Contingencies Fund Advance

Matt Hancock Excerpts

Thursday 17th December 2020 Written Statements

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

The Department of Health and Social Care has sought a repayable cash advance from the contingencies fund of £34,000,000,000.

The Department of Health and Social Care’s net cash requirement cash limit has been used in full between April 2020 and December 2020 to support the running costs of the Department, NHS and arm’s length bodies, including expenditure on the covid-19 pandemic.

The Department of Health and Social care will seek a significant increase to its voted funding at supplementary supply estimate to cover the increased costs of the covid-19 pandemic and this will be used to repay the advance after the Supply and Appropriation Act has received Royal Assent in March 2020.

Parliamentary approval for additional resources of £33,350,000,000 and additional capital of £650,000,000 will be sought in a supplementary estimate for the Department of Health and Social Care. Pending that approval, urgent expenditure estimated at £34,000,000,000 will be met by repayable cash advances from the contingencies fund.

[HCWS666]

Covid-19: Tiers System

Matt Hancock Excerpts

Thursday 17th December 2020 Written Statements

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

Local action is vital to our strategy of suppressing the virus, while protecting the economy, education and the NHS, until a vaccine can make us safe. Help is on its way thanks to the rollout of a safe and effective vaccine, but we are not there yet.

While we have moved to a localised approach through the tiers system, we have been clear that these must be tough, recognising that case rates are rising in many areas of the country, and our knowledge that the winter months are the most challenging for our NHS.

We have assessed each area individually, and as Monday’s decisions on Essex and today’s decisions on Waverley and parts of Hampshire show, we are prepared to move at a more localised level where the data and human geographies permit.

As set out in the covid-19 winter plan, there are five indicators which guide our decisions for any given area, alongside consideration of “human geographies” like travel patterns.

These are:

Case detection rates in all age groups

Case detection rates in the over 60s

The rate at which cases are rising or falling

Positivity rate (the number of positive cases detected as a percentage of tests taken)

Pressure on the NHS.

While each metric is important in its own right, the interplay between each indicator for a given area is equally important, so a hard and fast numerical threshold on each metric is not appropriate.

These are not easy decisions, but they have been made according to the best clinical advice, and the best possible data from the JBC.

The regulations will require the Government to review the allocations at least every 14 days. We will also take urgent action when the data suggests it is required, as we did on Monday.

The first formal review took place yesterday, and the allocations and a detailed rationale can be found as an attachment online.

I will also deposit the data packs used to inform these decisions in the Libraries of both Houses.

These changes will be implemented from 00:01 on 19 December. This list will also be published on gov.uk and a postcode checker will be available for the public to check what rules apply in their local area.

Attachments:

1. 16 December Tier Review (16 December Tier Review.docx)

Attachments can be viewed online at: http://www. parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2020-12-17/HCWS677/

[HCWS677]

Covid-19 Update

Matt Hancock Excerpts

Thursday 17th December 2020 Commons Chamber

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

As we enter the coldest months, we must be vigilant and keep this virus under control. Yesterday, 25,161 cases were reported and there are 18,038 people in hospital with coronavirus in the UK. We must keep supressing this virus. This is not just a matter for the Government or this House; it is a matter for every single person. These are always the most difficult months for people’s health and for the NHS. Especially with the vaccine already here, we must be cautious as we accelerate the vaccine deployment as per the winter plan. We have come so far—we must not blow it now.

When we reintroduced the tiered system, we resolved to review the data in each area every two weeks. The sophisticated covid surveillance system we now have in place means we can act swiftly and decisively when needed. At the weekend, we held an emergency review for London, Essex and parts of Hertfordshire where cases are accelerating fast. Yesterday, we held the first full formal review. I must report to the House that across the world cases are rising once more. In Europe, restrictions are being reintroduced. In America, case rates have accelerated. In Japan, cases are rising once again. Yesterday, the Welsh Government made the decision to tighten restrictions across the whole of Wales. No one wants tougher restrictions any longer than necessary, but where they are necessary, we must put them in place to prevent the NHS from being overwhelmed and to protect life. Even in a normal year, this is the busiest time for the NHS. As Chris Hobson, chief executive of NHS Providers, reminded us this morning:

“controlling infection rates is about limiting patient harm”.

This is a moment when we act with caution.

In the south-east of England, cases are up 46% in the last week. Hospital admissions are up by more than a third. In the east of England, cases are up two thirds in the last week and hospital admissions are up by nearly half. It is therefore necessary to apply tier 3 measures across a much wider area of the east and south-east of England, including: Bedfordshire; Buckinghamshire; Berkshire; Peterborough; the whole of Hertfordshire; Surrey with the exception of Waverley; Hastings and Rother, on the Kent border of East Sussex; and Portsmouth, Gosport and Havant in Hampshire. These changes will take effect from one minute past midnight on Saturday morning.

I know that tier 3 measures are tough, but the best way for everyone to get out of them is to pull together and not just follow the rules but do everything they possibly can to stop the spread of the virus. Where we have seen places get the virus under control and come out of tier 3, it is because everybody has taken responsibility on themselves to make that happen. We have seen case rates fall across large parts of England. I know that many places in tier 3 have seen their rates reduce. In most places, I have to tell you, Mr Speaker, we are not quite there yet and the pressures on the NHS remain.

However, we are able to move some place down a tier. We assess these decisions according to the five published indicators: case rates; case rates among the over-60s; test positivity; rates of change; and hospital pressure. Today, I am placing in the House of Commons Library an assessment of each area and publishing the data on which we make these decisions. For the vast majority of places currently in tier 3, we are not making a change today. However, I am pleased to say that some places can go down a tier. In Bristol and north Somerset, rates have come down from 432 per 100,000 to 121 and falling. I can therefore announce that Bristol and north Somerset will come out of tier 3, and into tier 2 on Saturday. Rates in Herefordshire have also come down, to 45 in 100,000, and are falling, and we can therefore bring Herefordshire out of tier 2 and into tier 1. 

I want to pay tribute to everyone who has been doing the right thing and getting rates down. Whether or not your area has come down a tier today, it is so vital that everyone sticks at it and does the right thing, especially over this Christmas period. It is important to remember that this can be a silent disease. One in three people with the disease have no symptoms but can still pass it on. Everyone therefore has a personal responsibility to play their part in keeping this pandemic under control. I know that other areas are so eager to move down the tiers, and the best thing we can all do is act with responsibility to get the virus under control.

These restrictions are, thankfully, not the only tool we have now to fight this disease: we are further expanding our testing programme, and later today the Education Secretary will set out further action on school testing in the new year; and, of course, the vaccine roll-out is accelerating. I can update the House by saying that over 200 vaccination sites are now open, in all parts of the UK, with more opening their doors and bringing hope to communities over the coming days. I know that everyone will be as thrilled as I am every time they are contacted by a friend or loved one who has been getting the jab. It was a wonderful sight to see the global map of vaccine deployment, with the UK proudly standing out as the site of the first vaccinations. It is a huge logistical challenge but the vaccine offers us promise of a better year ahead. Until the great endeavour of vaccine deployment reaches enough people to make this country safe, we must keep doing what it takes to protect our NHS and protect those we love. That means all of us doing our bit, following the rules and taking personal responsibility to help contain the spread of the virus, so that we can get through this safely, together. I commend this statement to the House.

--- Later in debate ---

[Matt Hancock]

The hon. Gentleman rightly asked about the arrangements in place for Christmas, which the Prime Minister set out yesterday very clearly. Christmas is a very special time of year and that is why we have put in the arrangements that we have. It is a matter of people’s personal responsibility to ensure that they act and see their loved ones in a way that is safe and careful. I think people understand that and, what is more, I think people will abide by it. We know that it is safer to see older people, especially if they are over 70 or clinically extremely vulnerable, if we have taken the care to reduce social contact beforehand. We also know that, after Christmas, being able to reduce social contact will be important for keeping this under control.

I think that aspect of personal responsibility is important. Sometimes in this House it feels to me that the debate is as though, if we do not, in Government, put in place concrete rules, nobody will take any action. Actually, it is down to individuals—each and every one of us—to take responsibility for our actions, within the rules, of course, but also being cautious. This is a massive team effort and my experience of the last few months is that when a community has come together to get case rates down, that is when it has happened and when it has worked. Even with the rules in place, it is only when the community essentially comes together to get this under control that we get cases coming down along with the pressure on the NHS. I regret having to take the action that we have to take. I deem it necessary, and there is a strong view right across Government that these actions are necessary, but I also plead that personal responsibility is absolutely central to how we as a society should respond to this pandemic.

The hon. Gentleman asked about the mass vaccination roll-out. The mass vaccination sites are appropriate for the Oxford/AstraZeneca vaccine, should that come through and be approved by the regulator, so it is some weeks until we will see those rolled out. However, we are every day having more and more primary care sites coming on board with the roll-out of the Pfizer vaccine, and it is very good to see that happening. I expect the numbers that are vaccinated to accelerate. The team have made a very good start and there is a long way further to go.

The hon. Gentleman asked about the data systems. They have largely been working very effectively. Of course, any very large logistical roll-out like this has niggles, but they are small and have been brilliantly dealt with locally on the ground.



The hon. Gentleman asked about the roll-out of testing in schools. As I say, the Education Secretary will set out more details on offering all secondary schools, colleges, special schools and alternative provision settings the help, support and facilities to test as many secondary-age and further education students as possible, as they resume their education in January. I thank in advance all the teachers and support staff in schools for their work; no doubt they will lean in and support this task to ensure that school return can be done as safely as possible.

Finally, I echo the hon. Gentleman’s words and wish him a happy and safe Christmas. I look forward very much to seeing him again in January.

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

In the past week, I have received unexpectedly joyful emails from residents of South West Surrey who have been among the first in the world to receive a clinically approved vaccine for coronavirus. I thank my right hon. Friend for that early Christmas present. I also thank him for the energy, for the endless media rounds and for the dedication that he has shown in the past year, which must have been one of the toughest imaginable for a Health Secretary. I am also grateful that Waverley has been excluded from the Surrey-wide move to tier 3, in recognition of our lower infection rates, although we will remain vigilant.

I want to ask my right hon. Friend about Christmas, just a week away. Of course personal responsibility matters, but, in a pandemic, so does clarity. Irrespective of the law or the regulations, should we or should we not have indoor social gatherings with elderly and vulnerable family members?

[Matt Hancock]

People should act with great caution in this pandemic, because doing so protects them, protects their families and protects their loved ones. We have set out what the rules are, but they are not a limit up to which we should all push. We can all act within those rules to limit the spread, by reducing social contact in the days up to meeting a family member who may be, for instance, over 70—or any other family member. It is reasonable and responsible to take that sort of action.

I am grateful to my right hon. Friend for what he said about the vaccine roll-out. I have been cheered by the messages I get from constituents and others now that they are receiving the vaccine. We just have to ensure that we get the deployment out as fast as the vaccine can reasonably be produced and as fast as the NHS can deploy it, so that we get people the safety of that vaccine and so that we can get through this and out of this as soon as possible.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is important that the festive days ahead do not become a five-day mass get-together. Therefore, we should use as little of the flexibility as possible, spread over several days, while ensuring that no one is facing Christmas alone. The concerns from medical professionals that the Christmas covid restriction relaxation will cost lives are not to be dismissed lightly. Does the Secretary of State agree that if people are to form a bubble, it should be kept as small as possible? If so, would it not be better to follow the Scottish approach, which sets a strict maximum limit on the numbers, up to eight people from three households, rather than the potentially unlimited numbers permitted currently in English bubbles?

[Matt Hancock]

This has been an incredibly difficult year for so many people and so many families. The fixed numerical limits place a particular burden on very large families. We have taken, I think, a balanced and right approach, but while I understand the urge for caution—of course I understand that, from my NHS colleagues and others—I also understand that people want to see their children and their loved ones. Christmas is an important time of year, and we have to find a balance.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I join my right hon. Friend in wishing NHS staff and everyone in this crisis a happy Christmas. Will he join me in wishing Essex County Council and local authorities in Essex a happy Christmas for what they have contributed to the test, track and trace operation since NHS Test and Trace started to share data much more quickly with local authorities? I can report to him that most districts have started door-knocking to follow up the contacts of cases, and the complete case contact rates are now around 87% and 90% respectively. Will he join me in congratulating the local authorities of Essex on this tremendous effort?

[Matt Hancock]

My hon. Friend is absolutely right, and I am grinning because I think this is the first time in the dozens and dozens of statements I have made this year when the hon. Member for Leicester South (Jonathan Ashworth) has not mentioned track and trace. I will tell you why, Madam Deputy Speaker: the latest statistics show that where communications were available, 96.6% of people were reached and told to self-isolate. That is because of the huge improvements in contact tracing and testing that have been delivered this year—[Hon. Members: “By local authorities.”] Including, of course, by local authority partners, but also by the brilliant national NHS Test and Trace system, which we should all congratulate. Getting those contact rates—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. This is not a moment for shouting. Listen to the Secretary of State.

[Matt Hancock]

I think the moment when we see contact rates of more than 90% should be one where everybody comes together and says thank you and well done to everybody at NHS Test and Trace and all their partners, whether they are in the public sector or are the brilliant private sector partners that we all support.

[Judith Cummins (Bradford South) (Lab) [V]]

Happy Christmas to you and yours, Madam Deputy Speaker. The Secretary of State will know the significant effect that the pandemic has had on NHS dentistry. There is a backlog of more than 19 million appointments. It is therefore shocking and unacceptable that NHS England has just decided to impose a new activity target on dentists in England, which many simply will not be able to meet under new covid restrictions. NHS England’s own data show that nearly 60% of dental practices will be hit by severe financial penalties. Dentists will now need to prioritise check-ups rather than dealing with the backlog of patients needing treatment while others may be forced to close entirely—a straight choice between staying financially liable or treating those in pain with more complex problems. Will the Secretary of State reverse this decision, which threatens patient safety and access and could lead to the demise of NHS dentistry as we know it?

[Matt Hancock]

I am very glad to be able to reassure the hon. Lady that the agreement that has been reached with the dentists is all about ensuring that while we support our NHS dentists we see them do as much as they can to look after people and help them get the treatments they need. This is a good, balanced programme and I am sure it will be implemented well by the dentists.

[Dr Liam Fox (North Somerset) (Con)]

May I say how delighted I am that North Somerset is moving down into tier 2, which is just reward for the efforts of my constituents and the whole community and also offers great potential help for our hospitality industry as we go into the Christmas period? On the question of balance, I completely agree with my right hon. Friend that we have to consider not just the number of people and the number of households but the age and vulnerability of those who are meeting? May I say, echoing the words of my colleague, that I wish a very happy Christmas to my right hon. Friend and his team of Ministers, who have done the most difficult job imaginable in a rather exceptional way? I hope—although without much expectation—that they will get some break over the Christmas period.

[Matt Hancock]

The people of North Somerset, who my right hon. Friend represents, and those of nearby Weston-super-Mare have done a remarkable job of bringing the case rates down to 120 for every 100,000. I am very pleased that we are able to take North Somerset out of tier 3 into tier 2. I would also say to everybody that the point about personal responsibility that my hon. Friend stressed and that I strongly agree with still applies. Coming out of a tier makes life easier, of course—we do not want the tiers in place any longer than absolutely necessary—but it is still on everyone in North Somerset, as well as in Bristol and Herefordshire, which have also come down, to do their bit and keep those case rates down.

[Karl Turner (Kingston upon Hull East) (Lab) [V]]

The lead-up to Christmas is the busiest period for hospitality businesses, with some pubs in my constituency making up to a quarter of their annual profits, which are now lost. If measures to control the virus are to be effective, they must go hand in hand with proper business support. To protect lives and livelihoods, what will the Secretary of State do to ensure that businesses forming the backbone of my communities in Hull get the financial support they desperately need?

[Matt Hancock]

I feel gratitude to everyone in Hull for the work they have done to get case rates down as far as they have. Hull has done well, along with the rest of the Humber area, but we are not quite there yet. We are providing the support that comes with being part of tier 3, and we have put record sums in to support hospitality, but I appreciate that this is tough, especially in the run-up to Christmas. I can commit to keep working with the hon. Gentleman and other colleagues across Hull, the Humber and other areas in tier 3 to do everything we can to get hospitality open again.

[Kate Griffiths (Burton) (Con) [V]]

I pay tribute to the work of Staffordshire County Council in rolling out rapid, large-scale asymptomatic community testing in my constituency of Burton and Uttoxeter. The director of health has raised a number of concerns with the Department about the lack of clarity over funding for those tests. Will my right hon. Friend review the three letters that have been sent to his Department on that issue, to provide the clarity that is urgently needed to allow this testing to continue?

[Matt Hancock]

Yes, I will get on to it right away. I am really glad that Staffordshire has worked hard on getting this community testing going. Stoke-on-Trent was one of the first places in the country to get going on it, and now we have spread it out wider in Staffs. I will pick up the point that my hon. Friend raises and get back to her straightaway.

[Stella Creasy (Walthamstow) (Lab/Co-op) [V]]

The Secretary of State tells us about personal responsibility. Does he recognise that he has a responsibility to be honest with the public about what is happening? This week, Whipps Cross Hospital had to turn away ambulances because the ICU was full as a direct result of the rising covid infections in our local community, and the hospital had to move to early discharge of patients. He says that he is publishing data. Will he commit to publishing real-time data about A&E “firebreaks”, ICU capacity and what planned surgeries have been cancelled by hospitals, so that the public can see the truth about why and how we need to protect the NHS and what impact it has on their health outcomes?

[Matt Hancock]

The hon. Lady is absolutely right about the impact of the virus on the NHS in her part of the world in north-east London. Whipps Cross Hospital is under significant pressure. The case rate in her Waltham Forest local authority is 431 per 100,000. We have to work together to get the cases down, especially in east London, where they are very significant. We publish a huge amount of data on hospital admissions and the impact on the NHS, and I am publishing further data on this today and putting it in the Library of the House.

[Felicity Buchan (Kensington) (Con)]

I am glad to see that three areas are coming down a tier. That is vital for compliance, because the general public need to see that if they follow the rules and get their cases under control, there will be a pay-off. Does my right hon. Friend agree that what is important is complying with existing restrictions, rather than ever more severe restrictions, and it is critical that we take the public, including the young, with us?

[Matt Hancock]

I agree with every word that my hon. Friend just said. I strongly agree that the best way to get out of tier 3 is by everybody coming together to comply with the restrictions—and not just to comply with them because they are the law but to take responsibility to ensure that we do not spread the virus, which each one of us can do unwittingly because of its asymptomatic nature. I thank my hon. Friend for her question and for the message that it sends: we can get areas out of tier 3 and we can get areas out of tier 2 and into tier 1, but we all have to work at it.

[Munira Wilson (Twickenham) (LD)]

I asked the Secretary of State, via a written question, what estimate his Department had made of the proportion of the population not registered with a GP, to which the answer was:

“No such estimate has been made.”

I found that concerning, given how important GPs are to the roll-out of the covid-19 vaccine, not least for vulnerable populations such as the homeless and those who move around a lot. Will the Secretary of State please explain what plans and provisions are being made to ensure that the vaccine is available to those who are not registered with GPs?

[Matt Hancock]

The hon. Lady raises an incredibly important point. It does not matter whether or not somebody is registered with anybody, they can still spread the disease. The reason for the answer that she was given is that we have to try to get the vaccination programme out to everybody, no matter their status. There are people who do not have any status in paperwork at all, and we need to make sure that we support the roll-out to them as well. We are working with the Ministry of Housing, Communities and Local Government, which is best placed, along with local authorities, to make sure that the vaccination programme reaches anybody who fulfils the criteria set out by the Joint Committee on Vaccination and Immunisation.

[Mr Mark Harper (Forest of Dean) (Con)]

I welcome the fact that Gloucestershire is remaining in tier 2 and thank the Secretary of State for his engagement with me and my Gloucestershire colleagues this week—it was very much appreciated and it was very much a team effort to get to where we are. May I press him a little on what he said about vaccines? Will he confirm that the data that is going to be published from next week will have enough detail in it that we will be able to see clearly the vaccination roll-out by age and by area? Will he set out, early on when we return in January, the Government’s thinking about how far the vaccination programme needs to have gone and the level of risk that we will have reduced for the country such that we can start to release the restrictions that are so burdensome on our population?

[Matt Hancock]

Yes. We are committed to setting out weekly updates on the vaccination programme—we released the first data yesterday, on the 137,000 number—and increasingly with the sorts of breakdowns that my right hon. Friend asks for, as more and more groups are reached. He asked for the calculus in terms of the proportion of the population that needs to be protected in order that we are able to bring down restrictions, and that is exactly how we are thinking about the next phase. We do not yet know the impact of the vaccine on transmission, so we cannot yet have a concrete answer to his question, but it is precisely the question that we are asking. We should know much more within the next few weeks.

[Chris Stephens (Glasgow South West) (SNP)]

Recent studies have shown that vaccine hesitancy is highest among the black, Asian and minority ethnic community and low-income groups, and there is a real fear that these groups are being deliberately targeted with misinformation. Will the Secretary of State tell us how his Department is going to counter that so that people can make informed choices, and to avoid covid health disparities going forward?

[Matt Hancock]

The hon. Gentleman is right to raise this issue. In fact, I was talking about the vaccination programme to the SNP Cabinet Secretary for Health only this morning, because making sure that we reach all those who need vaccinations, according to clinical need, is critical, but we also need then to persuade them to take the vaccine. There is a huge amount of work on tackling misinformation. The most important thing is to have the positive information out there. I thank all those who have gone public about their vaccine so far—we all saw the wonderful photograph of Sir Ian McKellen, and I thank Prue Leith, who went public with her vaccination. It is absolutely terrific to see people celebrating the fact that they are getting vaccinated and therefore encouraging other people to do the same.

[Sir Graham Brady (Altrincham and Sale West) (Con)]

This statement will be greeted with dismay in Greater Manchester, where we have had severe restrictions for nine months and where rates in nine of the 10 boroughs are below the national average. My constituents have behaved responsibly and our rates are lower than those in neighbouring Warrington or Cheshire, which have been put into tier 2, and they are also lower than they are in Bristol, which has been moved from tier 3 to tier 2 today. What exactly do we have to be moved out of tier 3?

[Matt Hancock]

I understand my hon. Friend’s disappointment at this decision. We looked very closely at Trafford, Stockport, Tameside and nearby High Peak, and the proposal to take a different decision for them from the one that had been taken for their near neighbours. The challenge is that each time we have done that in the past, we have then seen cases rebound, and there continues to be significant pressure on the NHS in the north-west, including in Manchester. I know that my hon. Friend and I have proposed different approaches on this one, and I look forward to working with him and people right across Manchester to get this sorted.

[Rachel Hopkins (Luton South) (Lab)]

We need to make sure that schools continue to be a safe environment for students and staff, and I would like to take the opportunity to thank all school staff and headteachers across Luton, who have done so much to make their schools as covid-secure as possible. I note the point made by the Secretary of State about the announcement later regarding testing in schools, but will the Government be publishing the evidence to support the use of lateral flow tests for serial testing of students, as this is outside the licensed use and requires a change to the legal duty to isolate?

[Matt Hancock]

We are working on exactly that proposal, because the need to use testing and use the easily available and rapid-return lateral flow devices is incredibly important. They have an important role to play, used in the right settings, in the same way that the PCR tests have an important role to play, but it takes longer to get the results back with those tests. I look forward to working with the hon. Lady, with Luton council, and with all those across Bedfordshire to try to get this sorted. Clearly, case rates in Bedfordshire are shooting up in a very worrying way, and I thank her for her efforts and public health messaging to say to everybody right across Bedfordshire, including in Luton, “Let’s work together to get this sorted.”

[Greg Clark (Tunbridge Wells) (Con)]

I asked my right hon. Friend to consider restrictions on a more local level than county-wide, and I am grateful that he has done so across the country today. Infections in Tunbridge Wells, while much lower than the average for the county of Kent as a whole, are nevertheless rising, and there is pressure on the local NHS, so I understand why there is no change from tier 3 today. However, will the Secretary of State commit to apply the five tests fortnightly, and to reduce our level of restrictions as soon as they are met? Will he also have a word with the Chancellor to see what extra support can be given to businesses in the hospitality sector, which have just lost the most important part of the trading year in what has been a miserable year for them?

[Matt Hancock]

Yes, of course I will talk to the Chancellor about the point that my right hon. Friend raises. Of course, we do already have a significant amount of support for hospitality businesses, but I understand how difficult this is.

On the point about looking at local areas, we will absolutely do so, as we have demonstrated in the decisions taken today. For instance, just over the border in East Sussex, we have unfortunately had to put Hastings and Rother into tier 3. Tunbridge Wells today has a case rate of 288 per 100,000, and I would say to everybody right across Kent that we really need to act with serious responsibility. No matter which part of Kent a person is in, we have a very serious problem in Kent, and the only way in which we can get it under control is for people in Kent to essentially behave as if they have the virus and are trying not to pass it on to somebody else. Be really cautious in Kent: it is the area of the country that has the biggest problem in terms case rates, and therefore there are huge pressures on the NHS in Kent. I thank everyone who works in the NHS in Kent for what they are doing.

We are putting in as much support as we can, and I look forward to working with my right hon. Friend, all colleagues from across Kent and of course the county council and district councils to try to get this under control. Other parts of the country have done it and brought the case rate down, and we have been able to take some into tier 2. I am sure that we can get there in Kent, but we have to work hard to make that happen.

[Mr Kevan Jones (North Durham) (Lab)]

On Monday, I asked the Secretary of State when care home residents in County Durham would get the vaccine and he did not answer the question. I have now been contacted by GPs in Chester-le-Street in my constituency who were first promised the vaccine on 16 December. That was put back to 21 December. Having done all the work to set up the hub, they have now been told that the vaccine will not be available till the new year. So when will residents in Chester-le-Street get the vaccine? I do not want hype or generalisations; I just want a straightforward answer for those constituents.

[Matt Hancock]

We are opening more and more GP vaccination hubs each day. The answer specifically on Chester-le-Street is as soon as we practically can, but it has to be done in a safe way. That is out my hands and out of the right hon. Gentleman’s hands. An important operational set of procedures needs to be gone through to open the hubs. It is complicated. I will look into the right hon. Gentleman’s example and write to him with details, but he will understand, as I am sure the people of Chester-le-Street will, that we are trying to get the vaccine rolled out as quickly and as safely as possible, but “safely” is an important part of that.

[Neil O’Brien (Harborough) (Con) [V]]

Will my right hon. Friend confirm that if people in Harborough and Oadby and Wigston continue to drive down rates of infection locally, the different districts and boroughs in Leicestershire can be put in different tiers if the data supports that? Will he join me in congratulating our local NHS here in Leicestershire on the efficient way in which it is rolling out the vaccine across the county?

[Matt Hancock]

Yes on both counts. We looked at Leicestershire in great detail and I wish that we could have taken the county and the city out of tier 3. Unfortunately the data did not support that conclusion. I am grateful to everybody across Leicestershire, because I know that this has been a long, hard slog with measures in place for a long time.

[Liz Twist (Blaydon) (Lab)]

I start by thanking the people of my constituency and across Gateshead who have worked really hard to get the figure down. Professor Michael Marmot’s covid-19 review, which was published this week, shows that the pandemic has exposed long-standing health inequalities, particularly in the north. Public health teams play a vital part in this pandemic and are core to addressing those longer-term health inequalities. What has the Secretary of State done to ensure that public health teams are properly funded so that they can address those inequities and, as Professor Marmot says, “build back fairer”?

[Matt Hancock]

We are absolutely determined to build back better. That needs to involve tackling long-term underlying health inequalities. A huge programme of work will be needed to do that, after the pandemic has demonstrated those inequalities.

People in Gateshead have done a great job of getting the case rate down. Like other areas, it is still in tier 3—we are not quite there yet. I know that my team and the hon. Lady’s local director of public health have been talking about getting Gateshead and the rest of the north-east into tier 2 when we can. I hope that we can do that, but for now, let us be cautious and keep this under control.

[Julian Sturdy (York Outer) (Con) [V]]

There will naturally be disappointment across Yorkshire as many areas stay in tier 3. I appreciate that York’s tier will be affected by the current virus picture, but which of the five criteria will the city of York have to improve on to stand a good chance of moving down a tier in future reviews? Will that depend significantly on how our neighbouring local authorities perform against the five criteria?

[Matt Hancock]

We do look at those human geographies because many people commute from North Yorkshire into York, but York and many of the local authorities around it have done an absolutely fantastic job of bringing the virus under control. In York, the case rate is 65 per 100,000—a bit higher than we typically take places into tier 1. For instance, Herefordshire is 45, which is the same level Cornwall was when it was put into tier 1, but York is moving in the right direction. The over-60s case rate is also low. There has been some pressure, as my hon. Friend knows, on the hospital, but that is abating. Therefore, York and large swathes of North Yorkshire are moving in the right direction. I urge everybody right across North Yorkshire to stick at it.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

The Secretary of State will remember that he has agreed to meet me and my constituent Kellie Shiers to discuss the issues that she has had accessing cancer services during the pandemic. During the pandemic, Kelly worked on the frontline with her ambulance service in Greater Manchester, despite her history of breast cancer, but she could not have her check-up and mammogram when it was due. When she did have it, the cancer had returned and spread to her bones. She is now having chemotherapy and may need surgery. I understand that the Secretary of State has many demands on his time, but can he ensure that this meeting is able to go ahead in early January as these matters are time-sensitive?

[Matt Hancock]

Yes, I can. I am very sorry that that meeting has not happened yet and we will get right on to it for early January.

[Richard Fuller (North East Bedfordshire) (Con)]

The changes for Bedfordshire announced by my right hon. Friend will be disappointing to residents and businesses, but it will be helpful for them to understand that, in setting up the tier system, my right hon. Friend established clear criteria, and he is publishing the data and has said that he will be open to regular reviews. On those criteria, when it comes to the issue of hospitals and pressure on the NHS, that is not a data-driven criterion; it comes with statements that the NHS is under considerable pressure, which is very difficult for people to understand, because we always hear, during pre-covid times and now, that the hospitals are under pressure. So will he commit to producing projections of occupancy rates and acute bed occupancy rates across the NHS and, if possible, on a local hospital system basis?

[Matt Hancock]

Yes, we are working exactly on how to demonstrate that in a numerical rather than a narrative form, not least for the reasons that my hon. Friend sets out. We have seen a very sharp rise in cases across Bedfordshire, especially in the more rural areas, including North East Bedfordshire, so it is so important that people across Bedfordshire take that personal responsibility and follow the new tier 3 rules. I hope that we can get the rate to come down as fast as it has gone up.

[Mr Toby Perkins (Chesterfield) (Lab) [V]]

People across Chesterfield will be very disappointed that, with all the work that they have done and with Chesterfield having lower transmission rates than some of the areas in tier 2, they remain in tier 3. They will be especially disappointed by the Health Secretary’s suggestion that the communities that have worked hardest and been the most disciplined are the ones that are in tier 2. We know that that is not the case. Does he not realise that, if the Government could offer a support package that supported our hospitality sector, and if they were not, at the very last minute, announcing changes to our schools just two days before they break up, there would be more credibility to the sense that it is personal responsibility that is the problem here, rather than the ineptitude of this Government?

[Matt Hancock]

No.

[Sir Edward Leigh (Gainsborough) (Con)]

On behalf of my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes), may I thank the Secretary of State for meeting us and for promising that he will adopt a more granular approach? We can assure him that we will work hard in Lincolnshire to try to get our tier, and that of the neighbouring cities, down. May I also thank him and the Prime Minister for resisting pressure from the Opposition and from Wales and Scotland to change the rules on Christmas? That is an entirely right approach. I also thank him for the tone that he has adopted today that, if we are to defeat this, it is a matter of self-responsibility and personal ownership of our health.

--- Later in debate ---

[Matt Hancock]

That is right. We looked very closely at the southern end of Lincolnshire, which is a long way from where the rates are incredibly elevated around Lincoln, the coast and West Lindsey, but unfortunately it was not possible to bring any of the lower-tier local authority areas in Lincolnshire out of tier 3, and over the border in Peterborough we have seen a very sharp rise. So we are not there yet, but I hope that we can make significant progress, especially if everyone listens to my right hon. Friend and takes personal responsibility for their actions and tries to do everything they can not to pass the disease on.

[Jack Dromey (Birmingham, Erdington) (Lab) [V]]

Jane Roche is a great champion of her community of Castle Vale. Her dad, Vincent, died of covid. Her sister Jocelyn died five days later of covid. They are two of the nearly 10,000 in the west midlands who have died of covid. Jane and her family are devastated. They grieve for the loss of their loved ones who will not be with them this Christmas. She asks the Secretary of State this: why have we had the largest number of deaths in Europe? Can we be confident that lessons are being learnt and that the mistakes made will not be repeated? She also asks: when will the inquiry into what happened over covid be established and, crucially, will the Secretary of State meet her and other relatives of those who have sadly died from across Birmingham?

[Matt Hancock]

Yes, I am very happy to meet the hon. Gentleman and constituents to hear their stories. Many of us have lost those close to us in this terrible pandemic. We are constantly learning how to do things better, and we are constantly learning more about the disease. For instance, the news earlier this week about a new variant was because our surveillance system enables us to look out for changes and try to understand them. There are huge challenges, as he knows, but I always try to approach this by looking at how we can get the country through what is an incredibly difficult and unprecedented time with as few people as possible suffering in the way that his constituent, Jane, has.

[Rob Butler (Aylesbury) (Con)]

The news that Buckinghamshire is going into tier 3 heralds the bleakest of midwinters, especially for local hospitality businesses, and it is imperative that they get extra help and that this lasts for as short a time as humanly possible. Given that Stoke Mandeville Hospital is currently under intense pressure, with many staff off, either with covid or self-isolating, it is alarming that Buckinghamshire Healthcare NHS Trust has been given no date for when it will get a supply of vaccines, especially when neighbouring Oxfordshire is in a lower tier and already has them. Will my right hon. Friend ensure that residents and healthcare staff can get the vaccine locally in Buckinghamshire before Christmas?

[Matt Hancock]

I will write to my hon. Friend immediately with our plans for the roll-out of primary care-based vaccination facilities in Aylesbury. I regret having to put Buckinghamshire into tier 3 measures, but unfortunately it was absolutely necessary on the numbers. Aylesbury Vale, the local authority area, has a case rate of 235 per 100,000 and it is rising really sharply, and my hon. Friend has set out the challenges at Stoke Mandeville, which is an excellent hospital but under significant pressure. I am glad that he understands why we have had to take this decision and I hope that across Buckinghamshire we can get these cases down and get people vaccinated as soon as possible.

[Jeff Smith (Manchester, Withington) (Lab)]

Secondary schools in south Manchester are worried about the extra pressure of running a mass testing regime on top of the contact tracing they are doing, on top of the online learning they are enabling and on top of their normal, everyday school responsibilities. We really need to know what support they are going to get to do the testing, so why does the Secretary of State for Education not come to the House to set out the plans and answer questions, as the Secretary of State for Health rightly does?

[Matt Hancock]

The Secretary of State for Education will be setting out these plans. We need to get them out as soon as possible so that people have the last couple of days of term to work on them, and he will be doing that. Testing in schools is incredibly important, and it is going to become more important as we roll it out more broadly. I am really glad to hear some of the statements from the teaching unions about how enthusiastic they are for testing, especially in secondary schools. I am sure that the Education Secretary will want to work with the hon. Gentleman and others right across the country to roll out this programme as effectively as possible and to make sure that we have high-quality testing in schools, so that we can keep kids in education as much as possible and get the infection rate down by finding the positive cases and having them isolate.

[Mr William Wragg (Hazel Grove) (Con)]

It being Christmas, and given the circumstances that we are in, covid-compliant carol singers in Stockport have been heard singing the words of that well-known epidemiologist Mariah Carey, “All I want for Christmas is tier 2”, but sadly their entreating that outcome has not been successful at all. Can my right hon. Friend explain, further to the question from my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), precisely what more residents in Stockport need to do in order to regain some relative freedom?

[Matt Hancock]

Yes. We have to keep getting the case rate down. In Stockport it is still over 100. There is further to go. Right across Greater Manchester and the surrounding areas, I would urge people to do as they have been doing, because the case rates have come down really quite significantly. Right across Greater Manchester and in Stockport, people have been doing the right thing, but the pressures on the NHS remain, partly from people who are in hospital with covid from when the rates were really high. I hope that we can make the move as soon as possible, and in the meantime I hope that everybody has a happy, safe and careful Christmas in Stockport.

[Ellie Reeves (Lewisham West and Penge) (Lab) [V]]

UK and EU pharmaceutical companies have warned that no deal will lead to delays of up to six weeks in obtaining vital medicines. Given that the Pfizer vaccine is complex to move and distributed from Brussels at -70°, does the Health Secretary agree that no deal would be catastrophic and that everything should be done to get a deal to protect our access to vital medicines?

--- Later in debate ---

[Matt Hancock]

We have plans in place to ensure that the vaccine can continue to be distributed whatever the outcome of the discussions on a future trading arrangement with the EU.

[Robert Halfon (Harlow) (Con) [V]]

Early this morning I visited a vaccination centre in Harlow that is running like a military operation and has started vaccinating the elderly and those in care homes. Will my right hon. Friend thank West Essex clinical commissioning group, GPs, staff and volunteers who are vaccinating many hundreds of Harlow residents? Will he also set out a route map by which Harlow can return to tier 2? I strongly welcome the testing announced for schools, but can he confirm that school openings will not be delayed in January?

[Matt Hancock]

I am very grateful for what my right hon. Friend says about the vaccination centre in Harlow. It is an uplifting sight visiting a vaccination centre. Rarely have I seen so many smiles on faces this year, which has been such a difficult year, as when I visited the Milton Keynes vaccination centre last week. I am really glad that it is working well in Harlow. I add my thanks to his thanks to the GPs, the volunteers and the staff—all those organising the vaccinations.

In terms of a route map out of the tier, of course in time the vaccination programme will help, but for now the best thing people can do is to bring the case rate down by doing everything they personally can to not pass on this disease. Unfortunately the case rate in Harlow is 302 per 100,000—very, very elevated—and in nearby Epping Forest, unfortunately, it is over 500. It is a very serious problem. We all have to pull together to try to sort out this growth of the virus locally, and that is the route to tier 2.

[Madam Deputy Speaker (Dame Eleanor Laing)]

May I echo to the Secretary of State what my right hon. Friend the Member for Harlow (Robert Halfon) said on behalf of the people of our community?

[Sarah Owen (Luton North) (Lab) [V]]

Scientific advisers, healthcare workers and doctors have all warned that the Christmas season will result in higher infection rates. The public are not fools and know that tougher restrictions will likely be needed in the new year. Will the Secretary of State come out with the obvious and admit now that he will need to bring in harsher restrictions in January, ending the uncertainty faced by families and businesses, or will he just allow these dangerous mixed messages to continue from Government?

[Matt Hancock]

Where I agree with the hon. Lady is that the public are not fools; the public know that it is their responsibility, as well as the Government’s, to get this under control. That is where the emphasis on people taking personal responsibility to ensure that they do not pass on the virus this Christmas comes from. If we look at how the public across Luton and the whole country have behaved during this pandemic, under restrictions that are so inimical to our way of life and unprecedented, we see that people have still followed them because they know that they are important. That is the approach we are trying to take for Christmas, to make sure that we can keep this precious time of year, but in a way that is safe.

[Jason McCartney (Colne Valley) (Con)]

I accepted Kirklees being in tier 3 when we had some of the highest covid rates in the country, but cases have now plummeted and hospitalisations are down. The case rate in Kirklees is about 167—below the English average—and in my Colne Valley constituency the case rates are actually under 100 per 100,000, and therefore I really thought we had a strong case to be brought down into tier 2. I appreciate that the Secretary of State wants to be cautious, but can he tell me when will the next review be, and what more do my constituents need to do to come out of tier 3?

[Matt Hancock]

Legally, there is a review every two weeks, but in practice we review every week, and I will not wait a week longer than necessary to get places out of tier 3 if we can safely do that. To people across Colne Valley I would say, first, that the reduction in rates has been impressive, but we are not there yet. The pressure on the NHS has reduced, but is still significant. I would also say to everybody in Colne Valley that they have a Member of Parliament who probably makes his case to me more than any other. It is not for want of effort from the local MP, but this decision is based on the epidemiology, and I really hope we can get there soon.

[Feryal Clark (Enfield North) (Lab) [V]]

Madam Deputy Speaker, can I take this opportunity to wish you and the House staff a merry Christmas and a very happy new year?

I have had numerous emails from unpaid carers in Enfield North concerned about access to the vaccine. Can the Secretary of State set out exactly when unpaid carers will be given the covid-19 vaccine, given that they spend their time caring for extremely vulnerable people and could pass on the virus? Any guidance would be a huge comfort to residents and their unpaid carers in Enfield North.

[Matt Hancock]

The guidance has been set out by the Joint Committee on Vaccination and Immunisation. I think it is very important that we follow the clinical advice in this prioritisation to make sure that it is fair.

[Mr Richard Holden (North West Durham) (Con)]

I would like to thank the Department of Health and Social Care and the Secretary of State for everything they are doing, but I am sure he will appreciate, like me, just how fed up my local hospitality sector is across County Durham and the north-east. Will he join me in thanking local people for everything they are doing, because case rates have really come down? Will he also thank my local NHS staff? I saw them, when I visited on a night shift a couple of weeks ago, not only giving care to people with covid, but really showing love to them as they look after them. Will he commit to a fortnightly review, and will he ignore the LA7 group of local authorities and allow County Durham and perhaps parts of the north-east to go a separate way if case rates come down in the future? Can he update me and write to me about the vaccine roll-out, and will he also push the Chancellor for extra support for my local hospitality sector?

[Matt Hancock]

Yes, of course; I will write to my hon. Friend as soon as I can on the roll-out of the vaccine across his part of County Durham. Making sure that everybody can get access is so important, hence we are taking this community-led approach as well as using the big hospital sites. The truth is that we do look at County Durham on its own merits, as well of course as a part of the other north-east local authorities. People in County Durham have been acting in a way that gets the case rates down, and I am very grateful to them for doing that. We are not quite there yet and there is still that pressure on the NHS, but we are moving in the right direction.

[Richard Burgon (Leeds East) (Lab) [V]]

In the past 100 days, more than 23,000 people in our country have lost their lives due to covid. That scale of loss was completely unnecessary; it is the result of a second wave caused by this Government’s failing to put public health first. We know the Government ignored the scientists’ advice in September before that second wave hit, and we know scientists are warning that the current plans, including for Christmas, are going to cause a deadly third wave. Will the Secretary of State come clean today and tell us how many lives Government scientists are warning him will be lost over the next few weeks under the current plans?

[Matt Hancock]

The advice I have and the answer to the hon. Gentleman is, I hope, as few as possible—especially as we get the vaccine rolling out. I want to pick up something he said about this pandemic. This pandemic is caused by the virus, not by any Government around the world. It is caused by the virus, and that is why it is so important that we all come together to try to tackle it, rather than trying to take this overly politicised approach.

[Sir Desmond Swayne (New Forest West) (Con)]

His waitress tested positive, so the proprietor of the small café closed immediately and went into self-isolation, but test, track and trace has not contacted him, so he is without the wherewithal to claim the allowance. Can the Secretary of State fix it?

[Matt Hancock]

Yes, if my right hon. Friend has the test reference number I will get on to it right away. If NHS Test and Trace has not contacted the owner, that might imply that he does not have to self-isolate, but of course I will want to look into the details of the case before making such a recommendation. I will ensure that my right hon. Friend’s constituents get a full, clinically approved recommendation ASAP.

[Barry Gardiner (Brent North) (Lab)]

Mr James Canning became our first octogenarian in Brent to receive the vaccine earlier this week. While congratulating him and the Wembley Practice team who delivered it, does the Secretary of State share my concern that care homes in Brent have been advised that the 970 doses that are in the vaccine packs cannot be split because of the licensing conditions, meaning that those in our care homes who are over 80 may have to wait until February or for the Oxford vaccine before they get vaccinated? Is that the case? If so, why? That is hardly the “protective ring” around care homes that he promised.

[Matt Hancock]

I am glad to say that we are making significant progress on tackling this issue. When the hon. Gentleman says it is a licensing concern, that should not be read to imply that it is some bureaucratic rule; it is about ensuring that things are done safely. If the vaccine is not delivered safely to the site, it is not an effective vaccine. Therefore, we are taking it carefully to be able to vaccinate in care homes. There has been some vaccination in care homes across the UK, so it can be done, and I hope we can make good progress soon.

[Dr Neil Hudson (Penrith and The Border) (Con) [V]]

I thank my right hon. Friend for the reassurance he gave me last week about the vaccine roll-out to rural communities. Will he join me in paying tribute to everyone in Cumbria and the wider UK who is involved in the delivery of the covid vaccination programme, and does he agree that the best way we can build a positive 2021 is for people to actively take up their invitation to have this vital vaccine when it comes, and to get their life-saving jab as soon as it is offered?

[Matt Hancock]

I could not agree more with my hon. Friend. He knows about these things, and he is exactly right that the best thing everyone can do, when the NHS calls, is to take up that vaccine and get it done. It will protect them and their community and help to protect the whole country and get us all out of these restrictions at which we choke.

[Wendy Chamberlain (North East Fife) (LD)]

Yesterday, on College Green, I met members of the Covid-19 Bereaved Families for Justice group and spoke with those who have lost loved ones during the pandemic and will be spending a first Christmas without them. They delivered a 200,000-strong petition to Downing Street asking for an immediate public inquiry in order to identify and learn lessons. There has been an ongoing inquiry by the all-party parliamentary group on coronavirus, to which the group has given evidence. May I ask whether the Secretary of State has read the APPG’s interim report and engaged with its findings?

[Matt Hancock]

I look at all these sorts of reports, as does the team at the Department, constantly to try to learn. Given that this is an unprecedented situation, all health authorities across the UK, whether here or in Edinburgh, Cardiff or Belfast, are constantly talking and trying to make sure that all the insights that can be gained can be applied. One example is that we now have contact tracing in the UK reaching over 90% of contacts. That is due to hard work and improvement, learning the insights from each other about how we can make systems better.

[Bob Blackman (Harrow East) (Con) [V]]

I am sure I speak on behalf of the whole House in thanking my right hon. Friend and his team for all their hard work over the course of this year to combat this dreadful virus, and also for updating the House on a regular basis on what action is being taken. May I give him the opportunity to reiterate the key message as we approach Christmas: that anyone who shows any signs of having the virus must get a test and, if it is positive, must self-isolate and not mix and mingle with people, so we can cut down on the spread of this dreadful virus? People must think twice before they mix with elderly relatives if they have been in contact with anyone who has had this dreadful virus.

[Matt Hancock]

I agree with every word my hon. Friend has just said. Over this Christmas period, I hope that people will, yes, take a moment to have some relaxation, especially given what a tough year it has been, and have the chance to see loved ones, but do so carefully, knowing that one in three people who have this disease does not know that they have it because they have no symptoms. Anybody can be inadvertently passing it on to a vulnerable loved one, so they need to be very, very careful. To reiterate, it is in the best interests of everybody, their loved ones and their community to get a test at the first sign of symptoms—testing is now very, very widely available right across the country—and if the test is positive or if they are contacted by NHS Test and Trace because they are a contact, to isolate and do so not just because they have to but because it is the right thing to do to isolate fully and properly.

Finally, I strongly agree with my hon. Friend in wanting to thank you, Madam Deputy Speaker, the whole of your team and all the staff of the House for supporting me in the many times I have had to come to the House this year and, in what has been an incredibly difficult year for the House as well as for the nation, for all the work they have done to support us in keeping our democracy going all the way through this, no matter how bad it got.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for his kind words. The whole House, and certainly the whole of Mr Speaker’s team, thank the Secretary of State, his Ministers and the shadow Ministers, who have worked so hard to keep us informed all the way through this dreadful pandemic.

--- Later in debate ---

[Jim Shannon]

May I take this opportunity to wish you, Madam Deputy Speaker, and your family a very merry Christmas and happy new year? Thank you for all you do in this House. I congratulate the Secretary of State and all his team on their energy and dedication in what has been an extremely difficult year. It has given us encouragement whenever he has come to the House.

Students, families and workers from England, Scotland, Wales and Northern Ireland will be travelling by boat, train, car and plane to meet their families from all tiers and very strict conditions. What discussions has the Secretary of State had with the devolved Administrations, in particular Northern Ireland, to ensure that travel can continue to happen within the regulations that we must all adhere to?

[Matt Hancock]

I thank the hon. Gentleman very much for his kind words. He said that people have been encouraged every time I have come to the Dispatch Box. Given some of the things I have had to announce, I am sure that is not quite true, but it has been my duty to come and answer questions as much as possible. I have probably answered more questions from the hon. Gentleman than from anyone, and I am very happy to answer this last one for this year.

I spoke to Robin Swann, the Health Minister for Northern Ireland, this morning as part of a call with all four of us across the devolved Administrations. We are determined to ensure that people can travel across the whole of the UK as much as is safely possible, but, again, we urge caution and personal responsibility. People can take advantage of this change in the regulations over Christmas to see loved ones—sometimes loved ones they have not been able to see all year—but we urge them to do that with the appropriate concern for the risk of spreading the disease, and to make sure, therefore, that everybody has a merry Christmas and a happy new year. We will return here, no doubt, in 2021 with the hope of that vaccine coming fast into view so that we can get to the point where I do not have to return every week to discuss restrictions and, instead, we can all get our freedom back.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for his patience in going through the whole statement, and everyone who is here to continue doing their duty on behalf of their constituents. We hope that the Secretary of State has a little bit of rest over Christmas, but we are all pretty sure that he will continue working to try to keep our people safe. Thank you.

In order to allow everyone in the Chamber the safety to leave without the hordes coming in for the next statement, I will suspend the House for a few minutes.

Blood Donation

Matt Hancock Excerpts

Monday 14th December 2020 Written Statements

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

I would like to inform the House that the Government, along with the Scottish Government, Welsh Government and the Northern Ireland Government, will be updating the blood donor selection criteria. This move will enable men who have sex with men in a long-term relationship to give blood from summer 2021.

In 2011, the lifetime ban on blood donation by men who have sex with men was lifted following an evidence-based review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). This introduced a deferral period of 12 months for men who have sex with men since their last sexual contact with another man. In 2017, the UK reduced this period to three months. These changes did not impact the safety of the blood supply in the UK.

Since then, the Government have taken steps to explore if further changes can be made to the deferral period for men who have sex with men, without risking the safety of the blood supply. At the request of the Department of Health and Social Care, the ‘For Assessment of Individualised Risk’ (FAIR) steering group was established at the beginning of 2019. The group reviewed whether the UK Blood Services could move to a more individualised blood donor selection policy.

The steering group reported to SaBTO in October 2020, advising that a more individualised risk-based approach to the blood donor selection policy could be taken without risking the safety of the blood supply. SaBTO reviewed the report and formally recommended that the Government implement the changes proposed by the FAIR steering group.

The Government have accepted this recommendation. This will mean a change to the current three-month deferral period for all men who have sex with men to a gender-neutral selection policy, where deferrals are based on higher-risk behaviours associated with acquiring infections.

This policy change will mean that anyone who has had the same sexual partner in the last three months will be eligible to donate and men who have sex with men will no longer be asked to declare if they have had sex with another man, making the criteria for blood donation gender-neutral and more inclusive.

This is a progressive and welcome step forward, reducing limitations for men who have sex with men to donate blood and creating a fairer system for blood donation. In implementing these changes, the UK will take on a world-leading role as one of the first countries to recognise that a risk-based approach for men who have sex with men does not pose a safety risk to blood donation.

The Department of Health and Social Care is working with NHS Blood and Transplant and devolved administrations to implement changes which we anticipate will be rolled out by summer 2021. We will have monitoring mechanisms in place to ensure the safety of donors and patients, including continued monitoring of both acute and chronic infections in new and regular donors. The changes will be reviewed in 12 months.

The report from the FAIR steering group can be viewed here at: https://www.blood.co.uk/news-and-campaigns /news-and-statements/fair-steering-group.

[HCWS646]

Covid-19 Update

Matt Hancock Excerpts

Monday 14th December 2020 Commons Chamber

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

With permission, Mr Speaker, I would like to make a statement on coronavirus. We are nearing the end of such a tough year where the British people have united and had to make so many sacrifices for the common good. I know the whole House and the whole country have been cheered by the progress we have seen in the last few weeks, which means we can now roll out the vaccine programme that will ultimately set us free.

I can tell the House that, today, the NHS has begun vaccinations through GPs in England and in care homes in Scotland. Day by day, we are giving hope to more people and making this country safer. It is life-saving work. However, it will take time for its benefits to be felt far and wide, so we must persevere because the virus remains as dangerous as it has always been.

Average daily hospital admissions are up 13% and the latest figures show that average daily cases have risen by 14% in the last week. As before, the rise and spread is not even across the country. We are seeing a sharp rise in south Wales, in London and in parts of the east and south-east of England. This is a trend that we are also seeing in other parts of Europe, in countries such as Sweden, where nearly all the intensive care beds in Stockholm are currently in use; in Germany, where they had to announce tougher new restrictions over the weekend; and in the Netherlands, which today has announced further measures. Until we can vaccinate enough vulnerable people and ensure that they get the second dose so that they are protected, we must act to suppress this virus.

Our strategy throughout, as set out in the winter plan, has been to suppress the virus while protecting the economy, education and the NHS until the vaccine can make us safe. Today, I would like to update the House on the latest steps we are taking in this mission. First, I want to update the House on a new development in the virus itself. Over the past few days, thanks to our world-class genomic capability in the UK, we have identified a new variant of coronavirus, which may be associated with the faster spread in the south-east of England. Initial analysis suggests that this variant is growing faster than the existing variants. We have identified over 1,000 cases with this variant, predominantly in the south of England, although cases have been identified in nearly 60 different local authority areas and numbers are increasing rapidly. Similar variants have been identified in other countries over the past few months.

We have notified the World Health Organisation about this new variant, and Public Health England is working hard to continue its expert analysis at Porton Down. I must stress this point: there is currently nothing to suggest that this variant is more likely to cause serious disease, and the latest clinical advice is that it is highly unlikely that the mutation would fail to respond to a vaccine, but it shows that we have to be vigilant and follow the rules, and that everyone needs to take personal responsibility not to spread this virus.

The first formal review of tiering decisions is taking place this Wednesday, two weeks after the new rules came into force. However, I need to tell the House that over the last week we have seen very sharp exponential rises in the virus across London, Kent, parts of Essex and Hertfordshire. We do not know the extent to which that is because of the new variant, but no matter its cause, we have to take swift and decisive action. Doing so is, unfortunately, absolutely essential to control this deadly disease while the vaccine is rolled out. In some parts of these areas the doubling time is around every seven days. This is no longer just about rising rates among school-age children, but about rising rates in all age groups, including the over-60s.

We know from painful experience that more cases lead to more hospitalisations and, sadly, the loss of more of our loved ones. Hospitals across the capital, Essex and Kent are already under pressure. We know that the doubling of cases will be mirrored in hospital admissions, and it only takes a few doublings for the NHS to be overwhelmed. Our NHS is straining every sinew to cope with the pressures, as it always does, but if cases continue to double, even it will be overwhelmed.

We must act now to shift the curve, because when the virus is growing exponentially, there is not a moment to spare. We are, therefore, acting ahead of the formal review date. I am very grateful to colleagues at Public Health England, NHS Test and Trace and the Joint Biosecurity Centre, whose surveillance of this virus means that we can act very rapidly when a problem arises. We have therefore decided to move Greater London, the south and west of Essex—that includes Basildon, Brentwood, Harlow, Epping Forest, Castle Point, Rochford, Maldon, Braintree and Chelmsford, along with Thurrock and Southend-on-Sea Borough Councils—and the south of Hertfordshire, which means Broxbourne, Hertsmere, Watford and the Three Rivers local authority, into tier three, the very high alert level.

That means that people can only see friends and family whom they do not live with, or with whom they are not in a support bubble, in outdoor public places and, of course, in line with the rule of six. Hospitality settings must close except for takeaway and delivery, and people should avoid travelling outside their area and reduce the number of journeys they make wherever possible. I know that this is difficult news. I know that it will mean that plans are disrupted, and that for businesses affected it will be a significant blow. This action is absolutely essential not just to keep people safe, but because we have seen that early action can help to prevent more damaging and longer-lasting problems later.

These restrictions will come into force at midnight on Wednesday morning, because when the virus moves quickly we must move quickly too. We must take actions that are not necessarily easy but that are effective. We will continue to stand with those who are most impacted, through our furlough scheme and support for the self-employed. We have already begun to surge mobile testing into these parts of London, Essex and Kent, and we are extending community testing too.

In addition, I can tell the House that this weekend, as part of our expansion of community testing, we are extending it to 67 local authorities across England. Further, today we will be publishing a guide for colleagues to promote, support and champion local community testing and contact tracing. We will be using millions of newly invented tests to reduce the rate of infection in areas where infection is highest and to help them move down through the tiers and closer to normal life.

Thanks to the forces of science, help is on its way. While we know now that that day will come, this is not over yet. While we deploy the fruits of scientific endeavour to keep the country safe, we must do what it takes to protect our loved ones and our NHS now. I know that these steps are hard, but we must not waver as we enter the final stretch, so that when we look back on this time of crisis, we can all say that we played our part. I commend the statement to the House.

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

As always, I am grateful to the Secretary of State for advance sight of his statement.

This is a virus that, without adequate restrictions in place, spreads with ferocity. Case rates are increasing again, hospital admissions are climbing and the R is edging up. Last week, the England-wide rate was 159 per 100,000; now it is 188 per 100,000. That is a 20% increase. Across London cases have increased by 30% and across the east of England by 36%, so none of us is surprised at the action the Secretary of State is taking today. Indeed, he was warned that tier 2 would not be enough to contain the spread of the virus in many places. Indeed, it looks like in some areas, such as Kent, tier 3 is not enough to contain the spread either.

Elsewhere in the country, tier 3 does appear to be forcing the virus to flatline. Indeed, in the north-west it is trending down. However, overall the increasing areas are rising faster than the decreasing areas are falling. As things stand, we are heading into the Christmas easing with diminishing headroom. The buffer zone that the tiers were supposed to provide is getting much thinner.

What is the Secretary of State’s plan to keep people safe through Christmas and avoid huge pressures on the NHS in January? What is his plan to support an exhausted, underfunded, understaffed NHS through January to deliver the care patients will need? Is he confident that our NHS will not be so overwhelmed in January that it impacts on the vaccination programme?

Our response to covid throughout could have been stronger had contact tracing been more effective. In boroughs such as Islington, only 65% of people have been traced by the national system. In Tower Hamlets the figure is only 60% and in Barking it is only 61%, yet Test and Trace is costing £22 billion—more than the policing and fire service budgets combined. According to the National Audit Office, up to September only £785 million was allocated to local council public health teams. Meanwhile, Serco has subcontracted to 21 other firms, offering little training to staff, with some people in call centres sitting alongside others making sales calls for gambling websites. Surely it is time to scrap Serco and put all public health teams in the lead in the retrospective cluster-busting contract tracing we need.

The Secretary of State has promised more testing for tier 3 areas. What about the tier 2 areas? On the lateral flow tests he is rolling out, he will know that some care home providers are refusing to use them because of concerns about their accuracy. Is he satisfied that these tests are accurate enough for this purpose and safe? If they cannot be used for care homes, how quickly can care home residents’ relatives make use of polymerase chain reaction tests?

The Secretary of State often praises Liverpool, but is not the biggest lesson to draw from Liverpool that people still struggle to isolate if they do not have the financial means to do so? The eligibility criteria for the £500 payment is still too tightly drawn. People need decent sick pay. People in some circumstances need alternative accommodation. People need help with their shopping and medicines. Surely some of the £22 billion spent on Test and Trace could be reallocated to offer people adequate isolation support.

On the variant that has been identified, our constituents will naturally be concerned.

Will the Secretary of State undertake to keep the House updated throughout? I am grateful for the briefings he has arranged for myself and others with the chief medical officer, but if this variation means the virus is more easily transmissible, fixing contact tracing and isolation becomes even more fiercely urgent.

Finally, today I spoke to Fred Banning. Fred is just 38, has two children under 10 and has terminal cancer. He asks that those with terminal illness are given quicker access to the vaccine, so he can in the words that he said to me this morning “make the most of the time he has left with his family.” I understand that these are clinical decisions, but can the Secretary of State through his offices look into access to the vaccine for those with terminal illness and see what can be done for people such as Fred and many others in this situation?

[Matt Hancock]

I am glad to say that across large parts of the country there is very good evidence that tier 3 restrictions are working and the rates are coming down, but we need to be vigilant and, as the hon. Gentleman knows, overall rates are no longer coming down, hence we are having to take further action.

The hon. Gentleman talked in particular about the lessons from Liverpool; the primary lesson from Liverpool is that when everybody pulls together and everybody makes the sacrifices that are necessary for their whole community, we can really get this thing under control. I am grateful to colleagues across London and Essex and Hertfordshire, to whom I have been talking today, who are committed to working to ensure that we get the public health messages out first and foremost, and to the Mayor and the Conservative candidate for Mayor, who are both committed to working on behalf of the capital and, of course, those parts of Essex and Kent and Hertfordshire that are affected, because the single best thing that we can all do is speak with one voice about what is needed to get this virus under control.

The hon. Gentleman asked about Christmas, and my recommendation to people is to be cautious and careful. He asked about NHS funding and staffing; of course we have the strongest funding in history for the NHS, and I am delighted to say that we have more nurses in the NHS than ever before—14,000 more nurses than this time last year. I pay tribute to each and every one of them.

The hon. Gentleman asked about contact tracing and no doubt he will have seen the figures published on Thursday, which show that contact tracing now reaches over 80% of contacts. I pay tribute to the team, both local and national, who are ensuring that we can get to more than four fifths of people whom we need to reach, and that has been rapidly improving.

Finally, the hon. Gentleman asked about Fred, the gentleman with terminal cancer whom he spoke to this morning. Those with terminal cancer are, of course, clinically vulnerable by the nature of that awful disease, and we will ensure that those who are clinically vulnerable get access to the vaccine when clinically appropriate. I am very happy to take up the individual case he raises and ensure that Fred gets a fair deal.

All in all, I am grateful for the hon. Gentleman’s support for the measures we have outlined today and of course for the vaccine programme, which is rolling out across the country right now.

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

These are incredibly difficult decisions, but I wholly support them, because the evidence from all over the world is that acting early and decisively is the best way to save both lives and jobs. It would be perverse in the extreme if we were to take our foot off the pedal so close to rolling out the vaccine.

However, may I first ask the Secretary of State about the new strain? He said that it is highly unlikely that the vaccine will not work with a new strain. When will we know for sure? Are any trials going on? Will he get more up-to-date scientific information anytime soon?

Secondly, may I ask the Secretary of State for clarity? With just 11 days before Christmas, lots of people will be thinking about Christmas shopping. From Wednesday, will it be against the regulations for those living outside London to go to Oxford Street to do their Christmas shopping? Will that also be against the regulations for those living inside London? Is the only way legally to do Christmas shopping now to go online?

[Matt Hancock]

First, on my right hon. Friend’s question about the new variant, it is being assessed in Porton Down right now. As I said in my statement, the medical advice that we have is that it is highly unlikely that this new variant will impinge on the impact of the vaccine, but we will know that in the coming days and weeks as the new strand is cultured at Porton Down and then, of course, tests are conducted on it.

My right hon. Friend’s question about Christmas shopping is important. It is recommended that people should minimise travel, unless it is necessary, in a tier 3 area, and should minimise travel, unless it is necessary, to a tier 3 area. We have taken this action to try to protect people and to try to slow the spread of this virus, and that is absolutely the right thing to do.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Many public health experts have questioned the use of Innova lateral flow tests for mass community testing, especially as the manufacturer does not recommend them for detecting coronavirus in people who are asymptomatic. The Secretary of State must be aware of the paper from the University of Liverpool, based on his own Department’s quality assurance programme, which has raised serious concerns about their accuracy when used in the community testing project in Liverpool. A comparison of lateral flow tests with PCR tests in over 3,000 people revealed a sensitivity of just 48%, meaning that more than half of those with the virus would be falsely reassured that they were negative. The test even missed 30% of those with a high viral load—those most likely to be infectious.

I understand the wish to use quick tests for case finding, but surely the Secretary of State should now delay rolling them out to 67 other local authorities and should not proceed with plans to spend £43 billion for a test that is so inaccurate. Would it not be better to focus funding on easier and quicker access to PCR tests? With more than half of all positive cases being missed, does he accept that despite the proposal by Baroness Harding, these tests cannot be used to release people who are contacts from isolation? On the basis of that study, the Liverpool health protection board has abandoned plans to use lateral flow tests to check visitors to care homes, so will the Secretary of State be recommending that local authorities and providers should return to PCR testing for care home staff and family visitors to reduce the risk to the most vulnerable residents?

[Matt Hancock]

I think that this argument against testing is wrong. I think that we should test, test, test, and that is what this Government are doing. We are working very closely with the Government in Scotland, from the same party that the hon. Lady represents, to make sure that we use testing as widely as possible to find people who have this virus. Yes, of course different tests have different characteristics. The lateral flow tests find around 70% of those who are infectious. That means that if we test people who would not otherwise have been tested, we find the positive cases, we can get them to isolate and we can break the chains of transmission. I strongly urge the hon. Lady to go back, to study the details and to back the testing programme that we have in this country.

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I fully recognise my right hon. Friend’s serious dilemmas—it is not an enviable position—but the application of tier 3 to London raises some questions. I have had long conversations in my borough with public health and the hospitals, and they maintain that the infection rate is now almost exclusively among secondary schoolchildren, who pass it on to their parents—those two least at-risk groups—so the hospitals are not overcrowded, with spare beds in the intensive care units and a very low level of covid patients in the hospitals.

Tier 3 will hammer down on the one area that does control what happens, which is hospitality. The key here, surely, is that doing that will cause people to shift back to their homes, and it is that area that we would worry about, with off-licences selling alcohol late in the evening. Will my right hon. Friend try to seek some kind of flexibility so that these measures target better the real risk and do not just hammer those who have been doing the right thing?

[Matt Hancock]

We are always open to finding new ways to protect the economy as much as possible and bring the virus under control. I share my right hon. Friend’s desire to get it under control and to keep it under control until a vaccine can make us safe, but unfortunately this is no longer just a problem among school-age children in Waltham Forest and north-east London, which it has been until the last week’s data. The case rate among the over-60s in Waltham Forest is now over 250 and we are seeing that rising over the last week. We are also seeing rising admissions to hospital.

I have a huge amount of sympathy for everybody affected by these decisions in Waltham Forest, but it is absolutely essential to get this under control now to protect the NHS from being overwhelmed in the future. We must break the inexorable link from cases now to hospitalisations in the future—and, sadly, deaths—by using the vaccine and by testing. Until we can have the vaccine fully rolled out and people inoculated by having their second dose, and until enough vulnerable people have had that second dose and have therefore become inoculated, unfortunately measures like this are necessary.

[Janet Daby (Lewisham East) (Lab)]

The Health Secretary is fully aware that hundreds of thousands of jobs have been lost during the pandemic, which continues to hit our economy. That means a vast number of families and individuals are diving into hardship. Having no heating and no hot water is what many residents across our country will face this Christmas, as they visit food banks. What discussions has he had with the Secretary of State for Work and Pensions with regard to reducing the rising level of poverty?

[Matt Hancock]

We are trying to support the economy as much as possible throughout all these difficult decisions. The extraordinary levels of financial support are a part of that, including the furlough scheme, which has now been extended to the end of March. I, of course, talk to my right hon. Friend the Work and Pensions Secretary regularly to make sure we take the action that is necessary in a way that supports people as much as possible.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I thank my right hon. Friend for his statement, albeit that it contains a lot of very grim news about the virus itself and its effect on many areas. It will be greeted with considerable relief in Harwich, Clacton, Colchester and Uttlesford, where the virus rates are much lower and we will stay in tier 2. Is the message now not that we stay in tier 2 or go down a tier much more by our own efforts—by the efforts of local authorities, with the support of NHS Test and Trace—to make sure we support those who have to isolate and track down and trace those who are spreading the virus? By doing that, and by compliance and forbearance, we can reduce the spread of the virus and help to defeat it so we can get down the tiers.

[Matt Hancock]

Yes. My hon. Friend is absolutely right. Trying to keep the virus under control is in the hands of local authorities and local communities. I would say to everybody in Harwich, and people across the south-east and east of England who have not gone into tier 3 today, that we all still need to work together, be vigilant and effectively do everything we can to stop the spread of the disease, because so many people are asymptomatic—about a third—and never have any symptoms but can nevertheless spread the disease. I am very grateful to my hon. Friend for the work he has done in giving me ideas to support colleagues to help in that effort. The links between the national system and local authorities are getting stronger all the time, and I want colleagues to be able to play our part—especially as, through our campaigning, we know our communities well—by getting into communities to spread the message that if we all stick by the rules and we get the testing and contact tracing in, we will be able to keep this under control.

[Mr Ben Bradshaw (Exeter) (Lab) [V]]

With cases in Devon down to 71 per 100,000 and falling, and covid hospital admissions also falling, will the only reason that Devon does not go into tier 1 this week be because of the shortage of staff and hospital capacity after 10 years of Conservative Government cuts?

[Matt Hancock]

No. First, there is a record number of NHS staff, thanks to this Conservative Government. There is a record number of nurses—we have 14,000 more nurses. What I say to people in Devon, which is currently in tier 2, but with low rates, is do not take it for granted. Let us all work together and try to get Devon into tier 1. In Exeter, those rates have come down really sharply in the last few weeks. Let us keep working at it, and let us keep those public health messages going in relation to not only coronavirus, but the importance of eating fruit.

[Munira Wilson (Twickenham) (LD)]

We all know where to go now if we run out of fruit.

My children are desperate to see their grandparents this Christmas, as is the case for many families up and down the country, but in view of these alarming numbers, what we are seeing in the US following Thanksgiving and the constant chopping and changing of rules, which leads to lower compliance and more confusion, although I appreciate that the Secretary of State does not want to be the Grinch, should he be reconsidering the Christmas measures that are in place? Do we risk unnecessary additional deaths in the new year, just as we have light at the end of the tunnel with the vaccine?

[Matt Hancock]

I would recommend people to exercise caution over Christmas, especially with respect to seeing elderly relatives, who, of course, people are yearning to see. I understand that, but I think it is important that people not only abide by the rules, but take personal responsibility in case they have coronavirus and might be passing it on, but do not have any symptoms and do not know about it.

[Robert Halfon (Harlow) (Con) [V]]

My right hon. Friend will know that I have supported all the measures that have been put in place, and I have put my faith in the Government and the scientists and medical officers. However, I have real worries about Harlow in Essex being put into tier 3, as local hospitality businesses are really struggling and on their knees. I would be grateful if he could explain how further restrictions will curb the disease, given that cases increased in Harlow during the second national lockdown. I understand that the virus has recently stabilised in Harlow and that there has been no rate of increase in the over-60s in the last week. Further to this, the overall increase in cases in Harlow is 12% against a regional average of 40%, so I ask him to consider keeping Harlow in tier 2.

[Matt Hancock]

Unfortunately, cases are rising in Harlow and in the districts of Essex and Hertfordshire nearby, so we do have to take the action that we are. What I say to my right hon. Friend, who is an incredible champion of Harlow and his local community, is let us work together to get this down, let us work together to get this done and let us work together to try to get Harlow back into tier 2 as soon as possible, not just to save lives and protect the NHS in Harlow, but to give people their livelihoods back.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his update to us on what is happening with covid. As a type 2 diabetic, I will take my vaccine when the time comes for me to take it. We will make sure that others get it before I do, but will the Secretary of State outline the response from the medical community about the reactions to the vaccination and the safety of the drugs for those who feel, in some cases, that it has been rushed through?

[Matt Hancock]

On the contrary, all the safety checks that are necessary have been carried out and we continue to monitor the roll-out of the vaccine throughout the UK. The Medicines and Healthcare Products Regulatory Agency has done a terrific job on that and continues to do so. For instance, my team and the MHRA were having an update assessment on Saturday morning to check the progress of the first week’s roll-out, and I am delighted to say that we are able to keep doing that. I say to the hon. Gentleman and everybody else who wants to see the impact of the vaccine: look at the faces of those who have had their first dose, and how pleased they are to have it and to be able to get that step closer to protection from this awful disease.

[Felicity Buchan (Kensington) (Con)]

I note that Essex and Hertfordshire have been split into two—partly tier 2, partly tier 3. However, Greater London has been treated as one. In central London, our cases are significantly below the national average and, whether this House likes it or not, central London is the powerhouse of our national economy. Will my right hon. Friend tell me why London has been treated differently from Essex and Hertfordshire?

[Matt Hancock]

As you know, Mr Speaker, we look in great detail and at a granular level at the geographies that these restrictions have to cover. Unfortunately, central London’s case rates are rising, and we know that if an area is surrounded by other areas where there are significant increases then those high rates tend to move into that area if it is left out of a set of restrictions. I understand, of course, the impact on the economy, but the very clear public health advice was that London should move together because all areas of London are seeing an increase in rates and we need to stop that.

[Tony Lloyd (Rochdale) (Lab) [V]]

The Health Secretary seemed to answer rather dogmatically the question of the hon. Member for Central Ayrshire (Dr Whitford) about lateral flow tests. May I say to him that it does seem reasonable that, as a diagnostic for people to self-isolate, the test has validity, but with its very high number of false negatives, is he seriously recommending that this is the first line of defence for people going into our care homes? If he is, it is a very dangerous proposition on his part.

[Matt Hancock]

It is important that we use the right tests in the right circumstances but with the right other conditions. So for instance, there is clear visitor guidance of which testing is one part, but personal protective equipment is another critical part. The nuanced question of the hon. Gentleman is entirely reasonable, but the thing that I find frustrating is the idea that we should discourage people from coming forward for asymptomatic testing when the task is to find as many people as possible who have the virus to get them to isolate. Yes, we should ensure that visiting care homes is done as safely as possible—there are health upsides to visiting as well as the challenges posed by the virus—but in terms of asymptomatic testing, I encourage people, where tests are available, to come forward, because that is how we find where this virus is and help to isolate it.

[Nigel Mills (Amber Valley) (Con) [V]]

I thank the Secretary of State for the roll-out of lateral flow tests across Derbyshire. When he does his reassessment on Wednesday, will he be willing to look at more localised geography, perhaps based around hospital catchment areas, and divide the county of Derbyshire between north and south, rather than use the whole county, which is not a very functional geography on the ground?

[Matt Hancock]

We are happy to look at the human geographies, as my right hon. Friend the Prime Minister put it, which is precisely why we have taken the decision today to take parts of Essex and parts of Hertfordshire into tier 3. We also look at the travelling patterns to see where the likelihood of the spread is greatest, and we set out the data on which we take the decision, so I think the answer to my hon. Friend is yes.

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

Contact tracing in Scotland has led the public health professionals to achieve contact rates of up to 95%. Down here, as we know, the job is handed out to privatised companies such as Serco. Serco has a £400 million contract, which it has subcontracted out to 21 further companies. What assurances does the Minister have that there is sufficient co-ordination across these 21 companies and Serco and that everything is under control, rather than adding further layers of complexity?

[Matt Hancock]

The good news is that the contact tracing across England is increasing in capacity. It is getting faster and it is finding more and more contacts. The comparison of apples and pears that continues to come from those on the SNP Front Bench does not take into account the fact that if we contact trace in a care home, the contact tracing is much easier, and that if we include that contact tracing in the data, we get different answers. This obsession with “public sector good, private sector bad” has been going on for months and it is just as wrong now as it was six months ago.

[Alicia Kearns (Rutland and Melton) (Con) [V]]

Today’s news is deeply sombre, so I ask my right hon. Friend to join me in urging residents of Rutland and Melton to be vigilant because we are also seeing cases rising locally, even in our villages. We have to get rates under control if we are to be decoupled from Leicester city, remain at most in tier 2 in Rutland, and protect ourselves from this new variant. Will he join me in thanking those who are working so hard locally to ready our vaccine hubs in Oakham and Melton for once the vaccine is ready for delivery outside of hospitals?

[Matt Hancock]

Yes, of course; absolutely. I am delighted that we are now vaccinating from over 100 different community settings, as well as 70 hospitals across the UK. It is a tribute to the whole vaccine roll-out team, who have done a magnificent job over the last—I was going to say over the last week that the vaccine has been rolling out, but it has been weeks and weeks in the planning before then. I would say to residents in Melton and Rutland that we will look at Leicester, Leicestershire and Rutland separately when we make the decision on tiering on Wednesday. Those in Rutland who are in tier 2 still need to work at it and do their bit to try to keep Rutland in tier 2, and, of course, hopefully get to tier 1. It is so important that everybody does their bit.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

The Secretary of State has rightly set out the very stark picture today—not only of the variant, but of the growing pressures, including the pressures that are likely to be placed on our NHS at this critical time. Will he therefore agree, particularly given the crucial supply chains for the vaccine, for PPE and for the 40 million packages of medicine that go back and forth between ourselves and the EU every month, that the talks must continue and we must not end up in a no-deal outcome, which would be absolutely devastating at the most critical time for our NHS and our country?

[Matt Hancock]

The Prime Minister is working hard to see if we can achieve a deal. I hope that there is movement from the European Union so that we can achieve that, but we are ready for any outcome.

[Nickie Aiken (Cities of London and Westminster) (Con)]

I am obviously very disappointed by the news that London is going into tier 3, but, having seen the data and spoken to Public Health England in London and to the hospitals in my constituency, I am fully aware of the threat that this awful virus continues to present to us all. Hospitality in particular has done so much to become covid-secure, but, sadly, we are where we are. I think of our hospitals and the amazing job that our NHS staff are doing day in, day out, night in, night out. The acute hospital trusts in my constituency are handling covid cases from across London, and one of the major concerns that they have raised with me is the length of time for which staff must isolate after a positive covid contact. I understand that lateral flow testing in hospitals allows staff to return to work safely after five days, rather than 14. Can my right hon. Friend confirm that the roll-out of lateral flow tests will be prioritised in hospitals where cases are increasing?

[Matt Hancock]

The short answer is yes. We are rolling out lateral flow testing to find asymptomatic cases in hospitals right across England. We are always looking for ways to reduce the burden of isolation needed for positive contacts. May I pay tribute to my hon. Friend’s leadership? These are difficult decisions and it is difficult to explain to people why these measures are necessary given the impact that they have, but she is quite right to do so. Her analysis is that the best way of London coming through this is by presenting a united front, and all of us working together to get the case rates down; that is how we will best get through this together.

[Charlotte Nichols (Warrington North) (Lab)]

Christmas is often the busiest period for many businesses, particularly in sectors such as retail and hospitality. The uncertainty created by tiering arrangements chopping and changing at days’ notice has made trading incredibly difficult, even for those places currently allowed to stay open. What support will be provided to businesses affected by the tier system in the months ahead to ensure that any closures mandated by the Secretary of State’s Department over this vital trading period do not leave their doors closed permanently?

[Matt Hancock]

We want to support businesses as much as we possibly can. The support that is available—the record sums—has been as outlined by my right hon. Friend the Chancellor. That will of course be available to businesses as we go into tier 3.

[Simon Fell (Barrow and Furness) (Con)]

We are delighted to have the first vaccinations rolling out in Furness this week, but we know that information is key to understanding and tackling this virus. With that in mind, will my right hon. Friend consider adding data to the Government’s coronavirus website on the number of people, by cohort, who have been vaccinated and on the number of people who have been infected by this new variant of the virus?

[Matt Hancock]

Of course, we will be publishing data on the number of vaccinations done—that is important. Meanwhile, let us all keep getting out there to make the case that the best way to keep you, your loved ones and your community safe is by getting vaccinated when the NHS calls.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

Self-isolation is crucial to breaking chains of transmission, but too many people cannot afford to self-isolate when asked to do so, because of the loss of earnings it will mean. In Salford, only 389 out of 1,760 applications for self-isolation payments have been successful to date, meaning that many people are not getting the support they need. Will the Secretary of State now agree to provide everyone who has to self-isolate with the financial support that guarantees they will not be worse off because they have done the right thing?

[Matt Hancock]

The principle the hon. Lady outlines is exactly the one we are working to. The £500 self-isolation payment for those on low incomes is a very important part of our approach, and I am glad that hundreds of people in Salford have been able to be reached.

[Chris Loder (West Dorset) (Con)]

I thank my right hon. Friend very much for his statement, and I fully understand the difficulties he faces. He will know that I am the Member for West Dorset, a rural seat whose western part is 55 miles away from the commercial centre of Bournemouth, which is the driving force of our tiering in rural Dorset. We have consistently maintained low numbers of cases, and on Friday we had just one person with covid in our county hospital. Although I understand full well that my right hon. Friend has had to consider increasing the tier in different places in the UK today, will he, for Wednesday, consider reductions to tier 1 in areas where that is appropriate, as I believe it is in Dorset?

[Matt Hancock]

I will look at this extremely closely after my hon. Friend’s entreaty. I have been noticing that in both West Dorset and Bournemouth the number of cases has been coming down. I say to everybody: stick at it, stick at the rules and do everything you can to reduce the number of transmissions. That is the most likely way of getting into tier 1.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

It is 12 months since the World Health Organisation told us that this was a pandemic, yet multiple schools in Southwark that have had covid cases have still never had any contact from the Government’s tracing system, including one college that has had 20 cases since September. In the face of this new, faster-spreading variant, will the Secretary of State finally fix contact tracing? Or will he continue to leave teachers picking up the pieces and having to work weekends, and the public picking up the bill while Ministers’ mates pick up the multimillion-pound contracts, which continue, as today shows, to let us down?

[Matt Hancock]

If the hon. Gentleman has an individual case of a school in that situation and he could let me know, we will sort that out, because in general the links between local directors of public health and the schools to tackle these sorts of problems are pretty good.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I know the whole House was thrilled at those wonderful images last week of people receiving their vaccines, including at the Royal Stoke University Hospital. Like other hospitals across the country, it has been gearing up for that really emotional moment for months. Like the NHS in general, it has a lot of experience of delivering these vaccine programmes, so will my right hon. Friend assure me that we will roll out this vaccine, and any others that get approved, as quickly as possible and as quickly as manufacturing allows?

[Matt Hancock]

Yes, that is absolutely the goal. I pay tribute to everybody at the Royal Stoke, and it was wonderful to see some of the examples of those who have been vaccinated. Stoke has been having a rough time of it of late and we need to make sure not only that we get the virus under control, but that that vaccine is rolled out, not just in the city centre, but in communities right across Stoke and Staffordshire.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op) [V]]

The Secretary of State will know that I have warmed to his performance over the months of this pandemic, and I think he is doing a pretty good job. I think it was the Prime Minister who pushed him into the relaxation around Christmas, so may I warn him that my local hospitals in Huddersfield and Halifax are preparing for an awful surge after Christmas, just at the very wrong time, in January and February, when we do not want that kind of pressure? Will he think again and persuade the Prime Minister to think again about any relaxation of the rules over Christmas, in order to save lives?

[Matt Hancock]

I urge the hon. Gentleman to say to his constituents that we all need to be careful and take personal responsibility to limit the spread over Christmas. I should also like to thank him for his kind and generous words.

[Harriett Baldwin (West Worcestershire) (Con)]

I have always warmly appreciated the energy with which the Secretary of State has successfully prevented our hospitals from being overwhelmed, and I have also backed this amazing vaccine that has now been rolled out. May I ask the Secretary of State about capacity in hospitals? I understand that social distancing requires there to be fewer beds in hospitals at the moment, but will hospitals be able to add more capacity as the vaccine roll-out is completed?

--- Later in debate ---

[Matt Hancock]

I certainly hope so; that is one of the things that we are talking about with the NHS. For now, that is not possible. We of course have extra emergency capacity in the Nightingales, and the testing regime has allowed the NHS to restore many of its services, so that in places such as Worcestershire it is able to carry on with almost all the necessary activity, including the electives and the cancer work, even through this second peak. I pay tribute to the NHS in Worcestershire for the work that it has done, with the support of the testing regime, and I really hope that the vaccine allows that to improve again, once we have got enough of the people who are most vulnerable to this disease vaccinated.

[Lilian Greenwood (Nottingham South) (Lab)]

The Nottingham Post website is reporting today that 72 areas in tier 2 now have a higher covid rate than tier 3 Nottingham. Since we came out of the national lockdown and went into tier 3, our situation has improved on all five indicators, but we still do not know whether the improvement is enough to allow us to move down a tier later this week. Will the Secretary of State spell out the thresholds that will be used, and will he commit to publishing the rationale for his decision making?

[Matt Hancock]

Yes. We have set out what statistics we look at, and we publish the statistics. I think Nottinghamshire, including Nottingham, has done a very good job in getting its cases down.

[Jason McCartney (Colne Valley) (Con)]

My Colne Valley constituents now follow the local data really closely, and they can see that covid rates are thankfully plummeting in Kirklees, thanks to the local action we have been taking. Can the Secretary of State confirm that he will be using this local data at a granular level later this week to decide whether my area can come out of tier 3 restrictions?

[Matt Hancock]

Yes.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

A recent report has concluded that some of the poorer countries might not get access to vaccines until 2024. If the ongoing roll-out in the western countries is successful and normality starts to return by spring, will the Secretary of State give a commitment that he will resist calls to declare the pandemic over, and accept that a global challenge will remain until all countries have widespread vaccination programmes in place?

[Matt Hancock]

Thanks to the strength of the UK, we have put more funding into the global vaccination effort than any other country in the world, and I am proud of that fact. Of course we have to work together to ensure that vaccines are available everywhere.

[Hilary Benn (Leeds Central) (Lab)]

Since the recent national lockdown began, the infection rate in Leeds has fallen from over 400 cases per 100,000 to less than 140 today, and the number of covid patients in hospital has declined by 45% in the past month alone. The Secretary of State will be aware that the city has on balance recommended that Leeds should move from tier 3 to tier 2, because businesses have been terribly affected. I realise that he cannot give an answer today, but does he accept, having assured areas that where they are placed in the tier system will depend on the efforts they make to get the numbers down—Leeds has done a great job—that the credibility of that statement needs to be reflected in decisions about where the areas are put when they show a dramatic reduction?

[Matt Hancock]

The right hon. Gentleman has made a typically wise intervention ahead of the decision making on Wednesday as to the wider tiering decisions for the rest of the country.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

The Minister for Care has today indicated that there are 12,500 retired GPs and nurses seeking to help with the roll-out of the vaccination programme. My constituent David is one of them. He is 67 years old, fit and well and keen to do his bit, but the system that he has to log on to in order to apply keeps timing him out. I know that my right hon. Friend is an absolute whizz with apps. Please can he make sure that this one works for people like David?

[Matt Hancock]

I am thrilled at the number of former clinicians who have come back to support this. In fact, I met some of them when I went to Milton Keynes to see the vaccine being injected. I will look into the little whizzing box that is preventing my right hon. Friend’s constituent from applying.

[Derek Twigg (Halton) (Lab)]

As the Secretary of State knows, I asked back in April to have mass testing in Halton—better late than never. I decided to go down to the new mass testing centre at Ditton Community Centre in Widnes in my constituency this morning and have a test, which I am pleased to say was negative. It took 10 minutes, and I had the result back in 30 minutes. When does the Secretary of State expect the vulnerable and elderly to have had their second dose of the vaccine?

[Matt Hancock]

There has to be a 21-day window from the first vaccine dose to the second. We are aiming to send out invitations so that people can come as close to that 21-day marker as possible. Clinically, the 21 days is a minimum not a maximum, but the goal is clearly on or as close to the 21st day as possible.

[Martin Vickers (Cleethorpes) (Con)]

As my right hon. Friend is aware, my constituency is in tier 3, and although there has been a considerable drop in the infection rate, people are still concerned about the roll-out of the vaccine. Can he give an update and an assurance that my constituency will feature in the roll-out in coming weeks?

[Matt Hancock]

Yes, we are working very hard to get the vaccine to every part of the country, including Cleethorpes. I will look into exactly when the vaccine is arriving in Cleethorpes and get back to my hon. Friend as soon as possible.

[Paul Blomfield (Sheffield Central) (Lab) [V]]

The Secretary of State is right that, at this critical moment, we must think about the NHS staff we were applauding on the streets so recently, and we clearly must do everything possible to protect people from the spread of the virus. May I press him to say how the advice for the Christmas period could be strengthened by the Government to minimise transmission? Does he recognise the need for better financial support for the sectors most affected by the measures that we need, such as hospitality, and particularly for those who have fallen through the gaps in the Chancellor’s schemes?

[Matt Hancock]

With the decision to move areas into tier 3 comes extra financial support, and as I have said several times, we recommend that people exercise personal caution and responsibility over the Christmas period.

[Lee Anderson (Ashfield) (Con) [V]]

The tiering system has worked incredibly well in Ashfield and Eastwood, as rates are down due to the hard work and suffering of my constituents. Could my right hon. Friend reassure me that our hard work, dedication and willingness to do the right thing will be taken into account when deciding what tier we will be in at the end of the week?

[Matt Hancock]

My hon. Friend knows from personal experience what this disease can be like. He has been a powerful voice for Ashfield, and I will take his representations into account when we make a decision on Wednesday.

[Laura Farris (Newbury) (Con)]

It is extremely concerning that more than 1,000 cases of the new variant have been identified in the south-east, but I understand that the vaccine still works. Data published by the ONS today shows that the mortality rate will fall by 84% when all over-70s are vaccinated. Could my right hon. Friend tell the House when he thinks that will be and what it will mean for the tiering system?

[Matt Hancock]

Believe me, I would love to be able to answer that question. We do not know, because it depends on the speed of manufacture of the vaccines and the approval or not of the Oxford vaccine by the MHRA. But the essence of the way that my hon. Friend asks the question is exactly how we are thinking about it in Government.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

I echo the request from my hon. Friend the Member for West Dorset (Chris Loder) for Dorset and indeed Bournemouth to be considered to be moved to tier 1. The stats support this, and the hospitality industry would be most grateful. While 2020 has been the most testing of years, 2021 should be different because of the vaccine. My concern is that letting down our guard for five days during Christmas could be very dangerous indeed. Will the Secretary of State review those conditions, which were put together some time ago, and come back to the House to present an updated version so that we do not begin the new year with a third wave?

[Matt Hancock]

I take my right hon. Friend’s views on this very seriously. I would say to everybody in Bournemouth and across the country that the best way they can help their area to go into a lower tier is by exercising personal restraint—not seeing the rules as something to push against but rather acting well within them as much as possible to ensure that this virus does not spread.

[Daniel Zeichner (Cambridge) (Lab)]

The Secretary of State talks a lot about testing and tracing but far less about isolating. The shadow Secretary of State made important points that I do not think the Secretary of State addressed. In my city, a couple of weeks ago, only 14 people had received the £500 payment. The reasons why people are not isolating are complicated, but what has gone wrong with the system? It really is not working, is it?

[Matt Hancock]

I am glad to say that thousands of people are receiving the payment. Of course it is aimed at those on the lowest incomes who need the financial support in order to isolate.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

Stoke-on-Trent has now seen our case rate drop to below 300 per 100,000 and boasts one of the highest testing rates in the west midlands. The additional lateral flow tests from the Government, added to the impressive work by Stoke-on-Trent City Council, mean that we can now test up to 25,000 people per week. Does my right hon. Friend agree that community testing will be hugely important in helping areas like Stoke-on-Trent North, Kidsgrove and Talke, and can he confirm when mass vaccination sites in the city will appear?

[Matt Hancock]

Yes. Stoke-on-Trent has had a tough time recently, but the work by Stoke-on-Trent City Council and the community testing that is going on in Stoke-on-Trent is very impressive. All of us, as MPs, can lean into that and help to support the councils, the military and others in delivering testing in our communities. We have set out details of how we can all do that today so that every single one of us can play our part.

[Andy Slaughter (Hammersmith) (Lab)]

Can I return to the vaccination of those with terminal illnesses? The wife of one of my constituents, aged 70, who has stage 4 bowel cancer and is receiving palliative care, contacted me at the weekend. If his only priority is being 70 and extremely vulnerable, he is in the fourth cohort for vaccination. The terminally ill should be in the first group. Will the Secretary of State make that change, and will he give a timescale for each of the nine priority groups for receiving the vaccine?

[Matt Hancock]

The hon. Member asks a very sensitive and reasonable question. Of course it is right that we should follow the clinical guidance in terms of the order of priority, and that does include those who are clinically extremely vulnerable to this disease. On the timescales, I am afraid that the answer is the same to him as to my hon. Friend the Member for Newbury (Laura Farris), which is that we do not know because it depends on the speed at which the manufacturers can produce the vaccine.

[Fay Jones (Brecon and Radnorshire) (Con)]

Last week I was absolutely delighted to see the vaccine rolling out across Brecon and Radnorshire. I am hugely grateful to the Vaccine Taskforce and the thousands of volunteers who have bravely stepped forward to take part in the trials, including—I must declare an interest—my dad. Can my right hon. Friend confirm that the vaccine has undergone months of rigorous trials, and that work continues to ensure that other vaccines can be rolled out as quickly, but most importantly as safely, as possible?

--- Later in debate ---

[Matt Hancock]

Absolutely. My hon. Friend puts it exactly right. We are working very closely with the Welsh NHS to deliver the vaccine right across Wales. I pay tribute to her father, who continues to play a leadership role in his community by stepping forward for one of the trials.

[Wes Streeting (Ilford North) (Lab)]

Mass testing in schools is something we have repeatedly called for in order to make sure that they can open safely. I welcome the fact that the Government are rolling out mass testing, but can they go further to ensure that schools can reopen in January, and stay open? On the vaccine, will he do everything he can, recognising that these decisions are clinically led, to make sure that school staff get access to vaccines as a priority?

[Matt Hancock]

I understand the yearning for a vaccine among school staff, and of course it has to be clinically led. The goal is to reduce hospitalisations and fatalities from this disease as quickly as possible. I am absolutely delighted by the community testing roll-out and the roll-out of testing to schools in the hon. Gentleman’s patch. I thank him for the leadership he has shown locally, and I encourage that.

[Katherine Fletcher (South Ribble) (Con)]

Lancashire’s community testing is really starting to ramp up and rapidly increase, and I thank the Secretary of State for that. Prioritising tier 3 areas, such as parts of Lancashire that have been in restrictions since July, is really important. Does he agree that community engagement and getting a test with the increasingly available community testing is the thing that gets us all out of tier 3 in South Ribble, Chorley and West Lancs?

[Matt Hancock]

I totally agree: do your bit and get a test.

[Peter Grant (Glenrothes) (SNP) [V]]

The Secretary of State is keen to remind us that we all have an individual responsibility to look after not only our own health but that of one another. Every single unnecessary journey into and out of London and the south-east increases the risk of the virus being transmitted from one part of the United Kingdom to another. The House of Commons Commission set an example today by asking all House of Commons staff not to attend Parliament unless they absolutely have to. What discussions has the Secretary of State had with his colleague the Leader of the House with a view to ensuring that all Members of Parliament can take part in all proceedings by video call, so that none of us has to make unnecessary journeys into London, with the attendant increased risk of either catching the virus or spreading it among other people?

[Matt Hancock]

I am afraid the answer to that question is a matter for the House rather than me as Health Secretary.

[Andrew Bowie (West Aberdeenshire and Kincardine) (Con)]

May I take this opportunity to wish my right hon. Friend and the entire ministerial team at the Department of Health and Social Care a very happy Christmas? I hope that they are able to have some respite over the festive period. They deserve it more than anyone in this place.

Obviously, it is brilliant to see the Pfizer/BioNTech vaccine being rolled out, but people are waiting to see the Oxford/AstraZeneca vaccine, not least because it is cheaper, quicker and easier to distribute. Does the Secretary of State have any indication of when it might get approval and come on stream?

[Matt Hancock]

I am tempted to try to give an answer to that question, but it is very much a matter for the MHRA. I am very grateful to my hon. Friend for the good wishes that he sends. In the Department these days, we no longer say at the end of a week, “I hope you have a good weekend.” We say, “I hope you have a weekend.” Likewise, I share his hope that we have a happy Christmas, but frankly I hope I get a Christmas.

[Mr Toby Perkins (Chesterfield) (Lab)]

Pubs in tier 2 areas are very heavily regulated environments, and in tier 3 they are completely closed. Nothing like the same restrictions are in place on public transport, in retail shops, in care homes and in other areas where we have seen much more of a spread than in pubs. Will the Health Secretary consider not just shifting areas from tier 2 to 3 when tier 2 clearly is not working, but rethinking his whole approach so that the pub sector is given the support it needs? It is actually a much more regulated, much safer environment than many of the areas that the Government have not regulated.

[Matt Hancock]

Many of the facilities that the hon. Gentleman talks about, such as care homes, are doing unbelievable work to remain covid secure. I understand the impact on hospitality. I love the hospitality businesses of our country—I love going to pubs—but unfortunately we need to tackle this virus, which means that some very difficult decisions are necessary.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con) [V]]

I am sure my right hon. Friend will appreciate that this news will be a bitter blow to people across Basildon and Thurrock, but I accept that case numbers are sadly rising rapidly, despite the recent lockdown. Therefore, can he assure me that, as we start mass asymptomatic testing in both schools and the community to identify those who are unwittingly carrying the virus, there will be enough rapid tests available for all those who need and want one?

[Matt Hancock]

Yes, and I strongly commend my hon. Friend’s leadership locally. These are tough decisions, but let us get this testing going, get everybody coming forward to get a test if they can, to find those cases and ask and require people to isolate to break the chains of transmission and get Essex and Thurrock back out of tier 3 as soon as we possibly can.

[Chris Bryant (Rhondda) (Lab)]

One of my closest friends, Dan Lass, who I had known for more than 30 years, died of leukaemia last Thursday morning. He was in the United States of America, but I want to ask the Secretary of State about the cancer recovery plan in this country because cancer carries on killing people and many people have ended up not presenting this year. I know we have got things going again—even during the second wave—which is an amazing job by all the oncologists and doctors, but we must ensure we get clinical trials up and running again. We must be able to save lives and we must ensure that people go into hospitals to get the treatment they need. Otherwise, there will be more people who have lost someone like Dan.

[Matt Hancock]

The hon. Gentleman is quite right to raise this issue. My condolences to him and to all the family and friends of his friend, who is sadly no longer with us. I pay tribute to the way in which the NHS has kept cancer services going during the second peak. It has not been easy, but it has saved lives. The NHS has worked hard at it, and we must keep that going for the remainder of this time until we can get through and beyond.

[Robbie Moore (Keighley) (Con)]

I thank my right hon. Friend for his statement and the tough decisions he is having to make at the moment. Tier 3 restrictions will be tough on London, but we should not lose sight of the fact that most of the north of England, including my constituency of Keighley and Ilkley, has been under these extra restrictions for an enhanced period of time, and that has had a detrimental impact on the hospitality sector. Will he therefore consider a test and dine scheme so that we can try to get our pubs and restaurants back open as soon as possible?

[Matt Hancock]

A test and dine scheme is being piloted. It is something we are looking at to try to support the hospitality industry while keeping the virus under control. I will report back to my hon. Friend with the results of that pilot and see if we can get it going in Keighley.

[Vicky Foxcroft (Lewisham, Deptford) (Lab) [V]]

The roll-out of the vaccine is welcome news, but there is still a long way to go. Public messaging has been poor throughout the crisis, and that is particularly true for disabled and clinically extremely vulnerable people, who have frequently received guidance after new restrictions have started. We have all seen the vaccine prioritisation list, and the Health Secretary has been asked this several times, but, honestly, if he agreed to publish an estimated timetable for the roll-out, that would be extremely welcome and allow people to have some faith in the future and be able to plan accordingly.

[Matt Hancock]

I wish I could do that, but I cannot do so faithfully. What I can do is say is that the majority of people will be vaccinated in the new year and we are working to ensure that the roll-out happens as swiftly as is safely possible. I understand the yearning, but I cannot put a date on it.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

My right hon. Friend will know how hard the people of Leeds have worked. The right hon. Member for Leeds Central (Hilary Benn) made those comments and, indeed, the Treasurer of Her Majesty’s Household, my hon. Friend the Member for Pudsey (Stuart Andrew), who is in his place, and I would like to put on record our thanks to the people of Leeds for what they have done. My right hon. Friend the Secretary of State has hinted about what may or may not happen, and I would not want to push him on that, but one thing I have concern about—this comes from the hospitality sector—is that, if an announcement was made about coming from tier 3 to tier 2, how quickly would that be enacted? If we do come down to tier 2, the hospitality industry needs time to get moving as quickly as possible for the Christmas business season.

--- Later in debate ---

[Matt Hancock]

My right hon. Friend makes the case strongly not only for him but for the Treasurer of Her Majesty’s Household, my hon. Friend the Member for Pudsey (Stuart Andrew), who as a Whip cannot speak. However, believe me, behind the scenes he makes the case for Pudsey more strongly than anyone in this House makes the case for anywhere—almost. [Laughter.] It is a team effort. The specific answer to his question is that the decision made on Wednesday will be published on Thursday and come into effect in the early hours of Saturday morning.

[Mr Kevan Jones (North Durham) (Lab)]

The announcement of the vaccine was very welcome, but like a lot of things with the Government, there is a big difference between what has been promised and spun and what is actually happening on the ground. I was contacted this morning by Mrs Lesley Rhodes from Chester-le-Street in my constituency concerning her mother, Mrs Gowland, who is a resident of the Picktree care home in Chester-le-Street. She has been told that the vaccine will not be available to them and other care homes in County Durham until into the new year. Can the Secretary of State tell her and other residents of care homes in County Durham when they will start receiving the vaccine?

[Matt Hancock]

The right hon. Gentleman is quite wrong. We have been very clear with the roll-out of the vaccine on the pace at which we can start it—in fact, we started it ahead of when we committed to—and the uncertainties over the timing of the roll-out, as he will have seen from my answer to the previous but one question. When it comes to the care home roll-out, I have been absolutely clear that we aim to have it started in England before Christmas, and I am delighted it has been able to be started in Scotland today.

[Huw Merriman (Bexhill and Battle) (Con)]

Evidence seems to suggest that when it comes to face coverings on public transport, if everyone wears them, it reduces the spread, but if some people do not, it can increase the spread, as people fiddle around with their face masks and others are spraying out. I do not know whether the Secretary of State agrees, but it has been very worrying travelling on trains, seeing what appears to be a marked deterioration in the number of people wearing face masks. Will he send the message out that people really must do better? I know that masks can slip for everyone, but by and large, people really must follow the rules and ensure that they are not just protecting themselves, but everybody and essential public workers on our public transport system.

[Matt Hancock]

What my hon. Friend says is exactly right.

[Kirsten Oswald (East Renfrewshire) (SNP) [V]]

The Secretary of State heard earlier about my constituent Fred Banning, a 38-year-old father of two who has terminal cancer. For Fred and others in his situation, the vaccine is all about making the best of the time remaining. I have written to the chair of the JCVI, the Minister for covid vaccine deployment, the hon. Member for Stratford-on-Avon (Nadhim Zahawi) and the devolved Administrations seeking a review of the priority given to those living with terminal illness. Will the Secretary of State work with them to deliver a speedy response for Mr Banning and others in his tragic circumstances?

--- Later in debate ---

[Matt Hancock]

I appreciate the sensitivity with which the hon. Lady raises this case. Of course I would be very happy to ensure that it is looked at properly by the JCVI, but the decision, as I am sure she will understand, is rightly for the JCVI.

[Sir Robert Neill (Bromley and Chislehurst) (Con) [V]]

The Secretary of State has to recognise that the decision in relation to London will have a crippling effect upon the hospitality industry in the capital, not least because this is the time of year when they might most hope to make good the losses that they have already suffered—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

We have lost Sir Robert for the time being, but would the Secretary of State like to answer half the question?

[Matt Hancock]

I got the gist of it, Madam Deputy Speaker. My hon. Friend is right to express the concerns about the hospitality industry. This will be a significant blow to the hospitality industry, and we only take this action because it is absolutely necessary, because of the rates of increase of this virus right across London, and especially in Kent. Therefore it is necessary, and the best thing we can do is all work together to try to get London out of tier 3.

[Mr William Wragg (Hazel Grove) (Con)]

rose—

[Craig Whittaker (Calder Valley) (Con) [V]]

Will my right hon. Friend join me in thanking all those local authorities, such as Calderdale, that have already come forward to put in place community testing? Can he assure me that central Government will stand squarely behind local areas, which are doing everything they can do to move to lower restrictions, as we hope Calderdale will later on in the week?

[Matt Hancock]

My hon. Friend makes his case, as other West Yorkshire colleagues have today. The roll-out of mass community testing in Calderdale has been impressive. There is lots more work to do, and my message, as I am sure he would reiterate, is let’s get tested and let’s get this virus under control in West Yorkshire.

[Madam Deputy Speaker]

And now I call William Wragg.

--- Later in debate ---

[Matt Hancock]

I can absolutely give that commitment and say to the people of Stockport that they have been in restrictions for a long time and have done a great thing in bringing the case rate right down. Of course we have to remain vigilant, and today’s news only further amplifies that fact, but by doing the right thing, they have helped to protect life, and I will look very closely at their case on Wednesday.

[Ms Karen Buck (Westminster North) (Lab)]

People want to spend the Christmas holiday with their loved ones—of course they do—and the message of doing so with care is one that we all must stress, but given the very worrying statistics we have heard today, can the Secretary of State tell us if he has asked for or received any modelling on the likely impact of the suspension of restrictions over the Christmas holiday and the movement of people all around the country on the spread of infections and the hospitalisation rates in the middle of January?

[Matt Hancock]

The truth is that it all depends on how people behave, and it is very important that we all urge people to behave with great care and responsibility over the Christmas period.

[Ms Nusrat Ghani (Wealden) (Con)]

I congratulate my right hon. Friend on the fantastic work he has done on the vaccine, but may I make a plea to him on behalf of my constituents in Wealden whom I spoke to this weekend? They will struggle to get to some of the hospitals which are over an hour away, so will he do all he can to ensure the vaccine comes into my rural constituency?

The other bit of good news is my right hon. Friend saying from the Dispatch Box that the tiers will no longer be at county level. My Wealden residents have gone above and beyond to keep infection rates down; they must not pay the price for what is happening outside of Wealden so can we ensure that their tier remains the same or is reduced?

[Matt Hancock]

I will take a look at the numbers in Wealden in particular. I am concerned about the rate of increase in other parts of the south-east and will have to look very carefully at that case.

On the vaccine roll-out, of course we want the vaccine in all communities across the country. I am delighted that today we managed to start the GP roll-out, which means that we have been able to get vaccine out of the major centres and major hospitals and into over 100 different local communities, and I will check whether Wealden is on the list to make sure everybody in Wealden can get their vaccine at the appropriate time.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab) [V]]

I hope the Secretary of State recognises the sacrifices Geordies have made to successfully reduce transmission rates here, but I want to ask about vaccine prioritisation. Public Health England has reported that those with learning disabilities have covid-19 deaths up to six times higher than those of the general population, and it is obviously extremely difficult to maintain covid-security in care homes whose residents cannot understand social distancing, yet I am told that they are being deprioritised for the vaccine because Joint Committee on Vaccination and Immunisation guidelines prioritise care homes for the elderly only, and that is interpreted as being those over 80. Can the right hon. Gentleman confirm whether that is the case, and will he give greater flexibility to local public health authorities to reflect risk?

[Matt Hancock]

Nobody has been deprioritised: the nation has been prioritised according to clinical need, and that is rightly a judgment for the JCVI. It has of course looked into the research and data the hon. Lady rightly raises and has come to the view that the level of risk for those who are clinically extremely vulnerable is akin to the level of risk for those who are 70 to 75 years of age, and that is the reason for the prioritisation decision it has taken.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

Despite all the sacrifices we have made in South Shields, we are one of the top 50 coronavirus hotspots. That is not surprising since centralised contact tracing is failing us. Just today, it has been revealed that contact tracing companies subcontracted by Serco are using inexperienced and unqualified people to gather vital clinical information. Will the Secretary of State publish a list of those companies and allow my local public health experts to take control of the situation?

[Matt Hancock]

The hon. Lady’s local public health experts are already working with the national system. I gently say that instead of trying to divide people with this public-private split, as the Opposition seem desperate to do, the best way to get the case rate down in South Shields is for us all to get on the same page with public health messaging. If for every time she asked me a question about Serco, she asked me a question about how we could work together to keep people alive and safe in South Tyneside, South Shields would be in a better place.

[Jacob Young (Redcar) (Con)]

Will the Secretary of State confirm that London is going into tier 3 because it is failing on the five tests that have been set out on tiering, and will he also confirm that Redcar and Cleveland have considerably improved across all five tests since the tier 3 decision was taken? The Secretary of State can make my wish come true, because all I want for Christmas is tier 2.

[Matt Hancock]

How can I reject an entreaty like that? My hon. Friend makes a very seasonal request. We will be looking at the situation very closely come Wednesday, and we will see what is in Santa’s bag.

[Zarah Sultana (Coventry South) (Lab)]

I was really proud to see that Coventry’s NHS staff administered the first coronavirus vaccinations in the country, but those staff have been let down by the Government. They were promised free parking throughout the pandemic, only for charges to be reintroduced in June, as they were at many other hospitals across the country. Only after I handed in a petition, wrote to the Prime Minister and secured a Westminster Hall debate was free parking reinstated for permit holders at Coventry’s hospital, but it is still denied to staff who do not have permits. Will the Government live up to their promise and provide NHS trusts with the funding for free parking for all their staff?

--- Later in debate ---

[Matt Hancock]

I will just answer the first bit. I was absolutely thrilled to see Coventry delivering the first vaccination with the clinically approved vaccine in the world. It made my heart sing, and I am so glad that we managed to do that. With the help of the international scientists, the NHS and the regulator, we have made such progress. That really put Coventry on the map, and I hope that the hon. Lady is proud.

[Siobhan Baillie (Stroud) (Con)]

Will the Secretary of State thank Stroud and Gloucestershire health and care teams, who are working to the point of exhaustion? This second wave is proving to be quite difficult in a number of ways. Separately, I welcome the developments in testing and vaccines. Would the Secretary of State be willing to get PHE to develop more pilots and work on roadmaps for the wedding industry and other struggling sectors, so that we can benefit from that as quickly as possible in the new year?

[Matt Hancock]

The best thing we can do for the wedding industry is to try to get the vaccine rolled out as fast as possible to protect people, so that this virus no longer kills as many as it sadly does today. I join my hon. Friend in paying tribute to all those in Gloucestershire, including in south Gloucestershire, who are working so hard. There has been a very difficult spike in the virus. Thankfully, it is coming down now, and I hope to see the number of hospitalisations in her area reducing. While that is happening, we have to get on with the roll-out of the vaccine, which is a 24/7 job. I pay tribute to and thank all the NHS staff who are working so hard to make that happen.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I will suspend the House for three minutes in order to allow colleagues to leave safely, and to allow those who are coming in for the next fixture to attend safely.

Covid-19 Vaccine Roll-out

Matt Hancock Excerpts

Tuesday 8th December 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care, if he will make a statement on the covid-19 vaccine roll-out.

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

At 6.31 this morning, 90 year-old Margaret Keenan from Enniskillen, who lives in Coventry, became the first person in the world to receive a clinically authorised vaccine for covid-19. This marks the start of the NHS’s Herculean task to deploy vaccine right across the UK, in line with its founding mission to support people according to clinical need, not ability to pay. This simple act of vaccination is a tribute to scientific endeavour, human ingenuity and the hard work of so many people. Today marks the start of the fight back against our common enemy, coronavirus.

While today is a day to celebrate, there is much work to be done. We must all play our part in suppressing the virus until the vaccine can make us safe and we can all play our part supporting the NHS to deliver the vaccine across the country. This is a task with huge logistical challenges, including the need to store the vaccine at ultra-low temperatures and the clinical need for each person to receive two doses 21 days apart. I know that the NHS will be equal to the task. I am sure we will do everything we can—everything that is humanly possible—to make sure that the NHS has whatever help it needs.

The first 800,000 doses of the Pfizer/BioNTech vaccine are already here in locations around the UK and the next consignment is scheduled to arrive next week. This week, we will vaccinate from hospitals across the UK. From next week, we will expand deployment to start vaccinations by GPs and we will vaccinate in care homes by Christmas. As more vaccines come on stream in the new year, we will open vaccination centres in larger venues, such as sports stadiums and conference halls.

People do not need to apply. The NHS will get in touch at the appropriate time and, when that time comes, we have one clear request: please step forward for your country.

I want to thank all those involved—the international team of scientists; the globally respected regulator, the Medicines and Healthcare Products Regulatory Agency; Public Health England; the vaccines taskforce; all the volunteers who took part in the trial; all those who have come forward for vaccination so far; and all those who will do so in future. Months of trials involving thousands of people have shown that this vaccine works and is safe. By coming forward, you are taking the best possible step to protect yourself and your loved ones, and to protect the NHS.

Help is on its way and the end is in sight—not just of this terrible pandemic but of the onerous restrictions that have made this year so hard for so many—but even while we can now see the route out, there is still a long march ahead. Let us not blow it now. There are worrying signs of the virus growing in some parts of the country, including parts of Essex, London and Kent. Over the coming weeks and months, we must all keep following the rules to keep people safe and make sure we can get through this safely together.

[Jonathan Ashworth]

The pictures today of 90-year-old Margaret Keenan receiving her vaccine, given by May Parsons, a nurse originally from the Philippines, is a wonderful moment bringing home to all of us that there is now light at the end of this very long tunnel. We are all beaming with pride for our NHS today. Let me put on record my thanks to all our NHS staff working so hard today, tomorrow and in the coming weeks months in administering these jabs. I again pay tribute to all our medical scientists, clinical researchers, regulators and trial participants who have made today happen. We should applaud them on our doorsteps.

I want to put a number of specific questions to the Secretary of State. May I ask him about those areas that do not yet have a designated hospital hub? My city, Leicester, has effectively never really left lockdown, impacting hugely on the wellbeing of our people and the economic prospects of our city. We are a diverse city with a high proportion of black, Asian and minority ethnic communities, who we know are more at risk from the virus. My constituents, Leicester University and the Leicester leadership are all deeply disappointed not to see Leicester on the hospital hub list. I have been lobbying the NHS about this in the past 48 hours, and people in Leicester will get vaccinated, but can he say when areas like Leicester and other areas currently without a hospital hub will get one? When will local primary care network hubs be announced, and when will the mass vaccination centres’ locations be announced? Can he assure us that all vaccination centres and communications will be accessible for those with disabilities and that staff will be appropriately trained?

On care homes, I am grateful for the update the Secretary of State gave us when he mentioned Christmas. Does he anticipate that all care homes will have access to the vaccine by Christmas?

Of course we have to vaccinate NHS staff—that is really important. Can he confirm that that includes student nurses, medical students, physiotherapy students and so on? What plans are in place to ensure that harder to reach groups—such as the homeless, for example—have access to the vaccine?

The Secretary of State has presumably seen the reports today in the Health Service Journal that £567 million of requested funding for covid projects was turned down. Can he guarantee that the NHS will get all the resources it requests to ensure the smooth and rapid roll-out of the vaccine?

The Secretary of State indicated in the newspapers at the weekend that the tiers could be loosened by March if uptake is successful. In the same way that we receive daily published figures on case numbers and tests processed, could we receive daily updates on vaccination doses administered, and could it be by priority cohort?

Finally, what are the plans to tackle anti-vax harm online? I have literally just been sent a WhatsApp video claiming that this is all a global plot to change our DNA. We know that harmful content circulates on Facebook and other platforms. This is garbage: how can we deal with it?

This is indeed a momentous day, and we can all look forward to a much better 2021.

[Matt Hancock]

That is right—we can all look forward to a much brighter 2021. We must stick with it for now, but we can see the way through this.

The hon. Gentleman asked several very reasonable questions. We start today vaccinating in 70 locations across the UK, and we will expand these locations over the coming days. Today we will set out the next tranche of hospital hubs, including Leicester, and vaccinations in Leicester will start in the coming days.

On access to the vaccine, of course we need to make sure that it is available to all, and that includes all with disabilities and all our most vulnerable people, like those who are sleeping rough. This will be best accomplished when we get the primary care community vaccination model rolled out, which will be in the coming weeks. We need to make sure that how we get the vaccine physically out into the primary care networks can be assured as safe, because obviously that is one step more difficult than vaccinating from a hospital, hence we have started in hospitals and then we will get out into primary care and community delivery, and then into the vaccination centres after the new year.

The hon. Gentleman asked about NHS students. The definition of NHS and social care staff set out by the Joint Committee on Vaccination and Immunisation is those who are patient-facing, for obvious reasons. We will set out more details in due course.

Finally, the hon. Gentleman asked about the publication of data on the number of vaccines that have been administered, and according to which priority groups. We will set out those details when the vaccinations have taken place, so that people can see how the programme has been assessed. Overall, may I join him in saying how wonderful it was to see the pictures on the TV this morning—emotional for many of us—and that I am delighted that we have been able to make this progress?

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

Like many, I would like to congratulate our scientists; I would like to congratulate the Health and Social Care Secretary himself, the vaccines taskforce and NHS frontline staff, all of whom have made this extraordinary day for our country possible. It is very, very cold outside, and the question on many people’s minds is: are they now able to book a summer holiday? What is my right hon. Friend’s answer to that question, and is there anywhere in particular that he would recommend if the answer is yes?

[Matt Hancock]

It makes me very proud that we have managed to start this vaccination programme sooner than many people anticipated. People told me that it was not going to be possible and that it was all very difficult. It has been difficult, but we have got there, and we did so because of international science, working with German scientists and American pharmaceutical companies, and people right around the world working on this project. I have high confidence that the summer of 2021 will be a bright one, without the sorts of restrictions that made the summer of 2020 more restricted. I have booked my holiday—I am going to Cornwall.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

The commencement of a safe and effective vaccination programme is extremely welcome, but recent studies have shown that as little as 54% of the UK population are certain to have the vaccination. There is a clear need to counter misinformation, whether online scare stories or jingoistic nonsense, so what extra steps will the Minister take to ensure public trust in the vaccine’s safety and effectiveness and to encourage take-up? What assurance can he give that there will be fairness in access to the vaccine until it is widely available, and when does he think it will be available to anyone who wants it? During that period, will the UK Government commit to a similar strategy to that of the Scottish Government of pursuing the eventual elimination of the virus? With a vaccine now available, that is more possible than ever before.

[Matt Hancock]

It is only with a vaccine that we can finally defeat this virus and get life back to normal. This UK project has made huge strides forward, and I am very, very grateful to NHS Scotland for the work that it is doing right now in making sure that the vaccine can reach people across Scotland, as the NHS is doing in Wales, Northern Ireland and England. It is a big team effort, and it is because the UK vaccines taskforce was the first out of the blocks on buying the vaccine, along with the smart approach taken by the MHRA, that we have been able to get to this point before any other country.

The hon. Gentleman asked about fairness in access. Absolutely—fairness is critical, hence we will follow the clinical advice of the Joint Committee on Vaccination and Immunisation on priority, again, right across the UK. Finally, I agree strongly with him—the hon. Member for Leicester South (Jonathan Ashworth) also raised this, and I did not respond to it, so I shall now—that countering disinformation is incredibly important. That is best done with positive information and explaining objectively why and how the vaccine is safe. Something that we can all do in the House is talk positively about the benefits of the vaccine for keeping people safe and keeping their community safe. I pay tribute to all those who have been willing to come forward and talk in public, and I thank those who have already had the vaccine—since 6.30 this morning—and have been willing to tell their story publicly to help others have the confidence to do the right thing. Finally, surveys of the UK population show that we have one of the highest acceptances of taking the vaccine in the world. The numbers who are enthusiastic about it are rising at the moment, and we need to keep that going.

[Holly Mumby-Croft (Scunthorpe) (Con)]

I echo the Secretary of State’s thanks to the MHRA for its tremendous work in ensuring that this vaccine is safe. I look forward to having my jab as soon as it is my turn, and I will encourage everybody I love to do the same. Earlier this week, we learned that Scunthorpe General Hospital was not among the first group of vaccination hubs. Can my right hon. Friend provide further clarity on how those hubs are allocated, and can he reassure me and my constituents in Scunthorpe, who are currently in tier 3, that we will receive the vaccine in the very near future?

[Matt Hancock]

Yes, absolutely. We have started at 70 hospitals across the UK. Those are the ones that are best able to deal with the difficult logistics of a vaccine that has to be stored at minus 70° C. I understand the desire for every hospital to get on that list, and we will publish a further list later today. My local hospital, the West Suffolk, is also not yet administering vaccines. The other critical part of this is the primary care networks—the community roll-out—which will get us to many, many more sites where people are able to access the vaccine, so that in Scunthorpe and across the whole of the UK, everybody is able to access this vaccine as fairly and safely as possible.

[Nick Smith (Blaenau Gwent) (Lab)]

It is brilliant that the vaccine programme is beginning, but unfortunately, there are real question marks over who is benefiting from some of the covid-19 contracts. How will the Secretary of State ensure that cronyism and profiteering do not become features of this stage of the covid-19 response?

[Matt Hancock]

Thankfully, as the National Audit Office set out, they have not been a feature of any of the response to coronavirus, so that is good.

[Damian Green (Ashford) (Con)]

Those on the frontline normally face bullets, so my right hon. Friend and his entire team deserve the bouquets that they are receiving today. I am delighted that the William Harvey Hospital in Ashford is already dispensing the vaccine. Does he agree that one of the groups in greatest need who deserve it first are residents of care homes, who have faced such a miserable 2020?

[Matt Hancock]

Yes, I do, and I hope that we can get the vaccine out to residents of care homes as soon as is feasibly possible. They are in the top priority group clinically, and it is simply a question of how quickly we can operationalise getting the vaccine out to care homes. I hope that that can start before Christmas. I pay tribute to everybody working at the William Harvey Hospital in Ashford this morning, administering vaccines already and helping to protect the lives of my right hon. Friend’s constituents.

[Munira Wilson (Twickenham) (LD)]

May I start by saying what a joyful moment it was this morning to see those first vaccinations and thank everybody who has been involved in making this happen? I very much welcome the Secretary of State’s optimism about our summer holidays next year. However, I gently point out that we have seen setbacks from some of the manufacturers in terms of when the doses of vaccine will be delivered. With both Pfizer and AstraZeneca, it will apparently be 3 million doses arriving by the end of the year, rather than the 30 million that were originally forecast. Does he still think it is feasible that the most vulnerable will be vaccinated by the spring, and how many of those of us who are healthy under-50-year-olds might be vaccinated by the school summer holidays?

[Matt Hancock]

I understand why the hon. Lady and many others want to know what the speed of the roll-out will be. Because we are reliant on the manufacturing process, which is itself a difficult challenge, we cannot put figures on when the roll-out will be. We hope that we will be able to lift the measures by the spring, and we hope that we will all have a much more normal summer next year, but I do not want to put too much more detail on it than that, and I cannot put more in terms of the numbers, because there are so many contingencies. What we can be sure of, and what we can work and plan for, is the NHS being able to deliver the roll-out at the speed at which the manufacturers can manufacture.

[Joy Morrissey (Beaconsfield) (Con)]

May I thank my right hon. Friend for all he has done in his fight against the coronavirus, and may I thank the Department for this roll-out of the vaccine? It is actually a monumental step in our fight against the coronavirus—just in time for Christmas. It is the Christmas present we all wanted. Does my right hon. Friend agree with me that, because the UK was one of the first countries to secure the vaccine, we should be able to move more quickly out of local restrictions in the new year, as the vaccine is rolled out?

[Matt Hancock]

Well, I very much hope so, but there is some time between now and then, so we have got to temper our joy and enthusiasm at today’s announcement with the need to keep on keeping each other safe between now and then. Let us not blow it, since we can see that the answer is on the horizon.

I reiterate the point that my hon. Friend made about the team in the Department, because my civil servants and special advisers have been amazing during this year. They have worked so hard—seven days a week, often 18 hours a day—and they deserve enormous praise, because this is a team effort and nobody can do this sort of thing on their own.

[Jim Shannon (Strangford) (DUP)]

First, could I say what a positive news story it was this morning when Margaret Keegan got her jab, followed by a fellow called William Shakespeare, which I thought was quite interesting? I thank the Secretary of State and all those who have made this happen, because it is really good news. Will the Secretary of State outline whether he has liaised with the Treasury to secure the funding needed to roll out this vaccine in the devolved nations, bearing in mind that we are behind on our flu vaccine roll-out and both cannot be carried out at the same time? Further, what discussions have taken place with the Secretary of State for Defence to provide trained military assistance in the devolved regions to make it happen?

[Matt Hancock]

This year, I have sometimes turned for inspiration to the bard:

“If you prick us, do we not bleed?”

So it was a delight and a coincidence to find that Mr William Shakespeare of Stratford-on-Avon, a constituent of the vaccine roll-out Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi)—by coincidence; Members should not get any ideas—was called forward to be the second person to be vaccinated by the NHS. It is absolutely terrific to see that people right across this United Kingdom are being vaccinated right now according to need, and I hope it can bring us all together.

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

Can I start by joining my right hon. Friend in paying tribute to the scientists, clinicians, trial volunteers and many others who have made it all possible? They have given us the light at the end of the tunnel. We have to remember that there were no guarantees that we would get any vaccine; to have at least one is fantastic. I am glad to see a number of sites in the north-west have been allocated for the roll-out, but my constituents will probably be asking for and expecting somewhere closer to home—for example, at Leighton Hospital near Crewe and Nantwich. What are the plans for expanding the sites available for vaccination?

--- Later in debate ---

[Matt Hancock]

Yes, we will keep expanding the sites available. Of course, I understand why people want their local hospital to be dispensing the jab. Alongside hospitals and those vaccination centres, we will make sure that we have sites in the community, and we will get them going just as soon as it is safely possible.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

This brilliant news, on which I also congratulate everyone, contrasts with the rather alarming revelations last night that we may be veering towards a no-deal Brexit. If that does occur, could the Secretary of State guarantee that there will be no disruption to the supply chains for all these different vaccines—AstraZeneca, Moderna, Pfizer—and will he also rectify the rather Ealing-shaped hole in hospital provision in north-west London? We have 360,000 people, and we were No. 1 in London for cases recently, so that does need fixing.

[Matt Hancock]

There is very significant provision for vaccination in London. I will take up the specific point about Ealing, but London, thankfully, is a very well connected and interconnected city. To assure the hon. Member on the point about logistical disruption, we have five contingency plans in total to ensure that we can continue with the vaccination supply no matter the differing types of disruption.

[Mary Robinson (Cheadle) (Con) [V]]

I am delighted that Stepping Hill Hospital in my constituency will be part of this historic day as the coronavirus vaccine programme begins. Along with rapid testing, tracking and isolating, we aim to bring our covid rates down further, prior to the tier review next week. In welcoming this fantastic news, does my right hon. Friend agree that we must not lose sight of the importance of “Hands, face, space” as a key way to keep us virus-free while the vaccine is rolled out to the rest of the population?

[Matt Hancock]

Yes, my hon. Friend is completely right. We must all keep doing the basics—“Hands, face and space”, respecting the rules, and living carefully with personal responsibility, so as to minimise the chance of passing on the disease asymptomatically. We must keep doing that even while we have this great news of the vaccine which, as many have put it, is the light at the end of the tunnel.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

This is a momentous day, and I look forward to receiving my vaccine when it is my turn. I thank those who are being vaccinated, those who took part in the trials, and all those who worked to make this happen. I understand that the Joint Committee on Vaccination and Immunisation has set a priority list for vaccines based on clinical vulnerability, but that has made people who were on the frontline of the crisis, including unpaid family carers, feel as if they are being ignored. Our immediate priority during this phase of vaccinations has to be reducing deaths, but once the most vulnerable have been vaccinated, will the Secretary of State say whether unpaid carers will become a priority for vaccination?

[Matt Hancock]

The hon. Lady and I agree that clinical need must be the priority, and once we have reached all those with a significant clinical need, as set out by the JCVI, we will set the next stage of priorities in due course.

[Imran Ahmad Khan (Wakefield) (Con)]

I, too, commend the titanic effort of all those involved in the creation, manufacturing and distribution of the covid-19 vaccine. As more and more of us are vaccinated against covid-19, will my right hon. Friend outline what plans there are to ease the most draconian measures across the tier system, so that people and businesses can sensibly return to normal?

[Matt Hancock]

While the vaccine rolls out, the best way to get any area down through the tiers is to continue to follow the restrictions that are, unfortunately, still absolutely necessary to keep people safe. Having said that, because we have a vaccine, the faster we can roll it out, the sooner we can get to the point where we get rid of the system altogether.

[Peter Grant (Glenrothes) (SNP) [V]]

If I had not been on the call list for this urgent question, I would have been joining friends and colleagues of Leslie, to pay our final respects to a warm-hearted man who sadly lost his life to the virus. Thinking of his family, and what happened to him, brings home to all of us how urgent it is to get a vaccination programme up to speed as quickly as possible. That can happen only if a significant proportion of the population accept the vaccine. My hon. Friend the Member for Linlithgow and East Falkirk (Martyn Day) has highlighted the dangers if too many people are taken in by the scare stories circulating on social media, and people can also be put off if they see politicians responding with too much bombast or jingoism to the start of the vaccination programme. May I commend the Secretary of State sincerely for the measured tone that he has adopted today? Will he encourage his ministerial colleagues to be similarly measured in any future pronouncements that they make about this important day in the battle against covid?

[Matt Hancock]

All of us in Government feel encouraged by today’s progress, but we are also determined and resolute to get through this in the safest way possible, and out into the brighter seas beyond, when we can get rid of the restrictions altogether. I agree with the hon. Gentleman about how important it is that we all keep that resolve, not least because of the example that he set out, and I send my commiserations and those of the Government to his constituent. Many of us have suffered loss during this pandemic, and we want it to be over as soon as we can. We must keep going until it is safe to do so.

[David Johnston (Wantage) (Con)]

May I add my congratulations to my right hon. Friend and the many people who got us to the heart-warming images that we saw this morning? A lot of the highest priority groups in my constituency live in more remote villages rather than in towns, and there are issues from transport connections to a fear of going out. Will my right hon. Friend assure me that those factors that affect more remote locations are being included in the planning for the roll-out?

[Matt Hancock]

One hundred per cent. That is a very important point, and it is important right across the country, especially, if I may say so, in Scotland and Wales. We have the primary care network community roll-out, which aims to get the vaccine out into the community as close to where people live as possible.

[Bill Esterson (Sefton Central) (Lab)]

The start of vaccinations is excellent news, and it is excellent news for my constituents that Aintree Hospital is one of the first in the country for the roll-out. The Health Secretary rightly said, “Let’s not blow it.” We still need to fix the gaps in contact tracing and in financial support for those who need to self-isolate. Only 11% of people are being contacted, according to the figures that I am getting, and we still need to learn from contact tracing in east Asia. Will he put resources into local public health teams, which are much better placed to fill those gaps, so that contact tracing plays its part while we wait for the roll-out of the vaccine across the country?

[Matt Hancock]

The hon. Gentleman is right in principle that contact tracing and the testing roll-out are still critical while the vaccine roll-out happens. I am glad to say that his reports of only 11% being contacted are not right; the figure is much higher than that. I am also really pleased that in the Liverpool city region, which includes his Sefton constituency, we are now rolling out community testing much more widely, with the support of local teams. I hope that he will help us all in putting a shoulder to the wheel in that effort.

[Tom Hunt (Ipswich) (Con)]

I do not actually think it has happened by accident that we are the first country in the world to have approved this vaccine. We saw very emotive images today, and I make no apology for being proud of that. This is a proud day to be British. I would like to thank the NHS and all our wonderful scientists for being part of that, and the regulatory authority.

I was glad last year to hear—last year? A couple of days ago. [Laughter.] I was glad to hear that East Suffolk and North Essex NHS Foundation Trust is going to be one of the first to get the vaccine. Unfortunately, Ipswich currently does not have the facilities to store it. I am obviously keen for my vulnerable constituents to get access to that vaccine ASAP, so I just want to know what the plans are in the very short term, before any community roll-out, to make sure that Ipswich constituents can get access in Colchester, and for storage facilities in Ipswich Hospital to make sure that we can move forward.

[Matt Hancock]

My hon. Friend’s constituents will be able to access the vaccine in Colchester from now, and some will be being called forward. Like many others, he rightly asks for the vaccination roll-out to reach Ipswich itself, and it will reach Ipswich itself just as soon as we can get that sorted. I have a lot of sympathy with what he said about two days feeling like a year!

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

It is a great day for medicine, science and the population, but in response to my hon. Friend the Member for Blaenau Gwent (Nick Smith), the Secretary of State was somewhat dismissive of an important National Audit Office report that raised serious concerns about the letting of contracts in Government—contracts being published late; missing paperwork; the establishment of a high-priority lane, with one in 10 of those applying via that route awarded contracts; and an overall lack of transparency. As the NAO says, the lack of documentation of key decisions, including

“why particular suppliers were chosen”,

is important. It is taxpayers’ money that is being spent. In relation to the vaccine roll-out, are private companies involved, and will the Secretary of State commit to being open and transparent and publishing the contracts and all the paperwork that goes with them?

[Matt Hancock]

Of course I will defend to the end the work that we did to get the PPE roll-out to which the hon. Lady refers. Of course we had priority contracts, because we wanted, when somebody had a good lead, to be able to see if we could make an arrangement as fast as possible, but that was all done through the proper processes, as the NAO report sets out. She asks—I have a lot of respect for the hon. Lady, but really—whether private companies will be involved in the vaccine roll-out. Try Pfizer or BioNTech, the people who came up with and are manufacturing this vaccine. Without them, we would not have a vaccine at all, and a bit of a thank you would do well from the Chair of the Public Accounts Committee.

[Mr Mark Harper (Forest of Dean) (Con)]

I join the Secretary of State in thanking the NHS staff in my Gloucestershire Hospitals NHS Foundation Trust who are in the first 50 hospitals to be rolling out the vaccine. That is very welcome, including to my constituents. Given that he was right to be a little cautious about the speed at which we will be able to get this vaccine rolled out, it seems to me not right that we should keep every single restriction in place until we have rolled out the vaccine to the entire population. The onus still remains on the Government to justify every restriction and the balance between the benefits of reducing covid, the economic impact and the non-covid health harm. May I ask the Government to set out that detail before the House is asked to take another decision on these restrictions in January?

[Matt Hancock]

The House might be relieved to know that my right hon. Friend and I agree with each other on the need to ensure that, as the vaccine is rolled out to vulnerable groups, we monitor the impact of the vaccine on reducing cases, reducing hospitalisations and reducing the number of people who sadly die from this disease, and take that basis for the judgment of how soon we can lift the restrictions. He and I want to lift the restrictions as soon as is safely possible, and the question of the judgment on how safely is one that we will have to monitor and debate in this House over the coming weeks and months.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

When we speak about vulnerable groups, will the Secretary of State assure me that we will not forget those who are homeless? We know that people who are homeless, especially those who are sleeping rough, suffer many disadvantages and barriers to accessing healthcare at the best of times, quite apart from any pre-existing mental or physical health conditions that they have. What steps is his Department taking to ensure that we reach all vulnerable people, whether they are homeless or not?

[Matt Hancock]

That is an incredibly important consideration, both on the grounds of social justice and because all of us can pass on the disease to others, so it is right, fair and practical that we must ensure that everybody has access to the vaccine. The community roll-out will be the primary means by which we can reach some of the most vulnerable, including the homeless, whom the right hon. Gentleman mentions. That will be an important consideration in the roll-out.

[Peter Gibson (Darlington) (Con)]

Will my right hon. Friend outline how his Department is working with local authorities, such as Darlington Borough Council, which is keen to move out of tier 3, to inform our constituents about how, when and where they can access the vaccine?

[Matt Hancock]

I am delighted that the James Cook University Hospital in Teesside is one of the first and is vaccinating today. There is a lot of work to be done to make sure that we roll out the vaccine across Teesside, but in the meantime I pay tribute to everybody in the Tees Valley, including in Darlington, who has followed the rules. The numbers are coming down quite sharply, but we have to keep at it, because until this vaccine is rolled out to protect the most vulnerable, as my right hon. Friend the Member for Forest of Dean (Mr Harper) put it—until that day—we have to make sure that we keep the virus suppressed until the vaccine can make us safe.

[Mike Amesbury (Weaver Vale) (Lab)]

Today is a great day for Britain and the world, and I thank all those involved on a global level to ensure that we have light at the end of the tunnel, and hope and optimism. People in Cheshire West and Chester and Halton who have loved ones in care homes are desperate to visit them. When can those who are resident, the carers and the family members expect to get the vaccine?

[Matt Hancock]

I understand how important this is. The roll-out of testing to allow for visiting by Christmas is under way. In terms of the vaccine, care workers, because they can travel, are already—today—being vaccinated, and I hope that we can start the roll-out of vaccines to those who live in care homes, where the vaccine needs to be taken to them, before Christmas.

[Nigel Mills (Amber Valley) (Con) [V]]

I welcome the fact that hospitals in Derbyshire are in the first wave of the vaccine roll-out as well. Will my right hon. Friend assure those who are living at and not able to leave home that the roll-out plan will include home visits for those who really need them?

[Matt Hancock]

Yes. That is the hardest part of the vaccine roll-out to deliver by its nature, because of the minus 70°C requirements of the vaccine, but it is absolutely a part of the plan.

[Kate Osborne (Jarrow) (Lab)]

We already know that poorer areas have fewer GPs, so it is crucial that they receive extra resources to ensure that they are not left behind in the roll-out of the vaccine, on which I congratulate everyone involved. Will the Secretary of State assure me that the vaccine will be fairly distributed across the UK and that working-class communities such as mine in the north-east will not be put at the back of the queue again, as they have been so many other times during this pandemic?

[Matt Hancock]

I can absolutely assure the hon. Lady that the fundamental principle of the roll-out is that it must be done according to clinical need and fairly right across every part of the UK, and that is what we are delivering to.

[Jason McCartney (Colne Valley) (Con)]

Having been under a variety of restrictions since August, and being now in tier 3, my Colne Valley constituents are incredibly welcoming of the roll-out of the vaccine. We are looking forward to reopening hospitality businesses and starting to get back to normal in the new year. The chief medical officer for Leeds Teaching Hospitals has confirmed that his team are ready for the roll-out of the vaccine across West Yorkshire as soon as it arrives, so can the Secretary of State please confirm that this week we will start to see the roll-out of the vaccine across West Yorkshire?

[Matt Hancock]

Today we are seeing the very start of that roll-out, and I absolutely hope that that will expand across West Yorkshire over this week.

[David Linden (Glasgow East) (SNP)]

I, too, pay tribute to everybody in the NHS who will be administering the vaccine. One of the concerns I had at the beginning of lockdown was that many of my asylum-seeking constituents who have no recourse to public funds were very much left behind in the original lockdown. What work will the Government and the Red Cross in the United Kingdom be doing to liaise with the Home Office to ensure that no one is left behind? After all, covid does not adhere to people’s nationality.

[Matt Hancock]

We have a programme under way to ensure that those without an NHS number can get vaccinated; the NHS number is the basis of the calling system to invite people to be vaccinated, but of course not everybody has an NHS number, and we must ensure that those without one get called forward too.

[Mr Simon Clarke (Middlesbrough South and East Cleveland) (Con)]

I pay tribute to everyone involved in administering the vaccine from The James Cook University Hospital in Middlesbrough today. Looking ahead to the next stage of the roll-out, I have been contacted by a GP surgery in Berwick Hills in my constituency that is concerned about the resource implications of delivering the vaccine, since it is severely under strength and serves one of the most deprived communities in England. Will my right hon. Friend agree to look at their case and discuss what extra support might be made available to surgeries that find themselves in that position?

[Matt Hancock]

The way we have organised the primary care roll-out is through networks of GP practices—primary care networks, as they are called—so that if one GP practice is under particular pressure, for instance because it may be carrying vacancies, the effort can be put together over a wider network of GP practices. The funding support for GPs to deliver this vaccine, as with the flu vaccine, is negotiated and agreed with the British Medical Association and is part of the operational roll-out of the vaccine in my hon. Friend’s constituency and elsewhere across the country.

[Naz Shah (Bradford West) (Lab)]

First, may I add my thanks to everybody who has put in the effort to ensure that we get the vaccine? That is lovely news, but unfortunately once again this Government are failing to plan. My clinical commissioning group was given 24 hours to get together the GP practices to roll out the vaccines, and the criterion was 1,500 over-80s. The fact that places such as Bradford West and inner cities have nine years’ less life expectancy and 16 years’ more ill-health means that the three centres that have been set up are in affluent areas. Not a single one is in inner-city Bradford, yet the Government’s own review accepts that covid disproportionately affects black and minority ethnic communities. When will the Government stop discriminating against those who live in inner-city areas, and prioritise them because of their health risks?

[Matt Hancock]

The roll-out of the vaccine is being managed by the NHS, and it is entirely unfair of the hon. Lady to describe the NHS in that way.

[Simon Fell (Barrow and Furness) (Con)]

It was a delight to turn on the radio this morning and hear some good news for once, but my right hon. Friend is right to describe the roll-out of this vaccine as a Herculean task. In the light of that, what measures is he putting in place to accelerate the development of capacity to make more vaccine, and also covid therapeutic antibodies?

[Matt Hancock]

Yes, today has been a celebration of progress we have been able to make, but there is a huge amount more to do, not just in the roll-out but in making sure we have the future vaccines that may be necessary, and the capacity in this country to manufacture and deliver the next generation of vaccine technologies. The advance in vaccine technology over the past 11 months globally has been extraordinary and it is critical that we in the UK have that future capability. That is something the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), the Minister with responsibility for vaccine roll-out, is concentrating on very clearly.

[Kevin Brennan (Cardiff West) (Lab)]

Thank goodness for science, thank goodness for international co-operation and thank goodness for our NHS. As a Member of Parliament representing the capital city of Wales, obviously I am very interested in how the different parts of the United Kingdom are going to get the vaccine. Can the Secretary of State tell us a bit more about the work his Department is doing with the devolved Administrations to make sure the vaccine is distributed quickly and fairly to all four nations of our UK?

[Matt Hancock]

Yes, this is a UK project that is being done through the NHS in the four nations. The Welsh Government are playing their part. I spoke to Vaughan Gething, my Welsh opposite number, last night to ensure the roll-out was co-ordinated and the final details put in place. There are seven hospitals in Wales that are injecting the vaccine today. I want to thank everybody across Wales for their forbearance. This has been a tough time in Wales. There are still sacrifices to be made while we keep the virus under control until the vaccine can get rolled out through enough of the vulnerable population and we can return life more to normal.

[Suzanne Webb (Stourbridge) (Con)]

With the vaccine now being rolled out, I was thrilled to see this historic moment—in the world, no less—being administered in the west midlands. I urge my constituents of Stourbridge, when the call to arms comes, to please do take up the vaccine. This question has been asked already, but I do not think there is any harm in my right hon. Friend reiterating his answer. Does he agree with me that we must keep adhering to social distancing, and face, space and hands, and that never more so than now is that a moral imperative, so we can all get back together sooner as a non-socially distanced community, with covid-19 confined to a memory only?

[Matt Hancock]

Yes, my hon. Friend puts it very well for the people of Stourbridge and right across the west midlands. We must keep our resolve and stick to the rules. She is right that we have a call to arms, in more sense than one, because we are injecting hope into the arms of people from today. If people are asked to come forward by the NHS then, like her, I urge them to do so.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

The Secretary of State will not be surprised, bearing in mind his track record in rolling out testing and tracing, that the hope offered today comes with some serious concerns about the delivery and administration of the vaccine. He has said repeatedly this morning that there are five contingency plans for delivery in the event of failed Brexit talks. What are they?

[Matt Hancock]

As I said, we have those five contingency plans. The hon. Lady will understand that ensuring we have high security around those plans is also very important. I want to put on the record my thanks to the people of the north-east, who have done so well over the past few weeks in bringing the number of cases under control, in part thanks to the huge injection of testing we have been able to put in because we have built up testing capacity. I look forward to the day, Mr Speaker, when she and I can work together in the public interest, as we do everything we can to keep people in the north-east safe.

[Mr Speaker]

Do you know, I don’t think you’re going to get an answer.

[Elliot Colburn (Carshalton and Wallington) (Con)]

May I join in paying tribute to the NHS, the scientists and indeed my right hon. Friend for today’s amazing news? Carshalton and Wallington residents were touched to hear the words of George Dyer this morning, who, in next door Croydon University Hospital, was the first Londoner to be vaccinated. He said that he was looking forward to going to the shops at Christmas and seeing his family once again. Can my right hon. Friend tell me a bit more about how the vaccine roll-out will roll over into next door Carshalton and Wallington, so that people can share in George’s joy?

[Matt Hancock]

Some of the stories we have heard this morning have been really heart-warming, of people being able to have the confidence to do the things that in normal life we take for granted. I heard the story that my hon. Friend refers to and it was truly charming. I look forward to seeing the roll-out in Carshalton and Wallington, and then I look forward to building a new hospital in Sutton for his constituents.

[Rachael Maskell (York Central) (Lab/Co-op)]

Huge demands are being placed on our NHS staff and they are being asked to step up yet again today, so we thank them for all their efforts. Let me ask about one thing the Secretary of State could help with: instead of every vaccine being individually prescribed, he could issue a patient group directive. Is that in his plan? Will he be doing it?

--- Later in debate ---

[Matt Hancock]

We are working on doing that as soon as it can safely be achieved.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

I join colleagues in thanking the Secretary of State and his team for their incredible hard work, which has brought us to this place. Today is indeed a really good, positive day for the whole United Kingdom. Although the past nine months of pandemic may at times have shone a spotlight on some of the division and tension inherent in our system of devolved government, does he agree that what today fundamentally demonstrates is that when we work together—when we collaborate as a strong family of nations—what we can achieve as a United Kingdom is truly remarkable?

[Matt Hancock]

Yes, I could not put it better than my right hon. Friend, who speaks with such power on this subject. I truly believe that it is only because we, as a United Kingdom, went in so early to be buying and developing these vaccines, using all the strength of our United Kingdom, that we have been able to get to this point before any other country in the world.

[Ben Lake (Ceredigion) (PC)]

Like many others, I welcome today’s developments and agree with the Secretary of State that we can look forward to the new year, when, we hope, further vaccines will come online. He will be aware that there has been some discussion of the relative effectiveness of different vaccines, so will that influence the Government’s distribution strategy in any way? Specifically, will certain vaccines be prioritised for certain groups?

[Matt Hancock]

The Oxford-AstraZeneca vaccine, should it be approved, does have easier logistical and distributional qualities—it does not have to be stored at minus 70°—so that helps. Of course, the JCVI will consider the clinical properties of any vaccine that comes forward when deciding who it can be distributed to, so that is taken into account. Finally, the hon. Gentleman is right to say that this has been an international as well as a UK success. I had a text exchange with my German opposite number this morning to thank, through him, the German scientists who have done so much to make this possible.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con) [V]]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests, as a practising NHS psychiatrist who has been working on the frontline throughout this pandemic. The Secretary of State will be aware that mental health patients are often an afterthought of policymakers, although I am sure that is not the case for him, and that many of them have multiple medical comorbidities, which make them more vulnerable to covid-19. Will he reassure me that patients in mental health services, particularly in-patients, and NHS staff who work in in-patient mental health services will be prioritised for this vaccine and will not be an afterthought?

[Matt Hancock]

Absolutely. NHS staff are in the second priority cohort set out by the JCVI, and that includes all patient-facing staff in the NHS and social care. Patients who are clinically vulnerable to covid absolutely have their rightful place in the prioritisation, according to clinical need.

[Tonia Antoniazzi (Gower) (Lab)]

The roll-out of the covid-19 vaccine today is welcome news, especially for the exciting sporting calendar for 2021, with events such as the Olympics and Paralympics in Japan, the Euros, the Lions tour to South Africa and the women’s rugby world cup in New Zealand, which I must not forget. Concerns have been raised with me about whether sporting competitions will be subject to compulsory vaccination, so what assessment has the Secretary of State made of that—not only for elite sport, but for all competitive sport in 2021?

[Matt Hancock]

We have not made such an assessment; we are still in the early days.

[Steve Brine (Winchester) (Con)]

I think I have sat through every single urgent question and statement that the Secretary of State has done, but the fact that it says “Covid-19 Vaccine Roll-out” on the annunciator screen is still hard to believe. The Secretary of State said earlier that we had got there because of international science. We will deliver global health security only through an international effort—put another way, no one is safe until everyone is safe—so I wonder whether he can update us on how we will work with Gavi, the Vaccine Alliance to help the poorest countries in the world, and of course, those nearest to us who are not the poorest countries, but with which we have a lot of inbound and outbound travel? How can we get them on the same page as us quickly?

[Matt Hancock]

The UK has put more money into the international search for a vaccine, and the distribution of a vaccine to the countries that otherwise would not be able to afford it, than any other state of any size, and we should be very proud of that. The way that we have managed the Oxford-AstraZeneca vaccine is to ensure that it is available on a not-for-profit basis, essentially, worldwide. We have taken this approach because, to put it exactly as my hon. Friend did, nobody is safe until everybody is safe. This is a global pandemic and we need to address it globally. That is the only fundamental way to solve this for the long term. In the short term, what we all need to do is keep following the rules.

[Mary Kelly Foy (City of Durham) (Lab)]

The vaccine is indeed welcome news, but until it is fully rolled out, the north-east will continue to be harmed by the lack of economic support that accompanies tier 3 restrictions. The Health Secretary stated that the restrictions were based on

“cases among the over-60s; the rate at which cases are rising or falling; the positivity rate; and the pressures on the local NHS.”—[Official Report, 26 November 2020; Vol. 684, c. 1000.]

Can he therefore tell me precisely what level these figures will have to be at for the north-east to be moved into tier 2?

[Matt Hancock]

We consider all those figures, and because we consider them alongside special factors such as whether there is an outbreak, we do not put a specific figure on that, as the hon. Lady well knows. But what we have done is put in more economic support than almost any other country in the world, as the International Monetary Fund has recognised. We have tried as best we possibly can to support people through what has been an incredibly difficult year. We have not been able to save every job, but with the economic measures of support for business and the furlough scheme in place, we have put in very significant support. But the best support that people in the north-east, and elsewhere in the country, can have until this vaccine is rolled out is to continue to follow the restrictions that are necessary and then, if they get the call from the NHS, take that vaccine.

[Bob Stewart (Beckenham) (Con)]

A charming lady of 92 has contacted me. She lives on her own, and she cannot get out of the house. I have assured her that the Secretary of State for Health will make especial efforts to ensure that she is looked after and gets her vaccination as soon as possible. Is that correct?

[Matt Hancock]

Yes, if she can travel. When the NHS calls, my advice to my hon. Friend’s constituent is to get that card with that invitation and to phone up my hon. Friend, and he will give her a lift.

[Holly Lynch (Halifax) (Lab)]

This is incredibly welcome news today. Looking ahead to Christmas, I have been approached by a number of emergency service workers in the NHS, policing and other sectors who will miss out on the opportunity to see loved ones because of the window for household mixing—they will still be working on the frontline in the fight against the coronavirus crisis during that period. I appreciate that this is a difficult one to crack, but has the Secretary of State given any consideration to flexibility to ensure that those who really deserve a Christmas with their loved ones can still get it?

[Matt Hancock]

I have a huge amount of sympathy with what the hon. Lady says, and we have looked into this. We are not proposing to extend the Christmas bubbles, but we hope that NHS trusts and employers across the NHS can look compassionately at exactly this situation for all those brilliant colleagues who are working so hard and have had such a tough year.

[Mr William Wragg (Hazel Grove) (Con)]

I always enjoy my exchanges with my right hon. Friend, and this time I mean that when I say it, because this is incredibly welcome news, particularly given Stepping Hill Hospital’s role in the administration of the vaccine. I will certainly encourage all my constituents, when they receive the invitation, to have the vaccine, take it and dispel some of the more eccentric views that are circulating on the internet. Can my right hon. Friend tell me specifically when those with particular vulnerabilities, such as cancer patients, can expect the call for vaccination?

[Matt Hancock]

The plan is, according to clinical priority, to vaccinate those in care homes and their carers; NHS and social care staff, and the over-80s; then the over-75s; and then, at that point, we will turn to ensuring that all those who are on the clinically extremely vulnerable list get vaccinated along with the over-70-year-olds. That is the assessment of the JCVI, which looked into the relative risk that people face and found that age is the No. 1 risk factor.

[Charlotte Nichols (Warrington North) (Lab)]

I am sure the Secretary of State was far from the only one to be emotional today watching the first vaccinations taking place. This is truly a proud day for our country. Although it is right that NHS and social care staff will be among the first to receive the vaccine, what consideration has the Department of Health given to prioritising access for other groups of key workers, including school support staff and workers in transport and essential retail, not only in recognition of the enormous sacrifices that they have made for our nation during the pandemic, but to minimise disruption as we return to normality?

[Matt Hancock]

We looked at that very closely, as did the JCVI, and because of the risk of dying of covid, it is absolutely right that age takes priority. The prioritisation of health and social care staff is also high because they look after those who are most at risk of dying. Once we are through those clinical priorities, then of course, we will be looking to prioritise other workers, including those the hon. Lady mentions.

[Dr Neil Hudson (Penrith and The Border) (Con) [V]]

I congratulate and thank my right hon. Friend, his Department, the NHS, the scientists, the clinicians and everyone involved in the development and roll-out of this covid vaccine technology. Will he provide assurance that logistics are in place to ensure that those in remote rural areas, such as those in Cumbria, will be able to access the vaccination programme without any delay, given that they are some distance from major hospitals?

[Matt Hancock]

Yes, my hon. Friend rightly raises an important point. Vaccination is happening in Cumbria today, which I am really pleased about. Cumbria is, of course, one of the most rural parts of the UK, so when we get to the primary care and the community roll-out, we will make sure that we can get the delivery as close to communities as possible. That is much harder with the Pfizer vaccine because of the minus 70° requirements. The AstraZeneca vaccine is much easier from that point of view, but of course, we do not have that clinically signed off yet.

[Kerry McCarthy (Bristol East) (Lab)]

This morning, at Southmead hospital, 98-year-old Jack Vokes became the first person in Bristol to be vaccinated, which is obviously great news, and I join my colleagues in congratulating NHS staff on all their work at this time. May I press the Secretary of State on the point about transport workers, particularly taxi drivers, who we know are vulnerable not just because of their contact with the public, but because they are overwhelmingly drawn from the black, Asian and minority ethnic communities, which puts them more at risk? Under the headings of prioritising occupations and minimising the inequalities in the second tranche, are they likely to be considered for vaccination early?

[Matt Hancock]

We absolutely will consider that factor when we come to the groups after the clinical prioritised groups. I join the hon. Lady in thanking Jack and all those who have put themselves forward today to be vaccinated, including sometimes in the public eye, as part of this programme to help build confidence in vaccination overall and, of course, to help protect themselves and their loved ones.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con) [V]]

I congratulate my right hon. Friend and his whole team on their Herculean effort to get us to the point where, today, Basildon University Hospital has started delivering the vaccine. Now, as we scale up the roll-out programme, will he join me in reassuring people that, despite the speed of development, not a single stage was missed and that the Medicines and Healthcare products Regulatory Agency has done its usual due diligence in approving this vaccine?

[Matt Hancock]

That is right. The MHRA has gone through the same safety processes as normal, but it has done them in parallel at the same time, rather than in a series, one after another. It is that sort of smart and thoughtful approach, alongside the work of the Vaccine Taskforce in buying the vaccine in the first place, that has allowed us to get to this point of having confidence in the safety and efficacy of this vaccine before anybody else in the world. Everybody in Basildon who gets the call can have confidence that they should come forward, get the jab, protect themselves, protect those around them and, therefore, help us all get through this terrible thing.

[Christine Jardine (Edinburgh West) (LD)]

I echo the sentiment that it is such a pleasure to be able to stand here today and talk about covid-19 with a smile on our faces, and to look forward to 2021 after such a horrific year. That is particularly true for people who are vulnerable and have been shielding, and they will now need reassurance that the vaccine will get to them. Does the Secretary of State agree that, as we go into next year, we should take with us and bear in mind the fact that we have done this across the UK, as a United Kingdom?

[Matt Hancock]

There is more in common than divides us, and we are stronger as a country when we all work together; those two things I have long believed. I have always thought that a vaccine would come through. Lots of people told me that it was not certain and that it could not happen, but I have always driven it forward for the whole UK, because it is the clear route out.

[Damian Collins (Folkestone and Hythe) (Con)]

It is obviously excellent news that the vaccine has been rolled out today. I was delighted to see that my constituent, Kenneth Lamb from New Romney, was the first patient to receive the vaccine at the William Harvey Hospital in Ashford. Does the Secretary of State agree that it is really important that people take the vaccine when they are offered it, and that we do all we can to combat harmful disinformation about it? The next time that he speaks to Mark Zuckerberg, will he remind him that we expect his companies to act against harmful anti-vaccine disinformation?

[Matt Hancock]

Yes, yes and yes.

[The Parliamentary Under-Secretary of State for Health and Social Care (Nadhim Zahawi)]

Thrice yes.

[Matt Hancock]

Thrice yes, indeed; I thank my hon. Friend, who is Stratford’s representative in this place.

My hon. Friend the Member for Folkestone and Hythe (Damian Collins) is right about disinformation. I have been doing a lot of work with Nick Clegg, who is Mark Zuckerberg’s representative on earth. Facebook and Instagram have taken significant strides forward in terms of removing anti-vax content, and I am very grateful to them for the work that they have done. I have no doubt that there is more work that we can all do together, but they have played their part.

[Mr Speaker]

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for three minutes.

Coronavirus Vaccine

Matt Hancock Excerpts

Wednesday 2nd December 2020 Commons Chamber

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

With permission, I would like to make a statement about the coronavirus vaccine.

Today marks a new chapter in our fight against this virus. Ever since the pandemic hit our shores almost a year ago, we have known that a vaccine would be critical to set us free. So all through this arduous year—it has been an arduous year—while we have been working night and day to fight the virus and keep it under control, we have been striving, too, to develop the vaccines that can give us hope and let us eventually release the curbs on our freedoms that have bound us for so long.

Thanks to the incredible work of the Vaccine Taskforce, the Business Secretary and Kate Bingham, we have already amassed a huge portfolio of different vaccine candidates. We have backed seven vaccines and ordered 357 million doses on behalf of the whole UK, one of the biggest portfolios per capita in the world. We have said from the start that a vaccine must be safe and effective before we would even consider deploying it. Any vaccine must go through a rigorous process of clinical trials, involving thousands of people and extensive independent scrutiny from the Medicines and Healthcare Products Regulatory Agency, one of the world’s most respected medical regulators.

Today, I am delighted to inform the House that the MHRA has issued the clinical authorisation of the Pfizer/BioNTech vaccine. This is a monumental step forward. It is no longer “if” there is going to be a vaccine, but “when”. In our battle against the virus, help is on its way. Today is a triumph for all those who believe in science, a triumph for ingenuity and a triumph for humanity, and I thank everyone who has played their part in this achievement. I thank the team at Pfizer, the team of scientists at BioNTech, the volunteers who stepped up and took part in clinical trials, and the MHRA itself, which made sure that this is a vaccine we can all have faith in. Thanks to their efforts, I can confirm that the UK is the first country in the world to have a clinically approved coronavirus vaccine for supply, and now our task is to make use of the fruits of that scientific endeavour to save lives.

We have spent months preparing for this day, so that as soon as we got the green light, we would be ready to go. We were the first country in the world to pre-order supplies of this successful vaccine, and we have 40 million doses pre-ordered for delivery over the coming months—enough for 20 million people, because two jabs are required for each person. Following authorisation, the next stage is to test each batch of the vaccine for safety. I can confirm that batch testing has been completed this morning for the first deployment of 800,000 doses of vaccine. Those doses are for the whole United Kingdom. This morning, I chaired a meeting of Health Ministers from the devolved Administrations to ensure the roll-out is co-ordinated nationwide.

This will be one of the biggest civilian logistical efforts that we have faced as a nation. It will be difficult. There will be challenges and complications, but I know that the NHS is equal to the task. Rolling out the vaccine, free at the point of delivery and according to clinical need, not ability to pay, is in the finest tradition of our national health service, and I am delighted to confirm that the NHS will be able to start vaccinating from early next week.

The whole purpose of the vaccine is to protect people from covid, so that we can get lives back to normal. We will prioritise the groups who are at greatest risk. This morning, the Joint Committee on Vaccination and Immunisation has published its advice, setting out the order of priority according to clinical need, and that includes care home residents and their carers, the over-80s and frontline health and social care workers. We will deliver according to clinical prioritisation and operational necessity. The need to hold the vaccine at -70˚C makes it particularly challenging to deploy.

While we begin vaccination next week, the bulk of the vaccinations will be in the new year. I urge anyone called forward for vaccination by the NHS to respond quickly to protect themselves, their loved ones and their community.

Over the next few months, we will see vaccines delivered in three different ways. First, we will begin vaccinations in hospital hubs. Secondly, we will deploy through local community services, including GPs and in due course pharmacies, too. Thirdly, we will stand up vaccination centres in conference centres and sports venues, for example, to vaccinate large numbers of people as more vaccines come on stream. This is an important step, but we are not there yet, so I stress that we must all keep playing our part, keep following the new rules that the House approved overwhelmingly yesterday and remember the basics, such as “Hands, face space”, and, “Get a test”, which we know from experience are so important in keeping the virus under control.

Before I finish, may I also update the House on another bit of good news? From today, I am absolutely thrilled to say that we can safely allow visits in care homes for those who test negative for covid-19. Coronavirus has denied so many people the simple pleasure of seeing a loved one, which is so precious to so many, especially in our care homes. This is possible only because of the success we have had in building one of the biggest testing capacities in Europe, with local and national teams working together, side by side—something we have often discussed right across this House. We have worked hard on testing. We have worked hard on the vaccine. Our strategy is suppressing the virus until a vaccine can make us safe. That strategy is working, and I am delighted that we will be able to see families and friends come together ahead of Christmas, thanks to this improvement.

This is a day to remember, frankly in a year to forget. We can see the way out of this but we are not there yet, so let us keep our resolve and keep doing our bit to keep people safe until science can make us free.

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

As always, I thank the Secretary of State for advance sight of his statement. This is indeed fantastic news about the Pfizer vaccine, and I join him in congratulating all who have been involved in making this happen. We have rightly clapped carers throughout this crisis. I wonder if we should as a nation come together and applaud our scientists as well one evening. It is also incumbent on all of us across the House to reinforce the case that vaccination saves lives, and if it helps, I will stand alongside the Secretary State, socially distanced of course, on any platform or in any TV studio to show that we are united cross-party in promoting vaccination.

Our constituents will have legitimate questions and they should not be ridiculed for asking them, so will the Secretary of State launch a large-scale public information campaign to answer questions and encourage uptake? Will he consider sending a pamphlet, perhaps, to every household? We know that dangerous myths circulate on social media, and we repeat our offer to work with Ministers to curb online harms. I hope we can work together and take something forward on that front.

Hospital trust staff will start receiving this vaccine first. I understand that it is a massive logistical exercise, given the temperatures and the need for two doses, but could the Secretary of State tell us how many NHS staff he expects to be vaccinated by January, which is of course the time when we expect the NHS to be under the most pressure?

Where does this leave social care and care home residents and staff? There are concerns that this particular vaccine cannot be moved multiple times to care homes, so can he set out exactly how and when care home residents will receive a vaccine? Our constituents will want to know: when will primary care networks start rolling out vaccination, and when will the mass vaccination centres he has reported to the House start opening in our communities?

We have historic strengths as a country with vaccination, but in recent years we have lost our measles-free status. We know that vaccination rates can be lower in poorer and vulnerable communities and that covid has often had a disproportionate impact in these communities, so will he ensure that there is a health inequalities strategy as well in his vaccination campaign, so that black and minority ethnic groups, and the poorest and the vulnerable, do not miss out on this vaccine?

I think we all understand that restrictions will have to remain in place for some time, but can the Secretary of State offer us a timeframe or a target for when we should expect to achieve herd immunity and life gets back to normal? Will he consider publishing a route map of what restrictions could be released as vaccination rates increase? In the meantime, if someone is vaccinated, will they still have to isolate if contacted by Test and Trace, or are they now released from that obligation?

On mass testing, some directors of public health have told me that the lateral flow tests are not licensed for door-to-door testing in hotspots and therefore can only be administered at sites. If that is correct, can the Secretary of State resolve it? If is not correct, can he issue urgent clarity to directors of public health? The Government’s document published on Monday suggests that local areas could use mass testing as a freedom pass. Will he outline to the House what that means in practice? Will local areas enforce rules? What happens if some people have had the test but some have not had the test in a particular area that is supposed to be under tier 3? In the House yesterday, the Prime Minister suggested that people may want to take advantage of mass testing ahead of visiting their families this Christmas. Will the Secretary of State update the House on whether that is the plan and how that will be implemented?

We of course welcome the Secretary of State’s news on care homes, but many care homes report that they will need resources to support the testing exercise. Will those resources be in place?

Finally, if mass testing is to work in communities, people will need support to isolate, if it is found that they have covid when they are not feeling unwell. Will the Secretary of State now expand the eligibility criteria for the £500 grant?

This is a good news day, and we should all pay tribute to everyone who was involved—we should pay tribute to the scientists. I will say again, we will work together to make the case that vaccinations save lives.

[Matt Hancock]

The hon. Gentleman has worked supportively and constructively with the Government throughout this pandemic. I pay tribute to the approach that he has taken, and that he took again today.

I stand with the hon. Gentleman in saying that vaccinations save lives. If we can encourage anybody who might be hesitant to take a vaccine by appearing together to be vaccinated together, of course I would be happy to do that. I recommend that we have a professional vaccinate us, of course—I do not think that he would trust me to do it.

The hon. Gentleman asked for a public information campaign, and there will of course be one. He asked about health inequalities, which are a very important consideration. The best thing to support tackling health inequalities is the fact that we have a vaccine, but we absolutely need to reach all parts and all communities across the whole country.

The hon. Gentleman asked how many will be vaccinated by January. While today brings more certainty, it does not end all uncertainties. We have 800,000 doses that have now passed the batch testing, but the total number to be manufactured over this timeframe is not yet known, because it is all dependent on the manufacturing process, which is itself complicated. After all, this is not a chemical but a biological product, so I cannot answer that question—that is as yet unknowable.

The hon. Gentleman asked when the PCNs and the centres will open. The answer is very soon. We have 50 hospital hubs ready to go from next week. The PCNs are also being stood up, and the centres outside hospitals. They are all coming very soon.

The hon. Gentleman then asked when we will get to lift restrictions. Of course, I understand why not only he but almost everybody in the country wants to know the answer to this question: how many people do we have to vaccinate before we can start lifting the restrictions? The answer to that is that, while we know that the vaccine protects an individual with a 95% efficacy, we do not know the impact of the vaccine on reducing transmission, because of the problem of asymptomatic transmission, which has so bedevilled our response to this virus and made it so hard to tackle.

We do not know the answer to that question, but what we will do is to follow the same five indicators that we were discussing at length yesterday, which are the indicators of the spread of the disease. We will look at the cases, the hospitalisations and of course the number of people who die with covid, and we will hope very much that, as we vaccinate more and more vulnerable people, we will see those rates come down and therefore be able to lift the restrictions. We will have to see how the vaccination programme impacts directly on the epidemic, and then move as swiftly as we safely can to lift the restrictions, which we all want to see gone.

The hon. Gentleman asked about community testing being licensed from door to door. I have not heard about that problem—I will ensure that I get back not only to him, but to those who raised it with him, if he will work with me. I am a bit surprised to hear that. Administering the lateral flow test currently requires a professional, although we hope to move on from that, but as far as I know it can take place in any setting, hence my surprise. However, as the comment was made by a public health professional, I shall dig into it further.

Finally, the hon. Gentleman talked about the testing prospectus we launched on Monday. We hope to be able to use testing to do more things that we would not be able to do without testing. In a way, visits to care homes are an example of that, as something we can now safely recommend that we could not recommend before; so too is testing to release from quarantine people coming into this country. If there are further examples of that sort of enablement of normal life through the use of testing that can be safely done and can be approved by a director of public health and by the chief medical officer and his team, we are enthusiastic about working with local areas to deliver it on the ground.

There are lots of ideas out there, and I urge people to be creative about how we can we can use testing to enable some of the things we love to get going again in a way that keeps people safe. That is what that part of the testing prospectus was about. I am very enthusiastic about it and look forward to working with directors of public health and with colleagues in this House. Yesterday, the Prime Minister said that with the roll-out of mass testing and the availability of these tests, we all, as leaders in our local communities, have a role in promoting mass testing. I am sure that there are communities across the country represented in this House that can benefit from the roll-out.

Looking around the Chamber right now, I see many people who have already approached me—not just from Lancashire. I look forward to working with colleagues in all parts of the House to promote this public health message, along with all the other important public health messages we have to promote, not least that if the NHS phones you up or sends you a letter saying that there is a vaccination slot open to you, just say yes.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I congratulate my right hon. Friend on this moment and the Government on the news about the Pfizer vaccine, but please can we continue to have increased honesty about what we still do not know? We do not know how long the immunity will last, we do not even know whether people who have been vaccinated can still transmit the disease, and of course we do not know whether tier 2 restrictions will succeed in bringing the R rate down. Until we can answer those questions, we will continue to need maximum effort behind contact tracing and isolation of virus spreaders.

Councils including Essex County Council need daily access to all the positive cases recorded by NHS Test and Trace immediately and without delay, so that they can make their own operations effective, so why are they having to wait 48 to 72 hours before they get the data? Also, what are the Government going to do to engage districts and their community volunteer hubs to help to persuade people to support those who must still isolate even if they have been vaccinated?

[Matt Hancock]

Dealing with the pandemic has been a case of dealing with uncertainty in large degree. Today we have more certainty because we know this vaccine is safe and effective, but just as I said to the hon. Member for Leicester South (Jonathan Ashworth) that we do not know the effect of the vaccine on transmission, so, as my hon. Friend says, we do not know the longevity of its effectiveness.

My hon. Friend is right about another part of public health advice that all of us as local representatives can play a part in promoting: that is, engagement with contact tracing. I will write to him about access to daily data in Essex. Of course we have to wait until the test result comes in, which can sometimes lead to delay, even though the results of the majority of tests done in person now come back within 24 hours, but I agree with him in principle, so let us make it a reality in practice.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

As chair of the all-party parliamentary group on vaccinations for all, I welcome the authorisation of the Pfizer vaccine and echo the shadow Secretary of State’s call for a public health campaign to encourage uptake. It will naturally take some time before the vaccine is widely available, so we all still need to stick to the rules and ensure that we can test, trace, isolate and support all those carrying the virus.

Last week, the Secretary of State claimed that the pilot project of mass testing in Liverpool was responsible for driving down cases, despite the city having been under lockdown for much of the time. Lateral flow tests miss up to 40% of cases, so the Government’s plan to use them to free people from isolation are causing concern among many public health and screening experts. When will the formal assessment of the pilot be published, and how can he justify already putting out tenders for £40 billion-worth of contracts to extend that approach without scientific evaluation? Would it not be better to invest some of that money in getting the traditional test, trace and isolate system working properly? Six months on, the Serco and Sitel system has still not improved, and over 40% of contacts in England are still not being informed that they should be isolating.

The Secretary of State does not often talk about it, but he knows that it is not testing but isolation that stops the spread of the virus, so if people who are carrying the virus are not isolating, no amount of mass testing will stop the spread. When I raised the King’s College London report last week which found that less than 20% of cases and only 10% of contacts were isolating, the Secretary of State claimed that the Government have data showing much higher compliance. Can he tell us the figures for isolation rates for those with covid and their contacts? People will not stay off work if it means that they cannot feed their family, so is he concerned at reports that many requests for the isolation payment are being refused? How will he ensure that those carrying the virus are financially supported to isolate and reduce its spread?

[Matt Hancock]

The hon. Lady says that I do not talk about contact tracing very much. I was literally answering a question on contact tracing just before her question— I talk of little else. We are publishing further data tomorrow on contact tracing, precisely in response to the question that she asks. She will see that the continued improvement of our contact tracing across the country is advancing further. I cannot say any more than that, because the figures are not being released until tomorrow.

The hon. Lady asked about scientific evaluation. We are constantly scientifically evaluating the work that is going on, especially in Liverpool. That is one of the things that the scientists who work as part of my team, in NHS Test and Trace and in Public Health England do. It is a matter of constant scientific evaluation, but we will not wait until ages after something has finished to do an overly long evaluation. We have to evaluate as we go along, because we are constantly trying to improve the response to this pandemic, and we are constantly trying to learn. I urge her to support the approach of constant learning and constant improvement. We will have to do that through the roll-out of the vaccine too.

[Dr Whitford]

indicated dissent.

[Matt Hancock]

The hon. Lady shakes her head, but that is how we have to deal with a pandemic in practice.

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

This is a huge personal triumph for the Health Secretary, who has always backed the science. In choosing and backing on behalf of the country the first vaccine to prove efficacious, he has scored a massive goal for the country; he deserves great credit for that. It will also have global significance. I was in a meeting with the World Health Organisation this morning, which congratulated the UK on being the first country to approve a vaccine, because it will encourage other countries around the world to approve vaccines faster.

I want to ask the Health Secretary about something different, which is the plight of people with learning disabilities. He will know that Public Health England says that they are two to four times more likely to die from covid. The news he has given this morning about people in care homes is tremendously welcome, but people with learning disabilities often feel that they are forgotten, particularly those in supported accommodation. Will he redouble his efforts to ensure that they, too, are able to be reunited with their families ahead of Christmas?

[Matt Hancock]

My right hon. Friend is gracious and kind in what he says, and I welcome the WHO’s comments this morning. It has supported the UK approach and rightly commended the MHRA, our independent regulator. It has followed all the same steps that any high-quality regulator would, should and will, but it has followed them rapidly and sometimes in parallel, instead of one after the other. That is how we have got to the position of being the first country in the world to have a vaccine that is clinically authorised; it is because the MHRA has done a brilliant job, working with Pfizer and BioNTech, to make sure that the same safety considerations are looked at but in a way that made the process as fast as is feasibly and safely possible. The WHO has backed that approach. Regulators around the world could take a look at the MHRA, and we should all congratulate it.

My right hon. Friend rightly asks about making sure we vaccinate those with learning disabilities and offer them vaccination at the right point in the prioritisation. I have discussed that important consideration directly with the JCVI, which takes into account the higher mortality of those with any given condition and has done so in the prioritisation that it set out this morning. Age is the single biggest determinant of mortality from coronavirus, which is why age is the predominant factor in the prioritisation, but it is not the only one. That matter has been considered by the JCVI and it is important that we accept and follow the JCVI advice as much as is practicable in the delivery and deployment of this vaccine.

[Munira Wilson (Twickenham) (LD)]

It is, indeed, a fantastic day. I add my thanks and congratulations to everybody who has been involved in getting us to this point, not just in the UK, but worldwide, because this is a great example of global scientific collaboration. May I also pick up on the point about batch testing, which the Secretary of State mentioned on the radio this morning and in his statement? Will he clarify that if we signed up to a mutual recognition agreement with the EU, we would not need to batch test the vaccine again once it arrives in the UK, which could slow down the process, not least because having enough qualified persons to do the batch release testing could be a real challenge? Is he working on a mutual recognition agreement?

[Matt Hancock]

We have that mutual recognition agreement in place now. The hon. Lady is right to point to the global scientific work—work between UK scientists and scientists based in the UK, German scientists at BioNTech, the American scientists and the Belgians, who are producing and manufacturing this vaccine. The approach has been about people coming together right around the world, and the UK has put more into the global search for a vaccine in cash terms than any other country; despite our medium size as a nation, we have been the most generous, and I am really proud of that.

[Lee Anderson (Ashfield) (Con)]

It is great news about the vaccine, and, on behalf of the residents of Ashfield and Eastwood, let me say a big thanks to the Health Secretary, the scientists and the pharmaceutical companies.

The small businesses in Ashfield and Eastwood have taken a massive financial hit during lockdown, despite doing their very best to be covid-secure, while supermarkets have recorded record profits. I have received lots of complaints this week from customers and staff at local supermarkets who say that the stores are overcrowded and not covid-safe; this is happening all over the country and is unfair to the small businesses, which have been hit the hardest. While the UK is being vaccinated, in the run-up to Christmas traders in my constituency will do their very best to beat the virus. Will my right hon. Friend therefore please remind the supermarket executives that they have a duty to protect their staff, customers, our NHS and the whole of the UK in order to beat the virus and get our lives back?

[Matt Hancock]

Yes, I am very happy from this Dispatch Box to remind the supermarkets of their responsibilities to follow covid-secure guidelines and ensure that they are in place for their customers and staff. I pay tribute to my hon. Friend for standing up for the small businesses of Ashfield. It is tough in Ashfield at the moment—I get that. We have the restrictions in place only because they are absolutely necessary. I know that he understands that. He is a strong voice in this Chamber for all the small businesses and residents of Ashfield.

[Jim Shannon (Strangford) (DUP)]

What a joy it was at 7 o’clock this morning to see this news being broken, and to see the Secretary of State as well. I put on the record my thanks to the Secretary of State and all his team for making this happen.

Is the Secretary of State aware that there are still those who are unable to access their flu vaccine? What steps have been taken to ensure that the flu vaccine roll-out is completed before the corona programme begins? What discussions has the Secretary of State had with the Northern Ireland Assembly on providing vaccines and, more importantly, on the roll-out for our vulnerable and our frontline key workers?

[Matt Hancock]

I am grateful to the hon. Gentleman for his kind words. It has been a big team effort. I echo his thanks to the whole team.

We have a further tranche of flu vaccines ready to go; that is just about to be rolled out. Making sure that flu vaccines are available right across the UK is very important. It is an issue that Robin Swann—my opposite number in the Northern Ireland Administration—and I have worked on extensively. He is incredibly diligent in ensuring that we get the flu vaccines rolled out to Northern Ireland. There is an interaction between the massive flu vaccine roll-out programme, which the NHS does every year but which this year is bigger than ever, and at the same time having to do a covid vaccine roll-out. We have taken that into account in the plans. In fact, before the announcement at 6.30 this morning, I was talking to Robin Swann on the phone, which shows how hard-working he is.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I thank the Secretary of State for all his hard work and congratulate him, the Government and all the scientists on the approval of the vaccine. The Secretary of State will know that Medway and neighbouring Swale, both of which are served by Medway Maritime Hospital in my constituency, are currently recording the first and the second highest covid rates in the country. Parts of Gillingham are recording rates as high as 753 per 100,000 people. I thank the Secretary of State for listening to representations from my local authority, myself and other local MPs on providing military assistance with rapid testing in Medway. The Secretary of State also knows that Medway has some of the highest health inequalities in the country, and that health inequalities are linked to high covid rates. Will he join me in paying tribute to the fantastic work of the hospital and its staff in helping local residents?

[Matt Hancock]

Yes, I will. There is a significant problem with the epidemic in Medway and north Kent, which I know my hon. Friend is concerned about. I pay tribute to those working on the frontline at Medway Maritime Hospital, which is one of the most pressured hospitals in the country at the moment, and also thank other parts of Kent and other trusts across Kent for providing mutual aid. We have to get this virus under control in Medway and across north Kent. The way to do that is for everybody to abide by the tier 3 restrictions and to do everything they can to ensure that they do not pass on the disease, and then we can get these cases coming down. At the same time, we are going to inject a huge number of tests into Medway. We are working closely with Medway Council on this, and we will be using the armed forces to help make it happen, because we have to get this virus under control in Medway.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

I add my thanks to the scientists and to the volunteers who put their own health at risk so that we could beat this pandemic. My constituency has been under enhanced restrictions for many months now. The community has worked with the councils and others, and we have finally had a 41% drop in infections in the past week, but we need to go further to get out of the restrictions. Part of that is mass testing. Can the Minister clarify my understanding that councils get £14 per head for mass testing but do not get those boots on the ground from the Army—they get logistical advice and support, not physical help? We cannot do mass testing on the cheap, so will the Minister confirm that he will give the resources to councils? Will mass testing roll out before February 2021?

[Matt Hancock]

Oh yes—mass testing is rolling out as we speak. My team have been working with Kirklees Council to make sure that the council’s enthusiasm for mass testing is matched by the resources that come its way in terms of the tests themselves, the financial support—£14 per test, as the hon. Lady says—and the logistical support from the armed forces. Kirklees’s plans are very advanced, I pay tribute to its local leadership and look forward to working with them to make it happen.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I want to get everybody in but we are getting a little behind schedule, so I ask for succinct questions.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I congratulate the Secretary of State and our Government on their brilliant work to make sure that we were the first country in the world to have a vaccine approved.

It would be worth the Secretary of State’s repeating the criteria and pecking order for the 800,000 doses. A colleague of mine, Councillor Bentley, always says that people need to hear something at least eight times before they embed it, so will the Secretary of State take this opportunity to repeat it?

[Matt Hancock]

Yes, absolutely. We will follow a clinical prioritisation according to need. That starts with those who are resident in care homes and their carers, the over-80s and NHS staff, and then essentially comes down the age range, including those who are clinically extremely vulnerable. Through the experience of the past 10 months, we know, sadly, who is most likely to die of covid, and they are the people we will try to get to first.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

This is hugely welcome news. As well as paying tribute to the scientists, I pay tribute to all the teams in our local health boards who are preparing to deliver the vaccine—particularly Fiona Kinghorn and her team at Cardiff and Vale University Health Board—and the armed forces who have been involved in the process. They have done an absolutely incredible job over the past few weeks to be ready for delivery.

The Secretary of State said, crucially, that this is a UK-wide effort; will he give a cast-iron guarantee that not only this tranche of vaccines but future tranches will be available on a completely equitable basis throughout the United Kingdom, so that we can bear down on this virus in every part of our country?

[Matt Hancock]

Yes, I can give that assurance. I join the hon. Gentleman in thanking the volunteers, whom I should have thanked in response to an earlier question, and also thank in advance everybody in the NHS who is going to be involved in this roll-out. It is going to be a mammoth effort—people are going to be working really hard this winter, when people already work hard during winter in the NHS—and I am sure that the whole House is very grateful to them.

[Greg Clark (Tunbridge Wells) (Con)]

I join the Secretary of State in thanking the scientists who were involved in this major breakthrough for their brilliance and hard work, and I join my right hon. Friend the Member for South West Surrey (Jeremy Hunt) in paying a personal tribute to the Secretary of State, who has been tenacious, positive and energetic right throughout this. We are the first in the world and a lot of that is down to him.

We need to keep the virus suppressed during the months ahead. One of the problems with test and trace is that quite often people do not disclose all their contacts because they do not want them to have to isolate for two weeks. Sir John Bell, whom I know the Secretary of State admires as much as I do, suggests that if we subject people who are isolated to two tests and they are both negative, they should be released. He thinks that will safely encourage people to share their contacts and suppress the spread of the virus. The Secretary of State has moved heaven and earth on vaccination; will he do this for test and release?

[Matt Hancock]

It is a great day for science and a great day to be Chair of the Science and Technology Committee, I would have thought. I am grateful to my right hon. Friend for what he said, which was very generous.

On the point about repeat testing instead of isolation for contacts, that is something we are trialling right now, and I hope we can make significant progress on it in the weeks ahead.

[Geraint Davies (Swansea West) (Lab/Co-op) [V]]

Last Tuesday, the Prime Minister reassured me that Government guidance would stop non-essential travel out of areas in tiers 2 or 3 into less-infected areas. However, in fact the guidance says that

“if you live in a tier 2 area, you must continue to follow tier 2 rules when you travel to a tier 1 area.”

That means that someone can travel from higher-infection areas to lower-infection areas, including to Wales. Will the Secretary of State update the guidance to comply with the Prime Minister’s advice and stop non-essential travel from higher-infected to lower-infected areas ahead of the vaccine?

[Matt Hancock]

The guidance is precisely as set out on gov.uk.

[Mark Jenkinson (Workington) (Con)]

May I place on record my thanks to Kate Bingham and the vaccines taskforce, as well as all the Government Departments that have played their part in this welcome announcement, particularly the part played by my right hon. Friend? Does he agree that as community testing and vaccines are rolled out throughout the winter and into the spring, the need even for localised restrictions will gradually be reduced and that life can begin to return to something closer to normality for my constituents?

[Matt Hancock]

Yes. I have good news for the people of Workington and the whole country, which is that suppressing the virus using these restrictions until a vaccine came along has been the strategy all along, and we can just start to see the light at the end of the tunnel getting much brighter because we know we now have a vaccine.

[Fleur Anderson (Putney) (Lab)]

I also welcome this news and thank all the scientists involved in this great breakthrough. When it is my turn to have the vaccine, I will have absolutely no hesitation in doing so. When it comes to turns, can the Secretary of State confirm that community workers—care workers who work in the community going from home to home—will be part of the first assessment of clinical need? Then, after clinical need, will educational need be a factor in keeping our schools open? A school in Southfields has been closed for the last two weeks for lack of teachers being able to teach, so as a next phase, will educational need be a consideration for the roll-out of the vaccine?

[Matt Hancock]

Once we have got through the clinical priority, of course there is a debate to be had about the order of priority after that. Between now and then, if we can get the repeat testing of contacts up and running and working across the board, I hope that that will be effective in ensuring that fewer teachers have to isolate because they are contacts as opposed to positive cases.

[Mary Robinson (Cheadle) (Con) [V]]

I congratulate my right hon. Friend on securing this vaccine and on his amazing success in preparing us for its speedy roll-out. This is indeed a good news day. The news that hospital staff, care workers and patients will be among the first to receive it will be welcomed in my local hospital and across our care sector. We are keen to make a start. Meanwhile, as the vaccine rolls out to other groups, will my right hon. Friend consider introducing rapid targeted testing at scale in Stockport and across Greater Manchester as we continue to drive down our covid rates and work together to beat the virus?

[Matt Hancock]

Yes, I will. Let us work together and make that happen, with Stockport Council as well, and try to get those rates right down even further than they already are.

[Caroline Lucas (Brighton, Pavilion) (Green) [V]]

I echo the congratulations to all involved with the good news about this vaccination. Last week, I asked the Secretary of State to

“publish the modelling his Department holds on the effect of the relaxation of covid-19 restrictions over Christmas on covid-19 transmission rates”.

Yesterday I was told that it was “not possible to answer” that question yet. That seems quite extraordinary. Has the Secretary of State been given an estimate of how many additional deaths are likely to be caused by the loosening of restrictions over Christmas? If he knows the answer, I ask him to tell us now. If he does not know the answer, why would he make such a major decision without any idea of the number of deaths that could result?

[Matt Hancock]

We have to make judgments based on what is right, balancing the different considerations we have to take into account, including the yearning that many people have to come together at Christmas, and trying to find a balanced way through. We did that by working with the devolved authorities, and I am glad that we came to a UK-wide approach to Christmas, taking into account all the considerations that were necessary.

[Greg Smith (Buckingham) (Con)]

May I add my voice of congratulation to my right hon. Friend and to the scientists, the pharmaceutical companies and everybody involved in today’s good news on securing that vaccine? However, he will know of my deep reservations on the severity of the restrictions being placed on my constituents through the new tier system. I am grateful for the time he took to discuss this with me yesterday. A big part of my reluctant decision to vote with the Government last night was the promise of more granularity when it comes to the review on 16 December. Can he therefore confirm that, if the numbers continue to come down, the Buckingham constituency can be considered for tier 1 before Christmas?

[Matt Hancock]

I enjoyed the conversations that I had with my hon. Friend on the approach to the Division Lobby. I can confirm that the answer to his question is yes.

[Rachael Maskell (York Central) (Lab/Co-op)]

I also congratulate the scientific community on their achievements today. But will the Secretary of State look with precision at the York model of delivering contact tracing? It has been a phenomenal story. Precision of contact tracing interviews has reduced the rate right down. They need the information on day one, not after 48 hours, which is being held back, but they also need to ensure that they get payment and support for people isolating. It works, so will the Secretary of State now follow that model?

[Matt Hancock]

We will not only follow the model; we will promote it. The link between the local authority and the national system in York has indeed had the effect that the hon. Member rightly describes, and the teamwork between the two has meant that the figures in York—I was looking at them this morning—are coming right down. I pay tribute to everybody in York. It is an example of the national and local systems working together. We have to get the case rates right down all the way across North Yorkshire—indeed, everywhere in Yorkshire—and I am sure that we can.

[Stephanie Peacock (Barnsley East) (Lab)]

Barnsley has fewer GPs than areas down south, so will the Secretary of State explain his plan to ensure that places such as my constituency are not left behind in the roll-out of the vaccine?

--- Later in debate ---

[Matt Hancock]

Yes, of course. GPs, pharmacists, and hospital hubs and vaccination centres are the three routes to getting a vaccine. We will do it through the primary care networks, which are groups of GPs, and we will ensure that it is equitable right across the country. It is so important—not only between England and the devolved nations, but within England—to make the roll-out fair right across the land.

[Dr James Davies (Vale of Clwyd) (Con)]

Today’s vaccination announcement certainly is extremely good news. My right hon. Friend has already outlined that there will be equitable provision of the vaccine across the United Kingdom. Will he do the same for community mass testing, and will he outline the logistics involved in getting the vaccines and the community mass testing kits to Wales?

[Matt Hancock]

My hon. Friend, as a GP, understands this subject more than most. We are working with the Welsh Administration to try to get community testing throughout Wales. We are working in Merthyr Tydfil right now to get the case rates down there. I am very happy to work with him, the Welsh Administration and local councils to ensure that we get the case rates down wherever we can.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

As we await the welcome roll-out of a vaccine, test and trace remains vital. In Scotland, over 90% of cases and contacts have been reached, whereas England, with its reliance on Serco, has seen barely 60% of contacts reached—far lower than is needed to meaningfully limit the spread of covid. Will the Secretary of State advise us what clauses are in the contracts regarding this failure to deliver, and what is he going to do about it?

[Matt Hancock]

I gently advise the hon. Member and other Scottish National party Members not to try to make this comparison. I looked into this matter in some detail when somebody else raised it. It turns out that the figures are only comparable if one strips out finding contacts in places where it is easy to get the contacts, such as care homes, because everybody who lives in them can easily be accounted for. Comparing apples and pears like this is not sensible and it is not right. Trying to drive a wedge between the public and private element of the system’s provision—which, by the way, Scotland also has—is a mistake.

[Selaine Saxby (North Devon) (Con)]

I, too, thank everyone involved in today’s good news from North Devon. My right hon. Friend will know that the Nightingale in Exeter has now opened, but he will also know that we are seeing a large number of NHS staff absences across Devon. Can he assure me that the Government are doing everything they can to keep staff safe, and to ensure that we have enough staff to keep all hospitals in Devon running as they should?

[Matt Hancock]

My hon. Friend is right to raise this important issue. I am glad to say that we have more staff working in the NHS in Devon over the last year and we have increased the number of nurses nationally by over 14,000, but there are also those absent because of covid. I hope that regular testing will help to bring that number down; and then, of course, there is the vaccine, which I hope will solve this problem once and for all.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Secretary of State will know that there was much disappointment in Devon that we were put in tier 2, although our rates are only 80 per 100,000 and coming down. Can he spell out exactly what has to happen in Devon over the next two weeks for us to move into tier 1? If the phenomenal success of the York modelling, which virtually eradicated covid in York, is for the reasons that he suggests, why is that not being done elsewhere?

[Matt Hancock]

We are very happy to work with Devon County Council if it wants to come forward for that sort of model. We are constantly learning from around the country. The local-national partnerships often bring lessons, because people have chosen to do things slightly differently in a local area, and we can all learn from that. As for Devon coming into tier 1, Devon does have lower rates than many places, but it is not the lowest area in tier 2, as that honour belongs to my own county of Suffolk. There are elevated numbers of cases in some parts of Devon. What I urge everyone in Devon to do to get into tier 1 is to abide by the tier 2 rules and, more than that, to take personal responsibility to do all they can to reduce the spread of the virus.

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

I say a big well done to everybody involved with this triumph. I share the Secretary of State’s concern over vaccine hesitancy, and he is right to say that everyone in this House has a duty to try to dispel it. Does he agree that, had this House not taken the decision on 16 October to empower the nimble MHRA and leave regulation instead to the European Medicines Agency until 31 December, he would not be in this happy position today?

[Matt Hancock]

Yes, I am very glad that we changed the law to allow the MHRA to make this authorisation on UK terms. This House voted unanimously to do that—well, we did not even have a vote as it went through without one. I am really glad that we were able to do that. I want to thank my right hon. Friend for his support and encouragement throughout this period. It has been a very, very long year as Health Secretary and I really appreciate his support.

[Mr Toby Perkins (Chesterfield) (Lab)]

The Health Secretary spoke about learning lessons and continuing to improve the system. My partner’s daughter is currently self-isolating because someone in her class at school has got coronavirus. She comes home and lives with her sister who is still expected to go to school. Surely a world-class testing system would be testing everyone in the bubble of those who had been sent home so that immediate family could be identified as having the virus or not, and could take appropriate action. Is there any more that can be done to improve this so that people such as my partner and many other parents at Holymoorside school will be able to take the necessary steps?

[Matt Hancock]

Yes, we are piloting exactly that idea in, I think, eight schools right now and I hope to be able to roll it out once we have learned from those pilots.

[Karl MᶜCartney (Lincoln) (Con) [V]]

My right hon. Friend will be aware that Lincoln has a high student population, something of which I am very proud, and that our two universities are highly regarded. Quite a number of constituents have contacted me regarding the potential increase in cases when students return in January. What steps is he taking to support universities with this and what further steps can we take to support students who have to isolate as, often, they are far away from loved ones who can support them with shopping and so on and, as a Government we must do all we can to ensure that education continues as normal?

[Matt Hancock]

Yes, my hon. Friend is absolutely right. Just as when students go home for Christmas, we are able to use the massive testing capacity that we have built up to ensure that they do so safely, so we propose to use testing to allow students to return safely. It is rather like the previous answer I just gave about being able to use testing instead of isolation in schools. I say gently to the hon. Member for Chesterfield (Mr Perkins) who, as he sat down, muttered about this: it is far better to work together, and it is only because of the massive testing capacity that has been built up through the actions of this Government that this is possible. We have the biggest testing capacity in Europe and we can use it for keeping people safe in schools and for allowing people to go safely to and from universities. This is exactly the sort of empowerment that we now have as a result of the huge testing programme that we have built.

[Liz Twist (Blaydon) (Lab)]

Last week we celebrated Carers Rights Day, and today they are not included on the priority list issued by the Joint Committee on Vaccination and Immunisation. They do a huge job in looking after some of our most vulnerable people. Will the Health Secretary look again at that decision?

[Matt Hancock]

I am very happy to ensure that the JCVI takes all the appropriate considerations into account. However, it is not my decision to look at again. My decision is that we should follow the clinical advice. I think we should respect the JCVI, which is hugely expert in the clinical advice it gives.

[Jason McCartney (Colne Valley) (Con)]

It is fantastic news about the vaccine, but we cannot be complacent. The Kirklees director of public health briefed me and other local MPs last night that Kirklees needs to be in tier 3 right now. We were in the top five councils for covid cases, but good local action, combined with the national lockdown, has helped to reduce cases by 41%. Can the Health Secretary confirm that he will use localised data at the first review of the tiers on 16 December so that, if we continue that progress, we might be able to come out of tier 3? In the meantime, will he speak again to the Chancellor to see what extra financial support we can give to our pubs, restaurants and cafés at this challenging time?

[Matt Hancock]

Yes. Of course, the Prime Minister announced extra funding for wet pubs yesterday. I am very happy to have a further discussion on that matter, but I also pay tribute to Kirklees, the people who live in Kirklees and my hon. Friend’s constituents, because it has been tough and it has been a long time. These measures have been in place for longer than almost anywhere else in the country, and the rates are now really coming down. Everybody should be very grateful for that.

[Mr Kevan Jones (North Durham) (Lab)]

The Secretary of State talks a lot about partnership at local level. Two weeks ago, his Department contacted the local public health directors and asked them to draw up plans for care home testing. Last week, his Department sent out a letter directly to care homes, bypassing those local directors of public health, to introduce testing in those care homes. Why was the approach changed? How will the data from that testing in local care homes be fed through to local directors of public health to do local tracing?

[Matt Hancock]

It is very important that tracing happens, and the data, as the right hon. Gentleman knows, is fed through to councils where that data agreement has been put in place. The best approach is for councils and the national system to work well together.

[Andrew Griffith (Arundel and South Downs) (Con)]

Will the Health Secretary and his colleagues accept my congratulations on making sure the UK is one of the first countries in the world to have a deployable vaccine? Does he agree that businesses and their employees in the UK pharmaceutical sector, which invests over £4 billion a year of private risk capital, are heroes every bit as much as our wonderful NHS employees on the frontline?

[Matt Hancock]

Absolutely, and my hon. Friend gives the lie to this idea that we should somehow split public and private. I want to pay tribute, on behalf of all those in the House who believe in private enterprise, to everybody: the major global pharmaceutical companies such as Pfizer and AstraZeneca, the small entrepreneurial start-ups such as BioNTech and all those who have come to the aid of the nation. If they do it and make a profit, if they do that to save lives, that is fine by me.

[Chris Bryant (Rhondda) (Lab)]

Advent always starts with the prospect of good news, so this is a really good Advent. [Interruption.] Says the former vicar. Yes, quite.

Can I add one element to this issue of the prioritisation of vaccination? Covid has savagely exposed the health inequalities across the whole country. The poorest communities have suffered most, and the poorest communities often have the fewest health services and the least additional capacity to be able to deliver vaccination. As part of the mix, can we make sure that equality, real equity, across the whole country means that the poorest communities may need additional support?

[Matt Hancock]

Yes. The hon. Gentleman raises a point that is important for the vaccination programme but also important thereafter, because if levelling up means anything, it means trying to level up health and make sure that the health inequalities of which he speaks are addressed.

[Joanna Cherry (Edinburgh South West) (SNP) [V]]

Everyone involved in delivering this great news is to be congratulated, including the Secretary of State. The First Minister, Nicola Sturgeon, has said that provided that we receive the first doses of the vaccine as soon as we are expecting them in Scotland, we can start vaccinating people on Tuesday next week. Will the Secretary of State join me in applauding all at NHS Scotland who are going to make this possible?

--- Later in debate ---

[Matt Hancock]

Yes, I absolutely will. Our goal and our aim, and the commitment and agreement between all four nations of the United Kingdom, is that we will all start vaccination at the same time, fairly, across the four nations. That will happen early next week. When the announcement was made at 7 am, the one remaining regulatory hurdle was the batch testing, and that has now been completed, so we are on track to deliver on that commitment, which will be delivered through the NHS in all four corners of our land. We are working closely together. I spoke to my opposite number in Scotland early this morning to make sure that we are as co-ordinated as possible. This UK-purchased vaccine being delivered by NHS Scotland is a really good example of the power of this country when we all work together.

[Alicia Kearns (Rutland and Melton) (Con) [V]]

The first country in the world to have a vaccine, and a world-class testing programme—what a phenomenal achievement. I thank my right hon. Friend and all the scientists and clinicians who have made today a reality. I am pleased that before Christmas we should have vaccine centres established in Oakham and in Melton Mowbray in my constituency. Will he please join me in extending his thanks to my local councils, our clinicians and residents for their enormously hard work to get ready to bring this vaccine to my communities?

[Matt Hancock]

Yes, I absolutely will. I pay tribute to their work on preparing for the vaccine roll-out, and also their work in keeping the virus under control, which is such an important task, is so difficult, and has consumed so much effort this year, yet there is still more work to be done over this winter to get the vaccine rolled out.

[Ms Angela Eagle (Wallasey) (Lab)]

Two injections per person for everyone in the country is going to take an awful long time. The Prime Minister was hoping that it would be done by Easter. Does the Health Secretary share that timetable or will he publish another one? Is he planning on making this vaccine available again next year, since we do not know how long immunity lasts, and covid is likely to be endemic and with us for some time to come?

[Matt Hancock]

The hon. Lady asks two incredibly important questions, the first of which the hon. Member for Leicester South (Jonathan Ashworth) asked and I did not answer, for which I apologise. The speed at which we can continue this roll-out will be determined by the speed at which Pfizer can manufacture and whether the AstraZeneca Oxford vaccine, of which we have 100 million doses on order, is approved by the MHRA. I am afraid that I cannot answer the hon. Lady’s question on the timetable, or indeed the hon. Gentleman’s, because it is dependent on the approval of AstraZeneca and the manufacturing process of the Pfizer vaccine.

On the hon. Lady’s second question, I have completely forgotten what it was. [Hon. Members: “Next year.”] Next year, yes, and whether this vaccine is only short-term. One of the reasons we have 357 million doses from seven different vaccines is to be able to vaccinate with further doses if that is needed in due course, whether that is through re-procurement of one of the existing vaccines or by switching to a different vaccine if that is clinically appropriate. That is absolutely part of the potential future plans that we have under consideration, but it is too early to know the answer to that question as well.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is wonderful news on the vaccine—many congratulations to all involved, including the Secretary of State. He will concede that it will be some months before restrictions can be lifted. North Yorkshire is the largest county in England by miles—it takes three hours to drive from one side of it to the other—and the variation in infection rates is considerable across the region. Will he consider, when he moves tiers around in two weeks’ time, moving one of the seven districts of North Yorkshire with low infection rates into tier 1?

[Matt Hancock]

As the Prime Minister said yesterday, we do look at the human geography and how the epidemiology shows the spread of the virus is occurring across the country, especially, but not limited to, the big rural counties. We have to be slightly careful in North Yorkshire. One of the challenged areas is Scarborough, where the case rates are elevated. I appreciate that that is a long way from my hon. Friend’s patch. We do look at it at that granular level and make decisions on that basis, but the decision to put the whole of North Yorkshire into tier 2 was taken looking at each part of North Yorkshire on its merits.

[Margaret Greenwood (Wirral West) (Lab) [V]]

Dr de Gruchy, the president of the Association of Directors of Public Health, has said:

“it is completely incomprehensible that the Government is not increasing the public health grant”

to local authorities next year. She spoke of the importance of

“learning the lessons of how existing health inequalities have driven and exacerbated the impact of COVID-19”,

as well as addressing

“the socio-economic determinants of health”

and giving public health teams the resources they need both to continue the fight against covid-19 and for the longer term. Will the Secretary of State pay heed to that message, and will he call on the Chancellor to give local public health teams the funding they need?

[Matt Hancock]

We are increasing the public health grant next year. Also, the public health grant is but one part of the massive overall investment in public health that we have made this year and will, of course, have to continue to make next year as we get the virus under control.

[Sara Britcliffe (Hyndburn) (Con)]

The news this morning about the vaccines gives my constituents in Hyndburn and Haslingden light at the end of a very dark tunnel. The announcement on care homes is genuinely brilliant news and something I have pushed for, as the Secretary of State will know, both in and out of this Chamber. As has been mentioned, mass testing is also a vital part in our fight against coronavirus. Will the Secretary of State confirm when it will be rolled out in tier 3 areas such as Hyndburn and Haslingden, so we can continue to get our rate down and get our brilliant hospitality sector up again?

[Matt Hancock]

My hon. Friend is right. The candle of hope is burning brighter today. On the mass testing she is so enthusiastic about, I can tell her that this morning when I asked my officials to ensure that the community testing programme that is being developed for Hyndburn is advanced as quickly as possible, they told me that they had been told of the need for it by so many people and that so many people had been lobbied by her, that it was already in hand. I suppose that that goes to show just how vociferous my hon. Friend is in fighting for the people of Hyndburn.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. We will have a three-minute suspension.

Virtual participation in proceedings concluded (Order, 4 June).

HIV Commission

Matt Hancock Excerpts

Tuesday 1st December 2020 Commons Chamber

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

Just a few minutes ago at this Dispatch Box, I was here to update the House on the national effort to fight the new pandemic of our times. As we grapple with this one pandemic of coronavirus, so too we need to look today at both the progress we have made and the progress still needed, to mourn the loss of those who have been taken from us, and to redouble our efforts in our fight against another killer pandemic, HIV.

Just like coronavirus, HIV was a challenge for humanity that, at times, especially early on, seemed almost impossible to surmount, but thanks to the ingenuity of scientists, the compassion of healthcare professionals and the determination of people living with HIV and their loved ones, we have made so much progress against this disease. So today, on World AIDS Day, let us all commit, across the House and in all parts of our country, to stand firm against the disease that threatens us and commit that we will give it no ground.

I thank my hon. Friend the Member for Winchester (Steve Brine) for securing this debate. He worked tirelessly on this issue when he was a ministerial colleague—a brilliant Public Health Minister—and I want to tell the House in all honesty that he was absolutely pivotal to so many of the achievements and aspirations that we are discussing today. Without him, I wonder whether the 2030 commitment could have been made. We should all be grateful to him for his dedicated work in office and his continued powerful advocacy. He mentioned the “Don’t Die of Ignorance” campaign and I can tell him and the House that the early messaging in the coronavirus pandemic, including “Stay at Home”, was explicitly inspired by that campaign, which was so successful and so brave.

Every day when I walk into my Department, I walk past a list of my predecessors on the wall, and I feel honoured to follow in the footsteps of Lord Fowler, who did so much to tackle this pernicious virus and who, in particular, took a view and a judgment that we must face it on the basis of compassion and science. That was central to the decision that this country took all those years ago, and I am glad to say that we have followed it ever since.

We have made significant progress since those dark days when, as my hon. Friend said, HIV was a death sentence for so many. Now, if diagnosed early and with access to appropriate treatments, the majority of people with HIV in this country can have a life expectancy that is close to normal. I am so proud that, here, the overall number of people with a new HIV diagnosis has fallen by over a third over the past five years and that the number of gay and bisexual men with newly diagnosed HIV has fallen to its lowest point in 20 years. I am also really proud that, through the efforts of so many people, we have met our UNAIDS 90-90-90 target for the third consecutive year and that we were one of the first countries in the world to do so. That means more than 90% of people who live with HIV being diagnosed, more than 90% of those diagnosed getting treatment, and more than 90% of those who are treated having quantities of HIV that are so small that it is undetectable.

[Alison Thewliss]

The Secretary of State is talking about the excellent progress that has been made, and I acknowledge that that is true, but one area where there is still significant difficulty is among intravenous drug users, particularly in the city of Glasgow. We want the public health intervention of a supervised drug injection facility, but the Home Office is blocking this. Does he agree that there needs to be a public health approach to this, otherwise we will not be able to treat those remaining percentages of people who still have the virus?

[Matt Hancock]

I was immediately going to turn to say that despite the successes, there is further to go and we would all agree on that. We need to follow the evidence of what works and, crucially, we need to work together. I know that the Home Secretary has been working with the Administration in Scotland on the approach to be taken. The attitude that we should have is that every new case of HIV is one case too many.

That brings me to the commitment that we were able to make two years ago. At the suggestion of my hon. Friend the Member for Winchester, I announced the commitment to ending new HIV transmissions by 2030. I remember being told at the time that this was an ambitious target, but I know that we can get there. This year, we have been making PrEP routinely available across England to those who need it, and have backed that with funding for local authorities. None the less, it is really this report from the HIV Commission that shows us the way. I want to thank all those who have been involved: the Terrence Higgins Trust, of course; the National AIDS Trust; the Elton John AIDS Foundation; Public Health England; and work across the devolved Administrations. I also take this opportunity to thank Sir Elton for his exceptional personal advocacy for people living with HIV and the sterling work that he has done to raise money for HIV prevention and treatment across the world, and to thank all those who have played their part in getting us to where we are.

Let me turn now to the work of the commission itself. I know that colleagues across the House have played an active role in it. The report that the commission has published today makes many important recommendations for how we can progress on our path to zero. I pay tribute to all the commissioners for their hard work and thank each and every one of them. I wish to put on record my thanks and praise for Dame Inga Beale for her expert leadership.

My hon. Friend set out the core recommendations, which include the interim milestone of an 80% reduction in new HIV transmissions by 2025, early diagnosis at the core of the approach we should take and the default assumption of test, test, test—that sounds familiar, and we know that it works—as well, of course, as the expansion of testing.

The reason I wanted to come to the House personally tonight was so I could say this: we will use the excellent report of the HIV Commission as the basis of our upcoming HIV action plan, which I commit to publishing next year. I want that to be as early next year as is feasible to ensure that the work is high-quality, can be delivered and can set us fair on a credible path to zero new transmissions in 2030. I look forward to working with Members from all parts of the House in making that happen.

[Stephen Doughty]

May I, on behalf of the all-party group, thank the Secretary of State for that commitment, which is absolutely crucial? I know it will be welcomed by me and my predecessor, who cannot speak here. Will the Secretary of State also commit to doing all we can as a country, working with his colleagues at the Foreign, Commonwealth and Development Office and elsewhere, not only to ensure that our commitments globally are met in the UN Global Fund, but also to support the world-beating research that goes on in places such as the international AIDS vaccine initiative at Imperial College, which is leading the way towards treatments and vaccines not only for HIV but for so many other infectious diseases, including covid?

[Matt Hancock]

The cross-party nature of the support for this work could not be better demonstrated than by the fact that when our colleague from the Scottish National party, the hon. Member for Glasgow Central (Alison Thewliss) intervened, she anticipated my very next sentence, and so has the hon. Gentleman. I wanted immediately to turn to the global matters, because no one is safe until everyone is safe. If we have learned anything this year, we have learned that. We also need to work on shared solutions together and across the world, and we as a country will lean into the global efforts to tackle HIV and AIDS, as we have done under Governments of all persuasions over the past three and a half decades.

[Jim Shannon]

In my intervention on the hon. Member for Winchester (Steve Brine), I referred to the good work that has been done in Swaziland. From a global point of view, I just wonder whether the Secretary of State will be able to make contact with Swaziland and see how it has reduced the numbers.

[Matt Hancock]

I would be very happy to ensure that that happens and to work with the hon. Gentleman on a subject that I know is close to his heart. I reiterate that over the past three and a half decades, here in the UK we have played our part in supporting efforts right around the world. I am proud that we are the world’s second-largest donor to the Global Fund, which is reallocating up to $1 billion to support the prevention and treatment of HIV and other threats to global public health during the pandemic. We have to make sure that work goes on, even in the clutches of another public health emergency. It is absolutely critical that we do not let up, because we cannot let one virus undo the progress we are making in fighting another.

Today is a day to look back and remember those we have lost to HIV. It is a day to look back and acknowledge the progress we have made, but it is also a day to look forward and together reaffirm our resolve to keep working towards that goal of no new infections in 2030, because HIV is a virus that has taken too many people before their time. We should all redouble our efforts to make it a thing of the past.

Question put and agreed to.

Public Health England: Annual Report and Accounts 2019-20

Matt Hancock Excerpts

Thursday 26th November 2020 Written Statements

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

I wish to inform the House of the publication of Public Health England’s annual report and accounts for the financial year 2019-20. A copy of the annual report and accounts 2019-20 (“the Report”) has been laid before both Houses.

Public Health England (PHE) is an Executive agency of the Department of Health and Social Care, providing the evidence, support and advice needed locally, nationally and internationally. PHE is responsible for four critical functions: protecting the public’s health; improving the public’s health, improving population health; and supporting the capacity and capability of the public health system in England.

The report sets out the activity, performance and expenditure of PHE for key areas of its business for 2019-2020 financial year and reflects the position as at 31 March 2020. The report is based on activity in the 2019-20 financial year and notes that some performance in the final quarter was impacted because PHE rigorously reprioritised to free up significant internal resource for the covid-19 response.

As referenced in the report, on 18 August 2020, the Government announced the establishment of a new National Institute for Health Protection (NIHP), which will bring together the additional testing capacity at scale of NHS test and trace, the joint biosecurity centre intelligence and analytical capability with the public health science and health protection expertise of PHE. NIHP will be formally and fully established in 2021.

NHS test and trace and PHE put in place integrated arrangements on the covid-19 response and created a joint situational awareness team to provide analysis and insight into the progression of the virus, under single leadership.

Until further formal changes are made, PHE continues to operate and deliver its core functions in line with its framework agreement and continues to be held to account for delivery against the priorities set by Government in the annual strategic remit and priorities letter and agreed business plans through formal quarterly accountability meetings. PHE’s governance boards and groups and PHE’s advisory board also continue to operate. There will be a continued focus on responding to covid-19, now and throughout the winter. Health improvement, preventing ill health and reducing inequalities will also remain priorities for PHE, prior to full transition to new arrangements.

Work is underway to determine the right future arrangements for PHE’s vital non-health protection functions, including health improvement responsibilities, and we will engage widely on proposals before implementing new arrangements in 2021.

[HCWS606]

Covid-19 Update

Matt Hancock Excerpts

Thursday 26th November 2020 Commons Chamber

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

With permission, I would like to make a statement on coronavirus. We are approaching the end of a year where we have asked so much of the British people. In response to this unprecedented threat to lives and to livelihoods, the British people have well and truly risen to the challenge by coming together to slow the spread and support each other. I know how difficult this has been, especially for those areas that have been in restrictions for so long. The national measures have successfully turned the curve and begun to ease pressure on the NHS. Cases are down by 19% from a week ago, and daily hospital admissions have fallen 7% in the last week.

January and February are always difficult months for the NHS, so it is vital that we safeguard the gains we have made. We must protect our NHS this winter. We have invested in expanded capacity, not just in the Nightingales, but in hospitals across the land, and we have welcomed thousands of new staff. This morning’s figures show that the number of nurses in the NHS is up 14,800 compared with just a year ago, so we are well on our way to delivering on our manifesto commitment of 50,000 more nurses. Together, while we invest in our NHS, we must also protect our NHS, so it will always be there for all of us during this pandemic and beyond.

I am so grateful for the resolve that people have shown throughout the crisis. Thanks to this shared sacrifice, we have been able to announce that we will not be renewing our national restrictions in England, and we have been able to announce UK-wide arrangements for Christmas, allowing friends and loved ones to reunite and form a five-day Christmas bubble. I know that this news provides hope for so many, but we must remain vigilant. There are still today 16,570 people in hospital with coronavirus across the UK, and 696 deaths were reported yesterday. That means 696 more families mourning the loss of a loved one, and the House mourns with them.

As tempting as it may be, we cannot simply flick a switch and try to return life straight back to normal, because if we did that, we would undo the hard work of so many and see the NHS overwhelmed, with all that that would entail. We must keep suppressing the virus, while supporting education, the economy and the NHS until a vaccine can make us safe. That is our plan. We will do that by returning to a tiered approach, applying the toughest measures to the parts of the country where cases and pressure on the NHS are highest and allowing greater freedom in areas where prevalence is lower.

While the strategy remains the same, the current epidemiological evidence and clinical advice shows that we must make the tiers tougher than they were before to protect the NHS through the winter and avert another national lockdown. We have looked at each of the tiers afresh and strengthened them, as the Prime Minister set out on Monday. In tier 1, if you can work from home, you should do so. In tier 2, alcohol may only be served in hospitality settings as part of a substantial meal. In tier 3, indoor entertainment, hotels and other accommodation will have to close, along with all forms of hospitality except for delivery and take away.

I know that people want certainty about the rules they need to follow in their area. These decisions are not easy, but they are necessary. We have listened to local experts and been guided by the best public health advice, including from the Joint Biosecurity Centre. We set out the criteria in the covid-19 winter plan, and we publish the data on which the decisions are made. As the winter plan sets out, the five indicators are the case rate in all age groups; in particular, cases among the over-60s; the rate at which cases are rising or falling; the positivity rate; and the pressures on the local NHS.

When setting the boundaries for these tiers, we have looked at not just geographical areas but the human geographies that influence how the virus spreads, such as travel patterns and the epidemiological situation in neighbouring areas. Although all three tiers are less stringent than the national lockdown we are all living in now, to keep people safe and to keep the gains that are being made, more areas than before will be in the top two tiers. That is necessary to protect our NHS and keep the virus under control.

Turning to the tiers specifically, the lowest case rates are in Cornwall, the Isle of Wight and the Isles of Scilly, which will go into tier 1. All three areas have had very low case rates throughout, and I want to thank residents for being so vigilant during the pandemic. I know that many other areas would want to be in tier 1 and understand that.

My constituency of West Suffolk has the lowest case rate for over-60s in the whole country, and I wish to thank Matthew Hicks and John Griffiths, the leaders of Suffolk County Council and West Suffolk Council, and their teams for this achievement. However, despite that, and despite the fact that Suffolk overall has the lowest case rate outside Cornwall and the Isle of Wight, our judgment, looking at all the indicators, and based on the public health advice, is that Suffolk needs to be in tier 2 to get the virus further under control. I hope that Suffolk and so many other parts of the country can get to tier 1 soon, and the more people stick to the rules, the quicker that will happen.

We must make the right judgments, guided by the science. The majority of England will be in tier 2, but I am afraid that a significant number of areas need to be in tier 3 to bring case rates down. I know how tough this is, both for areas that have been under restrictions for a long time, such as Leicester and Greater Manchester, and for areas where cases have risen sharply recently, such as Bristol, the west midlands and Kent. The full allocations have been published this morning and laid as a written ministerial statement just before this statement began. I understand the impact that these measures will have, but they are necessary given the scale of the threat we face.

We will review the measures in a fortnight and keep them regularly under review after that. I want to thank everybody who is in the tier 3 areas for the sacrifices they are making to protect not just themselves and their families but their whole community. Regardless of their tier, I ask everyone to think of their own responsibilities to keep the virus under control. We should see these restrictions not as a boundary to push but as a limit on what the public health advice says we can safely do in any area. Frankly, the less any one person passes on the disease, the faster we can get this disease under control together—and that is on all of us.

We must all play our part while we work so hard to deliver the new technologies that will help us get out of this, in particular, vaccines and testing. The past fortnight has been illuminated by news of encouraging clinical trials for vaccines, first from Pfizer-BioNTech, then from Moderna and then, earlier this week, from the Oxford-AstraZeneca team. If these vaccines are approved, the NHS stands ready to roll them out as soon as safely possible.

Alongside vaccines, we have made huge strides in the deployment of testing. Our roll-out of community testing has been successful, because it means we can identify more people who have the virus but do not have symptoms and help them isolate, breaking the connections that the virus needs to spread. As part of our covid-19 winter plan, we will use these tests on a regular basis, for instance, to allow visitors safely to see loved ones in care homes, to protect our frontline NHS and social care colleagues and to allow vital industries and public services to keep running safely.

We have seen in Liverpool, where more than 300,000 people have now been tested, how successful this community testing can be. I want to pay tribute to the people of Liverpool, both for following the restrictions and for embracing community testing. It has been a big team effort across the whole city and the result is that in the Liverpool city region the number of cases has fallen by more than two thirds. In the borough of Liverpool itself, where the mass testing took place, cases have fallen by three quarters. It has not been easy and, sadly, many people in Liverpool have lost their lives to covid, but thanks to people sticking to the rules and to the huge effort of community testing, Liverpool’s cases are now low enough for the whole Liverpool city region to go into tier 2. This shows what we can do when we work together. We can beat the virus. I want to pay tribute to the people of Liverpool, NHS Test and Trace, the university, the hospital trust, Mayor Joe Anderson and so many others who have demonstrated such impressive leadership and responsibility, and a true sense of public service.

We are expanding this community testing programme even further to launch a major community testing programme, homing in on the areas with the greatest rates of infection. This programme is open to all local authorities in tier 3 areas in the first instance and offers help to get out of the toughest restrictions as fast as possible. We will work with local authorities on a plan to get tests where they are needed most and how we can get as many people as possible to come forward and get certainty about their condition. The more people who get tested, the quicker a local area can move down through the tiers and get life closer to normal.

Viruses can take a short time to spread but a long time to vanquish. Sadly, there is no quick fix. They call upon our determination to make sacrifices that will bring them to heel and upon our ingenuity to make scientific advances that will get us through. Hope is on the horizon, but we still have further to go, so we must all dig deep. The end is in sight. We must not give up now. We must follow these new rules and make sure that our actions today will save lives in future and help get our country through this. I commend the statement to the House.

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

I thank the Secretary of State for advance sight of his statement. I suppose that we should all thank him for advance sight of the website, but sadly, it crashed before we could check what tiers we were in.

The news of a vaccine is indeed light at the end of the tunnel, but we are still in the tunnel and we have a significant way to go to drive infection rates down and keep our constituents safe. We understand why tough restrictions are still needed, but let us be clear: today, millions of people trying to survive in the second lockdown will soon be forced to endure further local lockdown restrictions, so does the Secretary of State accept that these interventions succeed when made in tandem with local communities?

I remember that when areas such as Bury and Trafford went into lockdowns in the summer, the Secretary of State promised that MPs would be involved in the decision. Has that commitment been abandoned? Then, Ministers agreed to involve regional leaders, but took exception to being challenged by Andy Burnham, so what role do regional leaders now have in these decisions, or is the position really that the Prime Minister imposes from Downing Street restrictions on communities across the midlands and the north—restrictions that will have a huge impact on the livelihoods of families and small businesses?

Christmas, the Secretary of State will know, is vital for pubs, restaurants and entertainment venues across those areas. They will need substantial financial support to get through this period. Will those areas that went into tier 3 lockdowns before the national lockdown, such as Greater Manchester and South Yorkshire, get backdated economic support for their local small businesses?

Parts of the country, such as my own city of Leicester, Bury, Leigh and Heywood, have been under a form of lockdown for months, with families forced apart and grandparents not seeing their grandchildren. Those families today will want to know what the exit strategy is and what voice they will have in that strategy. The Secretary of State has outlined five criteria by which local lockdowns will be judged. Will he publish clear, transparent rules for areas entering and leaving tiers—a score card for every area, assessing its covid progress against its criteria, so everyone can judge this publicly?

The Secretary of State talks of mass lateral flow testing, and we welcome the advances, but over two weeks ago he announced he was sending, I think, 930,000 of those tests to local authorities, yet only around 8,500 are being used a day. Can he explain why that is? He will also be aware—I am sure that he will have studied this—that Slovakia recently tested more than 3 million people over a weekend using those tests. The Slovaks incentivised people to get tested by offering greater freedoms. Is that part of the Government’s thinking on how those tests could be used?

Evidence from Liverpool suggests that there is a lower take-up of tests in poorer, harder to reach communities. Is not the problem that if people and their contacts feel they will be financially penalised for a positive test, they will avoid a test, they will switch off the app and they will not answer their phone to unrecognised call centre numbers? The reason people soldier on when ill is not a stiff upper lip: it is that they cannot afford to feed their families otherwise. Surely, after months and months, it is now obvious that low-paid people such as care workers on zero-hours contracts need better support to isolate. Why did the Chancellor not increase statutory sick pay in the spending review yesterday?

The test and trace budget has now increased to £22 billion, more than the annual budget for the police and the fire service combined, yet the Office for Budget Responsibility yesterday confirmed that its forecasts are based on the fact that

“a less effective TTI”—

test, trace and isolate—

“system necessitates keeping a more stringent set of public health restrictions in place over the winter.”

At what point will the Secretary of State accept that the current Serco model has failed? I am not against using the private sector, but I am against throwing shedloads of taxpayers’ money at failing private sector contracts. Local authorities, especially those now in tier 3, should be leading this retrospective contact-tracing work, and they should be given the data from day one, so they can get on with it. By the way, why was there no uplift yesterday in the public health grant? Surely, this is a time when we should be investing in public health, not freezing the grant.

On the easements for Christmas, there will indeed be relief in families across the country, but the Secretary of State will understand that there will also be nervousness across the NHS. We need a clear public health message: asking people to be jolly careful is not good enough. He will know that January is an immensely busy and pressured time for our NHS. It is not just the patients filling up covid beds; it is the emergency pathways that are already running at hot and it is the immense elective backlog. We know there are fewer beds because of social distancing. We know staff are exhausted. One in seven hospitals have restricted electives or planned operations so far this winter. What plans are in place to protect the NHS through January, especially if there is a long cold snap? How many elective operations does he anticipate will be cancelled in January? Nobody in this House wants to see a third lockdown, so can he guarantee that the measures he has announced today will be enough to bring the R down and sustain it below 1 for the coming months until a vaccine allows life to return to normal?

[Matt Hancock]

The goal of the Government is to bring R to below 1 to suppress the virus until a vaccine can keep us safe. That is the strategy.

I shall take the precise points that the hon. Gentleman raised. He asked for an exit strategy. The statement I outlined is the exit strategy: it is to keep the virus suppressed with the minimum damage possible to the economy and, indeed, to education, while we work as fast and as hard as we can towards a vaccine and with the widespread use of community testing across the piece to help to keep the virus under control.

I would have expected the hon. Gentleman to welcome the massive progress in Liverpool that has shown that a combination of sticking by the rules and community testing at very large scale can help to bring this virus right under control. Instead, he criticised that it does not get into harder to reach communities. That is exactly where we need to get into, and that is why we do it in combination and hand in hand with the local authority.

I praise Joe Anderson, and I also praise other local leaders, such as Ben Houchen in Tees Valley, who is working with us on this, Andy Street and leaders across the west midlands, and the hon. Member for Barnsley Central (Dan Jarvis) in South Yorkshire, who we are working with to get a community testing system up and running in places such as Doncaster. I want to see the community testing that has been successful in Liverpool rolled out right across the tier 3 areas as much as is possible, and I invite all councils to engage.

We invited councils to engage ahead of the decisions today, and we also invited all colleagues in the House to have an input, but it is important that we have clear public health messaging, because unfortunately we did see the number of cases going up and continuing to go up in those areas where local leaders were not working alongside us. It was a sharp contrast to what happened, for instance, in Liverpool, but also in other areas where the local leadership was so constructive and positive.

The hon. Member for Leicester South asked for a scorecard for the exit strategy. We publish the data, and if we can make it into an even more accessible format, I think that is a good idea. He asked about supporting the NHS—absolutely. I am delighted that, yesterday, my right hon Friend the Chancellor of the Exchequer, with the support of the Prime Minister, put another £3 billion into the NHS, on top of the £6.6 billion that is already being invested. That money starts flowing this financial year for this winter and then runs into next year.

The hon. Gentleman mentioned the need to support people who have tested positive. We have put in place a £500 support payment. On NHS Test and Trace, I thought from the figures this morning that he would have welcomed the fact that the majority of in-person tests are now turned around within 24 hours. That is significant progress on the speed of turnaround in testing, for which I am very grateful to my team. There will be further support for local councils that find themselves in tiers 3 and 2 to support the action that is needed. But all in all, let us come together and work together to get this virus under control and keep it under control, so that we can get life back to normal as soon as possible.

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

May I welcome the Prime Minister back from his splendid isolation to the place that he has no doubt been itching to get back to more than any other—this House of Commons—and say how wonderful it is to see him here?

[Jeremy Hunt]

From a sedentary position, I think the Prime Minister said that he was delighted to see me here. [Interruption.] Indeed, he is delighted to see me here—on the Back Benches. [Laughter.]

Turning to more serious matters, these are very difficult decisions, and part of the leadership we have to show in a pandemic is telling people unwelcome news. I want to salute the Health Secretary’s cautious approach to Christmas because, much as we all want Christmas to be as normal as possible, nothing would be more crazy than to take our feet off the accelerator at this moment and then see a spike in deaths in February, so I think this is the right approach.

There is one bit of further good news—on top of the news about vaccines and on top of the news about mass testing—that I know the Health Secretary would like to be able to give and that would be enormously welcome: that every single person living in a care home could be sure that they could be visited by a close relative before Christmas. I know he wants to do that, but there are huge logistical challenges in getting that mass testing technology to work in time. May I urge him to do everything he can, because that would make such a big difference to the nearly 400,000 people in care homes?

[Matt Hancock]

I hesitate to interrupt the love-in between the Prime Minister and my predecessor, but I am grateful for his support—for their support. This is a set of difficult measures, but I think the public understand why we have to take them and why they are necessary.

On the point about getting visiting going in care homes, my right hon. Friend is absolutely right. Sometimes we talk about these tests and this new technology in an abstract way or from a scientific point of view, but it really matters and it really improves people’s lives. Where we can use testing to make visiting safe in care homes, that is an example of the way in which these new technologies can help to get life a little bit back towards normal. Of course, it must be done in a safe way and carefully, but we are now developing the protocols for exactly how that can happen and working hard with the goal that everyone should have the opportunity to visit a loved one in a care home before Christmas.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Many scientists have expressed concern that the easing of restrictions at Christmas could lead to another surge of covid cases in January. With cases still over 80% of the level at the start of lockdown, is the Secretary of State not worried that allowing outdoor events of 2,000 participants and indoor events of 1,000 in level 2 high-risk areas could drive up infection rates ahead of Christmas? Although lateral flow testing is very welcome, given how it increases capacity, the Secretary of State previously stated that the mass testing in Liverpool was a pilot and would be evaluated before being rolled out elsewhere. As the city has also been under tight restrictions and then lockdown, how will the impact of mass testing alone be evaluated? How does he plan to counter the lower uptake among deprived communities—the very ones at highest risk, as seen in Liverpool—and with no clinical evaluation yet published, how can he justify putting out contract tenders for an eye-watering £43 billion and rolling out this approach to 67 other areas? Should this strategy not be compared with investing money and energy in getting the traditional test, trace and isolate system working properly? Currently, over 40% of contacts in England are still not even informed that they should be isolating.

Finally, the Secretary of State knows that it is not testing, but isolation, that stops the spread of the virus. If people who are infected or could be carriers are not isolating, no amount of testing will stop viral spread. A study by King’s College London that suggested that fewer than a quarter were isolating when advised was incredibly worrying, so what assessment are the Government doing to clarify current isolation rates and understand the reasons why people may not follow the advice they are given?

[Matt Hancock]

Of course, we are constantly evaluating the impact of people isolating, and how many people isolate when asked to. I would encourage the hon. Lady to look at a broader range of studies than just that one from King’s College, especially those dealing with the self-isolation of those who test positive, for whom the rate tends to be higher.

The hon. Lady asked about the use of these lateral flow tests to have a negative impact on the number of cases in an area. Of course, we have been evaluating this all the way through the study in Liverpool, which is why we can have confidence in rolling out more broadly across tier 3 areas. I included in my statement a high-level assessment of this. The number of cases in Liverpool city region is down by two thirds, but in the city itself, where the testing took place—the testing was of people who live in the city and of people who work in the city and live largely in the wider city region—the number of cases is down by over three quarters. That is one piece of evidence. It is clear that it is the combination of people following the rules and community testing, with appropriate incentives to get people to take up that mass community testing, that can help to make this work. We want to work with local directors of public health to understand how this can work effectively in their areas, precisely to reach those hard-to-reach people whom the hon. Lady mentioned.

Finally, I echo the hon. Lady’s request that we be cautious this Christmas. However, I am delighted that we have agreed an approach across the whole UK, including with the SNP Administration in Edinburgh, with the Welsh Labour Administration and the cross-party Administration in Northern Ireland, because there are so many ties that bind us together and mean that we are stronger as one United Kingdom, working together to tackle this virus.

[Greg Smith (Buckingham) (Con)]

It is incredibly disappointing news that Buckinghamshire, having entered the national lockdown in tier 1, will emerge from that lockdown into the more punitive restrictions of tier 2 —a decision that will be hard to understand in the rural communities of north Buckinghamshire that have relatively low infection rates, and one that is hard to understand given that there has been zero consultation between central Government, Buckinghamshire Council and our local NHS. Appreciating that my right hon. Friend has impossible choices to make in order to control this virus, will he commit to ensuring that Buckinghamshire Council and our local NHS are fully consulted as these tiers are reviewed going forward?

[Matt Hancock]

Yes, of course. Along with my hon. Friend, the director of public health in Buckinghamshire was invited to engage with the team as we were looking at the indicators and making this decision. These are difficult decisions; he is right about that. The case rate in Buckinghamshire is 138 per 100,000, and positivity is above 5%. We will review these allocations in a fortnight and then regularly thereafter. I look forward to working with my hon. Friend and supporting the people of Buckinghamshire to do what is right, to get the case rate down and to get Buckinghamshire—if at all possible, and if it is safe—into tier 1, with the lighter restrictions. But it is critical, to keep people safe, that we take the action we need to today.

[Munira Wilson (Twickenham) (LD)]

A recent University College London study found that less than half the public understood what the rules were in the previous tier system. Today we have a new tier system. We have a five-day relaxation at Christmas. We have a Government website that has crashed this morning. The written ministerial statement published this morning has a number of question marks against different areas. There are inconsistencies between what the Prime Minister has said, what the OBR has said and what the Secretary of State has told MPs about the length of restrictions. I have a simple request: will the Secretary of State ensure that there is a clear, consistent and honest communications campaign to ensure public trust and compliance and so that we do not overly raise expectations?

[Matt Hancock]

Yes, there will be a widespread public information campaign about these new tiers. It is on all of us to follow the rules in our local area. Notwithstanding the rules, we all need to behave in a responsible way, because we all have a role in controlling the spread of the virus.

[Julian Sturdy (York Outer) (Con) [V]]

As the Government continue to impose further unprecedented restrictions on people’s freedoms, it is important to give people hope and justification. As York’s covid rate continues to fall and is the lowest in Yorkshire, can the Secretary of State outline how we can get to tier 1 as fast as possible? Will he publish the assessment and the data based on which York was placed in tier 2, so that we can best judge how to get to tier 1? He talks about regular reviews, but a weekly review would be much more desirable.

[Matt Hancock]

Yes; I can answer positively on all counts. We have a regular weekly session to go through all these. I am committing to regular reviews rather than weekly ones simply because we sometimes have to do it more than weekly, especially if cases are shooting up in an area. On my hon. Friend’s point about publication, we have published today not only the data—and we will publish more data on each area—but an explanation of the reason for the decision taken in each area. I know that he and colleagues across York have worked hard, because there was quite a serious spike in York, and it is coming down at the moment. Overall, we still require the whole of North Yorkshire to go into tier 2 because the case rates are still elevated right across it, and we all need to work together to get them down.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

I share the concern of my neighbouring colleague, the hon. Member for Twickenham (Munira Wilson), about clarity over tiers and messages. One message and rule that is clear but unwelcome is the 11 pm curfew for pubs and restaurants. Curfews fail to address the issue of crowds in the streets and on public transport, which risk spreading infection. Will the Secretary of State commit to meet London government, including the Mayor of London, as soon as possible to discuss this and agree the criteria that London needs to meet to de-escalate as soon as possible?

--- Later in debate ---

[Matt Hancock]

Of course we have been engaging with the team who work across London. There is a lot of work to do in London. There are parts of London where cases continue to rise, and we need to get that under control, but there are also parts where they are falling and things are very much going in the right direction. Likewise, there is pressure in some parts of the NHS, but there is a lot of mutual aid within the NHS across London. There is a lot of work to do in London to keep it in tier 2, and I look forward to working with the hon. Lady and other London colleagues on that.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

People living in Runnymede and Weybridge often ask me on what basis we are subject to local tiers and to restrictions, and it is clear that, alongside the data, other factors are taken into account in the two decisions. I thank my right hon. Friend for his response to the question from my hon. Friend the Member for York Outer (Julian Sturdy) that the reasons and the data will be published. Will local hospital bed utilisation be part of the reasons published?

[Matt Hancock]

Yes. There are five indicators that we take into account in deciding on which tier. One is pressure and anticipated pressure on the local NHS, and bed occupancy rates are of course a critical part of that assessment. I know that people are looking for a clear numerical boundary between the different tiers, but because we are looking at five different indicators rather than a single one, there is no automatic figure at which a different tier is triggered. We have to look at all the circumstances, including, for instance, outbreaks. Some cities, on their pure numbers, would be in tier 3, but because an outbreak is specific—for instance, in a school or care home—it is appropriate that they are in tier 2. We have to look at these very localised issues as well, and that is why the engagement with local directors of public health is so important.

[Sir Robert Syms (Poole) (Con)]

There will be bitter disappointment in Dorset, in both the urban and rural areas, that we are in tier 2 even though our infection rates are now falling quite rapidly. My main interest today is finding out how we get out of tier 2 and into tier 1. If we are going to have regular—that is, weekly—reviews, that is great and fine, but if we are not, and we are stuck in that tier for two or three weeks, would the Secretary consider some kind of appeals process, and might his admirable Minister for Health be the appeals process?

[Matt Hancock]

We work as a very cohesive team of Ministers in the Department, and we all work on covid-related issues. I take my hon. Friend’s gentle chiding that he would rather my No. 2 took these decisions, but I am afraid he is stuck with me for the time being.

On the serious point that my hon. Friend raises, we will review the tiers in a fortnight and then regularly, which he can reasonably take to be weekly. We have a weekly cycle of meetings, with the chief medical officer chairing a meeting, typically on a Tuesday. I then chair a meeting on a Wednesday for an announcement on Thursday of any change to the tiers.

[Geraint Davies (Swansea West) (Lab/Co-op) [V]]

The Secretary of State knows I chair the all-party parliamentary group on air pollution, so he will not be surprised if I point out that tier 3 areas tend to be the areas with the highest pollution. Every microgram of PM2.5 per cubic metre increases covid deaths by between 14% and 18%, and that is on top of the 40,000 deaths annually from air pollution. Does he agree that we need cross-Government activity and an all-Government report annually—from the Department for Environment, Food and Rural Affairs, the Ministry of Housing, Communities and Local Government and the Department for Transport—on what they are doing individually and collectively to combat air pollution and, in so doing, to reduce the covid death rate and the overall death rate? I can see the Prime Minister nodding sagely. Would the Secretary of State agree to an annual report?

[Matt Hancock]

It is very impressive that the hon. Gentleman can see the Prime Minister, since he has just left the Chamber, but I am sure the Prime Minister is nodding sagely, wherever he is. The hon. Gentleman makes a very serious and important point, on which we agree. Air pollution is a very serious issue. In lockdowns, air pollution has been reduced; that is one upside to what are otherwise very damaging things to have to do, but they are necessary to keep the virus under control. I hope we can continue to work together on tackling air pollution long after this pandemic is over.

[Richard Graham (Gloucester) (Con)]

With Gloucestershire in tier 2, next to South Gloucestershire, in tier 3, and the Welsh border, will the Secretary of State confirm that there will be no travel restrictions between different tiers or across the Welsh border? Since the Government can change tiers without debate, which has a huge impact, especially on the hospitality sector in terms of moving from tier 2 to tier 3, will he also confirm when the tier decisions will be published?

[Matt Hancock]

I am afraid that I cannot confirm that with respect to the Welsh border, because the legal restrictions on travel were a decision by the Welsh Administration, rather than by the UK Government for England. We have taken the view that travel restrictions should be in guidance, because there are all sorts of complicated circumstances in which people might need to travel. We have done that when we have been in national lockdown across England, as well as locally. I am sorry that I cannot be clearer than that. On the point about renewal and when we review these matters, we are proposing to review first on 16 December and then regularly thereafter to ensure that we keep the tiered restrictions as up to date as possible.

[Yvette Cooper (Normanton, Pontefract and Castleford) (Lab) [V]]

The Health Secretary will know the pressure that Pinderfields Hospital, especially, has been under. The staff there have been doing an incredible job. It is welcome that the number of covid patients in hospital is starting to fall and that the number of infections locally has fallen by around 30% in the last week, but he will also know that our NHS, social care and public health staff have had a really difficult year and that the winter is going to carry on being tough, with many operations to catch up on. Will he now look swiftly at the case for added support and pay for NHS, public health and social care staff this winter, in recognition of the incredible job they have been doing to care for all of us?

--- Later in debate ---

[Matt Hancock]

I am delighted that we have a significant increase in the number of NHS staff. The figures published this morning show that there are 14,800 more nurses than there were this time last year in the NHS. I am really pleased about that. The right hon. Lady will no doubt have seen yesterday that the pause on pay increases across the public sector announced by my right hon. Friend the Chancellor does not apply to nurses and doctors. That is, in part, in recognition of the incredible work that they have done during this pandemic.

[Jeremy Wright (Kenilworth and Southam) (Con)]

As the economic damage the pandemic is doing becomes increasingly apparent, it is clearly right that businesses of all types are reopened as soon as it is safe to do so. This will take longer than it needs to if the restrictions on those businesses are calculated on the basis of virus information for places a long way away or as a geographical average for a wide area encompassing urban and rural parts. That is exactly what is going to happen to the businesses in my constituency, which will not be able to open next week if they are hospitality businesses, not because of the rates where they are, but because of the rates somewhere else. Surely it is more sensible to calculate restrictions on the smallest geographical area where data is reliable, which is largely boroughs and districts. Will my right hon. Friend commit in his review in two weeks’ time to look not just at whether individual areas are in the right tier but at whether the areas are properly constructed?

[Matt Hancock]

Yes, absolutely. My right hon. and learned Friend is absolutely right about the importance of this. We have to balance the need for an area to reflect the human geography in which people live and effectively communicate the tiering decisions across that geography, with precisely the concerns that he mentions. For instance, Slough is in tier 3, despite the fact that Berkshire, of which it is a part, is in tier 2, so we are prepared to take those decisions at a lower-tier local authority area level. That is the exception rather than the norm, but we look at this every single week.

[Patricia Gibson (North Ayrshire and Arran) (SNP) [V]]

Covid-19 is a world pandemic and it needs to be tackled on a global basis. International travel will expose the UK to future outbreaks, particularly if the virus mutates, so on both humanitarian and public health grounds, does the Secretary of State not agree that it is indefensible to cut the international aid budget, just as a global vaccine roll-out begins?

[Matt Hancock]

Of course, we have been hugely supportive. In fact, the UK is the biggest supporter internationally of providing vaccines in countries that would not be able to afford them themselves. I am sure that that will continue, because we will continue to have one of the largest international aid budgets in the world.

[Peter Aldous (Waveney) (Con)]

I know that my right hon. Friend will thank everyone in both East and West Suffolk for getting down the level of infections, and that it is with a heavy heart that he has concluded that the county cannot exit to tier 1. Will he ensure that there are clear indicators as to what else needs to be done so that Suffolk may move to tier 1 as quickly as possible, and will he liaise with the Chancellor of the Exchequer to put in place additional support for the hard-hit hospitality sector?

--- Later in debate ---

[Matt Hancock]

I have constant discussions with the Chancellor of the Exchequer about the support needed. My hon. Friend is right to raise that, especially in Suffolk. It is with a heavy heart that we took the decision on Suffolk. Its case rate is higher than the Isle of Wight or Cornwall, which are the two areas in tier 1, but that gives an indication of where we need to get to. I am sure that if we all work together, we will be able to get there.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

We are stuck in an endless cycle of lockdowns that are simply not working. The Government have again wasted the opportunity over the past few weeks to get a handle on testing, tracing and isolating. Once again, hospitality in South Shields will be absolutely battered, and my constituents’ liberty impacted on. Will the Secretary of State tell us exactly what will be different this time that will make our sacrifices yield a reduction in the infection rates?

[Matt Hancock]

First, I urge the hon. Lady to look at the figures published this morning, which show that the majority of tests when done in person are now turned around within 24 hours across the country, and capacity has increased radically. What I would ask of her for the future, to help the north-east get out of tier 3, is to work with her local councils, with the directors of public health, to embrace the community testing that has been effective in Liverpool. If they are up for doing that—it has to be in consultation and conjunction with the local council, because they know the area—I very much hope that they will come forward to pick up the baton and make that happen.

[Mr Laurence Robertson (Tewkesbury) (Con) [V]]

This is not an easy question, but how will the Health Secretary take into account the wider mental and physical health implications for people who are prevented from living their lives as they would wish to live them?

[Matt Hancock]

We look as much as we can at taking the impacts into account. For instance, the mental health of people under lockdown is of course more challenged than in normal circumstances. We balance that against the impact of covid both directly and in filling up the hospitals on the healthcare that we all get for all the other conditions that exist. It is a difficult balance to strike. On the particular impact on mental health, which my hon. Friend raised, the Royal College of Psychiatrists has done very interesting work to understand the nuanced balance between the impact of covid on people’s mental health and the impact of lockdown. Both are significant and I commend its work to him.

[Mary Glindon (North Tyneside) (Lab) [V]]

It is devastating that after all its efforts, the north-east will be in tier 3. Across the whole country, obesity remains a serious factor in covid-19. Yesterday, the all-party group on obesity launched its report to build on the Government’s obesity strategy. Will the Minister meet officers of the group to discuss the report’s recommendations and work with us to ensure a focus on the prevention and treatment of obesity in the fight against covid-19?

[Matt Hancock]

Yes. the hon. Member and I share an enthusiasm for this agenda with the Prime Minister, who is a personal convert to the need to tackle obesity. In fact, this crisis shows how important it is, because people who are obese are more likely to have a more serious impact from covid, if they catch it.

[Rob Butler (Aylesbury) (Con)]

We have consistently been told that we must accept restrictions to protect the NHS, and Buckinghamshire Healthcare NHS Trust has done an amazing job in dealing with the pandemic from the very beginning. Can my right hon. Friend therefore explain the weighting that he puts on the pressures on the local NHS as one of the five indicators in the decision-making process over tiers? It will be very difficult for people in Aylesbury to accept stringent controls on our lives and livelihoods if, in fact, there is plenty of capacity in hospitals for both covid and non-covid cases.

[Matt Hancock]

We look at all five indicators essentially equally. The point about pressure on the NHS is a more sensitive indicator on the decision to go into tier 3. If an area is in the situation that Buckinghamshire is, for instance, where the case rate is elevated, but not as high as in many other parts of the country, the key thing to do is to keep that case rate where it is or lower. We could not make the decision to put Buckinghamshire into tier 1 because, if it went up from where it is, it would not be long until Buckinghamshire were in trouble. Therefore, the decision was to put it into tier 2.

I very much hope that the cases can continue to go down until they are very low—like they are in Cornwall and on the Isle of Wight, for instance. We will then be able to review and consider tier 1. I hope that that is a reasonable explanation. We need to continue to debate this matter as we try to ensure that we get the judgments around these geographies exactly right.

[Rachel Hopkins (Luton South) (Lab)]

The good people of Luton will want to get out of tier 2 as soon as possible, but the current resources provided to Luton Borough Council for the lateral flow rapid testing pilot are insufficient to enable it to provide the level of mass testing that is being described nationally. The contained funding—£8 per person—just will not cover tests for 10% of Luton’s population, as the funding also needs to be used for the wider covid response, including wellbeing support for vulnerable residents. Can the Secretary of State confirm that there are national plans to provide additional support and resources to expand testing if the intention to test close contacts daily is pursued?

[Matt Hancock]

Yes, there will be further funding for those areas that go into tier 2 and yet more funding for the areas that go into tier 3. That funding will go to the councils for the extra support that is needed.

[Christian Wakeford (Bury South) (Con)]

I thank the Prime Minister for the flexibility that the Government are providing so that we can all have a family Christmas. However, let me ask my right hon. Friend the Health Secretary: what consideration has been given to Hanukkah, which starts two weeks today, regarding family gatherings and public menorah lightings? Does he think it is fair if no flexibility is shown to the Jewish community?

[Matt Hancock]

We carefully considered this issue, consulted on it and discussed it widely. Christmas is a national holiday, as well as being very much a Christian celebration. That is reflected, for instance, in the fact that we have two days of bank holidays. We consulted members of different faiths around precisely the question that my hon. Friend rightly raises, and there was a strong degree of support for having something special in place for Christmas for everybody, even though we have not been able to put that in place for Hanukkah or for other celebrations of other faiths.

[Liz Twist (Blaydon) (Lab)]

May I start by assuring the Secretary of State that directors of public health and local authorities in the LA7 area and the wider north-east are certainly very focused on getting that figure down and have had some success? I would like to make that absolutely clear. The second point I would like to make is that my constituents and others across the north-east will be hugely disappointed to find they are in tier 3, particularly those businesses in hospitality and leisure which are going to be so desperately hit by this. The real point I want to make, however, is about public health. Nothing has shown more than this pandemic that public health should be at the heart of what we do. We know it affects outcomes in covid-19, and we know it affects health inequalities and the rate of transmission. Will the Secretary of State ensure that he impresses that on the Chancellor, and ask him for more funding for public health services, both now and in the future?

[Matt Hancock]

Yes, I agree with every word of what the hon. Lady said.

[Bob Stewart (Beckenham) (Con)]

My constituency of Beckenham is very relieved to be in tier 2. Very kind of you, Secretary of State. I have had a couple of constituents ask me whether they have to have a vaccination. I have said that no, they do not, as far as I know. Can he tell the House what percentage of the population is required to be vaccinated in order for the measures to be effective, so we can get back to normal?

[Matt Hancock]

I would urge everybody to get a vaccination, if we manage to get a vaccine that is approved by the authorities, because the regulator will only approve a vaccine if it is safe and effective. Having said that, we are not planning to make it mandatory, because we hope that the vast majority of people will take it up, not least because it will help to protect them and their community, and get the whole country and indeed the world out of the mess we are in.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

The winter plan confirms that the Government will be taking action to restrict the movement of care staff between care homes. On the face of it, that is a perfectly sensible infection control measure. However, many care staff are forced to work between multiple homes because of low hourly wages. Can the Secretary of State therefore give a commitment that care workers will suffer no loss of income as a result of the policy? Can he set out what he will do to ensure that no care staff lose any of their jobs because they are being forced to choose between the different homes they work in?

[Matt Hancock]

I hope that, partly through this measure and the increase in the national living wage that the Chancellor confirmed yesterday, we can improve the pay and conditions of staff across social care. The proportion of people in social care who work in a number of settings and work in agency and less secure work is, in my view, something we should tackle together. I hope we can use what has obviously been put in place, as the hon. Lady rightly says, for public health infection control reasons also to improve employment standards across social care. That is, of course, directly contracted by local authorities, rather than by central Government. Nevertheless, this is an area that I think we all know we need to work to improve as a nation.

[Dr Julian Lewis (New Forest East) (Ind)]

I am sure my right hon. Friend appreciates that many elderly people die with serious illnesses, such as prostate cancer, but not from those illnesses. How certain is he that statistics showing the number of people dying with covid-19 are not being presented or misinterpreted as people dying from covid-19?

[Matt Hancock]

The statistics on the number of people dying with covid-19 are the best estimate that the statistics authorities, both in Public Health England and the Office for National Statistics, come up with. It is one of the widest definitions, which countries use internationally. Therefore, as my right hon. Friend implies in his question, it does include people who may have died of something else, but with covid. Nevertheless, each of these deaths we should work to avoid. The best measure, according to the chief medical officer, is the total number of excess deaths compared with this time of year last year. That is elevated now and we need to get it down.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

May I first thank the Secretary of State for listening to local leaders, who have been pushing for a one-Oxfordshire approach to coronavirus as we go into tier 2? I am sure many residents understand the need to be careful for Christmas. Despite Oxfordshire’s data being better than that of surrounding counties, we cannot risk any further damaging lockdowns. The reason we have done so well is superb team working and a county-wide systems approach, involving all councils, the NHS and businesses. In particular, we were quick off the mark to implement a local test, trace and isolate system, which is paying dividends. Does the Secretary of State agree that the key to beating this virus is to treat local areas as partners, and when they say they should be moving up and down tiers will he give their voice considerable weight?

[Matt Hancock]

Yes, I do give considerable weight to local leaders when they make a case for a particular tier for their area, and in the hon. Member’s case I would like to pay tribute to Ian Hudspeth, who has worked incredibly hard during this crisis for the benefit of people right across Oxfordshire. I talk to him regularly about the situation in Oxfordshire, which has made great strides in tackling this virus, including tackling the student outbreak at the universities in Oxford. I hope they can work to get Oxfordshire appropriately down into tier 1 as soon as possible, but there is some work still to do.

[Antony Higginbotham (Burnley) (Con)]

Today’s decision will be disappointing to businesses and residents across Burnley, who have had extra restrictions on their lives and their businesses for longer than most, so can my right hon. Friend set out exactly what support is going to go to Burnley and the wider Lancashire area, and when it will be delivered, so we can end these restrictions as soon as we possibly can?

--- Later in debate ---

[Matt Hancock]

Yes, Burnley has been in restrictions for a long time now. It has brought its case rate down by about half since the peak in late September. My hon. Friend has played a dutiful and impressive role in his public leadership within Burnley. I hope that we can work with Burnley Borough Council and Lancashire County Council to get the case rate down and get Lancashire down into tier 2, in the same way that Liverpool has managed to come down into tier 2: a combination of people following the rules and community testing. That is available to people in Lancashire, and I very much hope to be able to work with the team in Burnley and across Lancashire to make this happen.

The final thing I would say is that these are tough measures; I get that. I understand the impact on hospitality, but they are done for the right reasons, which is to keep people safe and stop the local NHS being overwhelmed.

[Charlotte Nichols (Warrington North) (Lab)]

Warrington will be breathing a sigh of relief that we are emerging from national lockdown into tier 2, but while I welcome the return of fans to stadiums, I cannot support the extension of the substantial meal requirement to tier 2, which will leave many pubs across my constituency closed. The pub sector faces an existential threat and it flies in the face of logic and fairness that thousands can congregate at the rugby but wet pubs that are at the heart of our community must stay closed. Will the Secretary of State commit to publishing the specific evidence that underpinned the substantial meal requirement extension and, if he cannot, to removing this requirement?

[Matt Hancock]

Unfortunately, we will not be removing that requirement from tier 2. It is incredibly important that we keep the cases under control. The local team in Warrington has worked very hard along with the Liverpool city region to get the case rate down. They went into national lockdown in tier 3 and have come out in tier 2, and the people of Warrington should be commended for that, but the measures of tier 2 are necessary to keep the virus under control because, unfortunately, the virus thrives when people get together. The hon. Member mentioned the point about events in larger scale. They will only be held where there is very stringent social distancing, so there will not be congregations, as she said, of thousands of people—I would like to reassure her of that—because these events will only take place when the capacity in normal times of any venue is much, much bigger than the number of people who are there.

[Suzanne Webb (Stourbridge) (Con)]

First, I want to thank residents in my constituency for their hard work and sacrifice; their borough has been hard hit by the virus. With my constituency being in one of the worst affected areas, will my right hon. Friend consider rolling out the vaccine as a priority when it is ready to the country’s worst affected areas, which have been not only blighted by this virus, but hard hit economically? These are the areas that will be in much need of assistance to get back on their feet following prolonged lockdown of the local economy. The vaccine would provide much needed respite in these worst affected areas.

[Matt Hancock]

We have taken the decision to roll out the vaccine UK-wide at the same pace. I want to get it as soon as possible to the west midlands and to everywhere else, but it is fair to the areas that have had a low, or relatively low, incidence of the disease to make sure that they also have access to the vaccine. Also, the incidence in different parts of the country changes, and the vaccine roll-out programme is very complicated. It does not speed up the delivery of the vaccine in one area to have slowed it down in another. That is why we have taken a UK-wide approach.

[Ms Nusrat Ghani (Wealden) (Con)]

In keeping with my right hon. Friend’s spirit of working together, I stand not only to represent Wealden, but to speak on behalf of my hon. Friends the Members for Bexhill and Battle (Huw Merriman), for Eastbourne (Caroline Ansell) and for Hastings and Rye (Sally-Ann Hart). We wish to collectively thank the CEOs of the clinical commissioning group and East Sussex Healthcare NHS Trust, our county leader, Keith Glazier, and our local department for public health for working with us day in, day out to understand the data and the reason for the infection rates.

We are deeply disappointed that, considering all the five indicators, where we mark extremely low, we are in tier 2, and we are disappointed that central Government have not consulted local leaders, because they would then have been able to investigate the data and, hopefully, show us how we can move into tier 1 from tier 2. Will my right hon. Friend provide some assurances that these conversations will take place with local leaders and confirm that transparent objective criteria will be published for each tier, and how we can slide between each tier?

[Matt Hancock]

Yes, absolutely—I can give both those assurances. Across Sussex, case rates are at 120. They do need to come down. Like my hon. Friend, I would like to see Sussex get to tier 1 as soon as possible, and we will keep talking to the local area. As I said earlier, all directors of public health have been invited to discussions and consultations with the public health team. That feedback fed into these decisions, but we have to make sure that those conversations continue. The key message to everybody across Sussex and in the Weald, in particular, is that if we all stick together and follow the rules, we know that we can get this virus under control, and that will then lead directly to the lifting of restrictions, which we will regularly review.

[Marion Fellows (Motherwell and Wishaw) (SNP) [V]]

The Secretary of State will be aware of reports on the Oxford vaccine that the sub-group that suggested 90% effectiveness was due to a manufacturing error, rather than being a planned protocol. It included fewer than 3,000 people and did not have any participants over 55. Does he agree, therefore, that further research is required to verify the efficacy of the lower dose in all age groups before it can be adopted as a standard regimen?

[Matt Hancock]

Questions over the interpretation of the data in the clinical trials are rightly for the Medicines and Healthcare Products Regulatory Agency, which will assess these clinical trials and will only approve a vaccine for use if it is effective and safe.

[Jason McCartney (Colne Valley) (Con) [V]]

The first review of Kirklees being in tier 3 will be on 16 December. Will the Secretary of State please confirm that his Department will consult local MPs, council leaders and the local director of public health? Will he publish the full numerical criteria so that we know what we need to achieve to get out of tier 3? Will the Government support Kirklees in delivering mass testing? Finally, will the Secretary of State have a conversation with the Chancellor about delivering extra financial support for our hospitality businesses?

[Matt Hancock]

I will absolutely take up all those suggestions. We are in discussions with Kirklees about what more we can do, including in the area of large-scale community testing and the other considerations necessary to make that happen.

[Carla Lockhart (Upper Bann) (DUP) [V]]

The Secretary of State is to be commended for the initiative that he and the Minister for Care have spearheaded to allow close-contact visits between relatives and residents in care home settings. Will the proposed access vary depending on what tier a home is located in? I acknowledge that care is a devolved issue, but with little progress being made in this regard in Northern Ireland, will the Secretary of State undertake to share the experiences of his pilot with the Health Minister in Northern Ireland so that my constituents can also look forward to visiting loved ones as soon as possible?

[Matt Hancock]

Subject to the results of the pilots, which are ongoing, we hope to allow testing in England to allow for visiting in care homes before Christmas. I will absolutely have another conversation with my opposite number Robin Swann, who is the Health Minister for Northern Ireland. Robin Swann is an excellent Health Minister, we work very closely together, and I am absolutely sure that together we will be able to make progress on testing and other matters. He and I are constantly in touch about how we can best serve the communities of Northern Ireland, from the position of the UK Government’s role in procuring tests around the world and, of course, his vital role in keeping people safe right across the Province.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State; we have completed our exchanges on the statement.

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next item of business, I will now the House.