good enough just to control R and keep it lower than its natural rate; we have to get it below 1 to be able to change from a doubling time to a halving time of this virus. Even I—the most enthusiastic supporter of the tier system—can see that, unfortunately, cases were rising and the cases among the over-60s are rising, including in the areas with tier 3 restrictions. It is important to strip out from those data the outbreak among students. I have talked before about there being two overlapping epidemics: one among students and one among the wider community.
Mr William Wragg (Hazel Grove) (Con)
My right hon. Friend lists the many commendable achievements of the national health service in the period since the first wave, but the main contention is that this policy is for ICU capacity issues. What specifically has been done over the summer to increase that capacity?
Matt Hancock
There has been a significant capacity increase in critical care, which includes ICU but is not only ICU. We have a wider definition of critical care, which is important. Many people with covid do not need formal ICU intubation; they need critical care, including oxygenation, when they are not anaesthetised but on oxygen treatment. On that measure of critical care, which is the care required for covid, there has been a significant increase, including significant investment in the NHS around the country. I should have had that on my list.
Aaron Bell (Newcastle-under-Lyme) (Con)
Further to my right hon. Friend’s answers to my hon. Friend the Member for Wycombe (Mr Baker), it has been a fact for a long time that the three figures that are reported most often are the number of tests, the number of cases and, regrettably, the number of deaths. Does my right hon. Friend agree that the media and we should focus much more on the data on NHS capacity? That, rather than tests and cases, should be the message.
Matt Hancock
They are all important. Often, people focus on the cases, because they are one of the earliest indicators of the direction. The case rate among the over-60s is highly correlated with what happens to hospital admissions a week or 10 days later. That is why we focus on the over-60s case rate and now publish that data too, because looking at that as well as the overall case rate is important.
Nevertheless, my hon. Friend is absolutely right that although the translation of cases into hospitalisations and poor health outcomes is harder to estimate, the number of hospital admissions with covid is a concrete fact that we cannot get away from. We cannot escape the fact that that is rising and has been rising sharply. Even if we expanded the NHS enormously—we have, both in critical care and in terms of the potential capacity in the Nightingales, should it be needed, but even if we doubled the size of the NHS—once we are on an exponential growth curve, it would still be too small to cope if the virus were to run riot.
Jonathan Edwards
Returning to ICUs, the Secretary of State knows that nurses working in that environment are highly specialised; it takes a high degree of extra training. How confident is he, considering the potential for fatigue and for nurses to fall ill, given that this may last many months, that the line will hold against covid in ICUs?
Matt Hancock
With this action, I am confident that we can make that happen, but it is one of the reasons and justifications for this action that we are taking. The action is serious, and I do not deny or demur from the consequences that the action will bring. My argument is not that this action is good or anything other than regrettable; it is that the action is necessary because the alternative is worse.
I would like to address the specific point made about mental health. It is good to be here next to my hon. Friend the Mental Health Minister. There were a number of questions about mental health addressed to the Prime Minister earlier. Restrictions such as these do have implications for people’s mental health—of course they do—and we are expanding mental health support to address that. However, we also know that coronavirus itself, and the impact of high levels of covid on the NHS, has a significant impact on mental health too. The Royal College of Psychiatrists has said:
“Stricter measures to control the virus are needed to minimise Covid-related mental illness as much as possible.”
Today it said:
“The new lockdown will significantly impact mental health but allowing COVID to go unchecked would also have serious consequences for mental illness. We must ensure that people get the support they need.”
So yes, I am worried about mental health, but in my book that is another reason to bring this virus under control.
Turning to physical health, in the worst-hit areas we have already seen the cancellation of some non-urgent, non-cancer treatments, such as hip operations and cataracts. Without action to bring R below 1, the NHS would be overwhelmed, no matter what we did to expand the NHS and protect the vulnerable, and then we could no longer guarantee that solemn promise to every citizen that our NHS will be there for you when you need it. We must not let that happen.
I want to say this very directly to all those who need NHS services this winter: help us to help you. If you are asked to go to hospital, that is because it is the best place for you. I want to say this to all the staff working in the NHS: we will support you this winter. We are grateful for the sacrifices you are making and we will get through this together.
As we have learned more about this virus, we have been able to strengthen social care, too, and our winter plan sets out the work done to improve those protections, including free PPE, regular testing and the systems for safe discharge that will be so important over the coming months.
Finally, to escape the clutches of the pandemic, we must harness ingenuity and scientific prowess to make the breakthroughs that will help us turn the corner. Testing technologies are improving all the time. We are expanding our existing technologies, and since the pandemic hit we have been putting everything behind our mission to expand our testing capacity. In April, on schedule, we delivered the target of 100,000 tests a day. The Prime Minister then set the goal of testing capacity of half a million a day by the end of October, and I can tell the House that thanks to an enormous effort under the leadership of Baroness Harding and Sarah-Jane Marsh, to whom I give heartfelt thanks, we have hit our target. Testing capacity across the whole UK is now 519,770 a day—a phenomenal national achievement. We now have the largest testing capacity in Europe.
It has been a hard road. As with any new technology, there have been ups and downs, but I always knew we would get there. I am very proud of the team. The next stage is to harness the new technologies—the lateral flow tests that can take a matter of minutes, the high-throughput tests and the point-of-care tests, which are now bringing capacity into the hotspots and on the spot in our NHS hospitals. That is all part of a mass testing capacity that we are building right now, which, alongside the work on vaccines—that is progressing well—will give us so much greater protection from this disease in the months to come.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Before the Secretary of State moves on, just on the point about vaccines, it was reported yesterday in The Sunday Times that Kate Bingham, the chair of the taskforce, spoke at a commercial conference where attendees paid $200 to attend and revealed commercially confidential information. Certainly at the least she apparently revealed information about a vaccine being ready by Easter, which is welcome, and that the Government have done a rehearsal to get the vaccine distributed—again, that is welcome—but why has she revealed that information there? Why has the Secretary of State not revealed that information here? Members may want to take some of those things into account before they vote on Wednesday. Did he authorise her speaking at this event, and can he update us on what she said?
Matt Hancock
The covid vaccine taskforce is about the procurement of the vaccines. That is a matter for the Department for Business, Energy and Industrial Strategy. The Department has put out a statement and made clear the circumstances around that conference. What I would say is that I am very happy to answer any questions on vaccines. As the hon. Member says, we have procured a number of vaccines. We have procured six in total, two of which are the two leading vaccines in the world. The taskforce has done an excellent job of making sure that we have one of the strongest procurement pipelines for vaccines in the world.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
While we are still on the subject of vaccines and the Secretary of State is answering questions, the biography of Kate Bingham on her own website on SV Health Investors says that she is in fact leaving the taskforce at the end of 2020. Who is replacing her and what confidentiality agreements will she be asked to sign on her return to an entirely profit-making business?
Matt Hancock
It was a fixed-term appointment in order to do that vital work, and was always due to come to a close. This comes back to the old thing that we have across these Dispatch Boxes: on the Government side of the House, we want to harness the capabilities of everybody; on the Opposition side of the House, unless a person is in the public sector, they do not seem to get the credit. I think we should welcome everybody who is willing to put their shoulder to the wheel to drive the action that is necessary to improve this country’s response.
Matt Hancock
This is probably about how we should not use the private sector in test and trace, despite the fact that we have hit our target of more than 500,000 tests a day on time, as we have each of the targets for testing. I am very proud of that.
Several hon. Members rose—
Matt Hancock
I am happy to answer any detailed question about the provision of vaccines in this country.
Daisy Cooper (St Albans) (LD)
Does the Secretary of State accept that there are those of us in this House who like a mixed economy and who recognise the role of the private sector and of business, but that that does not undermine the need for any Government to have transparency about procurement and to protect the spending of taxpayers’ money?
Matt Hancock
Yes, absolutely. With comments like those, the hon. Lady should come over to this side of the House if she wants to be part of the big team effort. She obviously did not get the memo that says, “If you sit on the Opposition side, you have to attack anybody in the private sector who is helping.”
We have to pull together, because coronavirus is a powerful adversary. It has the power to overwhelm our hospitals, disrupt our economy and suspend the moments that make life so special, so we must take the hard but crucial steps to get it under control, and we will stand behind every single person who joins in this national effort. Everybody has a role to play, and as we come together once more, we must all work and make sacrifices to protect those who we love at this time of national need.
Several hon. Members rose—
Jonathan Ashworth
I am sure the hon. Gentleman is familiar with the minutes from SAGE, which read:
“The shortlist of non-pharmaceutical interventions (NPIs) that should be considered for immediate introduction includes:...A circuit-breaker (short period of lockdown) to return incidence to low levels.”
That is the proposal that we endorsed, and it is the proposal that was rejected on 21 September by the Prime Minister. Now the Prime Minister is putting the country into a four-week lockdown, which the Chancellor of the Duchy of Lancaster conceded yesterday could last beyond four weeks. This is fundamentally about the judgment of the Prime Minister, and indeed the Chancellor, who, we know from briefings, blocked the Government from making the choice to go for lockdown earlier.
Throughout this crisis, we have seen mistake after mistake. The preparations for this pandemic were poor and insufficient. The lessons of Exercise Cygnus were not taken on board. The country’s stockpile of PPE was allowed to dwindle, leaving frontline health and care workers unprotected and placed in harm’s way. I hope we can get a cast-iron guarantee that the same will not happen again this winter. Instead of putting the public health teams in charge of tracing, Ministers turned to outsourcing companies, with management consultants paid more in one day than care workers would be paid over four months. Week by week, the numbers followed up by the test and trace system fall. Directors of public health, who want to get on with contact tracing, complain that it takes days for them to receive the information on cases.
The app was months too late, and yesterday we learned that it has an not even been alerting people properly. The Secretary of State is supposed to be the digital whizz kid, and he could not deliver the app on time, and it has not been working sufficiently. Far too many test results are still not turned around in 24 hours, even though we know that we need speed when dealing with a virus that spreads with such severity. There have been 1,300 outbreaks in care homes since the end of August, and care staff still wait more than two days for results.
As we have heard, there is still inadequate financial support for people who need to isolate. It should be no surprise that there were reports of less than 20% of people isolating, given that they are expected to make a choice between feeding their families and their health. Rather than giving people proper, decent sick pay, the Chancellor spent hundreds of millions subsidising meals in restaurants through the summer. There is now evidence from academics to suggest that that led to the spread of the virus and seeded the virus in the early stages of this second wave. We welcome the announcement of the 80% furlough, but furloughed workers in the midlands and the north will conclude that their jobs were worth 13% less than those elsewhere.
The experiences of other countries were needlessly ignored, warnings were downplayed, and the precious advantage of time was squandered. Tragically, that has been as true in September and October as it was in February and March. The Government did not learn. It does not require a crystal ball to listen to scientists and make timely decisions in the national interest, so lessons must be learned, and this lockdown must be used wisely.
I welcome what the Secretary of State said about expanding testing capacity, but we also need to turn around the PCR—polymerase chain reaction—tests quickly for those with symptoms. They are still not turned around in 24 hours. If we are going to have extra capacity in the system, I hope there will be a commitment to turn those tests around in 24 hours for those who need them. We need to expand access to testing to more people, to rebuild confidence across society. UK universities are leading the way in piloting regular saliva testing for students, and some have extended that to the wider community. Rolling out these saliva tests across communities paves the way for weekly testing of key workers such as transport staff, care staff and, especially, NHS staff.
We have been calling for months for the Government to roll out a programme of regular, routine testing of frontline NHS staff. Surely, as we move into winter, that should be a priority. The saliva testing innovation should be brought on stream quickly to do that routine testing of all frontline NHS staff. If we could roll that out—I know that the Secretary of State agrees with me on this, and I do not disagree with him on the objective; I am urging him to use these four weeks to get a move on with it—it would allow us to identify asymptomatic carriers and protect the most vulnerable in society. Will he come forward with a plan to work with our universities on saliva testing, which he knows is very exciting and could make a huge difference?
Contact tracing has to be fixed. It has not been working properly through the call centre approach. The local directors of public health would do a more effective job, but they need to get the contacts within 24 hours, not within days. If they get those contacts within 24 hours, they can introduce as a matter of routine retrospective contact tracing, which finds where people got the virus from and identifies super-spreading cluster events. That approach has been taken in countries such as Japan, and we know that it is more effective. I know that it is happening in some hotspots, but it should be routine across the country.
As I said, we need reassurance that people will get support for isolation. In this lockdown, we will have a spending review, and the test of that spending review is how it will support our national health service and social care sector for the rest of this covid period. We entered this crisis after years of underfunding in the national health service, with capital budgets repeatedly raided—[Interruption.] There were years of underfunding in the national health service—of course there were. The national health service used to get a funding increase of around 4% to 5%. It got something like 6% to 7% a year under Labour Governments. Under this Government, for 10 years, it has got around 1%. Everybody knows that the NHS went into this crisis after years of underfunding. Everybody knows that the NHS went into this crisis with capital budgets having been repeatedly raided, which has left hospitals with a £6 billion repair bill. The NHS entered this crisis with around 15,000 beds having been cut since 2010.
Matt Hancock
We cannot let this stand—what a load of nonsense. The NHS went into this crisis with the highest funding level in its history, with more doctors than at any time in its history, with more nurses than at any time in its history and with the biggest hospital building programme in its history. The investment from this Government in this NHS is the highest that has ever been made by any British Government in history, and that is why it is only we who are the party of the NHS.
Jonathan Ashworth
The national health service has been systematically underfunded for years under this Tory Government. The NHS went into this crisis without adequate levels of PPE for frontline staff, with nurses using curtains and plastic bags to protect themselves on the wards in the face of this horrific virus. [Interruption.] They are sighing, but they sent our staff into the face of danger without the proper protection; that is what happened going into this crisis, because of years of cutbacks and underfunding of the national health service. The cutbacks and underfunding mean that we have lost 15,000 beds in the national health service since 2010, and that our public health budgets have been cut by £800 million under this Tory Government and because of years of austerity for the NHS. There are people with serious mental health problems who will be spending this lockdown in Victorian-style mental health dormitory wards because of the cutbacks in the capital funding for the NHS.
Matt Hancock
The hon. Gentleman mentions dormitories in mental health services. Dormitories have plagued mental health services for years and years and years—and who are the first Government to not only commit, but to put the funding in to end dormitories in mental health services? It is this Conservative Government. It is not only that this Government are the Government for the NHS and that we are the party of the NHS; we are also the party investing record sums in mental health services, with the biggest increase of all the increases in funding going into mental health services, including to end the dormitories in mental health services that have existed ever since the NHS was created.
Jonathan Ashworth
The Government have been cutting capital budgets in the NHS, which is why we have still got those horrendous dormitory wards, including at Leicestershire Partnership NHS Trust and Derbyshire Healthcare NHS Foundation Trust. Years of Tory cutbacks have meant that clinical commissioning groups have been raiding child and adolescent mental health budgets in order to fix the wider revenue gaps in the NHS. That is because of 10 years of underfunding in the national health service. We went into this crisis with an NHS that did not have enough staff—short of 80,000. It has seen 15,000 beds cut and public health budgets cut by £800 million. Hospitals have been left with £6 billion of repair bills and with these Victorian dormitory wards that have not been updated for years. The Secretary of State cannot stand there and say that the NHS had enough investment going into this crisis, because if it had we would not have had staff without PPE.
Jeremy Hunt (South West Surrey) (Con)
I wholeheartedly support these measures. When we look at the starkness of the data presented to the country at the weekend, we see that the issue is not whether the lockdown is wise, but whether we use the lockdown wisely. I hope that the Health Secretary will forgive me, as his predecessor, if I set out one or two of the things we need to use the next month to sort out if we are to ensure that this is the last coronavirus lockdown and that it is a short one.
First, it will not surprise the Health Secretary that I say this, but we must introduce weekly testing of NHS staff. In the first wave, up to 11% of coronavirus hospital deaths happened to people who picked up their infection in their own hospital. For the basic principles of patient safety and staff safety, we must make sure that that does not happen a second time; otherwise cancer patients will worry whether it is safe to go to their hospital, staff will worry about whether they are infecting their own patients and we will see the NHS again descend into being a covid-only service. We had some hospitals in London where more than 40% of staff were infected in the previous wave. It would be unforgiveable to let that happen again. I know that the Secretary of State is sympathetic and would like to do this. I would just urge him to do it as soon as possible.
Matt Hancock
My right hon. Friend knows that I agree with him. Indeed, we are rolling this out now, but we do need to get it everywhere.
Jeremy Hunt
I would be very grateful, and I know that staff everywhere would be grateful, if my right hon. Friend could give some indication of when all NHS staff can be confident that they will be tested, but I thank him very much for that answer.
Secondly, I hope the Secretary of State will not mind me saying that this is the moment when we have to fix contact tracing. To be reaching only 60% of people’s known contacts is not good enough. He knows that, and he does not try to defend it—
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
Dither, delay and disaster—that was the Prime Minister’s own word today—and, of course, it did not have to be this way. There has never been a starker contrast between the gross failings of the Prime Minister and the leadership shown by my right hon. Friend the Leader of the Opposition, my hon. Friends on the Labour Front Bench and our Welsh Labour First Minister, Mark Drakeford, in calling for action at the right time and taking action at the right time on a firebreak lockdown. Instead, we saw a Prime Minister who ridiculed the proposals, describing them as “the height of absurdity”. His office described the Leader of the Opposition as “an opportunist”. The Chancellor blocked those who wanted to act sooner, and now we are seeing the same mistakes repeated that we saw earlier in the year. Forty days have been wasted, with the consequence that England will now face a longer, harder lockdown and worse consequences.
What a contrast with Wales, where our First Minister set out a difficult but clear set of restrictions, with common-sense exemptions, when he announced our firebreak weeks ago. He has communicated throughout with, and engaged and listened to, our elected representatives, councils, businesses and trade unions—the hallmark of his approach throughout this crisis—bringing Wales together to tackle the tough reality that covid presents. Today, he has set out that on 9 November our firebreak will end, not in a free-for-all, but with a sensible, clear, national set of measures, where people will be encouraged to do the minimum, not the maximum, allowed and we will prioritise the safety of their families, their friends and our NHS as we continue to be led by the evidence and the threat of this virus.
The consequences of the wider approach taken by the Prime Minister could not be more serious for our collective health and the economy. As the Independent SAGE meeting last week suggested, over the next four weeks, we will now potentially see deaths locked in in their thousands in England if the trends continue, and the mental health and the economic impacts will be for longer and deeper. That is the cost of delay, and I have never known a more incompetent and reckless Prime Minister, Chancellor and Government.
Matt Chorley reported what Tory MPs tell him in private—they often tell us in private, too. There were comments such as:
“Shambolic. Rudderless ramblings. Constituents getting in touch furious or in tears”,
“Grim grim grim”
and
“I think it could be his Suez”.
At least they have the guts to be honest in private, but others, extraordinarily, would rather brazen it out in public. The Minister for Patient Safety, Mental Health and Suicide Prevention claimed that only a crystal ball could have predicted the need for a second lockdown—it is absolutely extraordinary. Has she even been reading her briefs? Anybody can see from the graphs, the trends or the historical examples—
The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
Will the hon. Gentleman give way?
Stephen Doughty
No, I will not—the Minister made her comments very clear publicly. Of course, others were simply patronising. [Interruption.] Oh, go on then—I will give way to her.
Ms Dorries
I thank the hon. Gentleman for giving way. The cases of infections, particularly in the over-60s, and the demand on hospital beds far exceed the previous reasonable worst-case scenario.
Dr Allin-Khan
I have engaged with such serious subjects when undertaking all four of my science degrees.
Speculation that self-isolation could be reduced from 14 to seven days does nothing to clarify how people can keep their families safe. [Interruption.] I am enjoying hearing the chuntering; I would welcome anybody who wished to intervene on me because I am well up for it, as they say in Tooting. I do enjoy debates—in fact, I would welcome debate, because what always happens is that I make my comments from the Dispatch Box, sit down and listen to the Minister, for whom I have a great deal of respect, but then I have no ability to intervene, so bring it on.
The resilience that British people have shown over the past seven months has been remarkable. In the face of uncertainty and fear, our communities have come together to support one another time and again. Like everyone in the Chamber, I am so proud of all those who helped to deliver food and medicines to our most vulnerable at the height of the crisis, and I have been incredibly moved by all those businesses, struggling themselves, that provided free school meals locally when the Government failed to act. It touches me to witness the hope and humanity of our communities and of individuals such as Marcus Rashford, but it is shameful that that has been necessary as a result of this Government’s actions.
It breaks my heart that more children than ever will know the taste of hunger in 2020 and that they will feel the cold that comes from their parents being unable to pay the bills. The last Labour Government lifted more than 1 million children out of poverty. We need more action like that, not Conservative Members blaming chaotic parents for child hunger, alleging that free school meal vouchers go direct to crack dens and brothels, or spinning the narrative that it is the sole responsibility of local communities to ensure that no child goes hungry. Where is the compassion and humanity from the Government? I hope we do not have to continue asking ourselves that question throughout winter.
Certainly, across our communities, compassion and humanity are in no short supply among our frontline health and care staff—on that we can all agree. Those frontline staff have been placed in an impossible situation throughout the year. Will the Government commit to ensuring that those staff have adequate levels of PPE across the winter, and will they commit to frequent testing of our frontline staff, who put their lives on the line day in, day out? The impact of the neglect of our NHS staff is that almost 2 million days were lost to mental ill health during the first wave of the pandemic. I fear the effects of the second spike this winter. We can stand on our doorsteps and clap, but why can we not give them the support they truly deserve?
Will the Minister agree to meet to discuss our care for carers proposal to address the mental health needs of our 3 million health and care staff? Will the Minister agree to meet me to discuss the care for carers plan? Will the Minister agree to work cross-party together to support our frontline NHS and care workers?
Ms Dorries
Obviously, I cannot answer from a sedentary position. On the care package, the hon. Lady will need to meet another Minister, but I will take her request on. I am the Minister for mental health, not for care workers, but I will pass that on for her.
Dr Allin-Khan
It is a package of mental healthcare for our frontline NHS and care workers, which I am sorry the Minister seems to have forgotten. I have raised it a number of times. Is she agreeing to meet me to discuss the care for carers mental health package for our frontline NHS and care staff?
Ms Dorries
I will provide a detailed explanation of what we are doing for frontline workers in my own speech.
Dr Allin-Khan
I take that as a no. I give the Minister the opportunity to give me a straight yes or no answer. Will she kindly agree to meet me to work cross-party together for the betterment of the mental health of our frontline NHS and care staff—yes or no?
Ms Dorries
Madam Deputy Speaker, this is a rather unusual way of closing a debate. We have a very comprehensive package in place for key workers, which has been provided by the NHS, and I am happy to detail that when I give my closing speech.
Dr Allin-Khan
I am very familiar with the detail, which the Minister uses every single time we have a debate, but I will take that as a hard no and continue with my speech.
For the mental health of people across the country—[Interruption.] The policy is very clear. The Minister is chuntering from a sedentary position; would she like to intervene?
The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
One of the joys of being a Minister in Government is that we won an election and that gives us the right and the ability to decide policy. If the hon. Member for Tooting (Dr Allin-Khan) wishes to decide policy, the Labour party should try harder at the next election.
As we heard from so many hon. Members during the debate, the virus is a deadly adversary. The debate has been wide-ranging, and many points were raised. It is impossible to mention everybody who spoke, but there were several themes and I would like to group them. Obviously, because of my portfolio, I will start with mental health, which almost everybody mentioned.
We recognise that it is a difficult time for people and the immense strain that the pandemic and measures to contain it place on everyone’s lives. Recently, the president of the Royal College of Psychiatrists said that there were significant mental health consequences for people who contract covid and for the families of those who are affected or sadly lose their lives. He went on to say that mental health concerns as a result of lockdown were
“being weaponised by those with other political agendas”.
He added that there is increasing evidence that the virus directly attacks the central nervous system, which can affect mental wellbeing and mental health, let alone the post-traumatic stress that those who contract the virus and may end up on medical ventilation can experience.
The result is that there are two mental health stories to the pandemic. We know that people will suffer exacerbated mental health problems as a result of the pandemic and that people with existing mental health conditions and frontline workers are particularly susceptible. However, there is another side to the story, which is long covid: young people who contract covid and consequently suffer mental illness. In the words of Dr Adrian James, the president of the Royal College of Psychiatrists:
“We need… to wake up to the very serious mental health consequences for people who get coronavirus and for the families of those who are disabled or killed by the disease.”
We are absolutely committed to continuing our investment in expanding and transforming mental health services in England. That will amount to an additional £2.3 billion of funding a year in mental health services by 2023-24. We are doing our utmost to ensure that our mental health services are there for everyone who needs them during the pandemic—for patients and our NHS colleagues. Thanks to the ingenuity of so many, we worked hard to keep all mental health services fully functioning during the first peak, using technology when required. All mental health trusts have established 24/7 crisis phone lines where people who experience a mental health crisis can access urgent support and advice. We have invested more than £10 million in supporting national and local mental health charities to continue their vital work in supporting people across the country.
It is a priority to keep services and support working and to provide full services throughout the winter months. I would encourage anyone who needs support to reach out for it so that the NHS can help them, just as we are together doing so much to protect the NHS. I would encourage everyone’s constituents to make use of the resources that are there and have been provided: for example, Every Mind Matters for frontline workers; online psychological first aid training has had 90,000 frontline worker users to date.
It is okay not to feel okay during this difficult time, and we will support everyone in getting the help they need. I am pleased to announce that the NHS will launch a major campaign to encourage people who may be struggling with common mental health illnesses to come forward for help. Talking therapy services will continue to be made available remotely, so that people can access help safely from home. While we know anecdotally that some people’s experiences of digital mental health services have been very positive, we also know that they do not work for everyone, particularly people with more serious mental health illnesses. The NHS will work to ensure that the option of face-to-face support is provided to people with serious mental health illnesses across all ages where it is clinically safe to do so, and people with serious mental health illnesses will continue to receive help from NHS volunteer responders to access essentials such as food and medication throughout the winter.
Overall, our response to the mental health impacts of the pandemic must be driven by the best possible evidence to help us access the data on the number of suicides. Public Health England is currently piloting a national surveillance system to monitor suspected suicide and self-harm by collecting data from local systems in near realtime. This will allow us to identify patterns of risk and inform national and local responses. I can also announce that we are developing a winter plan for wellbeing and mental health, and I hope to return to the House with more information on this shortly.
A number of Members have mentioned hospitals. It was lovely to hear my hon. Friend the Member for Warrington South (Andy Carter) talk about Warrington hospital, where I did indeed train as a nurse; I was there from 1975 until 1988, all those years ago. He spoke about the real pressures that hospitals are feeling at the moment, and while we have been having this debate the North West Ambulance Service has declared a major incident, owing to demand on ambulances tonight in the north-west of England due to covid. The pressures in Warrington hospital that my hon. Friend spoke about are being felt across the country.
We all stood and clapped for carers on a Thursday night during the first lockdown, and many of the comments tonight have talked about our frontline workers while, in the same speech, arguing against a second lockdown. What we are doing in arguing against a lockdown, or against the measures we are taking, is subjecting those frontline workers to the almost unimaginable and impossible stresses that they would have to experience, as they are in the north-west of England tonight. As someone said to me before this debate, the eerie sound of ambulances and sirens is noticeably more common across London tonight than it has been over the past week. It is our frontline workers who are dealing with those blue lights as they go into the accident and emergency departments in our hospitals across the UK. It seems impossible that we can clap for workers during one lockdown, then argue against protecting them through a second lockdown, because that is what the principle is: to protect our NHS, and to protect our hospital workers.
The pathway through a pandemic is never straightforward, and we have learned so much about this virus during these past few months, not least—as I said a few moments ago—the fact that it leaves young people with long covid and attacks the central nervous system, which in itself creates mental health problems. I reiterate that there are two sides to the mental health coin when it comes to coronavirus, and we need to protect families and those who have loved ones in hospital or who may end up in hospital and lose their lives. Bereavement brings with it its own mental health issues. All of us are required to make difficult decisions and tough sacrifices to bring this virus under control. We must persevere as we work so hard on the long-term solutions that will see us through and allow us to come together once again, so that we can look after the people and communities that we love.
Question put and agreed to,
That this House has considered covid-19.