Covid-19: R Rate and Lockdown Measures

Jonathan Ashworth Excerpts

Monday 8th June 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care to make a statement on the R value and lockdown.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Thank you, Mr Speaker, for this opportunity to update the House on progress on our plans for controlling coronavirus.

Thanks to the immense national effort on social distancing, as a country we have made real progress in reducing the number of new infections. As we move out of lockdown, we look at all indicators to assess progress in tackling the virus. Last week’s Office for National Statistics infection survey estimated that the number of people who have had coronavirus in England fell from 139,000 between 3 and 16 May to 53,000 between 17 and 30 May—a drop of over half. In terms of new cases, an ONS estimate released on Friday shows that there are now around 5,600 new cases each day within the community in England: a huge drop since the peak.

The number of new fatalities each day is, thankfully, falling too. Today’s figures record 55 fatalities, the lowest number since 21 March, before lockdown began. They also show that there were no deaths recorded in London hospitals. That is a real milestone for the capital, which, of course, in the early stages of the pandemic, faced the biggest peak. Yesterday, we saw no recorded deaths in Scotland, which is very positive news for us all. Sadly, we expect more fatalities in the future, not least because the figures recorded at the weekend are typically lower. What is more, Mr Speaker, 55 deaths is still 55 too many and hundreds of people are still fighting for their lives. Each death brings just as much sadness as when the figure was much higher in the peak. I know that the thoughts of the whole House are with those families and communities who are grieving for their loved ones.

We, of course, also look at the R rate. The Scientific Advisory Group for Emergencies confirmed on Friday that its estimates, taking into account 10 different models, are that R remains between 0.7 to 0.9, and that it is below 1 in every region of the country. That means the number of new infections is expected to continue to fall. So there are encouraging trends on all critical measures. Coronavirus is in retreat across the land. Our plan is working and those downward trends mean that we can proceed with our plans, but we do so putting caution and safety first.

Even at the peak of the pandemic, we protected the NHS and ensured that it was not overwhelmed. We will not allow a second peak that overwhelms the NHS. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on infections in our hospitals, including through the new measures to tackle nosocomial infection, such as face masks for visitors, patients and staff. Finally, we are strengthening protections for our care homes, including by getting tests to all elderly care home residents and staff.

I am glad to be able to tell the House that David Pearson, the eminent social care expert who has previously led the social care body ADASS—the Association of Directors of Adult Social Services—and has decades of experience of leadership in both social care and public health, will be chairing our new social care taskforce to drive our covid action plan yet further. David has an impressive track record and I am delighted that he will be supporting us in leading this important work. Together, we are getting this virus under control and now more than ever we must not lose our resolve.

[Jonathan Ashworth]

I note what has just been said about the social care taskforce, but may I say that it probably should have been set up some months ago? The Government are easing restrictions, but even when looking at their own tests we know that PPE supplies are still not secured—dentists are warning about PPE today; that tracing is still not fully operational—the chief operating officer of test and trace has warned that it will not be fully operational until September; that testing is still not sufficient—we are still not routinely testing all NHS staff, whether asymptomatic or not, even though we know that such testing will arrest the spread of the virus in hospitals; and that the R value, according to the PHE Cambridge model, is close to 1 in many regions and is at or above 1 in the north-west and the south-west. The modellers of that model warn that that may result in the

“the decline in the national death rate being arrested by mid-June.”

The British people have shown great resilience and fortitude in observing this lockdown and helping to slow the spread of this deadly, horrific virus, but we have still had more than 40,000 deaths. As the Secretary of State said, infections are still running at more than 5,000 a day. We should proceed with caution, but many now fear that the Prime Minister is starting to throw caution to the wind. I therefore wish to put some specific requests to the Secretary of State: will he agree to start publishing, on a weekly basis, the regional R value estimate, alongside the national estimates? Does he agree that the voices of regions must be heard in future decisions about lockdown? Will he start including the various metro Mayors, such as Andy Burnham, in the covid Cobra meetings? Will the Secretary of State ensure, this week, that local authorities and general practitioners start receiving specific data about who has tested positive so that they can start putting in place area-based responses? Will he issue, this week, written guidance on defining what a “local lockdown” is, how it will be enforced and what resources and powers local authorities and agencies will be able to draw upon?

Finally, we know that the more deprived an area is, the higher the covid mortality level. There are pockets of deep deprivation in the north-west and in the south-west, such as in parts of Cornwall. What financial support will be given to those who are asked to isolate? Given that we also know that black, Asian and minority ethnic people are more at risk from covid, will he now publish the PHE report on disparities in full—all the chapters, all the analysis, all the recommendations—because action to protect BAME people, especially BAME health and care staff, must be an urgent priority?

Covid-19 Response

Jonathan Ashworth Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

There have now been 56,308 excess deaths since the beginning of March, 12,500 of which are not related to covid, but we do have one of the worst excess death rates in the world—why does the Secretary of State think that is? What does he believe is the cause of the non-covid excess death rate?

With respect to the PHE’s findings, which I am pleased to see published today, we have always known that there is a social gradient in health. The poorest and most deprived have inequality in access to healthcare and inequality in health outcomes. What the Secretary of State has confirmed today is that covid thrives on inequalities. Yes, indeed, black lives matter, but it is surely a call to action that black, Asian and minority ethnic people are more likely to die from covid and more likely to be admitted to intensive care with covid. He has seen the findings. I note that the Equalities Minister is taking work forward, but what action will be taken to minimise risk for black, Asian and minority ethnic people?

There are other vulnerable groups who are highly at risk. I am sure the Secretary of State will have seen today the Care Quality Commission report which shows a 134% increase in deaths of people with learning disabilities. Surely it is now time to expand testing to those under 65 in receipt of adult social care.



On the easing of restrictions, the Secretary of State said that this was a sensitive moment—well, quite, Mr Speaker. Our constituents have concerns and are looking for reassurance, particularly those in the shielding group. They really should not have had to wake up on Sunday morning to find out that they could now leave the house once a day. They need clarity and details. And why were GPs not informed in advance?

We are still at around 50,000 infections a week, so may I press the Secretary of State a bit further on the easing of restrictions? The biosecurity level remains at 4, but his own Command Paper from 11 May said that changes to lockdown

“must be warranted by the current alert level”.

At the Sunday news conference, the Secretary of State for Housing, Communities and Local Government said that all the proposed easing of restrictions had been modelled and showed that the R value remained below 1. That is, of course, reassuring, but will he now publish that modelling so that it can be peer-reviewed?

The easing of restrictions was based on tests, so may I ask the Secretary of State a couple of questions? First, on NHS capacity, we know that the NHS has not been overwhelmed, but that has been on the back of cancelled planned surgery, delays to vital treatment, and the postponing of cancer screening. Arguably, it has been the biggest rationing exercise in the history of the NHS. Will he now publish the total number of planned operations that have been cancelled and detail them by procedure? As the lockdown is eased, is it his intention to step down some of that surge capacity so that this backlog of clinical need can start to be tackled?

On managing the virus, one of the tests is on whether we can manage the virus, but, as the Secretary of State has said, that depends on testing and tracing. There is now capacity for more than 200,000 tests, but there is still a lack of clarity about how that figure is arrived at. The UK Statistics Authority has written to him today, saying that his figures are still

“far from complete and comprehensible”,

that the testing statistics still fall well short of standards in the code, and that it is not surprising that testing data is mistrusted. That is quite damning, I have to say to him. Will he start publishing again the actual numbers of people tested? Will he stop counting tests mailed to homes as completed? Will he detail what proportion of the 200,000 tests are diagnostic PCR, what proportion are antibody, and what proportion are surveillance? Can he tell us how many care home staff and residents have been tested? When will he start weekly testing of all NHS staff, as that is crucial for getting on top of infections in hospitals? Will he tell us what percentage of the Deloitte-run testing facilities have been sent to GPs?

On test and trace, which is absolutely vital to safe easing out of the lockdown, the Prime Minister told the House before the recess that it would be “world-beating” and operational by yesterday, but it is not actually fully operational at a local level, is it? Can the Secretary of State confirm that local directors of public health have been told to prepare strategies for tracing with a deadline of the end of June, that they will not actually start receiving local individual data until next week, and that many have still not been told their allocations of the extra £300 million nor what they can spend it on? When will they get those allocations? Despite this, he said yesterday that test and trace is up and running. I am not sure how he can say that it is up and running when local directors of public health are still asking for that information. Will he publish the data and what percentage of infections have been contacted and how many contacts have been followed up? Will that data be published on a daily basis?

This is a crucial week, given the easing of restrictions, and our constituents want reassurance and clarity, but I am afraid that trust has been undermined by the Dominic Cummings scandal. Our constituents want to do the right thing for their loved ones and their neighbours. Can he give them those reassurances today?

[Matt Hancock]

I entirely agree that it is critical that people play their part in making sure that we continue the work of controlling this virus and driving down the number of new transmissions. I am glad that he recognises the work that has been done, not just by Government, but by all of us, to get this virus under control.

Let me answer the hon. Gentleman’s questions specifically. He asks about the inequalities in health outcomes. He is quite right to address that subject. It was important before we went into the coronavirus crisis, and it is even more important now. Black lives matter, as do those of the poorest areas of our country, which have the worst health outcomes. We need to ensure that all these considerations are taken into account and that action is taken to level up the health outcomes of people across this country, because there is no more important levelling up than the levelling up of a person’s life expectancy and the quality of health with which they live that life.

The hon. Gentleman asked specifically about those with learning disabilities and autism. That testing in care homes for those of working age has continued all the way through this crisis, and we are rolling it out further. He mentions the changes to those who are in the shielding category. I was very pleased that we were able to make these changes. We announced them at the weekend and they have been very well received, especially by those who are shielding, because they are now able, safely, to go outside. It is hard to overstate the impact of saying to people that the recommended medical advice was that they should not go outside for 10 weeks. I am glad we have been able to lift, just slightly, the restrictions on those in the shielding category.

The hon. Gentleman also asked about the restart of the NHS. It is vital that we get the rest of the NHS going again, and that work is under way. The expansion of cancer facilities is under way. The demand for accident and emergency and urgent care is not as high as it was, but I look forward to the full restoration of our A&E facilities across the country, including in central Lancashire.

The hon. Gentleman asks, rightly, about the NHS test and trace capability. That is up and running, and working well. He asks how I can say it is working well. It is working well because thousands of people have been contacted and their contacts are being traced. So the system is working. We absolutely will publish data on that, but, as the letter from the UK Statistics Authority this morning shows, it is very important that we get that data publication right. We will work with the UKSA to make sure it is happy with how we are publishing that data, to make sure we get the data published in a reasonable and sensible way, one that also supports the operation of NHS test and trace, which we agree is a critical part of the next stage. I commit to publishing that data and to working with the UKSA on how it is put together.

The final point to make in response is that the goal here is to have a more targeted approach to the lockdown, so that we can carefully and cautiously lift the broader lockdown. That is what we are working to achieve, and I am very grateful for the support from right across the House for our efforts to accomplish that.

Covid-19 Response

Jonathan Ashworth Excerpts

Monday 18th May 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

On symptoms, the right hon. Gentleman will know that many healthcare specialists were making these warnings eight weeks ago, so can he explain why there has been a time lag in updating the case definition?

I note what the right hon. Gentleman said about social care, but he will be aware that more than 12,500 people have sadly died in care homes because of covid-19. Last week, he said that he had put a protective ring around care homes from February, but yesterday a care home provider wrote in The Sunday Times:

“Elderly people weren’t a priority”

They also wrote:

“The government was asleep at the wheel.”

Is the reality not that there was no early lockdown of care homes when needed, and there was no testing of people transferred from hospital to care homes until mid-April, seeding the virus? Personal protective equipment was requisitioned from care home staff and given to the NHS because of wider shortages. There was guidance suggesting that infection was unlikely, and that guidance was still in place when there was community transmission.

We still do not have full testing of all residents and care home staff 12 weeks later. No wonder Age UK has said that this is “too little, too late”. I note that the right hon. Gentleman said that testing will be expanded. Can he bring forward the date by which all care home residents and staff will be routinely tested? The document last week says that it will be by 6 June. Why can the date not be sooner?

Has this crisis not shown that our care sector is staffed by exceptional, dedicated people, and that migrant care workers are not low skilled but immensely able? Does the right hon. Gentleman agree that the Home Office should acknowledge that, and praise such potential workers, not penalise them?

I welcome the wider roll-out of testing. The right hon. Gentleman did not mention the antibody test. Could he update the House on that front? It has also been reported today that 20% of hospital patients got covid while in for another illness. Two weeks ago, he suggested to me in the House that he planned to roll out screening of all healthcare workers, whether symptomatic or not. Can he update us on that front?

On tracing, I have long argued that the safe way to transition out of the lockdown is by having a test, trace and isolation strategy in place, but it depends on a quick turnaround of test results. Can the right hon. Gentleman tell us the current median time for test results to be received by someone when carried out by the Deloitte and other private sector testing facilities, and how soon do directors of public health and GPs receive those results?

The right hon. Gentleman knows that I believe he should be making better use of local public health services. None the less, he is pressing ahead with the national call centre delivered by Serco. Can he tell us by what date that tracing service will be operational? Will it be operational by 1 June?

The right hon. Gentleman did not talk about isolation as one of his key elements of the test-trace strategy. Many poorer people will not be able to self-isolate. Will he look at providing facilities for such people, such as empty hotel rooms so they can quarantine? Will those in insecure work be guaranteed sick pay if they are asked to isolate for seven or 14 days?

On the R number, will the right hon. Gentleman guarantee that every easing of restriction, such as asking children to return to school, is accompanied by a Government statement on the expected impact on the R number and the underlying prevalence of infection? If R rises to be greater than one in a region or local area, how will the Government respond?

As the right hon. Gentleman says, this is Mental Health Awareness Week. We are very fearful of a growing burden of mental health issues, especially in children, as a result of the lockdown. What extra investment is he putting into mental health services, particularly children’s health services? NHS staff, who are threatened not only by exposure to the virus, but the trauma, emotional distress and burnout associated with working on the frontline, need support as well. They need PPE, they need fair pay, they need mental health support. Those care workers who are caring for us need us to care for them and we should thank them again in Mental Health Awareness Week.

[Mr Speaker]

I now call Secretary Matt Hancock for a concise reply.

Covid-19

Jonathan Ashworth Excerpts

Tuesday 12th May 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I am grateful to you for that, Madam Deputy Speaker. We have heard many fine speeches over two days, and I hope Members will forgive me for not being able to mention them all. Throughout this outbreak, our paramount concern has been to save lives and minimise harm. That means suppressing the virus, not managing its spread. We are tracking towards one of the worst death tallies in the world, with more than 40,000 deaths, every one a tragedy, and this House cannot ignore the disproportionate impact the virus is having on black, Asian and minority ethnic communities—a thorough inquiry is a necessity. Today’s debate is not an inquest. No doubt there will have to be, in the future, a full and proper public inquiry, with access to an abundance of material and data. However, the Government must understand the concern, grief and anguish of our constituents who have lost loved ones or suffered great harm.

Ministers should expect searching questions. For example, did we enter lockdown too late? Ministers tell us they were following the science, but a SAGE paper from February on social distancing concedes:

“It is a political decision to consider whether it is preferable to enact stricter measures at first…or to start with fewer measures”.

As the Chair of the Health Committee, the right hon. Member for South West Surrey (Jeremy Hunt), said yesterday,

“Ministers have to take responsibility for their decisions.”—[Official Report, 11 May 2020; Vol. 676, c. 59.]

This virus exploits ambivalence. It demands clear public health messaging. Points about confused messaging have been made eloquently throughout the debate, but fundamentally the point is that nobody should be asked to go to work or send their children to school without it being safe to do so, and many do not believe that the Prime Minister’s instructions on Sunday evening yet meet that test. The Government must work with the TUC to ensure that strict safety measures are in place. No worker should be forced to put their health at risk. I hope the Minister can tell the House what the impact of asking people to go back to work will be on the R0.

The lockdown has been a powerful tool to bring down transmission, and easing lockdown too soon risks a dangerous second wave, with unacceptable further loss of life, so we support its continuation. But lockdown has a cost. It has an economic cost, certainly. It has a detrimental cost for children who spend months out of school; UNICEF has warned that children are not the face of this pandemic but risk being among its biggest victims. It also has a cost for health. We talk about protecting the NHS, but the extra surge capacity in the NHS has been built on the back of 2 million operations cancelled, cancer treatment delayed, unquantifiable mental health problems left to fester, and falling A&E attendance. There will indeed be long-term mortality and morbidity as a consequence of this lockdown. Ministers need to fund the NHS for that growing burden of unmet clinical need.

However, we cannot leave the lockdown safely unless thorough public health measures are in place. We need case finding, testing, tracing and isolation, which have been vital to the success of nations such as South Korea, Australia and New Zealand. Testing and surveillance are crucial to properly understanding prevalence and the estimates of the R0.

The former Business Secretary, the right hon. Member for Tunbridge Wells (Greg Clark), put it well yesterday when he said:

“A lack of testing has caused a lack of data, which has meant that too many of our policy decisions have been taken with a self-imposed blindfold.”—[Official Report, 11 May 2020; Vol. 676, c. 84.]

I agree. We were doing tracing in February, and then we abandoned it on 12 March. It took until 29 April for adverts to start appearing to recruit tracing call centre staff, a service that is to be handed over to the private sector. I do not believe that that tracing should be done by Serco. Instead, we must use the expertise in local public health services, our environmental health officers and our strength in primary care, and GPs should routinely be sent the test results of their patients.

Given the levels of significant asymptomatic and pre-symptomatic transmission, we need a proper targeted testing strategy too. All healthcare workers must be screened regularly. A study by Imperial suggested that that would reduce transmission in healthcare settings by up to a third. Because Office for National Statistics data show higher mortality in more deprived areas, with those in lower-paid occupations at greater risk, inequalities in accessing testing must be stamped out, and people must be provided with the means to self-isolate. That should include making use of hotel rooms and providing decent, more generous statutory sick pay if people cannot isolate at home.

We need to take other public health measures too. We support the quarantining of arrivals for 14 days at airports, but why did the Government not implement that earlier, and why is there still a lag in enforcing it? I am sure I am not the only Member struck by the curious irony that a party that promised to take back control of borders has conspicuously failed hitherto to enforce any border restrictions at a time of a devastating global pandemic.

We need to minimise outbreaks in vulnerable settings. Exercise Cygnus warned about the risks in care homes. The Government document published yesterday proclaimed that

“the Government will continue to bolster the UK’s social care sector”.

Today we learned of 8,312 tragic deaths in care homes. Why did Government official guidance until 12 March say:

“It remains very unlikely that people receiving care in a care home or the community will become infected”?

Why were patients discharged from hospital and transferred into the hands of social care without a test? And why still today, when we know that all staff and residents should be tested, are the Government promising to deliver that testing only by 6 June, a month away? This is not swift action. In many ways it looks like utter negligence.

Today is International Nurses Day and many will light a candle or shine a light from their windows at 8.30 pm to thank and pay tribute to every nurse. We will remember them and every health and care worker who has paid the ultimate sacrifice to this horrific disease. Our NHS staff and care staff, many of whom are exhausted and fearing burn-out, need more than Thursday evening clapping. They need our full support, safe staffing ratios, PPE and decent fair pay. They have been asked to give so much. They too often get so little in return. We hope that they are recognised for their true worth at the end of all this.

Oral Answers to Questions

Jonathan Ashworth Excerpts

Tuesday 5th May 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

We need to be doing all we can to protect our key workers, especially those in healthcare. I welcome and note what the Secretary of State said about testing, but has he considered the study from Imperial suggesting that weekly screening of healthcare workers—testing them every week whether symptomatic or not—reduces their contribution to transmission by around 25% to 33%? Will he look at testing all healthcare staff whether they have symptoms or not?

[Matt Hancock]

Yes. The shadow Secretary of State has asked questions in a responsible and reasonable way, and I welcome his support for the test, track and trace pilot on the Isle of Wight that we announced yesterday. His question is quite right; we have piloted the testing of asymptomatic NHS staff in 16 trusts across the country. Those pilots have been successful, and we will be rolling them out further.

Covid-19 Update

Jonathan Ashworth Excerpts

Tuesday 5th May 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the Government’s response to covid-19.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We have flattened the curve of this epidemic, ensured that the NHS is not overwhelmed and expanded testing capacity to over 100,000 tests a day. As a Government, we are working resolutely to defeat the coronavirus, and there are two important areas where I want to update the House today.

First, on the expansion of our work to test, track and trace, we have now built a national testing infrastructure of scale, and because we have this extra capacity, we will be delivering up to 30,000 tests a day to residents and staff in elderly care homes, making sure that symptomatic and asymptomatic staff and residents can all be tested. Our care system represents the best of us, supporting our loved ones with tenderness and dedication at their time of greatest need. Through this unprecedented expansion of testing, we can give them the certainty and confidence that high-quality testing can provide.

Secondly, we are working to build the resilience of the NHS. We currently have 3,387 spare critical care beds in the NHS and that does not include the capacity provided by our Nightingale hospitals, including the 460-bed Sunderland Nightingale, which opened earlier today. We should all be very proud that we built up the NHS so fast and that our collective national effort has helped to protect the NHS and flatten the curve. As a result, we are now able to start to restore some NHS services and we are in a position to be able to place the London Nightingale on stand-by. This is good news, because our NHS has not been overwhelmed by this crisis and remains open to those who need care, and that means that this nation’s shared sacrifice is having an impact.

Throughout its time, this Chamber has borne witness to so much, and it has borne witness to the nation’s resolve once more. I am delighted that the British people are well and truly rising to this incredibly difficult challenge.

[Jonathan Ashworth]

Our thoughts, as always, are with the loved ones of those who have lost someone to this awful disease. May we again pay tribute to our brave NHS and care staff? I say to the Secretary of State that clapping and campaigns for medals are appreciated, but does he agree that NHS and care workers deserve fair pay, mental health support and access to personal protective equipment? I am hearing reports that we may have problems with the stocks of sterile gowns. Could he update the House on that front or write to me if he is not able to do so today? We also rely on international staff, as he knows. Will he scrap the health surcharge that they have to pay? It seems particularly unfair at the best of times, but especially at this time.

We are tracking towards having one of the worst death rates in the world—we have seen the figures again today. I know that the Secretary of State said that we are through the peak, but can the same be said of the care sector, given the number of deaths we have seen reported today in the care sector? He knows that we support lockdown and it is right that we engage in a debate about it. The strategic aim must be to suppress this virus, not simply to flatten its spread, in order to save lives and minimise harm. Testing, tracing and isolation is crucial.

Does he agree that we should be mobilising our expertise in local authority public health services, as well as other specialists such as environmental health officers, and our expertise in primary care? Would that not be a better route than outsourcing the call centre work to firms such as Serco? We support digital tools, but he will understand that there are questions about privacy. Will he undertake to publish a data protection impact assessment?

As we heard in Question Time, deprived areas have experienced covid mortality rates that are more than double those in less deprived areas. There are disproportionate mortality rates among black, Asian and minority ethnic communities. Does that not show that covid thrives on inequalities and that we need a funded strategy to support low-paid, deprived and marginalised communities, including by enforcing protections in the workplace when we transition out of this lockdown?

Can the Secretary of State comment on the remarks that were made in a Select Committee earlier by the chief scientific adviser, who said that we imported many cases from Italy and Spain early on in March? That was when events such as Liverpool v. Atletico Madrid were still going ahead. What advice will he be taking about testing at ports of entry and quarantine when we transition out of the lockdown?

Finally, we are building up a huge a backlog of unmet non-covid clinical need in the NHS. What resources will be available to deal with that, and how will we get the waiting list down? We do not want the lockdown to result in excess mortality and morbidity among those with non-covid conditions.

[Matt Hancock]

I am grateful to the shadow Secretary of State for his questions, and he is quite right to raise them. I will go through them as fast as I can and respond to them in turn. First, gown supply is improving and we have a better distribution system for PPE, on which we have been working incredibly hard under the leadership of Lord Paul Deighton. He has come in to help on PPE and made a significant improvement already.

The shadow Secretary of State asked about the number of deaths in the care sector. It is incredibly important that we protect those who live in social care settings and those who receive social care in their own homes. I am glad that in the data released by the Office for National Statistics this morning, the number of deaths in care homes was slightly lower, but it is still far too high and there is a huge amount of work still to do.

The shadow Secretary of State rightly asks about making sure that we suppress the virus. That is the goal—not just to flatten the peak, but to get the numbers right down. In doing so, our local authority public and environmental health teams will be absolutely vital, and he is right to draw attention to them. In this Chamber, we often rightly praise the NHS and social care staff, but I think this is a good moment for us to come together to praise our public health officials and environmental health officials in local authorities.

Finally, the shadow Secretary of State asked about non-covid needs, which are incredibly important. People who need treatment should get that treatment. We are opening up and reopening the NHS, and that includes any temporary closures, for instance of A&Es that need to reopen. I can think of one example in Chorley, Mr Speaker, which we are working hard to reopen as soon as possible, as the NHS reopens. I am happy to put that on record. It sometimes seems slightly unfair that you, as Speaker, cannot ask open constituency questions, but I know that that is something you have worked incredibly hard on, along with your colleagues in Lancashire.

Finally, I want to reiterate the point about levelling up. The Government’s agenda of levelling up is unabated; in fact, it is strengthened by this crisis. There are many reasons for the disparate impacts of coronavirus on different groups. Public Health England work is urgently under way into, for instance, the impact on ethnic minority groups, the impact of obesity and deprivation, and the much greater impact of coronavirus on men than women. All those things need to be considered and looked into, and we need to level up our country once this crisis is over.

Covid-19 Response

Jonathan Ashworth Excerpts

Wednesday 22nd April 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op) [V]]

I am grateful to you, Mr Speaker, for making the arrangements for us to be able to participate in these circumstances. I thank the Secretary of State for advance sight of his statement.

My thoughts are with all those who have lost their lives to this horrific virus. I pay tribute to the NHS staff who have lost their lives. I hope that, when this is over, we can find an appropriate way to remember the frontline NHS staff who gave their lives for all of us. May we also remember those social care staff who have also lost their lives? Will the Secretary of State tell us the actual number of social care staff who have sadly died? The First Secretary did not have those figures at his fingertips a few moments ago.

It looks like we are heading for one the worst death rates in Europe. The Government have been careful to always say that they are following scientific advice. Will the Secretary of State tell us the explanation from the Government’s scientists for why our death rate seems so poor when compared with Germany’s, for example? Will he undertake to publish the Scientific Advisory Group for Emergencies’ minutes, which have not been published? Will he also undertake to publish the evidence on why we are following a seven-day rule for isolation? That appears to contradict the World Health Organisation, which suggests a 14-day rule for isolation.

As the virus develops, we see that, while it attacks the respiratory system, it also attacks cells throughout the body with ACE2 receptors, leading to cardiovascular and renal failure. In the same way that the Secretary of State can convene SAGE and other committees, will he convene the clinical societies so that we can share understanding of the disease among clinicians regarding how best to treat the disease as research emerges?

I am sure that the Secretary of State is struck, as I am, by the high proportion of deaths among black, Asian and minority ethnic communities. We see that in the United States, too. He has launched an inquiry. Will he update the House on that and tell us when it will report?

I am sure the Secretary of State is as horrified as I am by the deaths in care homes and nursing homes. This was always a high-risk sector, which is why we have long called for a social care strategy. Will he undertake to do four things? Will he ensure that all deaths are recorded on a daily basis?

The CQC suggested today that the death rate in care homes is double what was reported by the ONS yesterday. Can he ensure that testing for staff is delivered in care homes at local NHS sites or by mobile units? It is clearly ludicrous to expect care workers to travel for miles and miles to drive-through testing centres. Can he ensure that PPE supply systems for the NHS are expanded to the social care sector as well? The Secretary of State said in the past that the NHS will get whatever it takes. Will the social care sector now get funding to cover the huge costs that it is facing, which are associated with increased staffing levels and PPE? I join him in praising the leadership of the NHS for what it has done.

The Secretary of State gave us the critical care figures. How many general and acute beds are currently empty in the NHS? If there are significant numbers of empty beds, could they be used for social care residents, or to start a return to elective surgery? We know that the lockdown is having an impact on people’s wider health. Cancer patients are going without treatment, and we know that elective waiting lists will rise. Can he tell us the latest estimates how high he thinks those lists will rise? There are also bound to be mental health problems associated with the lockdown.

Many people are understandably angry that front-line staff do not seem to be getting PPE on time, and we do not seem to have taken part in some of the European procurement projects. The Chancellor of the Duchy of Lancaster said that was because we missed an email. The Secretary of State said that we are now part of that project, but that prompts the question of why we were not part of it at the beginning. The senior civil servant at the Foreign Office said it was a political decision. Will the Secretary of State tell us exactly what went on? Will he publish the background briefing so that we can see exactly what happened?

Finally, I agree that testing and contact tracing are vital to coming out of a lockdown. The Secretary of State talked about wanting to upscale contact tracing, but that is very labour-intensive. Can we use the 750,000 volunteers who have signed up to do some of that contact tracing? The app that he mentioned is welcome. When will it be available? Is he proposing that it will be mandatory, or will it be voluntary? If it is voluntary, how will we ensure that it is taken up by the population? Will he comment on reports today that the PCR test, which has been used for some NHS staff, returned false results and that those staff had to be tested again? How many people have been affected by that? What is now in place to ensure that that does not happen again? If the Secretary of State cannot answer all those points today, I hope that he will write to me with the details at a later point.

[Matt Hancock]

I thank the shadow Secretary of State for the approach that he has taken in applying scrutiny, but in a tone that makes it clear that right across the House we are united in our efforts to tackle this virus. He asked about the number of social care staff who have sadly died: 15 social care staff have sadly lost their lives. Just as we pay tribute to and remember all those NHS staff who have died, so we do for those who serve our country and look after people in social care.

He asked about international comparisons regarding the number of deaths. Of course, that needs to be done scientifically, taking into account the size of the populations of different countries. We are constantly making an important analysis of why the death rate as a proportion of the population in Germany is lower, and I speak to my German counterparts about that. In the same way, we look at all the European countries where the death rate is higher, and we try to learn lessons and ensure that we are doing the best we possibly can. There are many explanations for what is happening in Germany. One of them, which the German Health Minister explains both in public and in private, is the nature of those who first caught the disease in Germany. There is an awful lot of analysis of why, and we are constantly looking at that question, to improve our delivery here.

The hon. Gentleman asked about the seven-day rule and the proposals through SAGE. SAGE is an advisory committee, and it advises Ministers. We are guided by the science throughout this, and the science recommends the seven-day rule for coming out of full-blown isolation—it is not returning to normal by any stretch—once somebody has had the disease and no longer have symptoms. That is the scientific advice. The basis on which that decision was taken was, precisely as he says, that we listen to the advice from SAGE and then take decisions based on it. That was one where we fully accepted the advice, as we do with most of these clinical decisions.

The hon. Gentleman asked about expanding clinical understanding. He is right that the biggest impact of this disease is on the respiratory system, but it is not the only impact, and I will seek to take up his suggestion that the key clinical figures are convened. I think that the royal colleges are doing that already, but I will check that that is happening.

The hon. Gentleman asked about the disproportionate number of people from minority ethnic backgrounds in the figures of those who have died. We are indeed investigating that, and I will ensure that he has a copy of the results of that investigation as soon as it is concluded. That is a very important piece of work. There is also a disproportionate number of men who are badly affected by this disease compared with women. We need to look at all these characteristics and ensure that we have the full analysis, so that we can learn how to treat.

The hon. Gentleman asked about care homes. All deaths in care homes are, of course, recorded. In terms of the difference between the figures produced by the CQC, the Office for National Statistics and the NHS for deaths in hospitals, those figures measure slightly different things in different timeframes. It is important to look at a rigorous analysis of the comparison of the three. Yesterday there was some debate about whether the ONS figures showed that the deaths outside hospitals were 40% higher. It turned out that that was not true—it was comparing apples and pears—and the real figure is closer to 20%. I would caution the hon. Gentleman against comparing the headline figures without a true comparison of the underlying statistics.

The hon. Gentleman asked about the testing of staff. I am really pleased that we have managed to roll out testing to staff in care homes. He is right that that can helpfully be done through mobile units and the home testing kits that are increasingly available, especially for care homes that are not close to one of the drive-through centres. We now have 27 drive-through centres, and we are increasing that number over the next few days. There are new drive-through centres coming on stream all the time.

The hon. Gentleman rightly asked about PPE supplies to care. A new service is coming on stream directly to provide the PPE that is needed for care homes and domiciliary care—care provided in people’s homes. As I say, increasing that supply has been a massive logistical undertaking, with over 1 billion items of PPE delivered so far.

The hon. Gentleman asked about the spare capacity in the NHS. There are over 10,000 beds currently free in the NHS. We want to reopen the NHS to non-coronavirus symptoms and patients with non-coronavirus conditions safely and carefully as soon as it is safe to do so. The first step we are taking is to send the message loud and clear to people who have suspected conditions that they should come forward. If you think you have a lump that might be a cancer, come forward now, and you will be safely and properly treated in the NHS. The same goes if you have a suspected heart attack or stroke. We have systems in place to make sure that if you come to the NHS, you will be looked after and protected.

We will gradually reopen the rest of the NHS—for instance, to the sort of non-life-threatening conditions and elective surgery the hon. Gentleman mentioned—as soon as it is safe to do so. As he can see, the combination of having some spare capacity in the NHS and at the same time having reached the peak of the virus means that we can now start to reopen the NHS. Part of that is encouraging people to seek NHS treatment when they need it.

Finally, the hon. Gentleman mentioned contact tracing and the app. The app is currently in beta trials, which are going well, but, clearly, although an app to tell people who test positive for coronavirus whom they have been in contact with is helpful, we also need mass contact tracing so that as we bring the rate of transmission down and the rate of testing up, we can contact all the people anyone who tests positive has been in contact with and make sure that they get access to support and know what to do. In that way, we can control the virus with fewer of the extraordinary social distancing measures that have been in place.

Covid-19 Update

Jonathan Ashworth Excerpts

Tuesday 24th March 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State, as always, for advance sight of his statement. As he knows, yesterday we called on the Government to move to implement the enforcement of social distancing measures, so the Prime Minister was quite right last night to call for people to stay at home.

May I put to the Secretary of State a few quick questions? The virus thrives on inequalities. It is the most vulnerable, without financial security, who are especially at risk. I therefore urge him to consider abolishing prescription charges for the duration of the outbreak, especially for those with conditions such as asthma. We are very mindful of the mental health implications of asking people to stay at home, and we are also deeply concerned about the potential for domestic violence to increase. What support is available on those two fronts?

We also need clear and unambiguous advice around which workers can and cannot go out. The Opposition would call for just key workers to be able to go to work. We have seen Sports Direct, for example, insisting that its workers turn up today. We are hearing stories about warehouses insisting that agency workers turn up and about construction sites not putting in place social distancing measures. That is putting workers at risk, and it is putting the lives of us all at risk. We need clear enforcement; if we are telling people that they will be fined for leaving their house, why are we not fining employers for insisting that their employees turn up to work when they should be staying at home? My right hon. Friend the shadow Chancellor will be putting more points to the Government about income protection in the debate later today.

Let me quickly turn to personal protective equipment. I understand the efforts the Government have made, but there are still NHS staff saying that they have no access to adequate PPE. We still have hospital chief executives expressing concern that they do not have access to FFP3 masks, that they are not getting the visors and sanitisers they need on time and that, when they do get masks, they are different from the previous masks, so staff have to be retrained. I urge the Government to move heaven and earth to get the PPE our staff need to the frontline. We also need PPE in social care. We are beginning to see outbreaks of covid-19 in social care homes. What support is in place for the residents of care homes, and when will we get the PPE that we need into the social care sector?

Enforced social distancing is welcome—we called for it—but in many ways it is a blunt tool without ramping up testing and contact tracing. That is how countries such as South Korea have managed to suppress the virus. We are still testing only around 5,000 people a day. We do not have enough community testing. We are still not testing enough NHS staff. As the World Health Organisation has instructed the world, test, test, test.

Leaked emails today suggest that, on Sunday, the Government were asking to borrow research institutions’ testing kits—we have called for that, and we do not disagree with it—but the emails also said that the Prime Minister had said:

“there are no machines available to buy”.

Many of our constituents, and indeed NHS staff, will be asking why we did not procure machines and kits sooner.

On intensive care capacity, there are reports today that the ExCeL centre will be turned into a field hospital of 500 beds and that staffing ratios for intensive care are being relaxed. We understand that, given the staffing demands we face, but if we are setting up more field hospitals, will the Secretary of State tell us what oversight there will be? That change also means that more of our specialist staff will be stretched further—we understand why—but what guidance will be in place? Will the Secretary of State update the House on how many intensive care beds are now open, and how many more will be opened; how many ventilators we have, and how many more will be purchased; how many beds with oxygen we have; and what the current extracorporeal membrane oxygenation capacity is?

Will the Secretary of State quickly update the House on an issue that has emerged overnight about access to abortion care, as a result of some of the implications of the Coronavirus Bill? Will he assure the House that women who want access to abortion care will continue to be able to get it?

Our constituents are worried; our constituents are fearful. I hope the Secretary of State understands that when we put these questions to him, we are doing so because we want the national effort to defeat this virus to succeed.

[Matt Hancock]

I will go through the answers to the questions the hon. Gentleman reasonably asked. He asked about the most vulnerable. A programme of work is under way to ensure that those who need support because they are staying at home—especially those who are victims of domestic violence—get that support. It is incredibly important and difficult work, but we are doing what we can in that space. He also asked about prescription charges. Only around a fifth of people pay prescription charges, so those who are the least able to pay already get free prescriptions.

The hon. Gentleman asked about Sports Direct. Sports shops are not essential retail, and therefore they will be closed. I have seen a bit of the noise that has been going on around today about Sports Direct in particular. I want to be absolutely clear that sports kit is not essential over the next three weeks, so we will be closing Sports Direct, along with other non-essential retail. He also asked about fines for corporates as well as individuals—absolutely, those fines are available if that is necessary.

The hon. Gentleman asked about protective equipment, and he is quite right to do so, because as we discussed yesterday, having protective equipment for staff on the frontline—especially those in the NHS and social care, but also in other frontline services—is very important. We are moving heaven and earth, and the military involvement is ramping up the delivery of that equipment. He asked specifically about social care. I am glad to say that the current plan is to get protective equipment to all social care settings by the end of this week, and then we will have to keep going. We have put in place a hotline. If someone needs PPE and they are not getting it, they should call the hotline so that we know where the difficulties are in getting PPE to the frontline, and we can respond to those calls and get it to them. I feel that very strongly.

The hon. Gentleman asked about testing. As we have discussed many times, we are ramping up testing as fast as we can, including buying millions of tests. My team are currently buying these tests, which we will make available as quickly as possible. He asked about there being no machines ready to buy. I do not recognise that at all. I have not seen any leak, and I would not want to comment on a leaked email—certainly not one that I have not seen. It is true that we are bringing testing machines together to provide a more efficient testing system, and I am grateful to the universities that have put these testing machines into the system. This is a national effort, and they are playing their part. We are also buying machines where we can.

The hon. Gentleman asked about staff ratios, which have been publicised this morning. It is true that we are having to change the standard staff ratios for delivery of certain types of procedure, including ventilation. The reason is that we cannot easily train somebody to intubate a patient and put them on a ventilator. We are training those who we can train to the standards necessary, but this is an incredibly difficult task, and it is therefore safer to have the doctors who are trained to do it and experienced in doing it doing it to more people, with more support staff than in normal circumstances. That is absolutely necessary to respond to the quantity of need, because this is a very specialist part of the NHS and of medicine that suddenly has much bigger demand than could ever have been envisaged outside a pandemic scenario.

I pay tribute to the staff who will be working much more intensively and who are putting their vital skills at the service of the nation in order to save lives. I am grateful to all those who have worked with the royal colleges to ensure that we get these ratios right and stretch the capabilities we have as far as we safely can in the circumstances. Finally, the hon. Gentleman mentioned abortion. We have no proposals to change any abortion rules as part of the covid-19 response.

Coronavirus Bill

Jonathan Ashworth Excerpts

2nd reading & 2nd reading: House of Commons
Monday 23rd March 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

May I start by thanking the Secretary of State for his kind words and for the way in which he has continued to keep me updated throughout this process, for the arrangements he has made for us to be briefed by officials and the chief medical officer, for keeping me informed of Government decisions, and for his ongoing engagement on the Bill? I hope that Members across the House understand that when we ask the Secretary of State probing questions, we do so constructively—not to undermine him or to create some false dividing line for the sake of political point scoring. This is a frightening time for our constituents and we all have an interest in ensuring that the Government get this right. We want the Government to succeed in defeating this virus.

I will make a few remarks about where we are with responding to the virus before moving on to some specific comments about the Bill. As always, our thoughts are with those who have lost loved ones to the virus. Again, let me put on record our praise for the extraordinary efforts of our NHS staff and other dedicated public servants. This unprecedented global health crisis tests each and every one of them like never before; we are forever in their debt.

Today this House is being asked to make decisions of a magnitude that I simply would never have dreamt of only a few weeks ago. I know that no Member came into this place to put powers like this on to the statute book—powers that curtail so many basic freedoms that our forebears fought so hard for, and that so many people today take for granted. But I also know that every Member here will want to do all they can to support all means necessary to save lives and protect our communities in the face of this virus.

This is a global health emergency the like of which the world has never seen since the Spanish flu outbreak over 100 years ago. Throughout this outbreak, I have said that the virus spreads rapidly, exploits ambivalence and thrives on inequality. The Government have quite correctly sought to promote social distancing as a means of reducing person-to-person transmission of the virus. For the most part, these measures have been on a purely voluntary basis, but I am afraid that too many people are still not following the advice. This weekend we will all have seen the pictures of bustling markets, packed tube trains, and busy beaches and parks. I am afraid that the public health messages are still not being heard loud and clear. Everyone who can be at home should be at home. Everyone who can work from home must do so. This House must also send a clear message to young people—millennials—that they are not invulnerable to the virus; they are at risk too.

To be frank, we in this House need to adjust our behaviour as well. I love and respect this Chamber, and I think Members will agree that I relish the cut and thrust of robust debate across these Dispatch Boxes. But if other workplaces can use Zoom calls, Skype, conference calling and so on to make decisions, why can’t we? I therefore look forward to the reforms that Mr Speaker is looking into.

[Kevin Brennan]

It would be remiss of me not to thank my hon. Friend and the Secretary of State for the way in which they are both responding to this crisis—even though they are on opposite sides of the House—in the interests of the whole country. The whole House appreciates the way that both of them have conducted themselves throughout this crisis. On the point that he raises, an acquaintance of mine, who is an NHS nurse, asked:

“Why is the public creating more work for us medical staff and exposing us to the risk of dying?”

I thank him for giving those messages so clearly, but does he think that there is more that can be done to communicate more effectively to the public what social distancing means in practice and how people should behave given the scenes that we have seen this weekend?

--- Later in debate ---

[Jonathan Ashworth]

I agree with my hon. Friend. I did note that the Secretary of State talked about the comprehensive public health advertising campaign. We welcome that campaign, but we encourage the Secretary of State to use his offices to see whether that comprehensive campaign can become even more comprehensive. Can we have more adverts on television and more adverts on radio stations? Can we have a leaflet going through every door, explaining what social distancing means, explaining what shielding means? Before this virus took hold, the words “social distancing” and “shielding” were probably not often used in the Chamber, so if they are not words that we are familiar with, we can bet that our constituents are not entirely familiar with them either.

[Mark Pritchard]

The shadow Secretary of State will know Telford and Wrekin very well as he has visited them many times in the past 12 months due to flooding and other issues. I am grateful for his visits despite the fact that he is a member of the Opposition. Is he aware that, today, the Labour-led council made a decision, which I support, to close all the public parks, play areas and open spaces that it runs, and that that in turn will put more pressure on the other open spaces that are not currently run by the local authority? May I encourage him to continue to press the Government to move quicker to this lockdown that we all want to avoid, but that will ultimately save lives.

[Jonathan Ashworth]

I must tell the hon. Gentleman that my attempts to change the political complexion of Telford and Wrekin have completely failed to date, but I am grateful to him for his comments about the Labour council. I think that this is the nub of the matter. I have a point to put to the Secretary of State while he is still in the Chamber. Sadly, it has just been reported on social media that the case fatality figures are continuing to climb and there is some discussion that we are seeing now an exponential growth in line with Italy. I appreciate that there are different demographic issues in different nations, but, clearly, people are concerned that our death rates are increasing at a rate that suggests that we could be heading to an Italian-style situation. We all know what is happening in Italy. The point is that clinicians are warning us that our intensive care bed capacity and our high-dependency unit capacity, could very quickly be overwhelmed. We have already seen a critical incident at one hospital, and no doubt we will see more in the coming days. This is a crisis and it is a crisis that demands an overwhelming Government response.

[Sir Edward Leigh]

It is vital that we have a sense of national unity on this. If it becomes necessary for the Government to impose a lockdown, which I suspect may well happen if people do not change their behaviour, can we rely on the Opposition to support the Government?

[Jonathan Ashworth]

The right hon. Gentleman has rather anticipated my point. Looking at the graphs—and I do caveat this with a recognition that different countries have a different demographic profile—we are now beyond the numbers of fatalities that existed in Spain and France when they announced their stricter enforcement measures and their lockdowns. I do not really like the term lockdown, because it means different things in different contexts, but I think that we broadly understand what we are talking about this afternoon. In answer to the right hon. Gentleman’s point, we, as Her Majesty’s Loyal Opposition, do now call on the Government to enforce social distancing and greater social protection as a matter of urgency. I am sorry and disappointed about that, but I am afraid that many people are not adhering to the type of social distancing that we expect.

[Imran Hussain]

My hon. Friend the shadow Secretary of State is absolutely right in what he says, but there are those who are finding it difficult to socially isolate because of the financial circumstances that they find themselves in. There are self-employed taxi drivers, those in the gig economy and others who are sometimes only just getting by in the first place. There needs to be clear financial packages available to put those people on an equal footing so that they can also take up that measure.

[Jonathan Ashworth]

My hon. Friend is absolutely right, and his point has been made repeatedly by my right hon. Friends the Leader of the Opposition and the shadow Chancellor. The challenge of social isolation will not be boredom and fatigue, as some behavioural scientists have suggested; I think the biggest challenge of social isolation will be personal finances, and so on. That is why our proposed measures on sick pay are so important, and it is why we welcomed some of the measures announced by the Chancellor last week, but we think they need to go further.

[Caroline Lucas]

I am grateful to the hon. Gentleman for giving way and for taking the issue of communication more seriously than the Secretary of State. We need leaflets going house to house, and we need them in different languages so that different communities can hear this.

The hon. Gentleman’s point about a strict lockdown is well made, but I echo what others have said about the importance of guaranteeing economic security to make it much more possible for people to cope with that lockdown, particularly the self-employed who are now struggling so much. Statutory sick pay is not enough for them.

[Jonathan Ashworth]

The hon. Lady is absolutely right. I am proud to represent the great city of Leicester, which is probably the most diverse city in the United Kingdom—every language in the world is spoken there—so I entirely endorse what she says. If we funded local government properly, it would be able to put such measures in place.

I entirely agree with the hon. Lady’s broader point that if we have to ask people to stay at home, or if we have to force them to do so—we would support the Government if they took that action, and I think they do need to take that action—we would also need to provide them with the economic security they rightly deserve.

[Stephen Doughty]

I thank my hon. Friend for his approach to this issue on a day-to-day basis. I completely support what he says about the need to enforce social distancing, and I know many Members on both sides of the House would do so, too.

I am struck by the contact I have had with friends in Italy and elsewhere who are, frankly, aghast that we have not moved to tougher measures sooner. Anybody looking at the graphs of the situation in Italy would definitely want to avoid it here, so I wholeheartedly support such measures, but they have to come with the economic measures he rightly talks about.

[Jonathan Ashworth]

I totally agree.

[John Spellar (Warley) (Lab)]

There is a lot of talk about income, but it is also about expenditure. I have had many complaints from constituents about prices rocketing, particularly for staples, but it is unclear whether that is the fault of the retailers, the cash-and-carry wholesalers or, indeed, the suppliers. The Competition and Markets Authority is looking into it, but I urge the Government to crack down urgently on profiteering from people’s difficulty.

[Jonathan Ashworth]

My right hon. Friend makes an excellent point, and we are seeing it in my constituency. I have had complaints from constituents about exploitative profiteering, so I hope the Government will come forward with some proposals to stamp it out. It is an absolute disgrace that it is happening at this time of national crisis.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

May I raise, once again, the issue of housing? Social isolation is great, but it is really difficult for people who happen to live with their family in one room in a deeply overcrowded shared house—sharing a kitchen and sharing bathrooms—as so many of my constituents do, particularly when the kids are off school. There needs to be some thought about letting them out in parks and stuff like that, because they do not have gardens.

[Jonathan Ashworth]

My hon. Friend makes an excellent point. I represent an inner-city seat, and I appreciate that her seat is on the outskirts of London but, none the less, our seats have similar demographics. I know full well that many, many families are living in cramped, small flats. There are intergenerational families living with elderly mums, elderly grandmothers and so on who have various comorbidities and who need to be shielded.

If we enter a situation in which we force people to stay at home, I hope the Government will look at how to support such families, because it is quite outrageous that, in many parts of the country—especially in London, but also in my constituency—there are flats with families of nine or 10 people sleeping on the floor, and so on, while property developers have flats standing empty. Why cannot we take over some of those empty flats to house some of these very vulnerable families and to help us get through this national crisis?

[Mr David Davis]

I commend the hon. Gentleman for the stance he is taking in this debate. The whole House will respect him for it. The series of interventions that he has just taken demonstrates a wider point: the need for the Government, sadly—and I did not think I would ever say this in this House—to get into intrusive levels of planning that we have never seen before, because every time we have a change in the level of ferocity or intensity of our dictating what the state and society should do, we run into a new set of problems, whether that is crowding on tube trains overwhelming our desire for social distancing, or young mothers with children at home finding it very difficult to get to supermarkets and therefore literally running out of food, which is even more fundamental than running out of money. We need to think forward, and I say that because we have seen in Europe—between Germany, Italy and Spain—very similar policy actions but with completely different outcomes. I suspect that it is because of a different approach taken by the German Government and society from that taken by the Italians or the Spanish, and we have to think about that as we go into the next stage.

[Jonathan Ashworth]

The right hon. Gentleman is absolutely right. We are asking people, and are probably on the cusp of probably of forcing people, to radically adjust their behaviour in a way in which we have not been used to for more than 70 years. The last time that we asked people to radically adjust their behaviour was in the second world war. We have generations who are not used to this. We are a society who are used to going where we want, buying what we want, doing what we want and socialising when we want, and clearly, for a lot of people, it is not dawning on them that they will have to change the way they behave. That has huge knock-on effects for how public services will be organised, how the criminal justice system will have to work and how food distribution systems are going to work. It is right that we as parliamentarians continue to ask Government Ministers serious questions about that, but we also have to be aware that we have a responsibility to set an example to the country. We have to socially distance ourselves, so I really hope that the good offices of the Speaker, the Leader of the House and everyone who is involved in House business can quickly find a satisfactory set of procedures for us to continue having our discussions and asking Ministers questions, but not setting the example that we are unfortunately setting today. I am not making any personal criticism of any Member, because it is the situation we are in—we have to debate the Bill today—but we are going to have to hold the Government to account on the far-reaching, extensive powers that they are taking.

[Dr Murrison]

As always, I am listening with great attention to what the hon. Gentleman has to say. Does he agree that part of the problem is that policy has to be based on behavioural science, but behavioural science is one of the most imprecise of sciences? The difficulty is that it is not like chemistry or physics. It means that we have to have a wider margin of error when designing policy, and what that means, in effect, is erring on the side of caution and safety, which I think is the burden of the direction that he is urging on Ministers. In a sense, it is about getting ahead of the curve by bringing in measures that we would all regret. However, if we are going to base policy on behavioural science—it being fairly inexact and difficult to predict, as we have seen over the weekend—we have to have that margin of error and caution, which I think he is recommending.

[Jonathan Ashworth]

The right hon. Gentleman has shrewdly interpreted the stance I am taking. Throughout all this, given the way in which the virus has spread so rapidly, its reproduction rate and the mortality rate, I have always urged the Government to take a precautionary principle approach to every decision that they make. I have been a bit sceptical about some of the behavioural modelling that has been used. Let me give him a quick example. Before the Government banned mass gatherings, we were told by Ministers and officials—I hope that no Minister takes this is a personal criticism; I certainly do not mean it in that way—that there is no point in banning a football match with 70,000 people in the stadium, because the person with the virus is not going to infect the other 70,000 people in the stadium and that if we stop them going to the stadium to watch the match, they would all go to the pub to watch it and infect more people there. I am sure he has heard that example.

I am very proud to represent Leicester City football club, and all the football fans—or a large proportion of them—go to the stadium before the match, and go to the stadium after the match—[Hon. Members: “Pub!”] I beg your pardon, they go to the pub. They go to the pub before the match, and they go after the match—[Interruption.] Some of them do avoid the stadium, actually. I am sure that the right hon. Member for South West Wiltshire (Dr Murrison) sees the point I am making. Some of these behavioural models do not always, it would seem, reflect how humans behave. Given that, Ministers and Governments should follow a precautionary principle at all times. That is why Labour is now urging Ministers to come forward with their plans to enforce compulsory social distancing. There are different models in different countries—we have France, Spain and Italy, New Zealand, where they did it overnight, Greece, and Germany, where, other than families, they have banned more than two people from meeting outside the house—but we think that the time has come for the United Kingdom to go down this line. We would encourage the Prime Minister to come forward with plans for how he thinks that this should apply to the UK.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Ind)]

Behaviour is changing, and, unfortunately, some of it is unhelpful. Today, I have had probably one of the most upsetting emails that I have received throughout this time from my local foodbank, which tells me that two of the main supermarkets in the area are refusing to sell it food. The people who get that food from the foodbank have no other means of obtaining food in the midst of this crisis. Does the hon. Gentleman agree that the Government need to speak urgently to the major supermarkets to ensure that foodbanks can secure sufficient supplies for those people who have no other option?

[Jonathan Ashworth]

The hon. Gentleman makes a good point, and I totally agree that that is an absolute disgrace. I hope that the Government will look into that, because although foodbanks should not be necessary in this day and age, we know that they are vital and I hope that the Government can resolve that swiftly.

I was originally answering the point made by the right hon. Member for South West Wiltshire so long ago: we would support the Government if they came forward with such proposals, but suppressing and defeating the virus is about more than just so-called lockdowns and enforcement. We need more testing, we need more contact tracing and we need more isolation to break the chains of transmission. The World Health Organisation has famously instructed the world to test, test, test—and we agree. Labour has called for testing for the virus to be carried out in our communities on a mass scale, starting with NHS and care staff as a priority. We urge the Government rapidly to scale up testing and we thank all NHS lab staff and PHE staff who are working so hard.

For example, could the Government consider what is happening in the Republic of Ireland, where there are 35 community testing facilities in operation? They have six more planned, and the largest, in Croke Park stadium in Dublin, provides a drive-through service that tests 1,000 people a day.

[Chris Bryant]

I completely agree with my hon. Friend on the need, in particular, to protect all key workers and to therefore make sure that there is testing available for them. Is it not important that at the same time we make sure that path labs have enough resources and capacity to be able to be able, for instance, to do cancer biopsies and get them back to people fast enough, because all those other conditions and diseases that are very time-critical will be just as important?

[Jonathan Ashworth]

My hon. Friend is absolutely right. Path lab and virology labs are under intense pressure, because not only are they being asked to test for covid-19 but they have other testing responsibilities as well, whether that is for HIV, influenza, measles or all the other illnesses that are still circulating and still need to be treated. He makes a very important point.

I hope that Ministers can update us on testing capacity, because looking at the figures it appears that between 21 and 22 March, we did around 5,500 tests, but the previous day we did 8,400 and the day before that about 8,100. I am told that many labs at hospitals have not been able to start testing or are testing at under planned capacity because there are now supply chain issues with the chemicals that are used and the kits to do the testing. If this is the case, could the Government update the House on what they are doing urgently to procure the testing kits we need, and explain why we are not part of the EU joint procurement initiative on testing kits and other equipment?

I emphasise the point I have made in this House before that we really need to be testing our NHS staff. Not testing NHS staff puts them at risk and it puts their patients at risk. This weekend, we heard powerful messages from doctors who were literally shouting out for help and telling us they feel like lambs to the slaughter because of failures in the distribution of protective kit and because they are not able to get access to testing. I have heard of GPs—indeed, GPs have got in touch with me directly telling me this going to DIY stores to make their own PPE kit. It has been reported today that one of the healthcare distribution chains has put out a call to DIY stores asking them to donate or hand over their visors and goggles.

Pharmacists are worried that they cannot get through to CCGs to get appropriate PPE when sick patients are walking through the door daily asking for advice. We have heard stories of community nurses, health visitors and paramedics without PPE. Indeed, The Daily Telegraph reports today about staff at Norwick Park Hospital being forced to wear bin bags because of a lack of PPE.

The health, happiness and lives of our constituents, and of their loved ones and neighbours, depend on our NHS staff now more than ever. We should not expect our NHS staff to go into battle exposed and not fully protected—lacking the armour they desperately need. If more PPE has been delivered in the last 24 hours, as the Secretary of State indicated, then we welcome that, but to be frank, it should not have taken so long. Our NHS staff deserve every ounce of support we can offer, and on that front, will Ministers also consider binning hospital car parking charges for NHS staff at this time of crisis?

Those working in critical services more widely—our police, our careworkers, our postal workers—need appropriate protective clothing too. We urge the Government to ensure that all public services can access the appropriate PPE speedily. For example, in The Sunday Times yesterday, it was reported that flights continue to arrive at Heathrow from Italy, Iran and China. Those flights are obviously coming from hotspots—perhaps Ministers could explain why that is still happening—but what protections are being afforded to airline and airport workers, and what measures are in place for those passengers on arrival? On the tube and on the train, there is real worry that services are being reduced too steeply, causing our key workers to get on to crowded carriages and putting everyone at risk. What assurances can Ministers give us that there is a sufficiency of public transport services to get our frontline workers safely to their workplace?

Let me turn to some of the specifics in the Bill, and first to the health and social care clauses. On the health clauses—the hon. Member for Twickenham (Munira Wilson) raised this with the Secretary of State—the Bill makes provisions for retired staff and final-year medical and nursing students to rejoin or join the health service for the duration of the pandemic. We understand why, and we welcome this. Can Ministers tell the House, either in response to the debate or in Committee, whether final-year nursing and medical students will be able to return to learning and complete more supported clinical placements, if needed, once the crisis is over? Will Ministers also outline how these students will be fully supported while working during what will undoubtedly be an incredibly stressful time for new doctors and nurses? Will students be properly remunerated for their work, and what protections will be available for retired staff, many of whom could also be in a vulnerable group? I put on record our thanks to those retired staff who have returned to the frontline.

Some of the most vulnerable people in the country absolutely depend on all of us here to defend their human rights and civil liberties, and they are the ones in receipt of adult social care services. On social care, this Bill makes sweeping changes to the duties that are placed on local authorities. It removes the duty to assess care needs, including on discharge from hospital, so there will be no duty to assess people who may need care or to assess their carers, and no duty to assess some of those with the most severe needs who may be eligible for continuing healthcare. Can Ministers reassure us that this will not mean that carers, disabled people and older people are left abandoned by the state until after this crisis?

Most significantly, the Bill downgrades the level of support that councils are obliged to provide to older and disabled people. Rather than the current wellbeing measures, councils will now have to provide services where necessary to uphold people’s basic human rights. In short, this means people will only be entitled to receive social care to keep them alive and to uphold their rights to privacy and a family life. Obviously, that is not the vision for social care that we legislated for in 2014, but we all appreciate that these are incredibly difficult times.

Many older and disabled people, and their families, will be concerned that this will lead to existing care packages being significantly reduced overnight. Local authorities are already struggling to meet statutory needs, and increasing levels of workforce absence will only make that harder. None of us wants to see the new legal minimum of support become the default. Where local authorities can provide more comprehensive packages of support, they should, and they should always bear in mind that people who use social care are not simply passive recipients; there are doctors and nurses who rely on social care, as well as teachers, shop staff, food manufacturers and countless other vital professionals. When councils reduce care packages, they must be careful not to end up causing yet more difficulties for staff in crucial services.

[Catherine West]

Does my hon. Friend agree that, since the courts are likely to be stood down, and in a context where disabled people often use them to ensure that their rights are protected, we are in a doubly difficult situation for disabled people and elderly people?

[Jonathan Ashworth]

Absolutely. That is why these particular clauses must be scrutinised so carefully by Members across the House.

We have tabled amendments to schedule 11. We recognise that there will be difficulties delivering social care over the coming weeks and months, but it should not be possible for local authorities to immediately drop care packages to a lower level. As long as it is reasonably practicable to do so, they should continue to meet people’s care needs. The presumption should always be that services will be disrupted as little as they can be under the circumstances. Nothing in our amendments would stop a local authority cutting back care hours if it had to, but they would mean that disabled and older people could be reassured that any reductions in their care will be a last resort, and that their independence will not be the first sacrifice to be made.

There are particular concerns about people who live alone or are being held in in-patient units and care homes. We have seen visits to those settings stopped as part of the Government’s shielding approach, and the CQC has halted all inspections, but we know from incidents such as Whorlton Hall that is too easy for abuse to go unnoticed—something the current situation could make worse. How will we ensure that in-patient units and care homes do not become hotbeds of abuse of human rights over the coming months?

[Mr David Davis]

That is precisely why I asked the Secretary of State whether, when we get to the six-month review and renewal of this legislation, we will be able to amend it. If there is oppressive behaviour in one part or another of it while the rest is all very important to the survival of our people, what stance will the Labour party take?

[Jonathan Ashworth]

The right hon. Gentleman is right: we cannot just have a take-it-or-leave-it approach to these things. Tonight, the House will give the Government extraordinary powers, like we have never seen before, and it is right that we parliamentarians are given an opportunity, after the appropriate timeframe, to look at how those powers have been used and hold Ministers to account. I agree with the spirit of the point he makes, although I cannot at this stage—I suppose it may emerge later in the debate—give him a commitment one way or the other on a particular amendment. We will see how the discussions proceed throughout the afternoon, but I certainly endorse the spirit of what he says. As I say, these are extraordinary powers that the House will grant the Government this week.

We have tabled a new clause related to schedule 11. We propose that a relevant body, such as the Equality and Human Rights Commission, should be tasked with overseeing the Bill’s impact on the provision of social care. That body would have to report every eight weeks on the operation of these changes and whether they should be amended. It would provide the oversight that is needed to prevent people’s rights from being undermined.

One of the ways the Bill seeks to free up medical staff is by relaxing the requirements of the Mental Health Act 1983. Specifically, only one medical professional will have to agree to someone’s being sectioned, rather than the two it currently takes. The scale of that change should not be underestimated. No longer will a decision to section a person have to be taken in consultation by two doctors. There will be no requirement for anyone involved to have had prior involvement with the patient. Medical professionals are going to be under huge pressure in the coming months, and mistakes may well be made.

The Bill says that a decision should be taken on the basis of one signature if requiring a second signature would be

“impractical or would involve undesirable delay.”

That seems to be too vague and potentially open to misreading. I hope Ministers can tell us what exactly that means and what safeguards will be put in place to prevent the change from being misused. Our amendments to schedule 7 would narrow the provision so that a second signature could be left off only if acquiring it would mean an undesirable delay. If something is impractical, it will by definition create an undesirable delay. By narrowing the wording in the Bill, we can avoid the potential misuse of powers.

We propose changes to ensure that private mental health hospitals cannot detain someone solely on the single recommendation of one of their employees. That could create a conflict of interest whereby a doctor comes under pressure to sign a detention authorisation because doing so will provide their employer with income from the NHS. No medical professional should be put under that kind of pressure, and our amendment would ensure that they cannot be. [Interruption.] Is the hon. Member for Bracknell (James Sunderland) seeing to intervene?

[James Sunderland (Bracknell) (Con)]

indicated dissent.

[Jonathan Ashworth]

The Bill extends to five days from three the length of time for which somebody in hospital can be held waiting to be sectioned. That may seem like a minor change, but for the individual concerned it could make a significant difference. I hope Ministers can reassure the House that the intention should still be to adhere to the timetable set out in the Mental Health Act, with the changes we are discussing to be used only if absolutely necessary.

Let me turn to some of the proposals on education and schooling. Many parents of children with special educational needs and disabilities will understand the need for flexibility during this difficult time, but they are also extremely nervous that they could see the erosion of the hard-fought-for rights of disabled children and young people, children and young people with special educational needs, and their families. The Bill gives the Secretary of State powers to change section 42 of the Children and Families Act 2014: rather than giving children rights in law, it would only request that public bodies take “reasonable endeavours”. That sets a low bar, and we will seek to change that provision to a duty to take all practical steps, which will go much further.

Let me move on to some of the other issues in the Bill. Others have alluded to concerns that the Bill still does not go far enough in providing people with the incomes that they need to self-isolate. We welcome much of the Chancellor’s statement last Friday setting out plans to support the incomes of workers impacted by the coronavirus outbreak. However, there are still some gaps in the provisions that were offered. Currently, the proposal for income support through the job retention scheme does not include the self-employed and freelancers, whose incomes are increasingly being seriously affected by the coronavirus outbreak. Will the Government today offer assurances to those groups of workers, who do not have a safety net to safeguard and help them through this time?

We have welcomed the new Government measures to improve access to statutory sick pay for workers. However, the Bill does not extend eligibility to all workers, including the just under 2 million workers who earn less than the qualifying threshold of £118 a week on average. It does not raise the level of statutory sick pay, which is, at £94.25, already the second lowest rate in Europe. We hope the Government will respond on those issues quickly because, as we have continually said throughout this crisis, people should not be expected to make a choice between their health and hardship.

Nobody should lose their home because of this virus. It is welcome that Ministers have listened to Labour and committed to an evictions ban for renters, but despite the Prime Minister’s promises that the Government would legislate to that effect, no such measures are in the Bill. Some 8.5 million households rent their home from a private, council or housing association landlord in England. Our analysis of Government statistics shows that 6 million renting households have no savings at all and are particularly vulnerable if they lose their job or have their hours cut as a result of coronavirus. To give people confidence and reassurance during this difficult time and to ensure that no renter loses their home as a result of coronavirus, rent needs to be suspended for those adversely affected by the impact of the coronavirus outbreak.

Like many Members across the House, the Opposition support this Bill with a very heavy heart—heavy not just with the shock and grief that this deadly virus has brought, but given the very real threats that emergency powers of this nature pose to human rights. The Bill contains the most draconian powers ever seen in peacetime Britain—powers to detain and test potentially infectious members of the public, including children, in isolation facilities; powers to shut down gatherings, which could impede the ability to protest against the overall handling of the crisis or against the abuse of the powers themselves. It needs no explanation and very little imagination to understand the huge potential for abuse that such powers and others in the Bill, however well intended and needed, still give rise. Those words will chill every liberal and libertarian instinct of Members across this House, which is why we were grateful to the Health Secretary and the Solicitor General for discussing these measures with us and with my shadow Cabinet colleagues in the rapid preparation stage of this Bill.

We have heard many wartime analogies in the press. Many here have talked about Winston Churchill. Of course, Churchill was remembered not only for victory in the war, but for the European convention on human rights at the end of the war. Notwithstanding the anti-Human Rights Act and anti-judicial review grumblings that we have heard in recent times, this Bill comes under the cover of a statement of compatibility under section 19 of the Human Rights Act. Further, the Bill does not attempt to oust the supervisory jurisdiction of the courts. That means that every exercise of Executive power or administrative action under the legislation must and will be measured against human rights and common-law standards. These include necessity, proportionality, rationality, fairness and, crucially, non-discrimination. I thank the Government for that concession on their part and for agreeing, I hope once and for all, that human rights and the rule of law, far from impeding national efforts in time of crisis, should instead guide and inspire them.

It is important that various measures in the Bill, some interfering with liberties and others deregulating standards, may be turned on and off, as and when needed, by the appropriate Administration under our devolution settlement. It is welcome that the Bill contains a two-year sunset clause, but as we have discussed, two years is a very long time in normal days and longer still in the context of this pandemic. That is why we tabled an amendment last week seeking parliamentary votes on the renewal or revocation of these emergency powers at six-monthly intervals. Indeed, many of us would prefer even more frequent reviews, but given the particular challenge even for Parliament of this crisis, I am glad that the Government seem to have moved some way towards the compromise offered by the Opposition in the constitutional interest.

[Mr Steve Baker]

I welcome the spirit in which the hon. Gentleman is making his speech and also his proposal for a review at six months. I certainly support that, but does he agree that we could also sunset the powers in the Bill after one year and that the Government could then bring forward a Bill—there is plenty of time between now and then—that would go through Parliament about this time next year and make whatever changes proved to be necessary between now and then? Doing that—a six-month review and, after a year, a Bill—would not involve us signing off on two years today.

[Jonathan Ashworth]

As I understand it, our amendment calls for a review every six months, but the hon. Gentleman makes an interesting point, to which I am sure Ministers will respond in Committee, when we get to that point later.

I hope the Government will be able to explain the differences between their amendment and ours, and to reassure the House that there will not be large exceptions to the six-monthly review, especially in England, which has only this House to hold Executive power to account.

We have been scrutinising the Bill on behalf of our constituents. None of us came into politics to put a Bill like this on the statute book, and I for one will never rest until the day comes, hopefully not too far away, when I can come to this House and vote to get to get rid of it. But what we have seen in recent months is concerning, if not frightening, all our constituents, and it is right that we are taking the powers that we are taking today, although we have to continue to hold Government to account. We will overcome this virus, and when we do, serious lessons will have to be learned. The crisis has exposed the vulnerability of a society in which insecure work is rife, deregulation is king and public services are underfunded. When we come out on the other side, as we will, we have to build a society that puts people first.

[Several hon. Members rose—]

Covid-19

Jonathan Ashworth Excerpts

Monday 16th March 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for keeping me informed of developments. Our thoughts must be with the loved ones of those who have sadly died from the virus, including the family of the man who died at the Leicester Royal Infirmary in my constituency over the weekend.

I pay tribute to all our NHS staff, our social care staff and, indeed, all who work in public services. Never have we been more in their debt, and will be in the coming weeks. The public, as indeed all Members of the House, want the national effort to succeed. Every one of our constituents wants to do the right thing for their loved ones, for their neighbours and for themselves.

The virus spreads rapidly. It exploits ambivalence. It demands clarity of purpose. It demands Government effort as we have never seen before in peacetime. With that in mind, I put a number of questions to the Secretary of State, which I trust he accepts are raised in a constructive spirit. Specifically, on today’s measures, which we endorse, if we are asking people to work from home if they can, what is the advice to those who are not able to work from home because of their occupation—millions who work in the retail sector, for example?

Today, the Government will ask the elderly and those with long-term conditions to shield themselves, starting at the weekend. Can the Secretary of State give us more details of how that will work in practice? Will they be able to exercise or go for a walk? What happens if someone refuses to follow the advice? How will those who need social care support get the care they need? What protections are in place for social care staff embarking on regular 15-minute visits? How will those with complex needs and disabilities be supported?

We know that those with co-morbidities and a compromised immune system are also vulnerable. What specific advice is there for those with conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, asthma and cardiovascular issues, who the emerging literature shows to be particularly vulnerable at the moment? How will those people access repeat prescriptions?

I understand the gravity of the situation. Could the Secretary of State update the House on how far away from the peak he thinks we are? While I understand the reasoning for the decisions the Government have made today, surely there will now come a moment when schools will close. Teachers are already anxious, and parents need to plan. Can he offer some advice to parents, who will be worried tonight?

Throughout the outbreak, we have been as one in agreeing that all decisions must be based on science and evidence, but the Secretary of State, of course, will know and understand that different scientists can reach different conclusions, even when presented with the same data and evidence, so does he agree that all the evidence informing the UK’s strategy must be transparent, and that the modelling and the evidence base should be published, so that it can be peer-reviewed and stress-tested? This is about maintaining public confidence.

May I press the Secretary of State on the controversy, if I may put it like that, of recent days, in the debate about so-called herd immunity? He said yesterday that herd immunity is not the goal. The chief scientific adviser suggested something slightly different on Thursday. Could the Secretary of State clarify the Government’s position?

May I put a point that is repeatedly raised by our constituents? I hope that the Secretary of State appreciates the way in which we are putting these points to him. Many of our constituents are asking us why the UK has hitherto seemed to have taken a different course from other nations. They have suggested that other nations have been deliberately trying to delay, and to buy time to prepare for, future outbreaks. Will he explain what ideas the Government have and have not rejected, and what lessons they have learned, from countries such as Singapore, Taiwan and South Korea, which have brought the virus under relative control through containment policies? What lessons can we learn from Germany and Scandinavia, which, in recent days, according to the data, are reporting death rates of less than three per 1,000 covid-19 cases, whereas in the UK and France, the figure is much higher?

May I press the Secretary of State on the advice of the World Health Organisation? It has been clear that testing and contact tracing should continue. Many of our constituents are saying to us that surely we need community testing to continue, because we need to know the percentage of the population infected at any one time. Otherwise, the percentage of immunity will be unknown. People who are ill, those who work in the NHS or the care sector, and anyone caring for elderly relatives will surely want to know their covid-19 status, because it will have an impact on how they interact with other people in the community. NHS staff are being asked to care for covid-19 patients, not knowing whether they themselves are transmitting the virus. If they get ill, will they now be asked to stay at home for 14 days? Surely if we can test those NHS staff, and the test returns negative, we can get them back on the frontline sooner.

Is the issue around testing about capacity? If it is, has the Secretary of State considered demanding that UK-based pharmaceutical companies hand us their labs? Can we use the testing labs in higher education institutions and universities? Can diagnostic kit makers be urged to manufacture more testing kit urgently?

On a vaccine, we understand the timescales involved, but can the Secretary of State confirm that he will approve funding for scaling up manufacturing of the vaccine candidates that are being developed in the UK? On antivirals, clinical trials on repurposing drugs are under way across the globe; can he provide a written statement to the House on what capacity the UK has to assist in that process?

Turning quickly to the capacity of the national health service, our NHS and social care staff need support. They need quality personal protective equipment, whether in secondary care or primary care. Can the Secretary of State tell us how many additional intensive care unit beds have been opened? I think he has hinted that non-emergency elective treatment will now be suspended; could he confirm that? Members have long been asking him about ventilators. Can he outline the latest numbers, and say where he thinks we will be by this time next week? Can he update us on ECMO bed capacity, and say whether he is also increasing the availability of non-invasive ventilation, such as BPAP? If we need beds and equipment from private sector organisations, we should requisition that equipment, not pay for it.

Finally, we will co-operate with the Government on the proposed emergency legislation, and I am grateful for the discussions we have had, but the biggest challenge to the public health social distancing measures will not be boredom and fatigue; it will be finances and affordability. The poorest, who struggle to pay the rent, those who worry about putting food on the table, and those who have no savings to dip into, will be faced with impossible choices between hardship and health. From sick pay and lost earnings protection, to universal credit changes and rent and mortgage payment deferrals, we need a package of financial support, and we look forward to working with the Secretary of State on that front.

These are indeed serious times. Many of our constituents are anxious, and want as much certainty as possible. We have put these questions to the Secretary of State because the health and safety of the nation must always come first.