Covid-19

Debate between Jonathan Ashworth and Jeremy Hunt

Monday 2nd November 2020 Commons Chamber

[Jeremy Hunt]

I would be very grateful, and I know that staff everywhere would be grateful, if my right hon. Friend could give some indication of when all NHS staff can be confident that they will be tested, but I thank him very much for that answer.

Secondly, I hope the Secretary of State will not mind me saying that this is the moment when we have to fix contact tracing. To be reaching only 60% of people’s known contacts is not good enough. He knows that, and he does not try to defend it—

[Jonathan Ashworth]

He does.

[Jeremy Hunt]

No, no. This is the point: when we have 50,000 people being infected every single day, it is a massive logistical task, but if we are honest, we still had problems when it was a tenth of that number being infected every day. This is the moment to recognise the uncomfortable truth that this would be better done locally, with local authorities taking the ultimate responsibility. While we are making these changes to the contact tracing regime, to have only 20% of people who are infected and told to self-isolate actually complying suggests only one answer, which is that we as the state should pay their wages for the period that they have been asked to isolate. That is expensive, but it is less expensive than the cost of them not complying with the important direction to isolate.

On a more technical matter, I ask the Health Secretary to consider whether there is a way we can speed up the approval of the new therapeutic drugs that are coming online. As he knows, we generally wait until both safety and efficacy are proved before approval is given to a new drug. However, in a pandemic, would it not be right to allow the mass marketing of drugs to go ahead as soon as they are deemed safe, even though we cannot guarantee their efficacy? That could save lives, and any delay might mean that people could not get the benefits of those new drugs.

I want to finish on the issue of population testing. My right hon. Friend and I have had many discussions about this and again I know that he is sympathetic. We are in an immensely stronger position because of the huge improvements in testing capacity that he rightly celebrated in his earlier comments. However grave the situation we are in now, it would be a whole lot graver if we had not increased testing capacity from 10,000 a day to 100,000 a day, and then to 500,000 a day last week and potentially 1 million a day by Christmas. We are not far off the 2 million a day that would be needed to test the whole population every month.

Now is the time for us to tell the public how we are going to chart a course to that destination, because this is the only true light at the end of the tunnel. Charting a course to that destination means charting a course through the incredibly complex logistics and through the technology that will be necessary to record who has or has not had their positive test on time, but if we can show people that there is a date next spring by which the whole population will be tested on a regular basis, we will also be showing people that there is a way through this pandemic. In that way, our national depression would be lifted and we would be able to give the hope to our constituents that is now in such desperately short supply.

Testing of NHS and Social Care Staff

Debate between Jonathan Ashworth and Jeremy Hunt

Wednesday 24th June 2020 Commons Chamber

[Jonathan Ashworth]

The hon. Lady makes a very important point, which affects the debate more broadly: those who test positive or are asked to isolate need to be given the financial support to do it, and statutory sick pay in many circumstances will not be enough. There are millions of workers—2 million in this country—who do not qualify for statutory sick pay, and just saying that they can apply online for universal credit is not going to be enough.

We need more radical thinking from the Government. Other countries offer greater financial support to those who are asked to isolate. Other countries even offer hotel rooms to those who are asked to isolate if it is not appropriate for them to isolate at home because of the nature of their housing situation. The Government should be looking into those sorts of things, and I hope the Minister can respond to that.

The point I was making is that regular testing of staff, whether asymptomatic or not, is so important not only for the safety of those staff and patients, but for building confidence in the NHS more generally. The study from Imperial suggested that it would reduce transmission of covid in healthcare settings by up to a third. We believe that this is a constructive suggestion that we are putting to the Government, which they should take on board and explore. It is disappointing that they are seeking to amend the motion to completely strip that out. They are not even prepared to take it away and look into it. They just want to pass a motion congratulating themselves on their handling of the pandemic.

A testing strategy for staff and patients, as we are proposing today, is a demand supported by many across the NHS as key to restarting that NHS work.

“A clear testing strategy is now more important than ever”—

says Chris Hopson from NHS Providers.

We

“need rapid testing available for all staff and patients, whether showing symptoms of COVID-19 or not”—

says Cancer Research UK.

“It’s absolutely essential to regain public confidence that we are able to test our staff regularly”—says Derek Alderson of the Royal College of Surgeons. And, of course—the right hon. Member for South West Surrey (Jeremy Hunt) will not be surprised that I am going to quote him in this debate—it is a position shared by the former Health Secretary, now the Chair of the Health and Social Care Committee, who in today’s Telegraph makes the case with far greater eloquence than I could ever muster:

“Until we minimise the risk of asymptomatic transmission by introducing weekly testing for all NHS and care staff, we are failing in a basic duty of care to the people most likely to die if they get the virus.”

[Jeremy Hunt (South West Surrey) (Con)]

May I put on record my thanks to the hon. Gentleman for praising me in this House for the very first time that I can remember on record?

[Jonathan Ashworth]

I praised him plenty of times from this Dispatch Box. The point is that this is a constructive proposal, which is not a party political point. There are clearly many people across the House who support this proposal. The right hon. Member, the former Health Secretary, also prays in aid in his article—I have it here for Members, if they have not had chance to peruse it—both Tony Blair and William Hague. So we now have a Front Bencher praising Tony Blair from the Dispatch Box—that is probably the first time it has happened on the Labour Front Bench for about 10 years.

--- Later in debate ---

[Jeremy Hunt (South West Surrey) (Con)]

It is a great pleasure to follow the hon. Member for Gordon (Richard Thomson). It is the first time I have heard him speak from the Front Bench and it was a very thoughtful contribution. I hope we hear more from him.

I thank the shadow Health Secretary for having this debate and, indeed, for mentioning my article in The Daily Telegraph. If I ever was on the Prime Minister’s Christmas card list, that mention will be sure to get me taken off it—[Laughter.]

I particularly want to congratulate the Minister of State on leading this debate for the Government. As a veteran of many Opposition day health debates, I can say that she elicited a much calmer response from the Opposition than I ever did, and she deserves many congratulations for that.

We need to start this important debate by recognising that, as a country, we are in a transformed position because of recent changes to our response to the pandemic. We are now contacting around three quarters of the people we identify as testing positive for coronavirus and 90% of their contacts are being asked to isolate. That is the basis of South Korean test and trace, and it is incredibly important that we are in that position. I am sad in this respect that the Health Secretary is not here himself, because that would not have been possible if he had not taken the courageous decision to set the target of 100,000 tests a day at the start of April. Indeed, yesterday’s announcement about the gradual easing of our national hibernation would itself not have been possible if that had not been in place, and we need to recognise that.

The challenge we now have is that we do not know where about two thirds of new infections are happening, so we cannot feed them into the test and trace process. That is a challenge, because SAGE’s advice is that we ask about 80% of potential coronavirus contacts to isolate, and we are still some way off that. In fact, we are contacting about 700 people a day to get their contacts and there are about 2,500 daily new infections. If we do the maths, assuming that each person with coronavirus has about nine contacts, which is the current figure, that is up to a quarter of million people since the process started whom we would have liked to have asked to isolate but we have not been able to do so.

How do we meet that challenge? Well, the answer is to do something that the Government have already shown they are very good at, which is a dramatic expansion of testing capacity. The city of Beijing has about a third of the population of the United Kingdom, but its daily testing capacity is nearly double ours at around 400,000 a day, and many of those tests come back within 24 hours. We look forward to the triumphant announcement next week that we are meeting the Prime Minister’s target for all non-postal tests to come back within 24 hours by the end of this month, because speed matters.

If we expand our testing capacity dramatically, we can use it, for example, to deal with localised outbreaks, such as the one we have had in Ynys Môn, where my hon. Friend the Member for Ynys Môn (Virginia Crosbie) is doing such a fantastic job in supporting her affected constituents. We can use it at airports instead of the quarantine policy, by testing people on arrival. We can use it for high-risk groups such as taxi drivers, who are particularly at risk. Most of all, we can use it for our frontline health and care staff. If we had Beijing levels of testing in this country, we would, in addition to the testing we are currently doing, be able to test every NHS frontline worker once a week. If we got it up another 200,000, we would be able to test every frontline care worker once a week as well.

Why does that matter? It matters because, according to the evidence submitted to SAGE on 20 April, up to 25% of the coronavirus patients in our hospitals caught coronavirus in the hospital. When we add on the people who catch their infection in care homes, what we end up with is that about a third of new infections are likely to be in healthcare settings—so-called nosocomial infections, which is one of the many new words we have learned over the course of this crisis.

[Jonathan Ashworth]

The right hon. Gentleman is making a superb speech, and I agree with every word. I was struck by the Minister’s response to me when she made the point that the Government’s position is based on the advice of the chief medical officer. I would entirely understand if the Government said, “The resources are not quite there yet. We have not quite got capacity there. We need to build up capacity before we can test all the millions of NHS staff.” I think everyone would have thought that a reasonable position, and we would be urging the Government to go further. However, if the advice to the Government from the CMO is not the correct clinical approach, will the right hon. Gentleman, perhaps through his chairmanship of the Health and Social Care Committee, ask the CMO whether they will provide the Committee with that advice, and could that advice be shared across the House?

[Jeremy Hunt]

That is a reasonable question. I will certainly take that away. In fact, the CMO is coming before the Health and Social Care Committee in a few weeks’ time, and I am sure we will ask that question. My understanding is that the concern in the clinical advice is the question of false positives—people who get told that they have coronavirus when they have not. Those people might be in a very important frontline clinical role and be asked to isolate, and that might take them off very important work. To me the obvious answer is to give them a second, confirmatory test to establish whether they really do have the virus.

Weekly testing matters and is so important not only because, with around a third of new infections happening in healthcare settings, it will save a lot of patients’ lives and save the lives of frontline healthcare workers, but because it is the critical thing stopping the NHS getting back to its normal levels of activity.

Last week, the president of the Royal College of Surgeons, whom the shadow Secretary of State quoted, talked about the mountainous backlog we face in, for example, orthopaedic surgery. He said that the thing holding the NHS back is the time it is taking to set up what he calls “covid-lite” facilities, where there is a low risk of people having coronavirus. That is why testing is essential.

I do not want to take up any more time than I need to, but I want to make this point. Korea, Taiwan and Germany are all held up as examples of places that have been particularly effective in tackling coronavirus. All of them introduced test and trace, but they all did it when the virus was at an earlier stage with much lower levels of community transmission. If we want test and trace to be effective here, we need to introduce mass testing, starting with health and care staff, and we must not delay.