Covid-19: Government’s Publication of Contracts

Debbie Abrahams Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right to highlight this amazing achievement. It reflects on the phenomenal effort of our frontline health and care workers, but also more broadly on the partnership we have seen at work in this country over the past year between the public sector, the private sector, the voluntary and charitable sector and ordinary members of the public all working together in a joint effort to beat this disease. My hon. Friend is absolutely right to highlight that.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

As much as I have a high personal regard for the Minister, he is incorrect in his remarks. The High Court ruling last Friday made it absolutely clear that at the time of the Prime Minister’s response to hon. and right hon. Members in this House last month 100 contracts had not been published; they were outstanding. Whether intentional or not, the Prime Minister—[Inaudible]—was factually untrue; he needs to come to this place with a full apology, as warranted by the ministerial code.

[Edward Argar]

I lost a few words of the hon. Lady’s question, but I think I know what she was asking about in respect of the Prime Minister’s remarks on 22 February. May I start by saying that her kind words at the start of her contribution are reciprocated? I have known her since I came to this House and I have the highest regard for her as well; so I am grateful for her kind words.

In terms of the specifics the hon. Lady asked about in respect of the Court judgment and the Prime Minister, as I understand it on the date the Prime Minister spoke 100% of the contract awards notices—the details of the contracts are contained within them—were published, and that, I believe, is what my right hon. Friend was referring to.

NHS Staff Pay

Debbie Abrahams Excerpts

Monday 8th March 2021 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

By the end of the year, £37 billion of taxpayers’ money will have been spent on the Serco Test and Trace programme, which is not even fit for purpose. That is on top of the Government spending £10 billion more on PPE contracts than they should have spent. Given that waste, how do the Government justify the view that most of the 300,000 NHS nurses are worth only a £250 a year pay rise?

[Helen Whately]

The pay conversation that we are having at the moment is indeed about nurses—who are a fabulous part of our NHS workforce, and I cannot thank them enough—but it is also about the wider NHS workforce, which includes paramedics and health support workers, and this pay settlement will also include some doctors. More than 1 million staff are being considered in this process, and that is why the cost is closer to £1 billion than the figure the hon. Lady mentioned; it is around £750 million. The Government were absolutely right to invest in PPE to protect staff in health and social care during the pandemic at a time when there was a global shortage of PPE, and we are absolutely right to have invested in a world-beating test and trace service, which is doing a phenomenal job and is essential to our country’s recovery from this pandemic.

Covid Contracts: Judicial Review

Debbie Abrahams Excerpts

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

I agree entirely. Some of the narrative around this reminds me slightly of my days back at school and “Animal Farm”—“Four legs good, two legs bad.” The reality is that both private sector and public sector have played an incredible role in tackling this pandemic, for which we should be extremely grateful. We need both, and we need both to continue delivering in the public interest, which is what we have secured.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

A couple of points seem to be coming up from this discussion. The first is that there were no shortages of PPE. That is patently not true. We have clear evidence that that was the case, not least from Exercise Cygnus back in 2016, but also from constituents working in the NHS who have reported this directly to me and to colleagues. The second is that the Government have published all the contracts, and the Minister has made reference to 100% of contract award notices being published. Unfortunately, we are not able to verify that. That is the key point made by the NAO, which said that there are still £4 billion-worth of contracts since November 2020 where we have no idea who they have gone to or how much for. Once again, will the Minister commit to publishing these VIP contracts, how much they were for, who they were awarded to and what for?

[Edward Argar]

The hon. Lady and I have known each other for a long time and she made her point forcefully but, as ever, fairly. She raised a number of points. In respect of PPE supplies, as I made clear to the hon. Member for Brighton, Pavilion (Caroline Lucas), the NAO report—I believe from last November—said that supplies did not run out nationally, but as I have clarified that is not to say that there were not local shortages and challenges in individual trusts, as I acknowledged to the hon. Member for Brighton, Pavilion. That is why we procured as much as we could as quickly as we could.

The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) raised Exercise Cygnus, which has come up a number of times. It is important to remember that Exercise Cygnus did not look at tackling a novel pandemic; it looked at influenza specifically. The PPE required for dealing with a disease of covid’s nature is very different from that required for flu. That exercise had, as one of its predicated actions, the swift arrival of antivirals to be delivered to tackle the flu; such antivirals did not exist until much later in the case of covid. It is important that we learned from Exercise Cygnus, but we should be careful about reading it directly across as representing a blueprint for how to tackle a pandemic of this sort.

On the hon. Lady’s final point about transparency, as I have made clear, the Government remain committed to transparency and to the publication of contracts, as required under the regulations.

Future of Health and Care

Debbie Abrahams Excerpts

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

Yes, these are very important measures and I am glad that they have my hon. Friend’s support, not least because of his extensive knowledge as a practising GP who has done so much during the crisis—the whole House is grateful for his commitment and work. On the timing of legislation, unfortunately I am not permitted to go into any further detail ahead of Her Majesty’s next visit to the other place, but the White Paper sets out the reforms that we hope to have in place by April 2022, and I hope that he can take from that some indication of our sense of pace.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

With one of the highest covid death rates in the world, and with NHS workers under such incredible pressure, this is hardly the best time to be talking about yet another NHS reorganisation. In his response to me two weeks ago, the Prime Minister committed to addressing the key underlying causes of the high and unequal covid death toll: primarily, socioeconomic inequalities driven by 10 years of austerity. He said that he would be implementing Professor Sir Michael Marmot’s recommendations, to “build back fairer.” How do the White Paper proposals address those inequalities and their impact on our declining life expectancy and on the highest excess mortality rate in Europe?

[Matt Hancock]

I gently say that I disagree entirely with the hon. Lady’s pessimism about the ability of improvements in the health service to assist in the closing of health inequalities and the provision of care. As a Greater Manchester MP, she will understand better than most the benefits that come from that sort of integration. The idea that we should fail to act on what the NHS has itself asked for because of the challenges it is facing is completely the wrong way round. I see it entirely the other way round; it is incumbent on us to act in order to deliver the improvements that the NHS is calling for.

Covid-19 Update

Debbie Abrahams Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

Yes, I am glad to say that we are working with our EU counterparts to ensure the fair distribution and manufacture of vaccines according to signed contracts, which is the right and proper way that it should be. Thankfully we signed those contracts early and we made sure that we got solid contracts to deliver the necessary doses to the UK. I look forward to those being delivered on, and I have assurances from all quarters that that is what will now happen.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

We know that there is a reduced antibody response against the new covid variants for vaccinated blood, but what is the level of change in vaccine efficacy, and what action is under way to update and approve new vaccines to address this? I am particularly thinking of the E484K mutation found in both the Brazilian and South African variants.

[Matt Hancock]

The hon. Lady is absolutely right to ask this critical question. We are doing a huge amount with the scientists and the pharmaceutical industry to develop modified vaccines should they be necessary. We are also monitoring the results of work to understand the efficacy of the existing vaccines against the variants of concern. We do not have a point estimate for the difference in the efficacy of the vaccine. The efficacy needs to be measured both in terms of someone’s likelihood of catching the disease and in terms of their likelihood of being hospitalised or dying from the disease. There is a significant amount of work under way to understand all those things, both in labs and in the field. For instance, AstraZeneca has a trial in South Africa that it is revisiting to understand the progress of those who were vaccinated as part of the trial. We will publish as much information as we get as soon as we credibly can. I wish I could give a number in answer to the hon. Lady’s very astute question, but unfortunately it is not scientifically credibly available yet.

Long Covid

Debbie Abrahams Excerpts

Thursday 14th January 2021 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I, too, congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this very important debate.

It is understandable that in the middle of the covid pandemic, the focus has been on primary prevention and managing the symptoms of those who become infected, but given that, as has already been said, the covid tracker survey suggests that more than 4 million people—about 12% of the population—have symptoms beyond the acute phase, which typically lasts just four weeks, with one in 10 having symptoms beyond 12 weeks, we also need to develop healthcare management responses that recognise that covid can have effects way beyond that acute phase. On top of that, we need an appropriate societal response to long covid, where people are supported during their illness and do not feel stigmatised. That is incredibly important.

I am pleased at the speed with which NICE has brought forward its guidelines for managing long covid. I particularly like the recommended holistic healthcare approach when assessing patients with symptoms between four weeks and 12 weeks, and after 12 weeks, with the emphasis on empathy and acknowledging the impact that the symptoms may be having on the patient’s day-to-day life, including their ability to work. However, I was surprised that there was no reference to immunology or immune therapies. I hope that we have learned from the mistakes made in how we prevent, treat and care for people suffering with chronic fatigue syndrome, also known as ME, and post-viral syndrome.

We know that covid-19, like other viruses, attacks multiple systems—respiratory, cardiovascular, nervous and gastrointestinal—as it attacks epithelial cells, which are distributed throughout the body, but our body’s ability to fight the virus depends on our immune system reacting appropriately and not overreacting. The British Society for Immunology and a number of other researchers have suggested that, in addition to long-term damage to multiple organs, the pain, muscle weakness, fatigue and even brain fog often associated with long covid may be due to inflammatory issues associated with our immune system itself rather than covid.

There is still so much we do not know about the virus, and I support calls for more research, as well as for the establishment of a disease register. More research is needed, and I am a strong advocate of evidence-based medicine, but it is important that we never let the perfect be the enemy of the good.

Finally, we must ensure, as I mentioned, that we have a societal response, not just a healthcare response. Working-age people in particular must be supported by their employers and by the Government, through the DWP. We must ensure that adequate support is provided to those with long covid who are not able to work. Stigmatising those with long covid should not be tolerated.

Dementia: Covid-19

Debbie Abrahams Excerpts

Thursday 12th November 2020 Westminster Hall

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I beg to move,

That this House has considered the effect of the covid-19 outbreak on people affected by dementia.

It is a pleasure to serve under your chairmanship, Mr McCabe. I am really happy to have been able to secure this debate with the hon. Member for Strangford (Jim Shannon) on a topic that is important to so many of us.

I am proud to be the co-chair of the all-party group on dementia and to work closely with the Alzheimer’s Society, which supports people living with dementia and their carers. We campaign on the issues that matter most to them. This debate is about the effects of covid on people with dementia and their carers. I will focus my remarks on the Alzheimer’s Society’s September report, “Worst hit: dementia during coronavirus”. The society undertook that collated work to assess the impact of the first wave of covid. I shall also discuss briefly the impact of covid on dementia research, particularly in view of the fact that we are approaching the comprehensive spending review statement later this month.

What has been the impact of covid on people living with dementia? People with dementia have unfortunately been among the worst hit by covid: they have experienced disproportionate loss of life, and those who live in care settings have been separated from their loved ones for many months. The Equality and Human Rights Commission has said in relation to older people, including those with dementia, that

“There is evidence that human rights standards may have not been upheld in the response to the pandemic…We are further concerned that equality considerations were not effectively and transparently built into decision-making at the national, regional and local level, both in terms of the immediate risks from coronavirus and the wider impact of restrictions. This may have resulted in failures to comply with the public sector equality duty.’

That is damning indeed, but on top of that, since March there has been a worrying decline in diagnosis rates for dementia, which were already low. There is some evidence that covid affects the brain and nervous system, as well as other systems in the body, and this needs to be monitored, particularly in relation to covid’s longer-term impacts.

In addition, we must not forget the family and friends who are carers, in my constituency and across the country, who have provided millions of additional hours of care during and between lockdowns. With no shielding support whatsoever, they have been feeling the strain from that lack of support during the pandemic.

To understand the scale of the problem facing people affected by dementia, I thought it would be helpful to share with colleagues information about the scale of dementia itself—of course, many colleagues will already be familiar with this information. In my local authority in Oldham, there are approximately 2,250 people who are currently living with dementia; across the UK, there are approximately 850,000 people living with dementia; and globally there are more people living with dementia than the entire population of Spain. A third of people born in the UK will develop dementia during their lifetime.

I know that most—if not all—of us here today have been touched by dementia in some way, as I was when my mum was diagnosed with Alzheimer’s disease, the most common form of dementia, at the age of 64. I want to highlight the fact that, contrary to popular belief, the majority of people with dementia—more than 60% of the total number—live well and live in the community. However, people with dementia account for over 70% of residents in care homes. This pandemic has laid bare and exacerbated inequalities across our country, and that is particularly true for people living with dementia and their carers.

Colleagues will be as horrified as I was to hear about the disproportionate death rates among people with dementia. Between March and June, over a quarter of the people who died with covid-19 in England and Wales had dementia. Dementia was the most common pre-existing condition in deaths involving covid, although it was never identified as a condition that made people clinically vulnerable. That is the reality we are presented with today, and it prompts the question whether people with dementia and their carers will now be given the proper support to be shielded. The miserly £14.60 per person that has been provided to local authorities to support the clinically vulnerable for the entirety of this second lockdown is, quite frankly, derisory.

In addition to those deaths from covid, there has been a sharp rise in excess deaths of people affected by dementia. Between January and July, 5,049 such deaths were recorded, and during the early peak of the pandemic excess deaths were double the five-year average. These excess deaths happened not only in care homes but among people living at home, with a rate 79% above the five-year average between the middle of March and the middle of September. We must ensure prompt and safe access to health and care services for people with dementia throughout the pandemic.

Why have people with dementia been dying in such high numbers? Various factors appear to be involved, with some undoubtedly contributing more than others. The risk of severe covid outcomes rises steeply with age; 94% of covid deaths between March and June were of people over the age of 60, and we know that people are more likely to develop dementia as they grow old. Evidence is emerging that suggests having dementia may increase the risk of severe covid symptoms and death when age and other conditions are taken into account.

Importantly, coronavirus can present itself differently in care home residents. A sizeable proportion—nearly one in five—of nursing home residents who tested positive for covid were either asymptomatic or had only atypical symptoms. They had no fever or cough, but often had a change in mental health status or behaviour, anorexia or digestive problems. That might also have contributed to the challenge of detecting and preventing the spread of covid in that population.

Perhaps the biggest contributor to the high death rate is where a person lives, whether in a care home or in the community. All of us here today have heard from local care homes and constituents about the serious challenges that have been faced in care homes, from unsafe discharges through to the lack of personal protective equipment and sporadic testing. Although we have made leaps forward in care home safety, I hope the Minister will commit today to ensuring that social care is on an equal footing with the NHS in terms of PPE and testing, and will respond to the issues raised by the EHRC. Looking forward, will she also ensure that the social care sector, including social care providers and experts in the third sector, as well as service users and their families, are involved in long-term developments for the sector?

I also want to speak up for the hundreds of thousands of informal carers across the UK, who are too often forgotten. It is unclear whether the lack of access to friends and families is affecting the progress of dementia, but one thing is clear: the emotional distress of not being able to see or touch our loved ones is very real. One of my Saddleworth constituents wrote to me:

“As the country pays its respects to those who fought and died for our freedom, let’s not forget that some of our war veterans, like my father, are still alive today. He like many others is locked away in a care home, having endured 8 months of separation from his family with no end in sight.”

Another constituent told me:

“My mother has been in a care home with worsening dementia for over three years. She is 96. I cannot see her and can’t even speak to her on the phone as she is almost deaf. It is heartbreaking to know that there is a very real possibility that I may never see my mother again, as visitors are barred from the care home. My mother probably believes her family have abandoned her.”

That is a dreadful thing to feel. With the roll-out of lateral flow testing, will the Minister commit to ensuring that family carers are given key worker status, are included in the care home testing protocols and have access to PPE, so that they can visit their relatives and provide the loving family care that is so desperately needed?

As I mentioned, most people with dementia live in the community, and one third live alone. I have already mentioned the amazing job that more than 700,000 carers do. Without them we know that the social care system would collapse. The pandemic has taken a significant and additional toll on many. The Alzheimer’s Society found that families and friends of people with dementia have spent an extra 92 million hours caring for loved ones with dementia during the pandemic; that is on top of the 100 hours or more a week of care that more than 40% of family and friend carers reported providing for their loved ones. For some that was on top of a full-time job. That dedicated group of people deserve more support as they struggle to care for their loved ones among their myriad other responsibilities.

Will the Minister today guarantee that where home care for someone with dementia has been stopped owing to coronavirus, it will be reinstated without any formal assessment? Will she also ensure that carers’ assessments are carried out; that short breaks are provided for people with caring responsibilities; that local authority data is collected on the provision of those services; and that the Government fulfil their commitment to do whatever it takes by properly reimbursing local authorities for the additional work that they are doing and the additional funding that they have spent during the pandemic?

I have already mentioned that people with dementia were not included in the Government’s formally shielded group in the spring. However, given what we know now about dementia being a significant clinical risk for covid morbidity and mortality, I am pleased that the Government have recognised that and are introducing a risk stratification for covid similar to that used for assessing heart attack and stroke risk. Will the Minister provide an outline of how that tool will work, including when she expects it to be available for use, and in particular what support will be available for those considered at risk?

As I also mentioned, the impact of covid had an impact on the diagnosis rate. It is well below the already low target of 66.7; it now stands at 63%. That means more people are living without a diagnosis of dementia and are unable to access emotional, practical, legal or financial advice, as well as the therapies associated with diagnosis. Memory services are adapting to open virtually, which is a welcome interim measure, but there is urgent need for a catch-up on waiting lists to ensure that the freefall in dementia diagnosis rates does not continue, and a virtual appointment is not the place to deliver a life-changing diagnosis. I will be grateful if the Minister can do all that she can to ensure that memory assessment services reopen in person at the earliest opportunity.

Finally, I want to raise the issue of dementia research as we look through and beyond the pandemic. The Conservative general election manifesto last winter pledged an extra £800 million over 10 years for dementia research—the “Dementia Moonshot”. I support that. The UK’s exceptional research into dementia prevention, therapies and care is already well under way. We have the second biggest research network on dementia in the world. We must not let that go. There are always new challenges. As I said, recent research has found that the neurological complications of covid can include brain inflammation, delirium and nerve damage. We need to be monitoring those types of effects on a long-term basis.

Unfortunately, much of the research that had been under way has been delayed during covid, with medical research charities, which do vital work to support early-career researchers, facing a 40% shortfall this year. A third of dementia researchers are already considering leaving the field. Losing that research talent would have a severe long-term consequence for dementia research, and ultimately for people with dementia. We cannot lose that innovative work. Let me give an example: the UK Dementia Research Institute’s care, research and technology centre has been developing tools and technologies to enable people to live in their homes as long as they can, reducing isolation and minimising the impact on the NHS and beds. Will the Minister confirm that the spending review later this month will fulfil the commitment to dementia research and provide the financial support that such organisations need? Research provides hope of a cure in the future, as well as developments in social care, technological innovation and public health advances to address the care needs of today.

Dementia is often an overlooked condition, but it is a condition that affects so many. People with dementia have been among the worst affected by this pandemic, and I hope the Minister will do all she can to ensure that we do not see such loss of life, strain on carers, and loneliness again as the pandemic progresses. I also hope that we see a long-term and fair funding solution for social care soon, which has the needs of people with dementia at its heart.

--- Later in debate ---

[Debbie Abrahams]

I start with heartfelt thanks to everybody who has contributed to the debate. It is so nice to be in such a high-quality debate where we all work together, and where we see and agree on the issues. Now, it is about moving forward on the solutions. There was much consensus, particularly on how we make sure that families can visit their loved ones in care homes. I have huge regard for the Minister. She has real empathy, and I am grateful to her for turning it into action, but I ask her to make a commitment. If the trial is starting next week, will she come to the House and make a statement at the end of this month, so that we know the results of that trial and when in December it will be rolled out? My hon. Friend the Member for Leicester West (Liz Kendall) makes an excellent point that this may be some people’s last Christmas. For everybody concerned, please can we do our utmost to make sure that this happens?

Covid-19 Update

Debbie Abrahams Excerpts

Tuesday 20th October 2020 Commons Chamber

[Matt Hancock]

The answer is yes. We absolutely want to use this sort of testing as it becomes more widely available to do exactly the sort of thing that my right hon. Friend sets out.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

May I say how shocked I am at some of the responses from the Health Secretary? All Andy Burnham and the leaders of the Greater Manchester local authorities have been trying to do is to ensure that their constituents— our constituents—are not plunged into poverty, homelessness and worse. That is all they have been trying to do. To describe it in the way that he has is really upsetting.

International evidence shows that key requirements for local lockdowns to work are, first, to have a competent test, trace and isolate system; secondly, that businesses and workers are supported by a financial package equivalent to existing incomes; and, finally, that national Government support local leaders. The Government have failed to deliver any of those. Are they following the evidence or not?

[Matt Hancock]

We are working incredibly hard to support the action that is needed to suppress this virus, while protecting the NHS and schools and supporting the economy as much as is possible. When it comes to the work in Greater Manchester, that is absolutely our goal. That is the work that we are doing and, given that support proportionate to that already agreed in Lancashire and Liverpool is on the table, I hope that local leaders will work with us.

Public Health: Coronavirus Regulations

Debbie Abrahams Excerpts

Tuesday 13th October 2020 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I support these restrictions with a heavy heart. On balance, I will be supporting the Government this evening, but I want to make just a few quick points.

I would be very careful about subscribing to the Vallance/Whitty orthodoxy that informed these regulations, while not at all examining very carefully respectable bodies of medical opinion to the contrary. I would cite particularly the Heneghan/Sikora/Gupta line. It is important that the Secretary of State and his ministerial team address those things head-on and treat them with the respect that they deserve.

The Secretary of State has my utmost sympathy. When coming into office, he opened a box marked “public health” and found tools for doing all sorts of things, such as sorting out lifestyle problems—obesity, smoking, diet and all of that. I suspect that he found very few that were geared towards dealing with infectious diseases, particularly this infectious disease. He has done some good things to try to remedy that in a very short space of time. May I suggest to him, to sort out the shadow Secretary of State’s obsession with Serco, that he looks again at the Public Health Laboratory Service, which was in its second incarnation as the Health Protection Agency when it was abolished in 2012. He might find in such a thing the means to deal with infectious diseases of this sort in the future.

We need to be careful about groupthink, confirmation bias, a thin evidential basis and uncertainty masquerading as certainty. There is a huge margin of uncertainty with all this, and we all need to develop a level of humility in our attitudes towards dealing with this crisis. That is why I shall be supporting the Government this evening.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I cannot let the right hon. Gentleman get away with that. In 2016, Operation Cygnus was very clear about what needed to happen. It was a question not of if there was going to be a pandemic; it was when. The Government failed to introduce all the recommendations from that exercise. I will not let them get away with this.

[Dr Murrison]

The hon. Lady can do what she likes. The Secretary of State is dealing with the situation that he found at the time. Developing the National Institute for Health Protection in short order from the disaster that was Public Health England was, I think, a very good effort, but there is much more to be done, as I know he appreciates.

May I sound a cautionary note for the Secretary of State? We have gone to great measures to close down schools, and I appreciate the need for that. That was informed, of course, by the Imperial College model, which was a flu model, in essence, and was inadequate for this particular virus. He will know—I hope he does—of the work published in September by the University of Edinburgh group under Ackland, which suggests that that certainly did suppress admissions to ITU. It certainly protected the NHS, but probably over time, unless we get a vaccine, it will cause more deaths directly from covid, quite apart from the incidentals for other diseases, the loss of liberty and livelihood. The Secretary of State needs to understand that and that there is an alternative view. If we do not get a vaccine, I fear, paradoxically, that we will see more deaths, not fewer, as a result of some of the interventions that we have put in place. Of course, Ackland was unsighted on this latest set, but the logic would suggest that those measures too may, over time, if we get a third and fourth wave, cause more trouble than they solve. It is a respectable piece of work and the Secretary of State needs to take account of it.

In all this, we simply do not know and we are learning all the time. We have to accept, I think, the expertise of those advising Ministers and that we have experts for a reason, but there is an alternative view. Unless we get a vaccine—goodness me, I hope we do—I think we may find that the cure is worse than the disease in terms of lives lost directly to covid, incidental lives lost to other common diseases—stroke, heart attack and particularly cancer—loss of liberty, loss of livelihood and the compete trashing of our economy. That is what is at stake. I do not envy the Secretary of State in his work.

--- Later in debate ---

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I would like to make the following points based on my 20 years’ experience as a former public health consultant.

Unfortunately, I do not believe that the new tier system and measures that were introduced yesterday are sufficient to contain the virus. The localised approach will not work because of seeding. The virus travels where people come from. I came down on the train yesterday—I talked to the hon. Member for Altrincham and Sale West (Sir Graham Brady) about this point—and there might have been people who were asymptomatic who unknowingly have spread the virus, unfortunately. There may also have been people who wanted to exercise their personal choice, who have the virus and knowingly exposed people to that risk. Unless the Government are prepared to set up roadblocks across the M1, M6, M62 and all other routes to and from the north, I am afraid that, just as happened in the first wave in Italy, the virus will spread.

To understand what we need to do now, we must understand how we got to this position. It is abundantly clear, as has already been said, that the national test and trace programme is not fit for purpose. In spite of clear WHO guidance, it was not fully operational in June when the first lockdown measures were eased, and as a consequence it has failed to cope with the predicted rise in infections ever since. On top of that there were, unfortunately, significant specific failures.

I support the calls of the CMO, SAGE and others for a short circuit break to help drive down infection rates, but that should be at the national level. Any circuit break period should be used to undertake the transfer of test and trace to local public health departments. That must be accompanied by full resource transfer. Currently, less than 10% of the money used by local authorities at a local level has been reimbursed by the Government. That is unjustifiable and unsustainable, and it must be resolved.

In addition, the circuit break should be used first to ensure that the NHS and social care are fully prepared. They must have adequate PPE. They must have flu vaccines. They must have regular testing regimes. We should identify vulnerable people for supportive shielding, and not via some algorithm. We need to define exactly how we are going to support people in a way that does not mean they will be detrimentally isolated. We must also make sure we have simple, coherent messaging with local community engagement, and I support what the Government are trying to do with the simplification. We must also make sure that we have monitoring and enforcement capacity.

All workers and businesses need to be fully supported during any circuit break. We are at war with the virus. The Treasury needs to recognise that and respond adequately. Finally, the Government must recognise that covid is a disease of poverty.

Covid-19 Update

Debbie Abrahams Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. People are asking questions about how the vaccine will be rolled out and of course I understand why people are so interested in that. We will of course protect the most vulnerable first and we will do that on the basis of clinical advice. The JCVI brings together the best clinicians in this area and it meets very regularly. Decisions of the JCVI will not be on the critical path to the roll-out of the vaccine—I have been assured of that.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

One of my 15-year-old constituents had a covid test over a week ago, and in spite of chasing, is still none the wiser as to whether she has covid or not. Not only is she having to self-isolate, but her mum, a nurse, is having to take the precaution of self-isolating, something she says her ward can ill afford. On top of that, last month, the time taken to get test results back from the national Test and Trace programme to Oldham’s public health team, to enable them to trace the cases that the national programme is failing to get in touch with, was 12 days—12 days, not 24 hours. Will the Health Secretary please tell my constituent how many of the 16,000 or so lost test results were from Oldham, and how many contacts—not cases— have not yet been traced?

[Matt Hancock]

The good news is that the turnaround time of test results has been coming down. I would love to take up the case of the individual who has not had a result back, as the hon. Lady has described, because that is rare: the majority of cases now come back the next day. I will specifically look into turnaround times in Oldham, because an average of 12 days seems a lot longer than I expected, and I will make sure to get back to the hon. Lady at the appropriate opportunity.