Lord Alton of Liverpool

As of 14 May 2021, more than 1 billion self-test and assisted lateral flow devices (LFDs) manufactured in China have been purchased for use in the United Kingdom. We are unable to provide the cost of these kits as this information is commercially sensitive. A gradual increase in the proportion of UK-produced self-test LFDs is anticipated by the summer.

It has not proved possible to respond to this question in the time available before prorogation. Ministers will correspond directly with the Member.

It has not proved possible to respond to this question in the time available before prorogation. Ministers will correspond directly with the Member.

The annual number of anti-depressants that have been prescribed and dispensed in England in the community between 2011-November 2020, the latest data available, is provided in the following table. Information is not held for items dispensed in secondary care. The total cost of prescription items between this period was £2,543,305,593.92

Note:

The data provided for the years 2011-2013 was supplied from NHS Digital whilst the data provided for the years 2014-2020 was supplied from the NHS Business Services Authority. Any data prior to 2014 may classify many products in different ways due to a significant reclassification of products.

Information prior to 2015 is not held. The following tables show the number of antidepressant products that were prescribed to under 18 year olds and the subsequent subset of those aged 5 to 11 years old in England on a National Health Service prescription, dispensed in the community in England between April 2015, the earliest age-based data held, and November 2020, the latest data available. Information relating to items dispensed in secondary care is not collected centrally.

Number of antidepressant items prescribed and dispensed in the community in England to patients aged under 18 years old.

Number of antidepressant items prescribed and dispensed in the community in England to patients aged 5 to 11 years old.

The total cost of prescription items prescribed and dispensed in the community in England to patients aged under 18 years old, including patients in the 5 to 11 years old age group between April 2015 and November 2020 was £9,110,589.79.

The Medicines and Healthcare products Regulatory Agency continuously monitors the safety of all medicines on the market in the United Kingdom. Information about possible side-effects associated with treatment is provided in the product information which is available to all prescribers and patients. This is based on a thorough assessment of the available information and is updated regularly as new information emerges.

Information on the average length of time antidepressants have been taken by patients is not held centrally. Between March 2020 and November 2020, the latest data available, the number of items of antidepressant products that were dispensed in the community in England was 59,000,280 and the total cost in this period was £286,838,390.64. Information on the number of products dispensed in secondary care is not held.

Two contracts have been awarded to PPE Medpro by the Department with a total value of £202 million and seven contracts have been awarded to Purple Surgical by the Department with a total value of £226 million. Information concerning whether any of the personal protective equipment (PPE) has not met the required quality standards or a particular specification, whose fault that is and what should be done about it are regarded as commercially confidential information as this process involves negotiations with the supplier where we may seek a refund or other redress as per the contract terms in these contracts.

In terms of how these suppliers were selected, the Government issued a public call to action to support the increased requirements of PPE. The aim was to reach suppliers who had experience of supplying PPE and also those who had no prior experience but who had access to sources of PPE through their business contacts. This resulted in over 15,000 suppliers offering their help and support, including PPE Medpro and Purple Surgical.

All suppliers were evaluated by Departmental officials on their financial standing, compliance with minimum product specifications and ability to perform the contract. All contracts were awarded by the appropriate accounting officer in line with Departmental policy and procedures.

One contract has been awarded to Ayanda Capital by the Department with a value of £252 million. The Contract Award Notice and the contract has been published online at the Government’s Contracts Finder service which contains details of the value of each contract and the types of personal protective equipment (PPE) which have been ordered against each contract.

Delivery is progressing for all the PPE items. All items of PPE undergo a rigorous technical assurance process before they can be released for use at which point decisions will be made about which healthcare setting they are suitable for or whether alternative settings need to be considered. Details of such decisions on individual contracts is regarded as commercially sensitive information as the Department may have to negotiate contract variations, which could include a refund or other form or redress against the supplier.

Seven contracts have been awarded to Purple Surgical by the Department with a value of £226 million. Contract Award Notices and the contracts themselves have been published online at the Government’s Contracts Finder service which contain details of the value of each contract and the types of personal protective equipment (PPE) which have been ordered against each contract.

Delivery is progressing for all these PPE items. All items of PPE undergo a rigorous technical assurance process before they can be released for use at which point decisions will be made about which healthcare setting they are suitable for or whether alternative settings need to be considered. Details of such decisions on individual contracts is regarded as commercially sensitive information as the Department may have to negotiate contract variations, which could include a refund or other form or redress against the supplier.

Two contracts have been awarded to PPE Medpro by the Department with a total value of £202 million. Contract Award Notices and the contracts themselves have been published online at the Government’s Contracts Finder service which contain details of the value of each contract and the types of personal protective equipment (PPE) which have been ordered against each contract.

Delivery is progressing for all these PPE items. All items of PPE undergo a rigorous technical assurance process before they can be released for use at which point decisions will be made about which healthcare setting they are suitable for or whether alternative settings need to be considered. Details of such decisions on individual contracts is regarded as commercially sensitive information as the Department may have to negotiate contract variations, which could include a refund or other form or redress against the supplier.

Seven contracts have been awarded to Pestfix by the Department with a total value of £348 million. Contract Award Notices and the contracts themselves have been published online at the Government’s Contracts Finder service which contain details of the value of each contract and the types of personal protective equipment (PPE) which have been ordered against each contract.

Delivery is progressing for all these PPE items. All items of PPE undergo a rigorous technical assurance process before they can be released for use at which point decisions will be made about which healthcare setting they are suitable for or whether alternative settings need to be considered. Details of such decisions on individual contracts is regarded as commercially sensitive information as the Department may have to negotiate contract variations, which could include a refund or other form or redress against the supplier.

Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse in Daventry show a record of receiving PPE masks produced by Medwell Medical Products.

The masks produced by Medwell Medical Products are marked as part of a donation from ‘Mail Force Charity’, a charity supported by the Daily Mail newspaper to solicit donations from the public to be used to purchase PPE from a variety of sources. These masks were procured through an intermediary who Mail Force had no direct dealings with. Of the 22 million masks supplied by the Mail Force Charity, only a small fraction of these were associated with Medwell.

Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse in Daventry show a record of receiving PPE masks produced by Medwell Medical Products.

The masks produced by Medwell Medical Products are marked as part of a donation from ‘Mail Force Charity’, a charity supported by the Daily Mail newspaper to solicit donations from the public to be used to purchase PPE from a variety of sources. These masks were procured through an intermediary who Mail Force had no direct dealings with. Of the 22 million masks supplied by the Mail Force Charity, only a small fraction of these were associated with Medwell.

Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse in Daventry show a record of receiving PPE masks produced by Medwell Medical Products.

The masks produced by Medwell Medical Products are marked as part of a donation from ‘Mail Force Charity’, a charity supported by the Daily Mail newspaper to solicit donations from the public to be used to purchase PPE from a variety of sources. These masks were procured through an intermediary who Mail Force had no direct dealings with. Of the 22 million masks supplied by the Mail Force Charity, only a small fraction of these were associated with Medwell.

The Medicines and Healthcare products Regulatory Agency (MHRA) is the United Kingdom’s regulator charged with the regulation of medicines for human use, which includes vaccines and medical devices.

The MHRA’s first priority is the protection of public health and any medicinal product or vaccine offered for sale which does not hold the appropriate authorisation will be investigated as a potential breach of the Human Medicines Regulations and a clear threat to health and safety of UK citizens.

Officials at the MHRA are actively assessing the nature and extent of such a threat and are working with partners in UK and elsewhere across the globe to provide an appropriate and effective response.

We have brought forward our Wellbeing and Mental Health Support Plan for COVID-19, backed by £50 million, to set out the support available for people in the context of a second wave and the winter months. This plan sets out the steps we have taken to strengthen the support available for people who are struggling, including for people with severe mental illness.

This includes the announcement that the National Health Service will receive approximately an additional £500 million next year, to address waiting times for mental health services, give more people the mental health support they need, and invest in the NHS workforce.

There is consistent evidence that people who are overweight or living with obesity who contract COVID-19 are more likely to be admitted to hospital, admitted to an intensive care unit and to die from COVID-19 compared to those of a healthy body weight status.

We published Tackling obesity: empowering adults and children to live healthier lives in July. Our strategy is designed to reshape the food environment by providing people with a healthier choice and encouraging them to take it. A copy is attached.

Claims that frail and elderly patients were denied care are categorically untrue.

Over two thirds of inpatients were aged over 65 years old. The National Health Service repeatedly instructed staff that no patient who could benefit from treatment should be denied it and even at the height of the pandemic there was no shortage of ventilators and intensive care.

Thanks to the hard work of NHS staff and care workers and the response of the public to public health measures we have protected our most vulnerable patients throughout the pandemic. For example, from the start of the pandemic we have done everything we can to ensure care home residents and staff are protected, including testing all residents and staff, ring-fencing £1.1 billion for infection control and making a further £4.6 billion available to councils to address pressures caused by the pandemic, including in adult social care.

The National Transplant Registry captures annual follow-up on all patients who receive a transplant in the United Kingdom, together with a minimal dataset on those who are transplanted outside the UK and return for follow-up care. Such transplant recipients may, or may not, become apparent to the National Health Service, depending on whether they sought follow-up NHS treatment.

Data from NHS Blood and Transplant shows that 48 solid organ transplants have been performed overseas in UK residents from 2015 to 2019. Of the 48 transplants, two were reported to have been in China, one in 2015 and one in 2017. No data is recorded for patients going overseas for a transplant and not subsequently returning or for patients returning to the UK with no need for clinical follow-up and or treatment.

The National Transplant Registry captures annual follow-up on all patients who receive a transplant in the United Kingdom, together with a minimal dataset on those who are transplanted outside the UK and return for follow-up care. Such transplant recipients may, or may not, become apparent to the National Health Service, depending on whether they sought follow-up NHS treatment.

Data from NHS Blood and Transplant shows that 48 solid organ transplants have been performed overseas in UK residents from 2015 to 2019. Of the 48 transplants, two were reported to have been in China, one in 2015 and one in 2017. No data is recorded for patients going overseas for a transplant and not subsequently returning or for patients returning to the UK with no need for clinical follow-up and or treatment.

The National Transplant Registry captures annual follow-up on all patients who receive a transplant in the United Kingdom, together with a minimal dataset on those who are transplanted outside the UK and return for follow-up care. Such transplant recipients may, or may not, become apparent to the National Health Service, depending on whether they sought follow-up NHS treatment.

Data from NHS Blood and Transplant shows that 48 solid organ transplants have been performed overseas in UK residents from 2015 to 2019. Of the 48 transplants, two were reported to have been in China, one in 2015 and one in 2017. No data is recorded for patients going overseas for a transplant and not subsequently returning or for patients returning to the UK with no need for clinical follow-up and or treatment.

Data is not available in the format requested.

Claims that frail and elderly patients were denied care in wave one of the coronavirus pandemic, in part because of a triage tool which was developed for use if the National Health Service was overwhelmed, are categorically untrue. Guidance to help clinicians make rational, evidence-based decisions in the event of intensive care units being overwhelmed was commissioned by the NHS England National Medical Director and the four United Kingdom Chief Medical Officers but work was halted when it became clear the NHS would not be overwhelmed.

The Department holds no contract with ADM Group for the supply of personal protective equipment.

The Department does not hold a direct contract with Medwell Medical Products for the supply of personal protective equipment (PPE). Investigation of stocks of PPE received from suppliers at the central distribution warehouse for PPE in Daventry show a record of receiving PPE masks produced by Medwell Medical Products.

The Department does not hold a direct contract with Medwell Medical Products for the supply of personal protective equipment (PPE). Investigation of stocks of PPE received from suppliers at the central distribution warehouse for PPE in Daventry show a record of receiving PPE masks produced by Medwell Medical Products.

The Department has no contract with Hubei Haixin Protective Products Group Co. Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse for PPE in Daventry show no record of items referring to this name.

NHS Supply Chain, which has its own framework contracts for the supply of PPE into the National Health Service, reports that it holds no contracts with Hubei Haixin Protective Products Group Co Ltd and that its records show that this company is not used by its existing suppliers.

The Department has no contract with Hubei Haixin Protective Products Group Co. Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse for PPE in Daventry show no record of items referring to this name.

NHS Supply Chain, which has its own framework contracts for the supply of PPE into the National Health Service, reports that it holds no contracts with Hubei Haixin Protective Products Group Co Ltd and that its records show that this company is not used by its existing suppliers.

The Department has no contract with Hubei Haixin Protective Products Group Co. Investigation of stocks of personal protective equipment (PPE) received from suppliers at the central distribution warehouse for PPE in Daventry show no record of items referring to this name.

NHS Supply Chain, which has its own framework contracts for the supply of PPE into the National Health Service, reports that it holds no contracts with Hubei Haixin Protective Products Group Co Ltd and that its records show that this company is not used by its existing suppliers.

In reviewing alert levels, the Government takes into consideration all the available data for the local situation, including incidence, test positivity and growth rate amongst other factors, to reduce the spread of the virus and bring ‘R’ back below 1.

Decisions on the response to suppress the virus in places at local COVID alert level very high, including Liverpool, were made in consultation with local authorities and directors of public health to ensure that the measures are relevant to that area’s economic, social and public health situation.

The Department responded to the letter on 23 November 2020.

As the pandemic has progressed, we have gained a better understanding of the virus and how it spreads. When reviewing the efficacy of restrictions, the Government assess a range of indicators which currently includes:

- Case detection rates in all age groups;

- Case detection rates in the over 60 year olds;

- The rate at which cases are rising or falling;

- Positivity rate or the number of positive cases detected as a percentage of tests taken in the general population; and

- Pressure on the National Health Service, including current and projected occupancy, admissions, staff absences.

These indicators are under constant review, regardless of the level of restrictions. Since March 2020, the Government has put in place national restrictions which have led to reduced case rates and hospital admissions.

The Government endeavours to communicate changes to restrictions clearly through the media. Additionally, the Contain framework sets out how national and local partners work with the public at a local level to prevent, contain and manage outbreaks, including through communication. Contain facilitates engagement with local authorities through regional partnership teams, including the Department, Joint Biosecurity Centre and Public Health England, ensuring local stakeholder views are part of the decision-making process.

Our first priority continues to be to reduce the risk of COVID-19 transmission in care homes and prevent future outbreaks, and to ensure the health and safety of both care workers and residents. To help reduce the risk of transmission, we have provided the Care Quality Commission (CQC) with test kits so CQC inspectors can undertake weekly polymerase chain reaction asymptomatic testing.

Regular testing will help identify positive cases in the CQC’s inspectors without symptoms and enable action to be taken to limit the spread of the virus, supporting the CQC to continue their vital work in ensuring services meet fundamental standards of quality and safety. As with all testing policies, this remains under review.

Since the start of this pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care. We have taken steps to ensure residents and staff are protected, including testing all residents and staff, providing 208 million items of personal protective equipment, ring-fencing £1.1 billion to prevent infections in care homes and making a further £3.7 billion available to councils to address pressures caused by the pandemic – including in adult social care.

Residents’ individual circumstances must be considered in any decisions, ensuring that their human rights, personal choices, safety and dignity are upheld. Early in the pandemic, we outlined the importance of this through the Adult Social Care Ethical Framework.

We keep our policies under continuous review based on the emerging international and domestic evidence and will consider Amnesty’s report as part of this. On 18 September, we published our Adult Social Care Winter Plan which included several additional measures to support care homes during the pandemic.

Evidence indicated that reduced operating hours allowed businesses to trade for the majority of the evening while also controlling transmission rates. This aimed to minimise damage to the economy and society, jobs and livelihoods and safeguard education in schools, colleges and universities.

COVID‑19 support is available to employers and the self-employed, including sole traders and limited company directors and includes loans, tax relief and cash grants, whether a business is open or closed.

From Monday 28 September, we increased the number of COVID-19 secure guidelines that have been placed into law and expanded the range of settings in which these laws will apply. The new ‘rule of six’ simplifies and strengthens the rules on social gatherings, making them easier to understand and easier for the police to enforce. Businesses will be legally obliged to prevent people mixing in groups larger than six, take appropriate measures to prevent mingling and to comply with the COVID-19 secure guidance already in place. Therefore, if venues are not COVID-19 secure then they could be liable for fines or closures.

Health is a devolved matter and each administration has the discretion and flexibility to find the right balance between managing risks and relaxing measures.

The Government is keeping its social distancing measures under continual review. The Government will only make changes when we are confident, we can do so safely. The Secretary of State for Health and Social Care keeps the restrictions and requirements under constant consideration, to ensure the measures continue to be both proportionate and necessary

The new limit from 14 September does not prevent anyone from seeing their grandparents, but those who live in larger households will need to think carefully about how to organise their social interactions to remain within the law. We know this is difficult, but we know people will understand the need to take those steps which are necessary to keep their loved ones safe. These rules have been simplified and strengthened so they are easier to understand, and so the police can identify and disperse illegal gatherings. We are also acting now to get the virus under control and, if we achieve that, we may be able to make changes and potentially lift the restrictions.

As the Prime Minister set out, if we are to beat the virus then everyone, at all times, needs to limit social contact as much as possible. We are seeing daily case numbers rise rapidly and across the country, which is why the Government, the Chief Medical Officer and the Chief Scientific Adviser jointly agreed the changes we announced.

The rules have been simplified and strengthened so they are easier to understand, and so the police can identify and disperse illegal gatherings. We are also acting now to get the virus under control and, if we achieve that, we may be able to make changes and potentially lift the restrictions.

The new limit from 14 September does not prevent anyone from seeing their grandparents, but those who live in larger households will need to think carefully about how to organise their social interactions to remain within the law. We know this is difficult, but we know people will understand the need to take those steps which are necessary to keep their loved ones safe.

The Nuffield Council on Bioethics undertook a comprehensive review of donor conception. Donor conception: ethical aspects of information sharing was published on 17 April 2013 and a copy is attached.

One of the report’s key recommendations was that “The state does not, and should not, have a role in informing donor-conceived people of the circumstances of their conception, for example through entries on birth certificates.”

In the light of this review and the report’s clear recommendation, the Government took the view that no further legislative action was appropriate in this area. The Government encourages the parents of donor conceived children to be open with them about their genetic heritage. This has remained Government policy through successive administrations.

The Government has made no formal assessment of these studies and the Department has not made an assessment of the relationship between the legalisation of assisted suicide and the rate of suicide in the general population.

The United Kingdom believes that the World Health Organization (WHO) has an important role to play in leading the health response to COVID-19 and in longer-term leadership in global health including preparedness. We also want to see the WHO continue to learn lessons on how to improve its response to global health emergencies and as such would expect a full review of all elements of their response once they are out of response mode, as has occurred after previous Public Health Emergencies of International Concern. The WHO has confirmed a review will take place and we will continue to work closely with them and other international partners to ensure this is wide-ranging and robust.

Effective local management of outbreaks is the first line of protection against a second wave that might overwhelm the National Health Service.

In this case, Blackburn suffered the highest incidence rates of all districts in Lancashire for three consecutive weeks between 13 July and 2 August. Incidents rates per 100,000 population rose from 83.25 and peaked at 91.98 before falling to 74.53 by 2 August once local resources were augmented with national support.

When considering whether an area can come out of a localised lockdown, there will need to be a reduction in cases consistent with the surrounding areas and a significantly diminished risk of further growth. We are keeping these restrictions under review and they will be removed when they are no longer proportionate or necessary. These decisions are made on a case-by-case basis with involvement of the scientific community and local leaders.

On behalf of affected families, the Chair of the Association for Children Damaged by Hormone Pregnancy Tests (HPTs) attended every meeting of the Commission on Human Medicines’ Expert Working Group on HPTs and was invited to discuss their draft recommendations and give a statement to the Commission on the draft report of the Group. In addition, 13 affected families gave their personal experiences with Primodos to the Expert Working Group. Since publication of the report of the Independent Medicines and Medical Devices Safety Review, we have received a letter from the Chair of the Association for Children Damaged by Hormone Pregnancy Tests and will be responding shortly.

The Independent Medicines and Medical Devices Safety Review published its report on 8 July and all of its recommendations will be considered carefully. The Government will provide an update in due course.

The Commission on Human Medicines Expert Working Group on Hormone Pregnancy Tests was an independent group convened to conduct a scientific review of the evidence for an association between the use of hormone pregnancy tests and adverse outcomes of pregnancy.

The report and all the evidence that was reviewed by the Group has been publicly available since November 2017. We cannot discuss specific issues regarding the litigation, but this does not prevent any re-examination of the report or evidence. Any relevant new evidence would be reviewed as it becomes available.

We are carefully considering the recommendations of the Independent Medicines and Medical Devices Safety Review and will respond in due course.

Throughout our COVID-19 response we have worked with the care sector and public health experts to put in place measures to reduce transmission and save lives. It has been our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. Wherever possible, people who are clinically ready should be supported to return to their place of residence, where assessment of longer-term needs will take place. This approach follows the ‘Discharge to Assess’ model, to support timely and appropriate discharge from hospital.

The Hospital Discharge Service and staff should clarify with care homes the COVID-19 status of an individual and any COVID-19 symptoms, during the process of transfer from a hospital to the care home. As testing capacity was being built priority for testing was given to the most clinically vulnerable patients:

- all patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu like illness;

- all other patients requiring admission to hospital for pneumonia, ARDS or flu like illness; and

- where an outbreak has occurred in a residential or care setting, for example long-term care facility or prisons.

As set out in the Adult Social Care Action Plan on 15 April, all patients are now required to be tested prior to discharge to a care home.

Public Health England has not made an assessment of the statements made by Dr Li-Meng Yan.

Many care homes have been doing an excellent job of keeping people safe.

The Care Quality Commission (CQC) reduced the number of physical inspections it conducted during the crisis in order to limit the number of people going in and out of care homes. It did continue to inspect a small number of settings where serious concerns have been identified. Some of these were linked directly to concerns raised with the CQC from staff and members of the public.

Furthermore, during this crisis, Care Quality Commission (CQC) inspectors have contacted more than 80% of all providers – over 20,000 care providers – to offer support, advice and guidance, including help accessing personal protective equipment and advice on infection control.

We are working to expand the supply of personal protective equipment (PPE) from overseas and improve domestic manufacturing capability. We are expanding and improving the logistics network for delivering to the front line.

Since 25 February we have delivered over 2.2 billion items of PPE across the health and social care system within England, plus tens of millions more will have been distributed by the devolved administrations. Almost 28 billion items of PPE have been ordered from United Kingdom-based manufacturers and international partners to provide a continuous supply in the coming months.

Two important customer alerts were issued on 22 May and 26 June regarding a product fault with Type IIR facemasks, sourced from Cardinal Health. The Cardinal Health Type IIR facemasks were subject to a formal shelf life extension process that enabled their shelf life to be extended and so were not out of date. The cost of these masks cannot be released due to commercial sensitivity.

We know that many people with long standing, limiting illnesses or health conditions are at higher risk of poorer outcomes from COVID-19.

The Office for National Statistics has undertaken provisional analysis of data comparing the risk of death involving COVID-19 according to a person’s disability status, as recorded in the 2011 Census for the period 2 March to 15 May 2020. This data suggests that, after adjusting for region, population density, socio-demographic and household characteristics, the relative difference in mortality rates between those ‘limited a lot’ by a health condition and those not disabled was 2.4 times higher for females and 1.9 times higher for males.

We continue to review all available evidence regarding the impact of COVID-19 for disabled people and we are commissioning new research to better understand the specific impact. This evidence will inform policy development going forwards.

Emergency guidance issued at the beginning of the pandemic and the Codes of Practice for the Mental Capacity Act and Deprivation of Liberty Safeguards offer guidance to individuals trying to determine and make decisions in the best interests of a person who lacks capacity to make a particular decision, including on where to live.

Those making best interests decisions should seek consent on all aspects of care and treatment to which the person can consent. They should consider the person’s wishes and feelings, as well as their beliefs and values that would be likely to influence their decision. They should also consider the views of the person’s family members and those interested in the person’s welfare. This approach applies to decisions about residence too.

Throughout our coronavirus response we have kept our policies under continuous review based on the emerging international and domestic evidence and have worked tirelessly with the care sector and public health experts to reduce transmission and save lives.

On 15 April, we published COVID-19: Our Action Plan for Adult Social Care. This set out that all patients are required to be tested prior to discharge to a care home. A copy is attached.

Patients are discharged when it is clinically safe and they no longer need acute care. Wherever possible, people who are clinically ready should be supported to return to their place of residence, where assessment of longer-term needs will take place. This approach follows the ‘discharge to assess’ model, to support timely and appropriate discharge from hospital.

As our understanding of the virus has changes throughout the course of the pandemic, we have continued to develop our policy. Our current policy is that due to evidence of asymptomatic spread, during periods of sustained transmission we recommend that all residents being discharged from hospital or interim care facilities to the care home and new residents admitted from the community should be isolated for 14 days within their own room. For care home residents, around 70% of people living in care homes for the over 65s have dementia. It is important they return to their familiar environments when they are clinically ready, with the personalised support and daily activities in place that help them to live well with dementia. This can be better achieved in their care home, rather than the hospital.

We have made £1.3 billion funding available via the National Health Service to help patients who no longer need urgent treatment to get home from hospital safely and quickly. We have also made £3.2 billion available to local authorities so they can address pressures on local services caused by the pandemic, including in adult social care. On 13 May we announced an additional £600 million to support care home providers through a new Adult Social Care Infection Control Fund.

The Medicines and Healthcare products Regulatory Agency (MHRA) has not received any applications for the use of niclosamide as a treatment for COVID-19 and has not undertaken any assessment of the trials in South Korea.

Currently, there are no ongoing clinical trials in the United Kingdom involving niclosamide for the treatment of COVID-19. However, there are three worldwide trials regarding this treatment listed on the United States National Library of Medicine, in the United States, France and Egypt, though none of these are recruiting currently.

The MHRA is working closely with the Department and the office of the Chief Medical Officer to prioritise potential treatments for COVID-19. The MHRA will consider any application made by a sponsor or potential marketing authorisation holder to run a clinical trial.

I replied to the noble Lord’s question of 28 April on behalf of the Department for Culture, Media and Sport on 30 June. I understand that they are responding directly on the points the noble Lord raised.

We recognise that COVID-19 is imposing significant pressures on the social care sector. We have now made £3.2 billion available to local authorities so they can address pressures on local services caused by the pandemic, including in adult social care.

On 15 May we published details of an additional £600 million Infection Control Fund for Adult Social Care. This funding is to support adult social care providers in England reduce the rate of transmission in and between care homes and to support workforce resilience.

This funding is part of the Government’s commitment to ensure the health and social care system have all the resources they need during the COVID-19 outbreak. The Government will continue to monitor pressures in the National Health Service and local government and will keep future funding under review.

When choosing to charge, a local authority must not charge more than the cost that it incurs in meeting the assessed needs of the person. A local authority must also regularly reassess a person’s ability to meet the cost of any charges to take account of any changes to their resources.

We know the social care sector is under pressure due to growing demand from both older people and those of working age. We are providing councils with a £1 billion grant for adults and children’s social care on top of maintaining £2.5 billion of existing social care grants for 2020/21. We have provided £3.2 billion to local authorities to help with COVID-19 pressures, and a £600 million Infection Control Fund for care homes, 75% of which must be distributed on a 'per bed' basis, including to social care providers with whom the local authority does not have existing contracts.

The scenario set out in Public Health England’s (PHE) National Infection Service document, issued on 24 February, related to hospital-acquired COVID-19 outbreaks during the containment phase of COVID-19, prior to 12 March, when there was no sustained community transmission in the United Kingdom. There was no evidence of recorded cases of hospital-acquired COVID-19 outbreaks during the COVID-19 containment phase and before 19 March when the COVID-19 hospital discharge service requirements were published.

On 12 March the Government announced that we were moving our COVID-19 response from the ‘contain’ to ‘delay’ phase. On 13 March PHE published new guidance to care homes. We subsequently published the COVID-19 hospital discharge service requirements on 19 March.

Since the start of the outbreak we have been working closely with the sector and public health experts to ensure we have the right guidance and support in place for care homes.

The Government does not comment on litigation matters.

Every death from this virus is a tragedy. It is our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. Patients are discharged when it is clinically safe and they no longer need acute care.

We have provided extensive support and guidance to care homes throughout the COVID-19 pandemic. We have also provided local authorities with £3.2 billion to help them deal with the impacts of COVID-19, as well as £1.3 billion via the National Health Service to enhance the NHS discharge process. On 13 May, we announced an additional new £600 million Infection Control Fund for care homes to tackle the spread of COVID-19.

We recognise how difficult the past months have been for people who are socially isolated and any death is a tragedy.

Local safeguarding partnerships have been ensuring that people with care and support needs are being safeguarded throughout the COVID-19 outbreak, including working with the shielding population to ensure they are well-supported. We are also aware of good practice through community-led social work and support networks which have ensured people stay connected and any concerns or support needs are identified more quickly.

The Department does not have record of the correspondence from the National Care Forum.

Throughout this pandemic, we have been determined to give both the National Health Service and social care everything they need to respond to the COVID-19 pandemic.

In February 2020, the first guidance for the social care sector was published. In March, we announced £1.6 billion funding for local government and £1.3 billion to go to the NHS and social care for discharge support. In April, we announced a further £1.6 billion for local government and our COVID-19: Our Action Plan for Adult Social Care. A copy of the Action Plan is attached.

On 15 May, the Government published the Care Home Support package and an additional £600 million Adult Social Care Infection Control Fund. This represents the next phase of our response for care homes.

We continue to work tirelessly with the care sector and public health experts to explore all measures possible to reduce transmission and save lives.

It has always been our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. On 19 March we published the COVID-19 Hospital Discharge Service Requirements to support the safe and rapid discharge of patients who no longer need acute care. This specified that, wherever possible, people who are clinically ready should be supported to return to their place of residence (this could be a care home), where assessment of longer-term needs will take place. This follows the ‘Discharge to Assess’ model. Where a patient had been tested for COVID-19, we specified that results – whether negative or positive – should be included in a patient’s discharge documents.

To support the sector, this guidance also sets out the steps that care providers should be taking, and we provided £1.3 billion to support the process. We have provided advice to care homes throughout the pandemic in response to the latest conditions and emerging evidence and data.

On 2 April we published our Admission and Care of Residents during COVID-19 Incident in a Care Home guidance. This set out further advice on infection control procedures for care homes e.g. limiting visits to essential visits only unless exceptional circumstances and providing advice on isolation, decontamination, cleaning and protective measures for staff. We recommended that all symptomatic residents in care homes should be immediately isolated for 14 days from the onset of symptoms, including patients discharged from hospital.

On 15 April we published our Adult Social Care Plan which included a commitment to all patients being tested prior to discharge to a care home. A copy of COVID-19: Our Action Plan for Adult Social Care is attached.

Copies of the COVID-19 Hospital Discharge Service Requirements and Admission and Care of Residents during COVID-19 Incident in a Care Home are attached.

Our number one priority for adult social care is for everyone who relies on care to get the care they need throughout the COVID-19 pandemic. The steps we have taken have been designed with care users in mind, to ensure that individuals are treated with dignity and respect and that their particular needs are addressed.

Since the start of this pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care to respond to the pandemic. This includes updated guidance for care homes published on 19 June. This guidance provides advice to care homes on infection control procedures to limit the spread of the virus in care homes, protective measures for staff and minimising workforce transmission. A copy of Admission and Care of Residents in a Care Home during COVID-19 is attached.

Our help to care homes, which includes financial support, infection control training and supplies of personal protective equipment, has meant that nearly 60% of England’s care homes have had no outbreak at all.

As the Chief Medical Office has made clear, the rate of transmission and the number of cases of COVID-19 that we will see in the coming weeks and months will depend of how well we all follow social distancing guidance. The work of NHS Test and Trace and public health teams across the country will allow us to keep on top of any local outbreaks and keep the number of cases of COVID-19 low.

We are continuing to seek further evidence as domestic and international experience accrues and is published, and we are working tirelessly with the care sector and public health experts to explore all measures possible to reduce transmission and save lives.

We have commissioned Public Health England to undertake a detailed analysis of the numbers of deaths of people with a learning disability. This will draw on data published by NHS England and by the Care Quality Commission to assess the impact of COVID-19 on this group of people.

Since the start of this outbreak we have been working closely with the sector and public health experts to put in place guidance and support for adult social care based on the latest domestic and international evidence, including that brought together by Public Health England and the Scientific Advisory Group for Emergencies, and drawing on the insights of care providers

In February, the first guidance for the sector was published. In March we announced £1.6 billion funding for local government and £1.3 billion to go to the National Health Service and social care for discharge support. In April we announced a further £1.6 billion for local government and published our detailed Adult Social Care Action Plan on 15 April. In May we announced an additional £600 million to support care home providers through a new Adult Social Care Infection Control Fund and our care home support package,

Alongside the care home support package, we have also published detailed guidance for home care providers to support them to deliver care safely and effectively during the pandemic. This will be relevant to retirement community settings where care is provided.

We have now made £3.2 billion available to local authorities so they can address pressures on local services caused by the pandemic, including in adult social care.

On 15 May we published details of an additional £600 million Infection Control Fund for Adult Social Care. This funding is to support adult social care providers in England reduce the rate of transmission in and between care homes and to support workforce resilience. As part of the grant conditions, local authorities have been asked to report later this month on the measures taken, such as steps taken to isolate residents within care homes and support staff who are self-isolating.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet Testing – note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library

Test kits have been offered to every care home for over-65s or those with dementia in England, reaching the testing target for 6 June. All remaining adult care homes are eligible to access testing through the whole care home portal. We have the capacity to send out over 50,000 test kits a day.

The safety of residents and staff is a priority. It is the responsibility of the local authority, supported by Public Health England and NHS England to manage outbreaks in the first instance. Every death from this virus is a tragedy and we are working around the clock to give the social care sector the equipment and support they need to tackle this outbreak.

We have published a range of guidance for care homes on how to continue giving care during the COVID-19 outbreak.

This includes the Admission and Care of Residents during COVID-19 Incident in a Care Home guidance. This guidance sets out infection control and cohorting advice to care homes, which providers should follow to ensure that they have the confidence to receive and support residents. A copy of the guidance is attached.

On 15 May 2020 we published a care home support package which outlines?the next phase of our response for care homes, including measures on infection prevention control, comprehensive testing and clinical support.

We believe the World Health Organization has an important role to play in leading the global health response. The United Kingdom has long been an advocate of reform in the WHO to ensure it is flexible and responsive, and we will continue to be so. We also want to see the WHO continue to learn lessons on how to improve its response to global health emergencies and as such would expect a full review of all elements of their response once they are out of response mode, as has occurred after previous Public Health Emergencies of International Concern. The Secretary of State raised this point in the United Kingdom national address for the World Health Assembly on 18 May 2020 and we were pleased to co-sponsor the COVID-19 resolution, which was an important step forward on the review as well as other areas of collaboration. The UK intends to engage constructively with a future review, including working with other Governments.

The safety of residents and staff is always a priority. We have provided extensive support and guidance to care homes throughout the COVID-19 pandemic, and we are working closely with local authorities, the care sector and NHS England to ensure everyone has access to the right care, in the most appropriate setting for their needs.

We are determined to give both the care sector and the National Health Service everything they need to respond to this pandemic. On 15?May 2020 we published a care home support package which outlines?the next phase of our response for care homes,?using the latest scientific evidence and drawing on the insights of care providers. To support this, on 13 May we announced an additional £600 million to support care home providers through a new Adult Social Care Infection Control Fund.

This is an unprecedented global pandemic and we will continue to review our guidance and national support in line with the latest scientific advice and engage with stakeholders to ensure we address the majority of their concerns.

Vaccine development involves evaluating the quality, safety and efficacy in a series of carefully planned clinical trials. The Government is backing two promising United Kingdom COVID-19 vaccine candidates at the University of Oxford and Imperial College London. Vaccine development is in the early stages but progressing rapidly. During clinical trials, both Oxford and Imperial plan to evaluate the safety and efficacy of their vaccines in older people. While there are no plans to specifically recruit those with disabilities, in both cases those with disabilities are eligible and welcome to take part in clinical trials subject to specific exclusion criteria which apply to all volunteers to ensure the safety of participants.

The Government has made no specific assessment of the report by the Association of Directors of Adult Social Service’s (ADASS) report of 2018, but the Department engages and considers views of ADASS as a key partner organisation. Since the start of the pandemic we have worked closely with the adult social care sector and public health experts to provide guidance and support, including on controlling infection.

On 2 April we published Admission and Care of Residents in a Care Home during COVID-19, which was updated on 19 June. We set out our plans to support the care sector in using and accessing personal protective equipment (PPE) in Covid-19: Personal Protective Equipment (PPE) Plan on 10 April. On 15 April we published our COVID-19: Our Action Plan for Adult Social Care which included strengthened advice around isolation and introduced testing for all patients prior to discharge from hospital to a care home. Copies are attached. On 15 May, the Government announced a support package for care homes backed by a £600 million Infection Control Fund for care homes to tackle the spread of COVID-19.

To support the health and social care sectors to respond to the COVID-19 pandemic, we have launched the National Health Service Volunteer Responders programme, developed by NHS England in partnership with the Royal Voluntary Service. It is up to individual social care providers to decide whether to use volunteers. We do not collect data nationally on how many volunteers are operating in the social care sector.

The Department has not had discussions with the Equality and Human Rights Commission on discharge policy. Providers of care homes in England are required to register with the Care Quality Commission and adhere to the ‘fundamental standards’, such as the duty to provide care in a safe way and treat residents with dignity and respect, as set out in the Health and Social Care Act 2008.

Health and care settings must always seek to fully protect the rights of their residents. The safety of residents and staff is always a priority and patients should not be discharged from hospital unless it is clinically safe to do so. On 15 April, in our Adult Social Care Action Plan, we introduced a policy of testing all residents prior to discharge to a care home.

The Government is aware of comments on care homes during the COVID-19 pandemic made by the UN Special Rapporteurs and the UN Independent Expert.

The Care Quality Commission (CQC) is not aware of any specific reports of care home staff abandoning care homes or specific cases where residents have been left to die alone. The CQC (Registration) Regulations 2009 set out requirements for incidents and events that must be reported to the CQC, which covers deaths and serious injuries, abuse, incidents reported to the police and events that prevent a service from being carried on safely and in a way that meets legal requirements.

Before the COVID-19 outbreak, each care provider was responsible for sourcing their own personal protective equipment (PPE) from wholesalers and distribution centres. While this was effective and appropriate before the outbreak, it became clear that this fragmented system would be slow to get PPE where it needed to be. To address this, the United Kingdom Government stepped in to support the supply and distribution of PPE to the care sector. We have focused on ensuring that there is an emergency supply in place, while building a longer-term solution for distribution to the sector.

We are supportive, in principle, of a multilateral instrument dedicated to the rights of older persons and welcome the work of the UN Open Ended Working Group on Ageing and its focus on substance to help deepen our understanding of the important issues, before we consider what might be the most appropriate solutions.

If a care home suspects a resident has symptoms, the care home manager should contact their local Public Health England Health Protection Team (HPT). The HPT will arrange for testing of all symptomatic residents and provide tailored infection control advice.

For subsequent testing, including ‘whole home testing’, the Department is responsible and testing kits will be delivered directly to care homes by courier or via a mobile testing unit. Kits are requested by care home managers or Local Directors of Public Health via the new online portal. They will provide testing for all residents and asymptomatic staff.

Since the start of the pandemic, nearly 125,000 workers in care settings and over 118,000 care home residents have been tested through Departmental and Public Health England testing routes. On Monday 11 May we launched the ‘whole home’ testing portal. As of 19 May, around 170,000 tests have been delivered to 1,243 care homes using the whole care home portal as part of this programme. We will make testing available for every resident and member of staff in care homes for older people in England between now and early June.

The Department recognises that this occurred due to an error which has since been rectified. All failed deliveries were replaced and we now have more than 500 test sites around the United Kingdom with the median distance people travel to sites at just 3.3 miles.

The adult social care sector has been, and continues to be, one of our highest priorities for the rollout of testing, and care homes have been one of the first groups to be given access to repeat asymptomatic testing.

Asymptomatic testing in care homes testing has not stopped, while any care home resident or member of staff with symptoms will continue to be able to immediately access a free test.

We are issuing more than 120,000 tests a day to care homes across the country prioritising high priority outbreak areas.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet Testing – note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library.

The Care Quality Commission (CQC) is aware of a small number of cases where care homes have told them that a patient’s positive COVID-19 status was known to the hospital but not disclosed at the point of discharge. The CQC is currently assessing whether there have been any breaches of regulation on the part of the hospital. Once all the relevant information has been reviewed, the CQC will assess what action might be appropriate, if any. Any enforcement action taken by the CQC would be made public. Due to the very small number of cases the CQC has been made aware of and is reviewing, it would be unlikely that this information would form the basis of a standalone report. If the CQC receives further information on this issue, it may seek to publish a report in the future.

Individual modelling groups use a range of data to estimate R including epidemiological data such as hospital admissions, intensive care unit admissions and deaths. R is an average value that can vary in different parts of the country, communities, and subsections of the population. It cannot be measured directly so there is always some uncertainty around its exact value.

We know that care providers across the country have been doing their utmost to keep those they look after safe and well in the most challenging circumstances. On 13 May we announced an additional £600 million to support providers through a new Adult Social Care Infection Control Fund.

The Government has also made £3.2 billion available to help local authorities deal with the immediate impacts of COVID-19, and £1.3 billion of additional funding to enhance the National Health Service discharge process, getting patients who no longer need urgent treatment home from hospitals safely and quickly.

There is little evidence to suggest a substantial transmission of infection from care homes into the wider community, but our work to reduce transmission within care homes will reduce any risk further. On 13 May we announced an additional £600 million to support providers through a new Adult Social Care Infection Control Fund. The Fund sets out the measures providers can take to support the workforce to minimise the spread of infection, including ensuring staff can self-isolate, reduce their hours, or reduce the number of establishments they work at, without experiencing any loss of income. Expanding and retaining the social care workforce is also key to enabling care providers to continue to provide care and support to their residents, and we have launched a national recruitment campaign for England to support this.

Social care has been at the frontline of our response to COVID-19, with social care providers looking after many of the most vulnerable in society. The Government’s number one priority for adult social care is to ensure that everyone who relies on care gets the care and support they need throughout the COVID-19 pandemic.

On 13 May we announced an additional £600 million for an Infection Control Fund for Adult Social Care. This funding is to support adult social care providers in England reduce the rate of transmission in and between care homes and to support workforce resilience. Furthermore, on 15 May, the Government published a Care Home Support Plan in an online only format on GOV.UK. This is the next phase of our response for care homes, using the latest domestic and international evidence brought together by Public Health England, and drawing on the insights of care providers.

The United Kingdom participated fully in the 73^rd World Health Assembly which we saw as an important opportunity to further international collaboration on COVID-19. We believe the World Health Organization (WHO) has an important role to play in leading the global health response. We want to see the WHO continue to learn lessons on how to improve its response to global health emergencies and as such would expect a full review of all elements of their response once they are out of response mode, as has occurred after previous Public Health Emergencies of International Concern. The Secretary of State raised this point in the United Kingdom national address and we were pleased to co-sponsor the COVID-19 resolution, which was an important step forward on the review as well as other areas of collaboration. The UK intends to engage constructively with a future review, including working with other Governments.

Regulations came into force on 29 January 2020 to add Novel coronavirus (2019-nCoV) (now known as COVID-19) to Schedule 1 of the National Health Service (Charges to Overseas Visitors) Regulations 2015. This means there can be no charge made to an overseas visitor for the diagnosis, or, if positive, treatment, of COVID-19. The exemption from charge does not extend to any pre-existing conditions, unless separately exempt under the Regulations.

This message has been disseminated to National Health Service staff, the public and organisations representing vulnerable migrant groups. It has also been published in 40 languages on Public Health England’s Migrant Health Guide.

The Government takes the welfare of all citizens seriously and we are working hard to ensure people get the support they need to look after themselves and their families during the COVID-19 outbreak. This includes enabling all communities to take the necessary measures to reduce the spread of the virus.

The Minister of State for Home Affairs and Housing, Communities and Local Government (Lord Greenhalgh) wrote to councils outlining their responsibility to support all communities, including Gypsy and Traveller communities, and to ensure they have access to water, sanitation and waste collections.

COVID-19 health guidance for members of Gypsy, Traveller and Boater communities is currently in development for dissemination in a range of formats.

NHS England and NHS Improvement have written to general practice reminding them of the importance of continuing to deliver appropriate care to their local population and the requirements on registration of patients, including those with no fixed address.

On 7 April 2020, NHS England published a letter outlining the importance of maintaining standards and quality of care in pressurised circumstances. This letter emphasised the NHS Constitution which is based on the principle of equity of access for those who could benefit from treatment escalation.

The evidence is clear that people who are over the age of 70 are at increased clinical risk of having severe cases of COVID-19. The Government recognises that social distancing and self-isolation are likely to increase the risk of loneliness and mental health issues for everyone, but particularly for vulnerable groups including those with pre-existing conditions and those shielding. The Government has provided guidance to support people both medically and socially, who on the basis of their condition and not their age, are extremely vulnerable to COVID-19. This is available in an online only format on GOV.UK. Furthermore, on 22 April the Government launched a new major plan to tackle loneliness which include a £5 million boost for national loneliness organisations.

It is important that people continue to receive support services in the community. The Government has made £3.2 billion available to help local authorities deal with the immediate impacts of COVID-19, and £1.3 billion of additional funding to enhance the National Health Service discharge process, getting patients who no longer need urgent treatment home from hospitals safely and quickly.

The Department, NHS England, Public Health England (PHE) and the Care Quality Commission co-published Admission and Care of Residents during COVID-19 Incident in a Care Home guidance on 2 April 2020, followed by the publication of PHE guidance How to work safely in care homes on 17 April 2020.

Residential care settings must always seek to fully protect the rights of disabled people now and throughout the course of this global pandemic. No changes have been made to the human rights protections in the Mental Health Act 1983 or as a result of the Care Act 2014 easements. The Adult Social Care Action Plan, published on 15 April 2020, includes information on supporting people to maintain their independence and responding to individual needs.

This is an unprecedented global pandemic. We are constantly reviewing our guidance in line with policy changes based at all times on the best scientific advice.

Since the guidance published on 2 April we have set out a comprehensive action plan, last updated on 16 April, to support the adult social care sector in England throughout the COVID-19 outbreak. Our plan sets out the actions the Government is taking to help minimise the spread of infection within all care settings. Local health protection teams have been working hard to support care homes in outbreak management providing help with testing and isolation, and infection control advice. We will continue to work closely with key stakeholders and keep our policies under review as the pandemic goes on.

We will continue to update our guidance based on stakeholder feedback, including changes to text to make content easier to read. The Accessible Information Standard is a requirement for organisations that provide National Health Service care or publicly-funded adult social care. It ensures that people with a disability, impairment or sensory loss are provided with information they can easily read or understand, with support, so they can communicate effectively with services.

We recognise the importance of care home staff, and the vital role they have to play in the United Kingdom’s response to the COVID-19 pandemic. On 17 April Public Health England published guidance COVID19: How to Work Safely in Care Homes. This includes advice on what measures to take in relation to physical distancing in various scenarios. A copy of this guidance is attached.

The Admission and Care of Residents during COVID-19 Incident in a Care Home guidance advised a 14-day isolation period over testing, based on the evidence available at the time of publication. The duration was chosen as a pre-cautionary measure and was informed by the recommendation of the Scientific Advisory Group for Emergencies, the New and Emerging Respiratory Virus Threats Advisory Group and multiple Government advisory groups.

Care home staff are advised to wear eye protection if a two-metre distance cannot be maintained and there is needed for certain tasks where there is risk of droplets or secretions from the resident’s mouth, nose, lungs or from body fluids reaching the eyes, for example prolonged tasks near residents who are repeatedly coughing or who may be vomiting.

Eye protection is not required when care home workers are not within two metres of someone with a cough. This advice applies to all care home staff, including cleaners.

Care home staff working in communal areas with residents but with no direct contact with residents although potentially within two metres of residents, do not need to wear eye protection.

The Department, NHS England, Public Health England (PHE) and the Care Quality Commission (CQC) co-published Admission and Care of Residents during COVID-19 Incident in a Care Home guidance on 2 April 2020, followed by the publication of PHE guidance COVID 19: How to work safely in care homes on 17 April 2020. A copy of PHE’s guidance is attached.

The guidance on disinfection in Admission and Care of Residents during COVID-19 Incident in a Care Home of 2 April 2020 is consistent with the World Health Organization’s advice on disinfection.

The use of 0.1% sodium hypochlorite, which is the same as 1,000 parts per million chlorine, has been deduced from studies conducted on SARS-CoV and other coronaviruses, including the European Centre for Disease Prevention and Control’s Interim guidance for environmental cleaning in nonhealthcare facilities exposed to SARS-CoV-2.

With reference to washing of laundry, the Admission and Care of Residents during COVID-19 Incident in a Care Home guidance states that care homes are expected to follow the advice in Health Technical Memorandum 01-04: Decontamination of linen for health and social care (2016). The Memorandum states that enhanced processing should be used when there is the possibility of infectious linen or clothing being generated. The enhanced process should be performed in a machine as for the standard process but using a cycle with a minimum temperature of 60ºC, or the highest temperature suitable for heat-sensitive items.

This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice. We are constantly reviewing our guidance in line with policy changes based at all times on the best scientific advice.

The Department, NHS England, Public Health England and the Care Quality Commission co-published Admission and Care of Residents during COVID-19 Incident in a Care Home guidance on 2 April 2020. A copy of the guidance is attached.

The guidance sets out infection control and cohorting advice to care homes, which providers should follow to ensure that they have the confidence to receive and support residents. With the needs of residents in mind, it asks care homes to facilitate remote visiting from family, friends and others, via phone, video, and using plastic or glass barriers.

All our guidance is designed with care users in mind, to ensure that individuals are treated with dignity and respect and that their particular needs are addressed. The Adult Social Care Action Plan published on 15 April includes information on supporting people to maintain their independence and responding to individual needs.

Together with the Chief Social Worker, the Department has developed an ethical framework to provide support to ongoing response planning and decision-making to ensure that thorough consideration is given to a core set of ethical values and principles when organising and delivering social care for adults. The framework emphasises that equal concern and respect should be given to all individuals, their families and carers, and communities, as well as the professionals and volunteers that we will be relying on to ensure the delivery of our services and ambitions.

We have not changed relevant duties for regulated providers (including care homes), contained in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including the fundamental standards which include provisions about person-centred care (regulation 9) and dignity and respect (regulation 10).

We know that care home residents, particularly those with cognitive and intellectual impairments such as dementia or a learning disability and autistic people, are likely to experience particular difficulties during the pandemic. This could include difficulty understanding and following advice on social distancing, and increased anxiety. Our social care workforce, including new recruits, will need to be trained to respond to these conditions appropriately. We will support providers to embed this in their training in relation to their role, whether they require basic awareness training or more specialist knowledge and skills.

Officials and Ministers are speaking to users of adult social care, and groups that represent them, frequently, to ensure that the Government’s adult social care COVID-19 response reflects their needs. The Government has produced a number of pieces of guidance to support people during the COVID-19 pandemic, including people with dementia and their carers. We are constantly reviewing our guidance in line with the views of users and policy changes, based at all times on the best scientific advice.

I have been asked to reply on behalf of the Department for Digital, Culture, Media and Sport.

The Department for Digital, Culture, Media and Sport has advised that a number of sports and other events took place in the period before the Prime Minister announced the lockdown on 23 March. It was absolutely appropriate for them to do so as it was in line with the public health guidance at the time, and indeed, in line with wider activity in the economy and society more generally. It was also in line with the Government’s border and travel policy.

It is the Government’s absolute priority to protect people's health and our advice to the public is based on direct, continuous consultation with scientific and medical experts. There are many factors that could influence the number of cases in a particular area, including population density, age, general health, and the position of an area on the pandemic curve.

We are working around the clock to give the social care sector and wider National Health Service the equipment and support they need to tackle this outbreak.

Sourcing sufficient supplies of personal protective equipment is a challenge that many countries are facing. We are working to expand supply from overseas, improve domestic manufacturing capability and expand and improve the logistics network for delivering to the front line.

The full weight of the Government is behind this effort and we are working closely with industry, social care providers, the NHS, and the army to ensure the right equipment continues to be delivered.

Tocilizumab has begun evaluation in the United Kingdom as part of the RECOVERY and REMAP-CAP studies. The Medicines and Healthcare products Regulatory Agency (MHRA) is in regular contact with sponsors and trial investigators to review clinical trials, offer scientific and regulatory advice on clinical trials and encourage early submission of emerging data though facilitated licensing routes. Emerging results from global trials will be taken into consideration by the MHRA during authorisation of UK clinical trials and to inform any amendments needed to ongoing trials.

The Government recognises the importance of collaborating effectively to combat COVID-19, and the UK is meeting regularly with other countries both bilaterally and multilaterally to share information on a variety of subjects including clinical trials. Working with partners across the health and care system, the National Institute for Health Research (NIHR) is supporting the identification, prioritisation and delivery of high quality COVID-19 research, a key element of the Government’s overall response. As part of this work, the NIHR Innovation Observatory is monitoring the progress of trials taking place across the world.

The Therapeutics Taskforce has not been in direct contact with the National Cancer Institute Pascale Foundation or the Colli Hospital in Italy.

We are not aware of the use of the term 'let it run hot' being used in relation to COVID-19 by the Department.

The Government is rapidly scaling up the national effort to boost testing capacity for COVID-19 to protect the vulnerable, support the National Health Service, and ultimately save lives. Further details of this work can be found in the Government’s Testing Strategy titled Coronavirus (COVID-19): scaling up our testing programmes, published on 4 April, which is attached.

There are a number of factors to consider in relation to easing of the present restrictions, with testing being just one. Consequently, the Department has not set a threshold on the number of tests necessary to end the current restrictions. The Government will continue to review advice on how testing, along with other efforts, can inform future measures to tackle the virus and how we can ease restrictions whilst keeping people safer.

We are aware of reports of people in care homes being told by general practitioner (GP) surgeries that they are unlikely to be prioritised for mechanical ventilation if they contract COVID-19, because they could be too ‘frail’. This stemmed from recent National Institute for Health and Care Excellence (NICE) guidance on prioritising critical care. NICE was forced to revise the guidance, which included use of the clinical frailty scale (CFS), following allegations it discriminated against people with learning and other disabilities. The guidance was revised on 25 March 2020 and now states: “The Clinical Frailty Score should not be used in younger people, people with stable long-term disabilities (for example, cerebral palsy), learning disability or autism. An individualised assessment is recommended in all cases where the CFS is not appropriate.”

A letter was sent on 3 April 2020 to primary care, acute trusts and community trusts from the National Director of Mental Health, National Clinical Director (for Learning Disability and Autism) and the Medical Director for Primary Care to the NHS on the appropriate use of Do not Resuscitate forms and clinical frailty assessments (which can be used to assess whether critical care is appropriate for a patient) following recent reports on inappropriate use. A copy of the letter is attached.

Furthermore, a letter to the system from Ruth May, Chief Nursing Officer, and Steve Powis, National Medical Director at NHS England and NHS Improvement was sent out on 7 April 2020, addressing concerns recently raised regarding the use of DNR forms and supporting best practice in the application of advance care plans. A copy of the letter is attached.

Finally, NHS England and NHS Improvement have produced a GP Standard Operating Procedure (SOP) for managing COVID-19 in general practice, published on 6 April. This includes a COVID-19 advance care plan template, guidance notes for completing an advance care plan and states that “Advance care plans should be made on an individual basis. It is not acceptable for advance care plans, with or without Do Not Attempt Resuscitation forms, to be applied to groups of patients”. A copy of the SOP is attached.

The Coronavirus Act 2020 does not provide for any changes to legal entitlements for aftercare services under section 117 of the Mental Health Act 1983.

The Government has announced £1.6 billion of additional funding to support local authorities to respond to the COVID-19 pandemic across all service areas.

The Department of Health and Social Care is working closely with the Ministry of Housing, Communities and Local Government, local authorities and providers to make sure the adult social care sector is ready. New adult social care guidance is available online and covers provision of residential care, supported living and home care.

Guidance for other sectors is being produced and updated regularly and the Government is also finalising COVID-19 related guidance for care homes including those housing individuals with dementia, which will be published shortly.

The Human Fertilisation and Embryology Authority (HFEA) have advised that this information is set out in its Code of Practice at section 33.35, which states:

“If a centre becomes aware that a child born following mitochondrial donation has been born with a mitochondrial disease, birth defect, or genetic abnormality, or if there has been some other adverse outcome (including but not limited to failed or no embryo development, miscarriage or premature birth) following treatment involving mitochondrial donation, the centre must regard this as an adverse incident and report this to the HFEA in line with the requirements on adverse incidents set out in guidance note 27. This is to capture information about any abnormalities that may occur as a result of carrying out the MST (maternal spindle transfer) or PNT (pro-nuclear transfer) treatment, to inform any regulatory or licensing action that the HFEA may wish to take and to inform the scientific sector.”

The HFEA has made no assessment of the efficacy of mitochondrial treatment to date as the number of treatments is so low, at this stage.

The Department is considering carefully all available evidence around the potential of different medicines for use in treating COVID-19. Clinical trials are ongoing and being developed to assess the benefits of a number of different medicines in treating COVID-19.

Hydroxychloroquine is not currently licensed to treat COVID-19 related symptoms or prevent infection. Clinical trials are being established to test hydroxychloroquine as an agent in the treatment of COVID-19. These clinical trials are still not completed, so no conclusions have yet been reached on the safety and effectiveness of this medicine to treat or prevent COVID-19.

United Kingdom stocks of medicines to treat malaria and HIV are being trialled for use on patients with COVID-19.

There are suggestions in the Chinese and French literature that both lopinavir/ritonavir and chloroquine/hydroxychloroquine may be beneficial. However, these data are not conclusive, because the studies done are too small, thus the findings, whilst promising, may ultimately be wrong.

The UK will evaluate both these treatments in two large randomised trials, one of which is already underway and the other of which is expected to begin recruitment next week.

We have significantly increased our ventilator capacity. To date, there are more than 8,000 ventilators in hospitals across the United Kingdom, with thousands more expected to come into use in the coming weeks and months and, of course, we will continue to order more. This is alongside work being done on the Prime Minister’s ventilator challenge.

Ventilators are being procured from existing worldwide stocks. Ventilators will be delivered to National Health Service trusts as soon as stock has arrived in the UK. In addition, ventilators will be available in the private hospitals that we have just contracted as additional capacity.

It is not yet clear precisely how quickly the number of cases requiring ventilation will increase, hence the efforts to increase capacity rapidly. Ventilator demand modelling continues to evolve and at present sufficient capacity exists. The supply and demand of ventilators is under constant review.

Work preparing the National Health Service has been ongoing and we have already nearly doubled ventilator capacity. New and existing suppliers are being asked to build as many as they can. The Prime Minister has issued a call to United Kingdom industry to produce additional ventilators and the Department asked appropriate potential manufacturers on 13 March to come forward with proposals for new ventilation machines. Around a dozen potential prototypes have now been presented to the Department which we are currently pursuing.

COVID-19 is not known to cause latent infections (becoming dormant in the body after infection and reactivate later on) or to cause persistent infection (continuous infection).

Public Health England is in the process of producing guidance for the conditions of discharge of infected patients from hospitals.

Assessment of the clinical and epidemiological characteristics of SARS-CoV-2 cases suggests that, similar to SARS-CoV, patients will not be infectious until the onset of symptoms. In most cases, individuals are usually considered infectious while they have symptoms. How infectious individuals are depends on the severity of their symptoms and stage of their illness. Further study is required to determine the actual occurrence and impact of asymptomatic transmission.

To provide a more comprehensive response to a number of outstanding Written Questions, this has been answered by an information factsheet PPE - note for House of Lords which is attached, due to the size of the data. A copy has also been placed in the Library.

The National Health Service has world-renowned critical care facilities which includes access to around 5,000 adult and 900 paediatric critical care ventilators, with further ventilators available outside of critical care facilities.

Work preparing the NHS has been ongoing and we have already nearly doubled ventilator capacity. New and existing suppliers are being asked to build as many as they can. The Prime Minister has issued a call to United Kingdom industry to produce additional ventilators and the Department asked appropriate potential manufacturers on 13 March to come forward with proposals for new ventilation machines. Around a dozen potential prototypes have now been presented to the Department which we are currently pursuing.

The Department is considering carefully all available evidence around the potential of different medicines for use in treating COVID-19. Clinical trials are being developed to assess the benefits of a number of different medicines in treating COVID-19. Further medicines may be trialled should evidence indicate to the Department that this would be an appropriate course of action. The Department, the Medicines and Healthcare products Regulatory Agency, Public Health England and the National Health Service are working together to ensure that trials can begin as soon as possible. The first trial in the United Kingdom for hospitalised patients should begin later this week.

The Department has not been in direct contact with the National Cancer Institute Pascale Foundation or the Colli Hospital in Italy regarding the experimental use of tocilizumab. However, the United Kingdom Therapeutics Task Force has independently assessed tocilizumab as having potential, and it is expected to begin evaluation in the UK imminently as part of the RECOVERY and REMAP-CAP studies. UK patients will be able to access tocilizumab as part of this trial. The Department will continue to monitor the results of trials of experimental therapies for COVID-19 from around the world.

The Government is aware of this report by the Begin-Sadat Centre for Strategic Studies.

Research into COVID-19’s origins is ongoing, and the United Kingdom is working with the international scientific community to determine the source of the outbreak.

The purpose of mitochondrial donation treatment is to prevent the transfer of serious mitochondrial disease passing from mother to child. The treatment is used to ensure that the embryos created do not carry mitochondrial mutations that would otherwise result in serious genetic diseases.

The Human Fertilisation and Embryology Authority has to date licensed 17 patients as eligible for mitochondrial donation treatment in the United Kingdom. To protect patient confidentiality, information on the number of patients that have begun treatment cannot be disclosed. It is therefore not possible to provide the information requested.

The following table shows the gene affected and the mutation in each application, the dates each application was made and approved by the Human Fertilisation and Embryology Authority (HFEA) Statutory Approvals Committee.

Source:

HFEA

The Human Fertilisation and Embryology Authority (HFEA) has no statutory role in following up the clinical outcomes of patients born after mitochondrial donation treatment. However, the HFEA Code of Practice requires any clinic licensed to offer such treatment to have a documented process to enable follow-up, where patients have consented to this. Clinics are also required to report any adverse outcomes following mitochondrial donation treatment to the HFEA.

The statement on the HFEA website is addressed to potential patients and explains that follow-up is useful, as doctors want to understand as much as possible about how mitochondrial donation affects children and future generations. This will ensure that children born following mitochondrial donation get the best possible care in the future, as well as contributing to continued understanding of mitochondrial disease. The Government has not made a specific assessment of this statement.

The 2016 update recommended follow-up of children born as a result of mitochondrial donation in order to gather information about safety and efficacy.

The Human Fertilisation and Embryology Authority (HFEA) is required under the Human Fertilisation and Embryology Act 1990 to keep a register recording identifiable information on patients, the treatments they undergo and their outcomes. This information does not include the method used to freeze sperm, eggs or embryos.

The HFEA has not said that there has been no effective difference between methods of freezing over the last five years. The HFEA’s published information on annual fertility trends shows an increase in success rates using frozen embryos and frozen eggs over time.

The HFEA does not carry out follow up work with patients. Under the Human Fertilisation and Embryology Act 1990, applications can be made to use HFEA data for research studies.

The Chancellor has set out a £12 billion package of temporary, timely and targeted measures to support public services, individuals and businesses through the economic disruption caused by COVID-19.

General practitioner surgeries and the National Health Service should continue to use their current procedures for ordering, supplying and procuring personal protective equipment and use their usual contracted routes should any escalation be needed.

We practise and prepare our response to disease outbreaks and follow tried and tested procedures, following the highest safety standards possible for the protection of NHS staff, patients and the public. Specific guidance on handling people with COVID-19 has been shared with NHS staff. Public Health England has also published online guidance for first responders and others who may have close contact with people with potential COVID-19.

The United Kingdom Government and devolved administrations, including the health and social care system, have planned extensively over the years for an event like this. The UK is therefore well prepared to respond in a way that offers substantial protection to the public. The Government’s action plan Coronavirus: action plan A guide to what you can expect across the UK sets out what we are planning to do next, depending upon the course the current coronavirus outbreak takes. A copy of the action plan is attached.

Among those who become infected, some will exhibit no symptoms. Early data suggest that of those who develop an illness, the great majority will have a mild-to-moderate, but self-limiting illness – similar to seasonal flu. It is, however, also clear that a minority of people who get COVID-19 will develop complications severe enough to require hospital care, most often pneumonia, in some instances leading to death.

Highly specialised beds will only be needed by a minority of affected patients. As the Chief Medical Officer has said, we are working through our clear action plan to make sure we can flex services to respond to extra demand. NHS England and NHS Improvement are working closely with providers across the country to support this.

The Government is being advised by the Scientific Advisory Group For Emergencies, known as SAGE. SAGE and its sub groups have, and will continue to, monitor all relevant epidemiological literature, including the World Health Organization’s Situation Reports. Estimates of mortality rates in different regions vary, so it is right that we are considering this information in the round.

We do not hold this information.

It is the responsibility of the Human Fertilisation and Embryology Authority (HFEA) to decide on individual applications for mitochondrial donation that meet the statutory test laid out in the relevant regulations. Decisions on when to begin treatment are a clinical decision and not a matter for the HFEA.

As of 25 February 2020, there have been 17 applications considered by the HFEA all of which have now been approved.

There have been no miscarriages recorded pursuant to clinical application in the United Kingdom of pronuclear transfer and spindle-chromosomal complex transfer.

The Human Fertilisation and Embryology Authority (HFEA) has no role in the follow-up of patients. The HFEA inspects clinics periodically and reviews licensed activity in accordance with the relevant legislation and its Code of Practice.

We are aware of the report and note the recommendations.

The Human Fertilisation and Embryology Authority (HFEA) has advised that it does not hold information on which methods of freezing are used.

The HFEA is required under the Human Fertilisation and Embryology Act 1990 to keep a register recording identifiable information on patients, the treatments they undergo and their outcomes. This information does not include the method used to freeze sperm, eggs or embryos.

On direct flights from Wuhan into the United Kingdom, 1,466 passengers and 95 staff arrived between 10 and 24 January. Of these, 162 of the passengers have already left the UK, 53 of the crew have already left the UK and all of the remaining passengers (1,304) are now outside of the incubation period.

As of 5 February, a total of 468 UK tests have concluded, of which 466 were confirmed negative and two positive. Information is published daily online on the Coronavirus: latest information and advice page on the Government website.

Posters and leaflets with health advice has been made available in all UK international airports, Eurostar terminals and Dover. As of 5 February, the two patients who tested positive are receiving specialist National Health Service care and we are using tried and tested infection control procedures to prevent further spread of the virus.

The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread. We are continuing to work closely with the World Health Organization and the international community as the outbreak in China develops to ensure we are ready for all eventualities.

On direct flights from Wuhan into the United Kingdom, 1,466 passengers and 95 staff arrived between 10 and 24 January. Of these, 162 of the passengers have already left the UK, 53 of the crew have already left the UK and all of the remaining passengers (1,304) are now outside of the incubation period.

As of 5 February, a total of 468 UK tests have concluded, of which 466 were confirmed negative and two positive. Information is published daily online on the Coronavirus: latest information and advice page on the Government website.

Posters and leaflets with health advice has been made available in all UK international airports, Eurostar terminals and Dover. As of 5 February, the two patients who tested positive are receiving specialist National Health Service care and we are using tried and tested infection control procedures to prevent further spread of the virus.

The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread. We are continuing to work closely with the World Health Organization and the international community as the outbreak in China develops to ensure we are ready for all eventualities.

The information requested is shown in the following tables. The following table provides the figures for each of the last 12 months, 1 January 2018 – 31 December 2018. The data is as shown on the Human Fertilisation and Embryology Authority’s (HFEA) register database on 5 February 2020. This is a live database so these figures reflect the data on this day.

Source:

Source: HFEA

The following table provides the cumulative figures for both circumstances since 1 August 1991.

Source: HFEA

1,466 passengers and 95 staff arrived into the United Kingdom on direct flights from Wuhan between 10 January and 24 January when direct flights ceased.

British citizens repatriated from Wuhan have been put into supported isolation for any medical needs that they may have and to protect the public.

Asymptomatic passengers have been transferred to a National Health Service accommodation facility to spend at least 14 days in supported isolation. If any passengers develop symptoms, they will be assessed and transferred to appropriate NHS care facilities nearby.

The World Health Organization has declared a Public Health Emergency of International Conern in response to the novel coronavirus as the outbreak continues to spread outside China.

NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

The amount the NHS has paid out, in total, for clinical negligence claims in each of the last 10 financial years for which figures are available is shown in the following table.

The five main reasons for the above claims by frequency are:

- Failed / Delay to Treatment;

- Failed / Delay to Diagnosis;

- Intra-Operative Problems;

- Inappropriate Treatment; and

- Inadequate Nursing Care.

Our ambition is for the NHS to be the safest healthcare system in the world. We have thoroughly overhauled the infrastructure underpinning healthcare quality and safety in the last decade to minimise harm. The NHS Patient Safety Strategy: Safer culture, safer systems, safer patients, published in July 2019, and Safer Maternity Care: The NHS Maternity Safety Strategy – Progress and Next Steps, published in November 2017, set out the comprehensive approach to continuously improve safety. Copies of the strategies are attached.

The NHS Resolution five-year strategy Delivering fair resolution and learning from harm, published in 2017, describes how the organisation is contributing to improved safety and tackling clinical negligence costs. NHS Resolution is committed to learning from claims and is working directly with trusts to share learning and best practice across the NHS to drive safety improvement. This will help to minimise the potential of clinical errors that could lead to harm and possible future claims. A copy of the strategy is attached.

The Department is also working intensively with the Ministry of Justice, other Government Departments and NHS Resolution to tackle the continued year-on-year-rises in clinical negligence costs which are eating progressively into resources available for front-line care. While there are no simple solutions and the work is still ongoing, good progress has been made in developing our understanding of all the drivers of cost and exploring ways forward.

The Medicines and Healthcare products Regulatory Agency aims to reply to all freedom of information requests within the 20 working-day statutory deadline set out in the Freedom of Information Act 2000. In circumstances where we need to consider whether the public interest in releasing the information is outweighed by the public interest in not giving the information (the ‘public interest test’) the Act allows us to extend the deadline for reply beyond the usual 20 working days. This was applied to Mrs Lyon’s request and we responded by the revised deadline of 13 January.

The former Foreign Secretary met with Prime Minister Imran Khan and Foreign Minister Qureshi on 3 September and discussed working together, to support the people of Afghanistan and to ensure safe passage out of the country. We will continue to explore all routes (air or land) with neighbouring countries, and what means can be put in place for Afghans to come to the UK, where that is their most appropriate destination. The PM is clear that we will support vulnerable and at risk groups, including ethnic and religious minorities, to come to the UK where appropriate.

The British Government opposes the use of the death penalty in all circumstances and takes any allegations of extrajudicial killings seriously. The UK has designated Iran as a Human Rights Priority Country, and we continue to take action with the international community to press Iran to improve its poor human rights record. This will include using all opportunities during the upcoming United Nations General Assembly session.

We urge Iran to allow the Special Rapporteur for Human Rights in Iran access to the country, so that he can conduct research and investigations into human rights concerns reported there, including the events of 1988. Meanwhile, we have always been clear that Iran must uphold its own international legal obligations, including conducting thorough and independent investigations into suspected human rights violations, both past and present.

We are in regular contact with the Iranian Government and expect to engage with President Raisi on a number of issues now he has taken office, including human rights. We call on President Raisi to set Iran on a different course and commit to improving human rights in Iran.

The British Government opposes the use of the death penalty in all circumstances and takes any allegations of extrajudicial killings seriously. The UK has designated Iran as a Human Rights Priority Country, and we continue to take action with the international community to press Iran to improve its poor human rights record. This will include using all opportunities during the upcoming United Nations General Assembly session.

We urge Iran to allow the Special Rapporteur for Human Rights in Iran access to the country, so that he can conduct research and investigations into human rights concerns reported there, including the events of 1988. Meanwhile, we have always been clear that Iran must uphold its own international legal obligations, including conducting thorough and independent investigations into suspected human rights violations, both past and present.

We are in regular contact with the Iranian Government and expect to engage with President Raisi on a number of issues now he has taken office, including human rights. We call on President Raisi to set Iran on a different course and commit to improving human rights in Iran.

We are concerned by reports of ethnic cleansing and atrocity crimes against Tigrayans committed in Humera within Tigray as the Minister for Africa made clear in the Westminster Hall debate on 8 September. The UK is supporting the Office of the UN High Commissioner for Human Rights to ensure that their joint investigation into atrocities in Tigray with the Ethiopian Human Rights Commission is independent, transparent and impartial and holds the parties to this conflict directly responsible for their actions.

The UK remains committed to supporting the people of Afghanistan. We have provided £3.3 billion of aid funding since 2002, which has helped improve the rights of all Afghans, including women and minority groups. These developments must not be lost. The UK will continue to be at the forefront of the humanitarian response in Afghanistan. On Wednesday 18 August, the Foreign Secretary announced a £286 million package of support for Afghanistan that will significantly increase our humanitarian support, providing life-saving assistance to people affected by conflict, drought and COVID-19.

The UK is committed to help Afghan staff who have assisted us and we are working to get them and their families out as fast as we can. The Afghan Relocations and Assistance Policy (ARAP), which came into effect in April 2021, offers relocation or other assistance to current and former locally employed Afghan staff. This scheme is in addition to the existing Ex Gratia Scheme (EGS) which will remain open until November 2022. After November 2022, eligible Afghan staff will still be able to relocate via ARAP. Prior to the current evacuation the UK assisted over 1,900 to leave Afghanistan between April and August under the ARAP scheme. Through the current Operation PITTING evacuation, as of 31 August we have evacuated more than 16,000 people from Kabul. This includes Afghan interpreters, staff and their families who served alongside our brave military and are eligible under the ARAP programme. Our officials are working as quickly as possible to bring more people to safety in the United Kingdom, via third countries.

The UK government notes the report of the All Party Parliamentary Group on North Korea Inquiry into Human Rights Violations in North Korea from 2014-2020, published on Tuesday 20 July. The UK remains extremely concerned by the human rights situation in North Korea, as G7 leaders made clear on 13 June, and G7 Foreign Ministers also stated on 5 May. We will review the Report's findings and recommendations and consider how the UK government can continue to address the appalling human rights situation in the country.

The UK remains extremely concerned by the appalling human rights situation in North Korea, as we made clear alongside G7 leaders on 13 June and G7 Foreign and Development Ministers on 5 May. The international community has a responsibility to respond to human rights violations in North Korea. The UK continues to press for annual debate in the UN Security Council on DPRK human rights issues. We welcome and support the annual Human Rights Council and UNGA Third Committee resolutions on human rights in North Korea which stress the importance of following up recommendations from the UN Commission of Inquiry Report on Human Rights in the DPRK, and provide the basis for further work on a credible framework for accountability for human rights violations in the country.

It is for competent courts to decide whether specific crimes have occurred and who is responsible for having carried them out. The UK continues to press for annual debate in the UN Security Council on DPRK human rights issues. We welcome and support the annual Human Rights Council and UNGA Third Committee resolutions on human rights in North Korea, which stress the importance of following up recommendations from the UN Commission of Inquiry Report on Human Rights in the DPRK, and provide the basis for further work on a credible framework for accountability for human rights violations in the country.

The UK remains deeply concerned by the appalling human rights situation in North Korea and is fully committed to the principle that there must be no impunity for the most serious international crimes. Since Resolution 69/188 was adopted by the General Assembly on 18 December 2014, the UK has continued to maintain a high level of engagement at the UN on the situation, continuing to press for annual debate on North Korean human rights issues in the UN Security Council, and working to secure a robust resolution on human rights in the DPRK at the annual Human Rights Council. North Korea is not a party to the Rome Statute and is unlikely to accept the International Criminal Court (ICC) jurisdiction ad hoc; therefore referral to the ICC would have to be through a UNSC resolution. We judge that there would not be the required support among the members of the Security Council for such a resolution.

The UK Government remains deeply concerned about the situation in the North-West and South-West regions of Cameroon, which has left 1.15 million people suffering from food insecurity. We regularly discuss the crisis within multilateral fora and with international partners, and welcome efforts from the African Union, the Commonwealth and La Francophonie to support a peaceful resolution.

During the Minister for Africa's visit to Cameroon in March, he met project partners to witness the impact of UK aid and called for unimpeded humanitarian access to those in need. The UK's representative reiterated these calls at the UN Security Council briefing on the UN Regional Office for Central Africa in June, and the British High Commission in Yaoundé continues to advocate for access alongside the diplomatic community and the UN.

We are aware of these reports. This is a matter for the company and Israeli regulators. The UK works closely with allies around the world to tackle cyber threats and improve our overall global resilience to attacks. It is vital that all cyber actors use capabilities in a way that is legal, responsible and proportionate to ensure cyberspace remains a safe and prosperous place for everyone.

We continue to call on the Nigerian Government to investigate allegations of human rights violations and hold those responsible to account, most recently during the Minister for Africa's visit to Nigeria in April. FCDO staff come from a range of backgrounds and religious identities, and all are encouraged to develop further understanding of religion and its role within society, supported by training from the FCDO's International Academy.

We provide capacity building support, training and technical assistance to state governments across Nigeria to help them manage resources more transparently and to be more responsive to citizen needs. We work with civil society on human rights and we will continue to make clear to the Nigerian authorities at the highest levels the importance of protecting human rights for all.

We condemn all attacks on places of worship including the reported attack in Ungwan Gaida, Kaduna State. We regularly raise concerns about attacks and broader insecurity with the Nigerian Government, including during the Minister for Africa's visit to Nigeria in April.

Defending and promoting human rights, including freedom of religion or belief, has been a long-standing priority for the UK Government. The UK believes that no one should be excluded from education because of their religion or belief. Discrimination damages not only societies, but also holds back economies.

Religious or ethnic discrimination can force families to flee their homes, with refugees and displaced children now constituting the largest group of those out of school, and their number increasing. For this reason, the UK is the founding and leading donor to Education Cannot Wait (ECW), the global fund for education in emergencies. The UK is providing £90 million of funding to ECW from 2019 to 2023. This investment is supporting ECW to expand its operations to more countries, respond to COVID-19, and will support up to 600,000 children living through conflict, and in areas of protracted crises, access education. For example, ECW's support includes the provision of basic education for 88,000 Rohingya children who are now living in refugee camps in Bangladesh.

The UK is firmly committed to supporting the rights of ethnic and religious minorities in Iraq and Syria who have suffered as a result of conflict and been persecuted, particularly by Daesh. We have contributed £28 million to the UNDP Funding Facility for Stabilisation (FFS), which is helping to enable the return of internally displaced persons, including minorities, to areas liberated from Daesh by restoring vital infrastructure and basic services.

The UK remains active and committed in this field. The UK was a penholder on UN Security Council Resolution 2347, which treats protection of cultural heritage as an issue of key importance to international peace with implications for national security. In Iraq and Syria, UK support for cultural heritage protection has ranged from providing psycho-social support to Yazidi women trafficked by Daesh, to addressing illegal antiquities trafficking through the flagship Cultural Protection Fund. The UK government is considering further work in both Iraq and Syria through the next round of the Cultural Protection Fund.

The UK and US regularly discuss our perspectives on Latin America, including Cuba. We agree with the US that the protestors' concerns need to be heard, and their right to protest peacefully needs to respected. Like the US, we have been clear in calling for calm and restraint. We will continue to discuss Cuba with the US and other partners, including our opposition to the US embargo, which we consider to be counterproductive.

The UK is in contact with our French partners on their planned changes to operations in the Sahel. We have had assurances that France will retain the critical support functions such as force protection, medical and logistical support, which allow the UK to effectively contribute to operations in the Sahel. We are building peace and stability in the Sahel, Nigeria and wider Lake Chad Basin. Our humanitarian assistance is supporting those most affected by conflict in the region.

The UK has consistently urged for an end to the conflict in Tigray. There can be no military solution. We continue to urge all parties to the conflict to protect civilians and respect international humanitarian law. We would not normally comment on defence cooperation between two sovereign states.

We are clear that all Cubans should have the right to protest peacefully. The UK government has called for calm and restraint, and the full respect of all Cubans' human rights. Detention should not be used as a tool to restrict freedom of expression, assembly, and religion. We have raised our concerns directly with the Cuban government, and called for the authorities to release information on detained citizens, including their whereabouts. We will continue to monitor the situation closely.

Recent arrests of Tigrayans in Addis Ababa and elsewhere in Ethiopia are extremely worrying, and discrimination against or targeting of any group is unacceptable. The UK is following the situation closely. We have consistently raised the importance of respect for human rights throughout this conflict, and will raise these concerns directly with the Government of Ethiopia.

The Foreign, Commonwealth and Development Secretary is leading work on the new International Development Strategy, which will be cross-government in scope. The International Development Strategy will set out the UK's approach to development, in line with the Integrated Review. It will refer to the Sustainable Development Goals (SDGs). FCDO officials will be engaging with external stakeholders on the development of the strategy. This will build on the extensive engagement and call for evidence that was undertaken to inform the Integrated Review. We intend to publish the strategy later this year.

The UK is concerned that humanitarian needs may be growing in North Korea. According to UN figures, 40% of North Korea's population were food insecure in 2019. We assess that North Korea's own restrictions at the border have prevented aid shipments from entering the country since January 2020, and that natural disasters last year may have reduced harvest yields. North Korea continues to claim that it has had zero cases of Covid-19.

We are unable to verify the humanitarian or Covid situations directly, because the border restrictions also forced the temporary closure of the British Embassy in Pyongyang in May 2020. Other Embassies have also closed or reduced their staff, and we understand the Russian Embassy sent some of its staff home in early July. All UN agencies and NGOs have also now withdrawn expatriate staff and ceased operations. We will work to restore the British Embassy presence in Pyongyang once it is safe and possible to do so, and encourage North Korea to allow entry for humanitarian workers to carry out an independent assessment of humanitarian needs, and to facilitate delivery of humanitarian assistance to vulnerable communities.

I was greatly saddened to learn of Father Swamy's passing on July 5, aged 84. I raised Father Swamy's case with India's Foreign Secretary, Harsh Shringla, and India's Minister of State for Home Affairs, Kishan Reddy, on 15 March while in India. Most recently, I discussed Father Swamy's case with the Indian High Commissioner on 8 June.

We engage with India on a range of human rights matters and oppose discrimination against minorities because of religion, caste, or belief. The British High Commission in New Delhi and Deputy High Commission in Mumbai had been monitoring Father Swamy's case closely and will continue to monitor progress on the rights of Dalits and indigenous people in India.

The British High Commission in New Delhi and our network of Deputy High Commissions across India regularly meet representatives from minority communities and run projects promoting minority rights. Our project work has provided legal training for 2,000 Dalit women to combat violence against them. We also helped establish the first network of Dalit Women Human Rights Defenders who are trained as paralegals in the states of Bihar, Uttar Pradesh, Telangana, and Maharashtra. Furthermore, we engaged 365 state criminal justice system officials in case issues, training programmes, legal roundtables, and awareness raising programmes.

The UK has played a leading role in supporting global access to safe and effective COVID-19 vaccines from the outset of the pandemic, and stands alongside its international friends and partners during this deeply challenging time to tackle COVID-19 infections and fatalities. The UK is among the largest donors to COVAX, which has so far shipped over 95 million COVID-19 vaccines to 134 participants, and aims to provide doses equivalent to up to 30% of the population in low- and middle-income countries by early 2022, including countries in South Asia, South East Asia, and Africa. The UK's investment in the research and development of the Oxford/AstraZeneca vaccine has also been a key contribution to the global vaccination effort. So far, over 500 million doses of the vaccine have been distributed worldwide at non-profit prices, with two-thirds going to lower- and middle-income countries.

Making vaccines globally available not only helps end the coronavirus pandemic in developing countries, but will also reduce the threat posed by vaccine-resistant variants emerging in areas with large-scale outbreaks that could threaten the UK. The health of the UK public remains our priority, but this virus will not truly be beaten until it is defeated everywhere. The UK is proud that our G7 Presidency secured agreement from leaders to support vaccinating the world in 2022, and to share and finance an additional 1 billion doses over the next year to accelerate vaccine roll-out. This includes a commitment from the UK to share 100 million doses, 80% of which will go to COVAX to support countries in need. We will also work closely with G7 and international partners to mobilise international financing; increase vaccine supply; and support in-country delivery, including community mobilisation, and work to build vaccine confidence.

We are seeking clarification from the Nigerian Government about the circumstances of the arrest and detention of Nnamdi Kanu. The UK has requested consular access to Mr Kanu from the Nigerian Government, and we stand ready to provide consular assistance.

The UK Government has been at the forefront of the international response throughout the conflict in Tigray. We have engaged directly with the Government of Ethiopia, and that of Eritrea, to press for protection of civilians, unfettered humanitarian access and an end to the conflict. This is in line with our approach to protection of civilians, commitment to Responsibility to Protect and atrocity prevention policy. We have also worked through international fora including the G7 leaders' communique of 13 June.

We are committed to working with partners in fragile environments, including Afghanistan, Pakistan and in sub-Saharan Africa where the risk of radicalisation is most acute. That includes engagement with important influencers such as religious scholars, civil society and community leaders in order to support people vulnerable to recruitment and to address underlying factors which may increase the risk of radicalisation.

We have deployed from the Preventing Sexual Violence in Conflict Initiative UK Team of Experts. Recommendations from an initial scoping mission by them will outline options for supporting the Government of Ethiopia, the Ethiopian Human Rights Commission (EHRC) and other key stakeholders to safely collect and preserve evidence, and bring the perpetrators of sexual violence to justice. The UK fully supports the joint investigation involving the UN Office of the High Commission for Human Rights.

Dialogue and reconciliation is required for an inclusive political process to be initiated. The UK endorses African Union Commission Chairperson Faki's views that a comprehensive and all-encompassing permanent ceasefire is necessary to pave the way for sustainable peace in Tigray. We will continue to urge all parties to the conflict to end violence and seek a political resolution.

The UK has allocated £47.7m to respond to the Tigray crisis, to help aid get to those in need and address famine risk through the provision of healthcare, sanitation, and nutrition. We have have consistently called for unfettered humanitarian access.

The Government is deeply concerned about the conflict in Tigray that has gone on for more than seven months and which has taken a terrible toll on the people of Tigray. Over 350,000 people are assessed to be in famine-like conditions with region-wide famine in Tigray now likely if the security situation does not improve significantly, and if urgent humanitarian support cannot be delivered.

The FCDO is currently working with implementing partners, drug companies, donors, and the World Health Organisation (WHO) to exit the programme Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases (ASCEND). As part of this we have participated in two stakeholder meetings in June, at which Uniting to Combat Neglected Tropical Diseases were present. We have also been in touch with the organisation recently via correspondence.

Global health remains a top priority for UK ODA and we will continue to be a major contributor in leading international action to strengthen global health security and help build more resilient health systems. Departmental cross-government allocations of ODA spend for 2021/22 were laid out in a Written Ministerial Statement in Parliament on 21 April and the Foreign Secretary highlighted that FCDO will spend £1,305 million on global health, which means that we will remain among the most generous international donors.

The UK is deeply concerned by reports, including from Korea Future Initiative, which tell of serious human rights offences and persecution of those who are caught practising religion. Defending the right to freedom of religion or belief for all is a priority for the UK Government and we continue to use international fora to call on the DPRK government to acknowledge and address the many reports of serious and wide-ranging human rights violations in the country. We also raise our concerns directly with the DPRK government, including with the DPRK's Ambassador in London.

As regards marking International Day in Support of Victims of Torture, as the FCDO Minister for human rights I made clear on 26 June that we honour the victims and survivors of torture across the world. The UK will always stand up against this cruel practice, working with global partners to end its use and deliver justice for victims.

The Foreign Secretary's Written Ministerial Statement on UK ODA allocations for 2021/22 included £30 million as a new ODA crisis reserve to enable FCDO to respond rapidly to new humanitarian crises. This reserve is not directly comparable to previous arrangements originally announced in 2015 for an annual ODA Crisis Reserve of £500 million. This was a Cross-Whitehall reserve and comprised of £200 million as an annual cash contingency used for a wide range of crises and £300 million as a 'redeployable reserve' on DFID's baseline that could nominally be reallocated to a major new crisis.

The UK is deeply concerned by reports, including from Korea Future Initiative, which tell of serious human rights offences and persecution of those who are caught practising religion. Defending the right to freedom of religion or belief for all is a priority for the UK Government and we continue to use international fora to call on the DPRK government to acknowledge and address the many reports of serious and wide-ranging human rights violations in the country. We also raise our concerns directly with the DPRK government, including with the DPRK's Ambassador in London.

As regards marking International Day in Support of Victims of Torture, as the FCDO Minister for human rights I made clear on 26 June that we honour the victims and survivors of torture across the world. The UK will always stand up against this cruel practice, working with global partners to end its use and deliver justice for victims.

The UK has deep concerns about the lack of freedom of religion or belief in North Korea. While the DPRK constitution allows religious belief as long as it does not attract foreign intervention or disrupt social order, in practice, Christians hide their faith and worship in secret for fear of being caught and persecuted. Defending the right to freedom of religion or belief for all is a priority for the UK Government and we remain committed to implementing the recommendations from the Bishop of Truro's independent Review on persecuted Christians in full. One of those recommendations related to the establishment of the UK's Global Human Rights sanctions regime, which came into effect on 6 July 2020 and allows us to designate those who commit serious human rights abuses or violations, including those who target individuals on the grounds of their religion or belief. We take decisions about whether particular individuals or entities could be subject to measures under the regime on a caseby-case basis. We have already designated two entities involved in administering the North Korean penal system.

The UK is deeply concerned by reports from North Korean escapees, which tell of serious human rights offences and persecution of those who are caught practising religion. We regularly engage and seek ways to support the work of NGOs on DPRK human rights, including Korea Future Initiative whose report contains disturbing accounts of violations of freedoms in North Korea. Under the Global Human Rights (GHR) sanctions regime which came into effect on 6 July 2020, the UK has already designated two entities involved in administering the DPRK penal system: the DPRK's Ministry of State Security (Bureau 7) and the Ministry of People's Security (Correctional Bureau) are now subject to an asset freeze and a travel ban.

The UK believes torture is an abhorrent violation of human rights and that it has a devastating impact on both individuals and societies. We work bilaterally to raise specific cases of concern as appropriate and take regular action on the international stage, including through the UN Security Council and the G7 to press countries to improve their record on human rights, including on torture and cruel, inhuman, or degrading treatment. The UK proudly partners with world-leading NGOs, such as the Association for the Prevention of Torture, to support torture prevention initiatives globally.

We are concerned by reports that members of certain Chinese diaspora groups are being harassed by Chinese authorities, have raised the matter directly with the Chinese Embassy in London, and will continue to do so as appropriate. The FCDO is monitoring the situation closely.

The UK continues to take a global leadership role in standing up for the rights of Uyghurs and other ethnic minorities in Xinjiang. We have repeatedly called on countries to respect their obligations not to force persons to return to a country where there are substantial grounds for believing they would be in danger of fundamental rights violations.

British diplomats - working closely with likeminded partners - have intervened privately at senior levels with host governments on behalf of Uyghurs who have been at risk of refoulement to China. We also encourage all states, including Turkey, Kazakhstan and Tajikistan, to uphold their international human rights obligations.

On 22 March, the Foreign Secretary announced that the UK has imposed, under the UK's Global Human Rights sanctions regime, asset freezes and travel bans against four Chinese government officials responsible for the violations that have taken place and persist against Uyghur Muslims in Xinjiang. Alongside those individuals, the UK also designated the Public Security Bureau of the Xinjiang Production and Construction Corps, the organisation responsible for enforcing the repressive security policies across many areas of Xinjiang. By acting with 30 other countries on an agreed set of designations we increased the reach and impact of these measures and sent the clearest possible signal of the international community's serious concern and collective willingness to act. The FCDO will keep all evidence and potential listings under close review.

Any decision to investigate and prosecute crimes of universal jurisdiction is for the police and the appropriate prosecuting body.

We recognise that there have been reports of discrimination against religious minorities in India linked to COVID-19. The situation for minorities varies across India depending on location, socio-economic background, and proportion of religious minorities. India's strength, like that of the UK's, is in its diversity and we are committed to supporting the continuation of that. This year, the British High Commission supported an interfaith leadership programme for a cohort of emerging Indian faith leaders, including Christians and Muslims, creating an opportunity to exchange expertise on leading modern, inclusive faith communities, and promoting values of tolerance and multi-culturalism. During my visit to India in March, I [Lord Ahmad] discussed the situation for Christians in India with Indian Minister of State for Home Affairs, Kishan Reddy.

The British Deputy High Commission in Kolkata has been monitoring the situation and assesses the violence to have been political rather than communal. We welcome West Bengal Chief Minister Mamata Banerjee's call for calm.

We understand that India's Supreme Court is currently hearing petitions seeking a special investigation into the post-election violence in Bengal. We await further details of what next steps the Supreme Court will take. Where we have concerns, we will raise them directly with the Government of India.

We do not comment on individual cases. Consular Transparency Data for 2020 can be found on GOV.UK (www.gov.uk/government/publications/foreign-commonwealth-development-office-consular-data-2021). This includes the number of new arrest or detention cases that have been opened by consular staff relating to British nationals in Hong Kong, and the number of allegations of torture or mistreatment relating to Hong Kong that have been reported to consular officials. In 2020, consular officials received fewer than five allegations of torture or mistreatment from British nationals relating to Hong Kong.

We take all allegations of torture and mistreatment very seriously and will follow up with action appropriate to the circumstances of the case. Although we cannot investigate torture or mistreatment allegations, with the individual's permission, we can raise them with the local authorities, demanding an end to the mistreatment, and that the incident is investigated and the perpetrators are brought to justice. The assistance we can, and cannot, provide to British nationals abroad is set out in the publication: Support for British nationals abroad: A Guide on GOV.UK (https://www.gov.uk/government/publications/support-for-britishnationals-abroad-a-guide).

The UK will not look the other way on Hong Kong. We will continue to stand up for the people of Hong Kong, call out the violation of their rights and freedoms, and hold China to their international obligations.

We recognise that the state assembly elections in West Bengal were divisive, and we look to the Indian and West Bengal authorities to address this through inclusive social and economic policies in the recovery from the pandemic. Human rights form a regular part of our dialogue with India and of our frontline line outreach and project work. Most recently, I discussed the situation for Christians with India's Minister of State for Home Affairs on 15 March. Our Acting High Commissioner in New Delhi also discussed UK Parliamentary interest in India's minorities with officials from India's Ministry of External Affairs on 5 January. The British High Commission in New Delhi and our network of Deputy High Commissions across India also regularly meet religious representatives and have run projects promoting minority rights.

We recognise that the state assembly elections in West Bengal were divisive, and we look to the Indian and West Bengal authorities to address this through inclusive social and economic policies in the recovery from the pandemic. Human rights form a regular part of our dialogue with India and of our frontline line outreach and project work. Most recently, I discussed the situation for Christians with India's Minister of State for Home Affairs on 15 March. Our Acting High Commissioner in New Delhi also discussed UK Parliamentary interest in India's minorities with officials from India's Ministry of External Affairs on 5 January. The British High Commission in New Delhi and our network of Deputy High Commissions across India also regularly meet religious representatives and have run projects promoting minority rights.

The FCDO is currently working with implementing partners, drug companies, donors, and the World Health Organisation (WHO) to exit the programme Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases (ASCEND), as responsibly as possible within financial constraints. We are continuing to distribute medicines in the most urgent cases, and as these are ongoing, it is not possible to assess the impact on the number of donated medicines distributed.

The latest target for the total number of treatments to be delivered by the ASCEND programme between 2019 and 2022 was 600 million. Hundreds of millions of treatments have been distributed to date under this programme, the full results of which will be published by early 2022.

Following a thorough review, the FCDO's aid budget for countries in sub-Saharan Africa has been allocated in accordance with UK strategic priorities against a challenging financial climate of COVID. It focuses our investment and expertise on issues where the UK can make the most difference and achieve maximum strategic coherence, impact, and value for money. Impacts on women and girls, the most marginalised and vulnerable, people with disabilities and people from other protected groups were considered.

The UK shares the concerns outlined in the report by the Integrated Food Security Phase Classification, and alongside 16 partner countries we have called for a humanitarian ceasefire to avert the risk of famine. The Minister for Africa and the UK Special Envoy for Famine Prevention and Humanitarian Affairs, Nick Dyer, discussed this and a need for an enhanced international response with counterparts from G7 and other key donor countries on 9 June.

We have serious concerns about gross violations of human rights occurring in Xinjiang and welcome any work that is rigorous, balanced and raises awareness of the situation faced by Uyghurs and other minorities in China. We are following the work of the Uyghur Tribunal and remain in contact with Sir Geoffrey Nice. We will study any resulting report carefully.

The UK Government remains deeply concerned by reports of discrimination and violence against religious communities in Pakistan, including against the Ahmadiyya Muslim community. We continue to urge the government of Pakistan at senior levels to guarantee the fundamental rights of all its citizens, regardless of their religion or belief.

As Minister of State for South Asia, I intend to raise our concerns about the persecution of Ahmadi Muslims with senior Pakistani government representatives during my visit to Pakistan this month. This engagement will build on my discussion of recent murders of Ahmadi Muslims with Pakistan's Special Representative for Religious Harmony, Tahir Ashrafi, on 23 March. The Special Envoy for Freedom of Religion or Belief, Fiona Bruce, also met with the International Human Rights Committee on 12 April in order to understand their concerns about the issues facing the Ahmadiyya Muslim community in Pakistan.

The UK Government has discussed with the US Government their decision to introduce visa restrictions with regards to the North-West South-West crisis in Cameroon, and we will monitor the impact of this announcement.

The UK Government works with international partners, including the French Government, to raise the North-West South-West crisis in Cameroon within multilateral fora. During a visit to Cameroon in March 2021 the Minister for Africa discussed the crisis with representatives from the French, US and Swiss Embassies.

We are concerned by the Nigerian Government's suspension of Twitter in Nigeria. Our High Commission in Abuja and likeminded countries issued a statement supporting freedom of expression and representatives met the Nigerian Foreign Minister, Geoffrey Onyeama, to discuss the suspension and statement.

We are clear in our condemnation of the coup and stand in solidarity with those calling for a return to democracy. We welcome the formation of the NUG to push for an inclusive, democratic future for Myanmar. They are an important voice for many in Myanmar. On 9 April, the UK convened an Arria-formula meeting at the UN Security Council to discuss the issue of Myanmar and invited Daw Zing Mar Aung, from the NUG, to address participants. On 20 April, the Minister for Asia met with Dr Sasa, a key figure in the NUG, and reiterated the UK's support for their ambitions for a federal democracy.

The UK is one of the largest humanitarian donors in Myanmar. UK aid provides life-saving humanitarian assistance to conflict affected and displaced people in Myanmar. We have carried out a review of our aid programme in Myanmar to ensure that we focus on the most vulnerable people. We are closely monitoring the ongoing impacts of the military coup with our partners, including ethnic civil society organisations, so that our support continues to reach those most in need and can respond to new needs. On 17 May, the UK imposed sanctions on Myanmar Gems Enterprise, a State Owned Enterprise responsible for all gems activity in Myanmar, a key source of revenue for the military. We have also sanctioned Myanmar Economic Holdings Ltd (MEHL) and Myanmar Economic Corporation (MEC), the two largest military conglomerates. These sanctions directly target the military's financial interests. Working with partners, including the US and Canada, we have sanctioned 9 military officers, including the Commander-in-Chief, for their role in the coup.

We have also welcomed the Five Point Consensus on Myanmar and ASEAN's unique role in addressing the crisis and supported ASEAN's call for an end to violence, for restraint, and for a peaceful resolution, in line with the purpose and principles enshrined in the ASEAN Charter. As was made clear in the communique after the G7 Foreign Ministers meeting on 5 May the military must implement this plan without delay.

We have consistently made clear our concerns about the human rights situation in Ethiopia, particularly in Tigray, both publicly and in direct discussions with the Governments of Ethiopia and Eritrea. We continue to call for an end to the conflict.

We welcome the report by the UN Special Rapporteur on the human rights situation in Eritrea, which is of continued concern. The UK Government takes every opportunity to voice these concerns, and has done so directly with the Government of Eritrea, at the Human Rights Council and publicly through our annual reporting on human rights.

We note and welcome the recommendations made by the UN Special Rapporteur in his report on the situation in Eritrea. We fully support all efforts to fulfil his mandate as stated by the UK's Ambassador for Human Rights, Rita French, at the 46th Session of the Human Rights Council.

We are concerned and disappointed that the UN Special Rapporteur continues to be denied access to Eritrea. We have raised this issue at the UN Human Rights Council and directly with the Government of Eritrea, and will continue to press for the Special Rapporteur to be given the access that they need.

The seismic impact of the pandemic on the UK economy has forced us to make tough but necessary decisions, including exiting from some programmes such as Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases (NTDs) programme. The UK has made a significant contribution to global efforts to protect hundreds of millions of people from NTDs. Our programmes have delivered NTD treatment, care, and strengthened health systems to deliver these services going forward. We are currently working with partners, drug companies, donors, and the World Health Organisation (WHO) to mitigate impacts, and to exit the programme as responsibly as possible within financial constraints. We continue to distribute drugs to fight NTDs, and perform surgeries in the most urgent cases.

Global health remains a top priority for UK ODA, and we will continue to be a major contributor in leading international action to strengthen global health security, and help build more resilient health systems. Departmental cross-government allocations of ODA spend for 2021/22 were laid out in a Written Ministerial Statement in Parliament on 21 April, and the Foreign Secretary has highlighted that the FCDO will spend £1,305 million on global health, which means we will remain among the most generous international donors.

The seismic impact of the pandemic on the UK economy has forced us to make tough but necessary decisions, including reducing our malaria spend. Although we are moving away from a fixed spending target, we will continue to be a major donor to malaria, as part of our wider ambition to end the preventable deaths of mothers, newborns and children.

The UK has made a significant contribution to global efforts to drive down malaria cases and deaths, and lay the foundations for eradication. We are proud of what the UK and partners have done to address the burden of malaria in developing countries. The UK remains committed to a high level of funding for malaria, including our sizeable £1.4 billion commitment to the Global Fund to Fight AIDS, TB and Malaria. We will also continue to invest in health systems strengthening and universal health coverage, which are vital for continued progress on malaria and for addressing other health needs broadly and sustainably. Global health remains a top priority for UK ODA. We will continue to be a major contributor in leading international action to strengthen global health security through our support to the WHO and multilateral global funds such as Gavi and bilateral support for health programmes within countries.

We are aware of recent reports of a public execution in DPRK of an individual charged with distributing smuggled CDs and USBs. Due to the closed nature of the regime in the Democratic People's Republic of Korea, we cannot verify the accuracy of these reports. The UK, working with partners, ensures that annual UN resolutions consistently call on the DPRK to end its use of the death penalty and adhere to international standards on judicial procedures. We also continue to raise our concerns directly with the North Korean Government, including with the DPRK's Ambassador in London.

No decisions have yet been made about Her Majesty's Government attendance at the Beijing Olympics in 2022.

We have spoken about the situation in Tigray in the five 'AOB' discussions on that subject at the UN Security Council and did so again in the 25 March debate on Protection of Civilians, where I as the Minister responsible for Human Rights, raised again continued atrocities inflicted upon the people of Tigray, including endemic sexual violence. In the Security Council Press Statement of 22 April, the members of the Security Council 'expressed their deep concern about allegations of human rights violations and abuses, including reports of sexual violence against women and girls in the Tigray region and called for investigations to find those responsible and bring them to justice'. We will continue to support discussion in the UN on this pressing matter. However, we do not plan to table a specific resolution on Tigray on 19 June.

The UK shares the concerns raised by the EU. The UK has been consistent in calling for the protection of civilians in Ethiopia, unfettered humanitarian access, and respect for human rights. Currently 5.2 million are in need of food aid. We are deeply concerned about the impact of the conflict on food security and nutrition in Tigray, including reports of people dying from hunger. We are also extremely concerned about the use of hunger and food insecurity as methods of war. We have raised these points with the Government in Addis Ababa consistently and at the highest levels, most recently during the visit of the Special Envoy for Famine Prevention and Humanitarian Affairs from 19-25 May.

UK-funded aid agencies in Tigray are delivering support in challenging circumstances, including food, shelter, water and healthcare. Teams from the British Embassy in Addis Ababa visited Tigray from 4-5 March, 4-7 April and the week of 19 April and met with humanitarian agencies working in the region. To date the UK has provided £22 million of badly needed support to people in Tigray. We continue to call for unfettered humanitarian access.

The UK has led calls on the parties to the Tigray conflict to place the survival and welfare of the affected people above political and military goals. We are deeply concerned about the impact of the conflict on food security and nutrition in Tigray, including reports of people dying from hunger. We have raised the points with the Government in Addis Ababa consistently and at the highest levels, most recently during the visit of the Special Envoy for Famine Prevention and Humanitarian Affairs from 19-25 May. To date the UK has provided £22 million of badly needed support to people in Tigray.

The UK is appalled by reports of atrocities in Tigray and is aware of recent reports that civilians have again been victims of indiscriminate shelling. It is clear that the conflict in Tigray is being conducted with little regard for civilian welfare and as a consequence reports of civilian casualties are all too common.

Ethiopia is a state party of the Chemical Weapons Convention (CWC) and has not declared any Chemical Weapons programme. The Government of Ethiopia has denied that Chemical Weapons have been used. We are working to establish the facts. Access to the affected areas, and to verified information, remains difficult. We have consistently called for access for independent human rights investigators and will continue to do so.

Implementation of the 2018 Peace Agreement remains behind schedule, with continued delays to key tasks such as the unification of armed forces and transitional justice. As the country's best chance for achieving sustainable peace, the UK is at the forefront of international efforts to pressure South Sudan's leaders to meet their 2018 commitments in full, including during my last visit in October 2020 and the UK Special Envoy's visit in early May.

The UK remains a leading donor to the Rohingya response in Bangladesh despite the financial pressures. At the launch of the Joint Response Plan on 18 May, we announced £27.6 million in new funding to the Rohingya response in Bangladesh, bringing our total contribution over £320 million since the crisis started in 2017. This financial contribution will continue to deliver lifesaving aid, including food assistance, health services, water and sanitation, camp management, shelter, cooking gas, and protection for survivors of gender-based violence. We have prioritised this assistance and the consolidation of the provision of services to achieve better effectiveness, impact, and value for taxpayers' money. In addition to bilateral funding, the UK is providing support to the Rohingya refugee response through global funds such as the Global Partnership for Education, Education Cannot Wait, Central Emergency Response Fund and Gavi, the Vaccine Alliance. UK funds also support the Rohingya through the UN agencies and the World Bank and the Asian Development Bank.

As the country's best chance for achieving sustainable peace, the UK is at the forefront of international efforts to pressure South Sudan's leaders to fully implement the 2018 peace deal, including during my last visit in October 2020 and UK Special Envoy's visit in early May. More broadly, the UK supports a number of peacebuilding initiatives at a grassroots level via the UK Peacebuilding Opportunities Fund and the UN Peacekeeping Mission in South Sudan, to which the UK contributed £57.9m and up to nine military staff officers in 2020-21.

The UK condemns the attack on the village of Dungob Alei on 16 May, for which the perpetrators have not been identified, but it follows a series violent clashes between the Misseriya and Ngok Dinka ethnic groups. We continue to press the Governments of Sudan and South Sudan to resolve the status of Abyei and we support the role played by the UN Peacekeeping Mission in Abyei (UNISFA).

The UN Mission in South Sudan (UNMISS) continues to play a vital role in the protection of civilians across South Sudan, including minority groups, and there have been no recent changes to the mission's focus or numbers of peacekeepers authorised to be in country. The mission's mandate was renewed in March, with UK support, for another year.

The Call to Action has raised awareness of the potentially devastating impact of COVID-19 on remittances. Over 40 countries took actions to improve access to remittances and financial services. Some remittance companies waived their transfer fees and offered incentives to senders and receivers of remittances. Two Call to Action Partners (United Nations Capital Development Fund and World Bank) are writing a stocktake report that will analyse key factors and measures taken that have contributed to changes in remittances flows since the start of COVID-19. The report will be published and made public in June.

The UK and Swiss Governments will build on the Call to Action coalition, including creating a "Peer-to-Peer Learning platform". This will facilitate learning between remitting countries and key stakeholders.

The Call to Action monitors developments at national levels through the World Bank and updates a tracker on the Call to Action website: https://www.knomad.org/covid-19- remittances-call-to-action/#actions.

The Call to Action has achieved its key objective of raising awareness on the potentially devastating impact of COVID-19 on remittances. Over 40 countries took actions to improve access to remittances and financial services. Remittance companies also responded by waiving their transfer fees and offering incentives to senders and receivers of remittances. A stocktake report is currently being written to understand the key factors and measures taken that have contributed to changes in remittances flows since the start of COVID-19. The UK and Swiss Governments are leveraging the unique composition and convening power of the Call to Action coalition to transition it to a "Peerto-Peer Learning platform", which will facilitate dialogue, share experiences and best practices, and facilitate learning between remitting countries and key stakeholders.

The Call to Action monitors developments at national levels through the World Bank and updates a tracker on the Call to Action website.

We are deeply concerned at human rights abuses and violations in Ethiopia's Tigray region, including of Eritrea's significant role in them. We condemn violations as consistent with an apparent policy of collective punishment of Tigrayans. There are numerous shocking reports of atrocities committed by Eritrean forces in Tigray, and their continued presence is fueling insecurity. These forces must leave Ethiopia immediately. The Minister for Africa made this clear to the Eritrean Ambassador on 16 March, and we set this out in our joint statement with the G7 on 2 April and a G7 Communiqué on 5 May. Our Ambassador in Addis Ababa met with the Chief of Staff of the Ethiopian National Defence Force in the week of 26 April and pressed this point.

We are closely monitoring the situation and are clear that their withdrawal must be swift, unconditional and verifiable. However, despite Ethiopian Prime Minister Abiy's commitment that Eritrean troops would withdraw from Tigray we are yet to see any evidence that this is happening. We continue to press hard for this commitment to be delivered.

We noted the Hogan Lovells report of 18 June 2014. The UK is fully committed to honouring its legal obligations under the Genocide Convention. The Government's longstanding policy is that any judgment on whether genocide has occurred is a matter for competent courts. These include international courts, such as the International Criminal Court and the International Court of Justice, and national criminal courts that meet international standards of due process. Our approach is to seek an end to all violations of international law, and to prevent their further escalation, irrespective of whether these violations fit the definition of specific international crimes.

Members of non-religious communities continue to be victims of harassment and persecution, despite progress over recent years with the promotion of freedom of religion or belief for all. The UK Government remains deeply concerned about the severity and scale of violations and abuses of freedom of religion or belief (FoRB) for all in many parts of the world. Protecting freedom of religion or belief for all faiths, and none, remains a priority for the UK Government. As the Minister responsible for Human Rights, I underlined these points at the All-Party Parliamentary Humanist’ Group Annual General Meeting on 24 May.

I also work closely with the Prime Minister’s Special Envoy for FoRB, Fiona Bruce MP. In addition to championing FoRB, Mrs Bruce represents the UK at meetings of the International Religious Freedom or Belief Alliance to advocate for the rights of individuals being discriminated against or persecuted on the basis of their faith or belief, including members of non-religious communities.

We have interpreted the question to mean how many staff were employed by the then Foreign and Commonwealth Office (FCO) and Department for International Development (DfID) in China and Hong Kong in each of the financial years, (a) 2018, (b) 2019 and (c) 2020 and as Foreign, Commonwealth and Development Office (FCDO) in 2021. All the figures shown are based on the headcount as at 31 March in each year. They include both UK Based Staff and Country Based Staff.

The figures below cover our Embassies and Consulates in Beijing, Chongqing, Guangzhou, Shanghai and Wuhan. And our Consulate General in Hong Kong.

China and Hong Kong staff numbers 2018 to 2020 as Legacy departments. Then as FCDO in 2021.

The Government condemns violence against civilians of all religions in Nigeria. In the North East, terrorist groups including Boko Haram and Islamic State West Africa, have abducted and killed individuals from Christian and Muslim communities. These groups target all those who do not subscribe to their extremist views. We are deeply concerned for the welfare of those still held in captivity by these groups. The UK Government is providing a comprehensive package of humanitarian and stabilisation assistance to support communities affected by the conflict. We are also concerned by recent criminal attacks on schools in Northern Nigeria, which have targeted students of all religions. We continue to raise these cases with the Nigerian Government.

Intercommunal violence also has a devastating impact on affected communities. The underlying drivers of violence are complex, and frequently relate to competition over resources and increasing criminality. The Minister for Africa visited Nigeria in April and discussed increasing insecurity across the country with the President’s Chief of Staff, Foreign Minister and community leaders. We continue to encourage the Nigerian Government to take urgent action to implement long-term solutions that address the root causes of violence.

As the Minister of State responsible for human rights issues for the Foreign, Commonwealth & Development Office, I tweeted on 11 May to express my deep sadness at the reported murder of priests in Tigray. This is one of a deluge of horrifying reports of atrocities coming out of Tigray. Civilians must be protected and the violence must stop.

The G7, under the UK Presidency, issued a statement on 2 April and a Communiqué on 5 May condemning human rights violations and abuses. The UK also condemned in the strongest terms the reported killings of civilians via a joint statement on Ethiopia with 41 other countries at the 46th Session of the Human Rights Council. We support the UN's call for a "zero tolerance" policy and welcome the UN Security Council's 22 April Press Statement expressing their deep concern about allegations of human rights violations and abuses in the Tigray region. The UK will support the UN Office for the High Commissioner for Human Rights to ensure that their joint investigations with the Ethiopian Human Rights Commission into atrocities in Tigray are independent, transparent and impartial and that those responsible for these human rights abuses are held to account. The Foreign Secretary, Minister for Africa and our Ambassador in Addis continue to raise human rights issues in their discussions with the Ethiopian government.