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?

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[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.

Oral Answers to Questions

Matt Hancock Excerpts

Tuesday 17th November 2020 Commons Chamber

[Damian Hinds (East Hampshire) (Con)]

What steps his Department is taking to increase covid-19 testing capacity.

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

We are processing coronavirus tests on an unprecedented scale and expanding capacity further, having already met our testing capacity target of 500,000 tests a day by the end of October. We now have five Lighthouse labs operating across the UK, with two more announced yesterday, and significant progress on next-generation testing technologies.

[Scott Benton]

I congratulate my right hon. Friend on the tremendous progress he has made over recent months on increasing our testing capacity, including the delivery of a new site in my constituency. The recent announcement regarding care homes is welcome. How quickly does he think the trial process can be concluded, so that we can roll out a nationwide scheme to ensure that those in care homes can finally see their loved ones again?

[Matt Hancock]

We have discussed many times in this House the importance of the use of testing because of the terrible dilemma of wanting to keep people safe in care homes, yet also wanting to allow visiting. Testing can help to resolve that. The pilots are ongoing in some parts of the country, and I very much hope that we can get to a position where we can offer testing to enable visiting across the country before Christmas

[Damian Hinds]

I welcome the testing pilots that are happening, including in Southampton. How will the Government be able to support local authorities and public health teams with the logistics of mass testing, particularly in large rural areas such as Hampshire?

[Matt Hancock]

Increasingly, the test itself is only one part of getting a high-quality testing system. The logistics around it are also vital. We are already funding local authorities across the country to support them to roll out mass testing, but we will learn from the pilots, including in Hampshire, to see what extra might be needed.

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

Testing, backed up by tracing and isolation, is key to avoiding further lockdowns. At the Secretary of State’s press conference yesterday, we heard that tier 1 has had “very little effect” and that the tiers must be strengthened. Can he confirm that it is the Government’s intention to impose a tougher set of restrictions on tier 1 areas post this lockdown?

[Matt Hancock]

It is too early to do the analysis that the hon. Gentleman requests, but of course, we remain vigilant.

[Jonathan Ashworth]

We will soon be asked to make a decision on the future of the lockdown, so the earlier we get that information, the better.

Testing for NHS staff is crucial for dealing with the backlog in NHS care. Last week, we learned that 139,000 people are waiting beyond 12 months for treatment. We now know that 252,000 people are waiting beyond 18 weeks for orthopaedic surgery, which is often hip and knee replacements, and 233,000 patients are waiting beyond 18 weeks for eye surgery—many could go blind. People are waiting longer for gynae surgery and heart valve surgery, and many are languishing on trolleys in dangerously overcrowded A&Es. As well as testing NHS staff, Ministers have promised to give the NHS whatever it takes. Can the Secretary of State guarantee that the spending review will deliver the resources, beds and capacity to bring waiting lists down?

[Matt Hancock]

The good news is that we are managing to continue to drive through the backlog that understandably built up in the first peak. Instead of attacking the NHS, the hon. Gentleman should be backing the NHS and thanking it for the incredible hard work that it is doing right now and will be doing this winter.

[Mike Wood (Dudley South) (Con)]

What steps his Department is taking to increase NHS capacity for winter 2020-21.

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[Sarah Olney (Richmond Park) (LD)]

If he will allocate additional funding to local authorities to support the roll-out of lateral flow covid-19 testing.

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

In addition to giving local directors of public health access to tests, NHS Test and Trace will provide access to training, clinical, operational and service design guidance, and communication and engagement support. In addition, all local authorities have funding available up to £8 per head of population to support the roll-out.

[Sarah Olney]

I welcome the allocation of lateral flow tests to both Kingston and Richmond in my constituency to allow for mass testing. Can the Secretary of State confirm whether, in addition to the support he has just outlined for the testing, there will be additional resources to support local tracing efforts and to support those who are found to need to isolate?

[Matt Hancock]

Absolutely, the funding to support people who need to isolate is in addition to the funding I just outlined, which supports both the roll-out of mass testing and local contact tracing, and we always keep these things under review.

--- Later in debate ---

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

What recent discussions he has had with the Chancellor of the Exchequer on reducing the economic effect of the covid-19 outbreak.

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

I have regular discussions with the Chancellor of the Exchequer and others. The best strategy for both health and the economy is to suppress the virus, supporting the NHS and the economy, until a vaccine can make us safe.

[Kevin Hollinrake]

The economic effect of the lockdown on the hospitality sector in particular is severe. In large constituencies such as Thirsk and Malton, the infection rate can vary significantly across different districts. When my right hon. Friend moves us back to a tiered system on 3 December, will he look at allocating tiers by district rather than by county to keep the economy as open as possible?

[Matt Hancock]

Throughout the process of the tiered system, we have always looked at a level of granular detail, whether at district council level or, indeed, ward level in some cases, to make sure that we have the appropriate measures in the appropriate places. While it is too early to say exactly how we will proceed from 3 December, that is a commitment that I can make to my hon. Friend.

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

As I have highlighted previously, covid is spread not just by droplets but by airborne particles, so good ventilation is key to reducing the risk of spread indoors, such as in hospitality. On 20 October, the Secretary of State agreed to speak to the Chancellor about removing VAT from ventilation and air-purification systems to make them more affordable. Can the Secretary of State tell us what discussions he has had with the Chancellor and what the outcome was?

[Matt Hancock]

There has been work on promoting ventilation in government. The hon. Lady is absolutely right that ventilation is important and that the scientific evidence on the aerosol transmission of coronavirus has strengthened over recent months.

[Dr Whitford [V]]

If that is the case, can the Secretary of State clarify whether we will hear an announcement from the Chancellor in the near future on supporting the installation of such systems? Even with the good news about potential vaccines, it will be a long time before most of the population are vaccinated, so what is the Secretary of State’s strategy to control covid over the coming year?

[Matt Hancock]

Our strategy is to suppress the virus and support the NHS and the economy until a vaccine can make us safe. Increased ventilation can help to reduce transmission, so it is an important consideration, among many others, for how we tackle this disease.

[Rosie Cooper (West Lancashire) (Lab)]

What recent assessment he has made of the effect of the covid-19 outbreak on (a) access to routine dental services and (b) early diagnoses of mouth cancers.

--- Later in debate ---

[Rob Roberts (Delyn) (Con)]

What steps his Department is taking to support the development of covid-19 vaccines.

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

Yesterday, the House will know that we secured 5 million doses of the Moderna vaccine, so we have now secured access to 355 million vaccine doses through agreements with seven separate vaccine developers. We have secured them for the whole UK.

[Mrs Murray [V]]

I thank my right hon. Friend for that answer. What assessment has he done of the logistics necessary to deliver a vaccine to more rural areas, such as Cornwall?

[Matt Hancock]

We have done a huge amount of work. The deployment of the vaccine is, of course, being led by the NHS, which reaches into all parts of the UK. Our principled approach is that we will deploy the vaccine according to clinical need in every single part of the UK at the same time. That, of course, includes rural areas. A significant amount of work has gone into how best to deploy to rural areas, especially as some of the people who clinically will need to get the vaccine first are also those who might find it most difficult to travel. It is a very important question on which a huge amount of work is being done.

[Rob Roberts [V]]

I thank my right hon. Friend and fellow one nation Conservative for his hard work and that of his Department in impossible circumstances this year. Kate Bingham and the vaccine taskforce have done an amazing job in securing so many doses of vaccines, as and when they become available, which will be centrally procured by the UK Government and equally available across all parts of our United Kingdom. Does my right hon. Friend agree that that shows the power of all parts of the UK speaking with one voice and working together for the good of our entire Union?

[Matt Hancock]

I feel very strongly about this, and I agree very strongly with my hon. Friend. We should take forward this vaccine and ensure it is available fairly and equally across all parts of our United Kingdom. Of course, it will be deployed in each of the devolved nations through the devolved NHS. I have been working closely with my counterparts, and the four NHS organisations have been working together. Ultimately, let us hope that should a vaccine become available—we still do not yet have one authorised—it will be a moment at which the whole country can come together in support of making sure that those who are clinically most vulnerable will get support first wherever they live.

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

What recent discussions he has had with the Secretary of State for Digital, Culture, Media and Sport on tackling anti-vaccination disinformation online; and if he will make a statement.

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

The Culture Secretary and I discuss regularly with social media platforms the action that is needed to tackle vaccination disinformation online. I am encouraged by the fact that social media companies who have attended meetings with us have agreed to commit to the principle that no user or company should directly profit from covid-19 vaccine disinformation and to ensure a timely response when we flag such content to them.

[Damian Collins]

It is obviously tremendous news that a vaccine will be available and that the people in the UK may be among some of the first in the world to receive it, but it is important that there is public confidence in the vaccine. The anti-vaccine movement is damaging: it is a threat to public health. Does my right hon. Friend agree that social media companies should not just be taking down anti-vaccine material when they are notified of it, but proactively looking for it on the internet and removing it themselves?

[Matt Hancock]

Yes, absolutely. A critical part of tackling disinformation is providing accurate, fair and objective positive information, and my hon. Friend is absolutely right about this point. The social media companies are working—and we are providing content for them—to ensure that proper, accurate information that the public can trust from the NHS about the effectiveness of vaccines can be promoted, as well as taking action to remove information that is not accurate and not correct.

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

What steps his Department is taking to help ensure that family members can safely visit relatives in care homes during the covid-19 outbreak.

--- Later in debate ---

[Mrs Heather Wheeler (South Derbyshire) (Con)]

What assessment his Department has made of the effectiveness of the whole city covid-19 testing pilot in Liverpool.

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

The Liverpool pilot will help to inform a blueprint of how mass testing can be achieved and how rapid testing can be delivered at scale. We are now making mass testing available right across the country.

[Mrs Wheeler [V]]

I thank my right hon. Friend for his reply. May I ask him to agree to extend the pilot for rapid testing to the whole of Derbyshire and Derby to give the pilot real work to compare our semi-rural area with the urban area of Liverpool?

[Matt Hancock]

We are now issuing test kits to 84 directors of public health across the country. I am very happy to work with Derbyshire and Derby to make sure that my hon. Friend’s request is taken up and we can make this happen.

[Ms Angela Eagle (Wallasey) (Lab)]

What recent plans he has made for the distribution of covid-19 vaccines.

--- Later in debate ---

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

If he will make a statement on his departmental responsibilities.

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

We are seeing major scientific advances that will help to get things back to normal. We are expanding mass testing with the two mega labs that will add another 600,000 to our daily testing capacity and, on vaccines, we have secured an initial agreement for 5 million doses of the very promising Moderna vaccine and begun clinical trials of the Janssen vaccine.

[Steve McCabe]

It is now 41 days since I asked the Secretary of State whether he would stop the clock so that no one seeking access to fertility treatment loses out because of delays due to the pandemic. When does he hope that his Department will get around to answering?

[Matt Hancock]

The provision of fertility services is happening in the normal way in as many places as possible across England, but it is not happening everywhere because of the huge pressures on the NHS from the second wave of covid. As my hon. Friend the Minister of State was saying a moment ago, there are pressures on the NHS. There are now 15,000 people in hospital with covid across the UK, but the NHS is doing far more normal services that it was not able to do in the first wave.

[Mr Speaker]

I call the Chair of the Select Committee.

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

This morning, the Select Committee has been hearing about workforce burnout. Witness after witness said that the one thing that would make a big difference to NHS staff is knowing that we are training enough doctors and nurses for the future even if we do not have enough now. Nearly two years on from the NHS 10-year plan, we still do not have the workforce projections published—I know that the Secretary of State is keen to get them published. Can he assure the House that, when they are published, they will be the independent projections and not what the Treasury has negotiated with his Department as part of the spending review?

[Matt Hancock]

I am grateful to my right hon. Friend for that question. I can give him a couple of projections and a couple of facts. Over the past year, we have 13,500 more nurses in the NHS than we did a year ago, and thousands more doctors. Let me give him this projection, which I am sure that he and everybody on the Government Benches will buy into: we are going to have 50,000 more nurses in the NHS by the end of this Parliament.

[Bill Esterson (Sefton Central) (Lab)]

Many of my constituents have taken part in the Liverpool mass testing pilots, but they need to know that the tests being used are accurate. Reports in The Times that suggest very high levels of both false positives and false negatives are deeply worrying, so can the Secretary of State tell us what steps he is taking to ensure that the tests being used in the mass testing are indeed accurate?

[Matt Hancock]

Yes; the lateral flow tests that are being used in Liverpool are accurate. They measure whether somebody is infectious and have a very high specificity. We publish all these statistics, having had them assessed at Porton Down in one of the best medical science units across the whole world, so I assure the hon. Gentleman—and, through him, his constituents —that the lateral flow tests have a quick turnaround and a high degree of accuracy regarding whether someone is infectious. I have not seen the reports to which he refers, but I assure him that the best thing that people can do if they are offered a test is to get one.

[Chris Loder (West Dorset) (Con) [V]]

  I was delighted when the Secretary of State came to visit the Yeatman Hospital in Sherborne at the end of last year, but my constituents in West Dorset are becoming increasingly concerned that the Yeatman Hospital’s minor injuries unit has been closed for too long. Will the Secretary of State confirm that the MIU will not be permanently closed, and that it will reopen at the first possible opportunity?

[Matt Hancock]

I am very happy to meet my hon. Friend and to discuss with him how we can strengthen the services that are available across Dorset, especially as the population is not as dense as in some other parts of the country. We need to ensure that we get services out into the community, rather than just in the big cities.

[Paula Barker (Liverpool, Wavertree) (Lab)]

Our home care workers have gone above and beyond during the pandemic. Tragically, they are some of the lowest paid workers in the entire labour market. Does the Secretary of State agree that there is a role for local government, as the commissioners of home care services, in strengthening enforcement of national minimum wage legislation to ensure that no home care worker, anywhere, is not properly paid for travel time between visits?

[Matt Hancock]

As a proud supporter of the Conservative Government’s introduction of the national living wage, I am a big fan of the pay increases that we have seen for some of the lowest paid people in the country, such as some of those working in social care including the home care sector, about which the hon. Member speaks. National living wage legislation is not a “nice to have”; it is mandatory, and all employers must follow it.

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

  I thank my right hon. Friend for his incredible hard work over recent months. I am delighted that Scunthorpe General Hospital has received significant funding, which will help with the short to medium-term pressures, but he knows that it is in need of a much more significant upgrade. When he is able to, will he meet me to discuss a way forward?

[Matt Hancock]

Yes; my hon. Friend has been a champion for Scunthorpe and for supporting Scunthorpe General Hospital. I am glad that we have been able to make an investment in that hospital, and I am happy to meet her to talk about what more we can do.

[Dan Jarvis (Barnsley Central) (Lab) [V]]

NHS Blood and Transplant has recently reported a dramatic reduction in some transplant operations. For example, living kidney donations are down three quarters on last year. What steps is the Department taking to ensure that patients who require an organ receive the life-saving operation that they so desperately need?

[Matt Hancock]

The hon. Gentleman and I share a passion for ensuring that organ donation is possible and is supported wherever it is needed. That is very close to my heart through personal experience—not mine, but that of a friend. The hon. Gentleman has raised this issue and driven a change in the law, and I am glad that the change in the law to an opt-out system has happened. However, during the first lockdown there was clearly a slowdown in the number of donations, and we do not want to see that. There are more services available in the second peak of this coronavirus crisis. I look forward to working with him and others to make sure that organ donation is as high as it possibly can be.

[Jo Gideon (Stoke-on-Trent Central) (Con)]

Royal Stoke University Hospital in my constituency has warned that the rising level of obesity is becoming an increasingly serious problem. With nearly one in seven adults considered obese in Stoke-on-Trent Central, does my right hon. Friend agree that tackling rising levels of obesity has never been more important for our public health and should remain a priority for our Government?

[Matt Hancock]

Yes, I do, and so does the Prime Minister. We feel very strongly about this. It is so important that we have the work across the country to tackle obesity; this has only been made more urgent because we know of the link between obesity and the risk of dying from covid. I look forward to working with my hon. Friend and others to make this happen.

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

York’s contact tracing work has proved to be incredibly effective, not just in its reach but in persuading people to isolate. However, it is not getting data through until around day five, when people are having a test, and it could be so much more effective if it had that data on day one. Will the Secretary of State look at York being a pilot for having immediate access to the data and the resources necessary to get on top of this virus and lock it down?

[Matt Hancock]

I am happy to work with the hon. Lady and the director of public health in York, and obviously with NHS Test and Trace, to make sure that the link-up is as effective as possible.

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

My right hon. Friend will be aware that nosocomial spread is high in the NHS and that transmission is sometimes via staff. In order to help the amazing teams at Royal Stoke University Hospital and the Hayward walk-in centre, will he give guidance that stops substantive staff working bank, agency and locum shifts in other hospitals, to help reduce transmissions?

[Matt Hancock]

I am very happy to look into that idea, while making sure, of course, that we also have the availability of staff, which is critical. We have just had two questions from Stoke-on-Trent. Let me say how much I appreciate the work of everybody at the Royal Stoke, who I know are doing so much. There are difficult circumstances there because of the second wave, which is quite significant in Stoke. I thank everybody at the Royal Stoke for all the work they are doing.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

I was very pleased by the Secretary of State’s answer to me last week that the vaccine would be rolled out on a needs basis. As the House knows, I represent a vast and very remote constituency. What worries me is the thought of elderly and vulnerable constituents having to travel long distances to get the vaccine. Health is devolved in Scotland, of course, but what proposals does he have for England and Wales to take the vaccine to those people who are elderly and vulnerable, and will he share that methodology with the Scottish Government?

[Matt Hancock]

Yes, I would be happy to do that. We are proposing roving teams who can get out into rural communities across England. I know that there are ongoing discussions between those in the NHS in England and in Scotland who are responsible for the deployment of the vaccine. However, it is a critical principle that it should be deployed according to clinical need, not according to where people live across the United Kingdom.

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

Although covid has highlighted the value of our care workers, care remains generally low-paid, high-turnover employment. A route into nursing would give care workers more opportunity to progress and build a career. Would the Government consider fast-tracking a specialised training course for care workers seeking to go into nursing, which reflects the many transferable skills that they have?

[Matt Hancock]

Yes, I think that is a brilliant idea. Let us work on it together.

[Gary Sambrook (Birmingham, Northfield) (Con)]

I welcome the news that the Secretary of State has secured 5 million doses of the Moderna vaccine, totalling 355 million dosages for the UK. Does he agree that it is key to putting this virus back in its box, and that it is down to the willingness of the great British public to step forward and to voluntarily have this vaccine so that we can all move on?

[Matt Hancock]

Yes, that is right. A vaccine will be approved only if it is both effective and safe, so when your ticket comes up, if you are asked to take the vaccine, then I and the whole serious clinical establishment—all of those who understand the vaccines and the value of them —will be urging people right across the country to get it, because it is good for you, it protects your loved ones and it protects your community. It is the primary route, alongside other things like testing, by which we will get out of this and get life back more closely to normal.

[Chris Grayling (Epsom and Ewell) (Con)]

I welcome the Government’s substantial investment in hospital services in my area. The Secretary of State knows that I remain disappointed that Epsom, was not the NHS’s choice of location— rather than Sutton—but will he assure me that as the NHS reviews the impact of the pandemic and looks at future capacity needs, he will keep an open mind if that decision needs to be changed, because in the end Epsom represents better value for the health service?

[Matt Hancock]

I appreciate my right hon. Friend’s tenacity and doggedness in making the case for Epsom. I am a big supporter of the decision that has been made, and I am afraid, from his point of view, that the final decision on the location of the new hospital—in Sutton—has now been made. However, I am always open-minded to what further health services can be deployed in Epsom itself, and I suggest that my right hon. Friend and I work together on that.

[Mike Wood (Dudley South) (Con) [V]]

Rising infection rates in Dudley are extremely worrying. The launch of the third covid vaccine trial in the UK this week is excellent news and I pay tribute to the volunteers and researchers involved in the trials, but does my right hon. Friend agree that it is still early days, so it is vital that all of us continue to play our part in doing everything possible to bring down that infection rate, particularly in areas, like Dudley, where it continues to rise?

[Matt Hancock]

Yes. Vaccines could not be approved if there were not volunteers who were willing to take them and play their part. I want to end this session, if I may, with a tribute to my PPS, my hon. Friend the Member for St Austell and Newquay (Steve Double), who, along with some other Members of the House, is taking part in a vaccine trial, and therefore doing his bit to make vaccines available to help everybody across this country.

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

The Health Secretary will remember—his hon. Friend the Member for St Austell and Newquay (Steve Double) was there as well—that we had a really good meeting on 2 October about the link between covid and vitamin D. Since then the PM even said, two weeks ago, that good news is on the way. Will the Secretary of State update us on what is happening? The Government are meant to be getting rid of dither and delay. We could be like New Zealand; they have only had 16 deaths in care homes in the whole of this pandemic. What can he do?

[Matt Hancock]

Yes, we are making progress on that and working on the clinical protocols. I look forward to updating the hon. Lady with more information when a final decision has been made.

[Mr Speaker]

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

Covid-19 Update

Matt Hancock Excerpts

Tuesday 10th November 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.

The virus remains a powerful adversary, but we are marshalling the forces of science and human ingenuity. These forces are growing stronger, and I have no doubt that in time, we will prevail. The latest figures show that the number of cases continues to rise, so we must all play our part to get it under control. As I have said many times at this Dispatch Box, our strategy is to suppress the virus, supporting education, the economy and the NHS, until a vaccine can be deployed. That is our plan, and with the resolve that we must all show, we can see that that plan is working.

Before turning to progress on testing and on vaccines, I first want to update the House on our response to the new variant strain of coronavirus that has been identified in Denmark. This shows how vigilant we must be. We have been monitoring the spread of coronavirus in European mink farms for some time, especially in the major countries for mink farming such as Denmark, Spain, Poland and the Netherlands. Spain had already announced the destruction of its farmed mink population in April. On Thursday evening last, I was alerted to a significant development in Denmark of new evidence that the virus had spread back from mink to humans in a variant form that did not fully respond to covid-19 antibodies.

Although the chance of this variant becoming widespread is low, the consequences, should that happen, would be grave. So working with my right hon. Friends the Home Secretary and the Transport Secretary and all the devolved Administrations, we removed the travel corridor for travel from Denmark in the early hours of Friday morning. On Saturday and over the weekend, following further clinical analysis, we introduced a full ban on all international travel from Denmark. British nationals or residents who are returning from Denmark, whether directly or indirectly, can still travel here, but they must fully self-isolate, along with all other members of their household, until two weeks after they were in Denmark. These are serious steps, and I understand the consequences for people, but I think that the whole House will understand why we had to act so quickly and decisively. Be in no doubt, we will do what needs to be done to protect this country.

We do not resile from our duty to protect, and to suppress the virus, we must harness new technology to keep people safe and, in time, to liberate. Our ability to suppress the virus begins with testing for it, and the House will know that we have been driving forward testing capacity based on new technologies and old. Yesterday, our polymerase chain reaction—PCR—testing capacity stood at 517,957, which is the largest testing capacity in Europe. Over 10 million people in the UK have now been tested at least once through NHS Test and Trace, and our NHS covid-19 contact tracing app is now approaching 20 million downloads, yet this historic expansion is just one part of our critical national infrastructure for testing. Just as we drive testing capacity on the existing technology, so, too, have we invested in the development of the new. I have been criticised for this obsession with new testing capacity, but we have not wavered from the task, and we are now seeing the fruits of this effort.

Last week, we expanded the pilot in Stoke-on-Trent to Liverpool, where we have deployed enough of the cutting-edge lateral flow tests to offer tests to the whole city. These tests can deliver a result on someone’s infectiousness in under 15 minutes, so that they can get almost immediate reassurance about their condition and so that we can find and isolate the positives and reassure the negatives. To make this happen, NHS Test and Trace has been working side by side with the logistical heft of our armed services and Liverpool City Council, and I want to thank Mayor Joe Anderson and his whole team for their work.

Next, these tests allow us from today to begin rolling out twice-weekly testing for all NHS staff, which will help to keep people safe when they go into hospital and help to keep my wonderful colleagues in the NHS safe, too. The next step is to roll out this mass testing capability more widely, and I can tell the House that last night I wrote to 67 directors of public health who have expressed an interest in making 10,000 tests available immediately and making available lateral flow tests for use by local officials according to local needs at a rate of 10% of their population per week. That same capacity—10% of the population per week—will also be made available to the devolved Administrations. By combining the local knowledge of public health leaders with our extensive national infrastructure, we can tackle this virus in our communities and help our efforts to bring the R down. Testing provides confidence, and it is that confidence that will help to get Britain back on her feet once more.

While we expand testing to find the virus, the best way to liberate and to get life closer to normal is a vaccine, and I can report to the House the news of the first phase 3 trial results of any vaccine anywhere in the world. After tests on 43,000 volunteers, of whom half got the vaccine and half got a placebo, interim results suggest that it is proving 90% effective at protecting people against the virus. This is promising news. We in the UK are among the first to identify the promise shown by the vaccine, and we have secured an order of 40 million doses. That puts us towards the front of the international pack, and we have placed orders for 300 million further doses from five other vaccine candidates that have yet to report their phase 3 results, including the Oxford-AstraZeneca vaccine.

I want to make it clear to the House that we do not have a vaccine yet, but we are one step closer. There are many steps still to take. The full safety data are not yet available, and our strong and independent regulator the Medicines and Healthcare Products Regulatory Agency will not approve a vaccine until it is clinically safe. Until it is rolled out, we will not know how long its effect lasts, or its impact not just on keeping people safe but on reducing transmission. The deputy chief medical officer, Jonathan Van-Tam, said yesterday that this was like the first goal scored in a penalty shoot-out:

“You have not won the cup yet, but it tells you that the goalkeeper can be beaten.”

And beat this virus we must, we can and we will. Yesterday’s announcement marks an important step in the battle against covid-19, but, as the Prime Minister said, we must not slacken our resolve. There are no guarantees, so it is critical that people continue to abide by the rules and that we all work together to get the R number below 1.

If this or any other vaccine is approved, we will be ready to begin a large-scale vaccination programme, first to priority groups, as recommended by the independent Joint Committee on Vaccination and Immunisation, then rolling it out more widely. Our plans for deployment of a covid vaccine are built on tried and tested plans for a flu vaccine, which we of course deploy every autumn. We do not yet know whether or when a vaccine is approved, but I have tasked the NHS with being ready from any date from 1 December. The logistics are complex, the uncertainties are real and the scale of the job is vast, but I know that the NHS, brilliantly assisted by the armed services, will be up to the task.

I can tell the House that last night we wrote to GPs, setting out £150 million of immediate support and setting out what we need of them, working alongside hospitals and pharmacies, in preparing for deployment. The deployment of the vaccine will involve working long days and weekends, and that comes on top of all the NHS has already done for us this year. I want to thank in advance my NHS colleagues for the work that this will entail. I know that they will rise to the challenge of being ready, when the science comes good, to inject hope into millions of arms this winter.

The course of human history is marked by advances where our collective ingenuity helps us to vanquish the most deadly threats. Coronavirus is a disease that strikes at what it is to be human, at the social bonds that unite us. We must come together as one to defeat this latest threat to humanity. There are many hard days ahead, many hurdles to overcome, but our plan is working. I am more sure than ever that we will prevail together.

--- Later in debate ---

[Matt Hancock]

I am very grateful to the hon. Member for his questions and for the approach that he is rightly taking. Like him, I am delighted that we are able to roll-out routine testing to NHS staff. That starts today. I am grateful to him for his support and I am grateful for the support and the urging of the Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt).

On contact tracing, we continue to work on the constant improvement needed, but, as the hon. Member said, the expansion of testing in a radical way because of the new technology that we have invested in and spent months working on, means that we will now be able to find more of the primary cases and more of the people who have the disease and then will be able to get them and their contacts to isolate. The single most important challenge is finding the people who have the virus in the first place.

The hon. Member mentioned children. The vaccine will not be used for children. It has not been tested on children. The reason is that the likelihood of children having significant detriment if they catch covid-19 is very, very low. This is an adult vaccine for the adult population.

He asked about the JCVI prioritisation. It is really important that we prioritise according to clinical risk. The JCVI has looked into all the risk factors, including ethnicity. It has concluded that age and whether a person works in health and social care are the two prime risk factors, which far outweigh any other, and so they are the primary risk factors that cascade into the draft interim prioritisation that it published on 25 September, which of course will be updated as it gets the final data that comes through from the clinical trials.

He asked about the proportion of the population that needs to be vaccinated. The honest truth to that question is that we do not know what proportion of the population the vaccination needs to reach in order for it to stop the epidemic. The reason we do not know that is that a clinical trial can check for the impact of the vaccine on protecting the individual—43,000 individuals, half of whom have had the vaccine. What cannot be checked is the impact on the transmission of the disease by those people, because a significant proportion of the population have to have had the vaccination to understand that. That is the difference between a so-called disease-modifying vaccine, which tests how much it affects the disease that an individual suffers if they get covid-19, versus an epidemic-modifying vaccine, which is about the impact on the spread and transmission of the disease. We cannot know that until after the vaccine has been rolled out, so we will monitor that very closely.

The hon. Gentleman asked about manufacture, which is important, and for this vaccine that is a matter for Pfizer. It is a difficult process. Distribution is also a huge challenge, and that is being led by the NHS. Because the vaccine must be stored at minus 70° until the final hours, the cold-chain requirements are significant and add to the logistical complications. However, we have known about that cold-chain requirement for many months, and it has been part of our planning for some time. We have a good degree of confidence that that will be in place.

Finally, the hon. Gentleman asked about international collaboration. I am delighted that the UK has been a leader in efforts for international collaboration to find a vaccine. It has put in more money than any other nation, co-ordinating and bringing together scientists and vaccine specialists, and using our aid budget to ensure that people around the world get the vaccine in countries that, in some cases, could not afford to vaccinate their own population. We are a big part of the international work, and I very much look forward to working with colleagues in the United States, and everywhere else around the world, to ensure that we have a global vaccination programme as soon as a safe and effective set of vaccines can be made available.

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

I warmly congratulate the Health Secretary on securing access to the new vaccine. Choosing which vaccine to back must be a bit like playing roulette, and to secure 40 million doses of the first vaccine to prove efficacious is an enormous achievement for the country. He deserves great credit for that. I also thank him for bringing forward the introduction of weekly testing of NHS staff to the end of next week. That will reassure our very hardworking front-line staff that they are not infecting their patients, which is one of their primary worries.

The biggest issue we now face is the fact that only around one-fifth of those who we ask to isolate comply with that, and we do not even know all the people who we would like to isolate. What does the Secretary of State think of Sir John Bell’s suggestion to the Health and Social Care Committee this morning that, instead of asking people to isolate, we should give them 48-hour lateral flow tests, and ask them to isolate only if they are positive?

[Matt Hancock]

I am grateful to my right hon. Friend. He is generous with his words. I also direct his warm words of gratitude to the vaccine’s taskforce, which has done so much work to ensure that we procure and secure the supplies of these vaccines, should they prove safe as well as efficacious. On Sir John Bell’s comments, that option of testing people regularly—not if they are a primary case and have the virus, but if they are a contact—would not be open to us had we not secured the huge capacity for lateral-flow testing that we now have in this country. I very much look to clinicians for advice. Sir John Bell is a highly respected clinician and expert in this area, and I am sure that everybody will want to look closely at that issue.

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

With three and a half weeks left of the current lockdown in England, what does the Secretary of State plan to change so that covid-19 does not get out of control again when restrictions are eased? He mentions the pilot project of population testing in Liverpool, using newly developed lateral-flow tests, but there are not yet published sensitivity or specificity data for those tests. What is the risk of false negative or false positive results? Has the UK National Screening Committee been involved to help assess the risks, benefits, and costs of such mass population testing?



I welcome the progress made on the Pfizer vaccine, but it will take time before it is widely available, and, as the Secretary of State said earlier, we do not yet know if it will reduce transmission, so it does not remove the need to control viral spread using current measures. While I also welcome the expansion of PCR testing, I am sure he recognises that what matters is not just the number of tests available but that testing is part of a test, trace, isolate and support system for it to be effective. Five months on, Serco is still struggling to reach even 60% of contacts, so will he copy the more successful approach of the devolved nations and fund local public health teams to lead contact tracing in their areas?

An effective test and trace system can identify those carrying the virus rather than isolating everyone in a lockdown, but it is isolation that actually breaks the chains of infection. Is the Secretary of State therefore concerned that so few people are isolating when they should? How can that be improved? People will not stay off work if that means they cannot feed their family, so how will he make access to the Government’s isolation payment easier?

[Matt Hancock]

Of course, we are working to ensure that, by us all working together and making sacrifices, we can come out of this lockdown and into the tiered approach we had in place beforehand. That is the goal, and the more that people follow the rules during the lockdown, the more effective it will be. We obviously monitor the data closely on that.

The hon. Lady asked about lateral flow tests and their sensitivity and specificity, which is an incredibly important question. The assessment of the tests we are using in Liverpool and now rolling out elsewhere was made at Porton Down. We then tested 5,000 lateral flow tests alongside 5,000 polymerase chain reaction tests of the same people in the field, and we have a high degree of confidence that they can find people who are infectious. In fact, the lateral flow tests have a lower false positivity issue than the PCR tests, so they are very effective for the right uses, including mass population testing.

The hon. Lady asked about isolation. Of course, isolation is important. I would mention that we have test and trace systems in place across the UK and it turns out that there are differences in how a successful contact is measured. In England, we are much stricter in requiring contact to be a confirmed contact with somebody rather than just sending them a message, which does count as contact in some of the devolved and local systems. It is really important that we measure the same thing, rather than trying to make divisions where divisions do not exist.

Finally, it is vital that people isolate when they test positive or when they are asked to by NHS Test and Trace. I gently say again that the 20% figure is not particularly robust, because it implies that 80% of people are not doing anything to isolate. That is not what the survey found. Nevertheless, we should all urge and require people to follow the rules. When someone tests positive, they must isolate, and contacts must isolate. That is part of our social duty.

[Damian Green (Ashford) (Con)]

It is indeed a relief to have some hope introduced into our discussions about covid. I am glad that the Secretary of State has announced that use of the rapid result lateral flow tests will be expanded to new geographical areas. As the roll-out continues, will he consider offering tests to specific groups and perhaps in particular close relatives of care home residents who are desperate to make regular visits?

[Matt Hancock]

Yes, of course. I have seen some heart-rending stories and I have met people who are affected by their inability to see their relatives in care homes. The lateral flow tests that we are sending to directors of public health can be used for cases that they think are important locally, so they can use them for this purpose if they so choose. But we are also looking at a broader solution to this problem, which is a conundrum we have discussed many times in this House: we need to keep people in care homes safe but at the same time, of course, we want to allow as much visiting as can be safe, which directly impacts on the health of many residents.

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

It would be very helpful to know how long the roll-out of the vaccinations will take once the Secretary of State gets the go-ahead. He has outlined a major Government project that does not stop with the first vaccinations, and with the mutations rife in Denmark and elsewhere, it could affect children in future, so as part of his major project planning, how is he going to make sure that we can logistically get this out through the entire population if that does, sadly, become necessary?

[Matt Hancock]

That is a very good question from the Chair of the Public Accounts Committee—I would expect nothing less. The critical answer to how long this takes is that it depends on the speed of manufacture in the first instance. My goal, and the goal I have set the NHS, is to be able to roll this out as quickly as it can be manufactured. That manufacturing schedule is uncertain because this is really hard stuff to make. We have got the Major Projects Authority in the Government involved in many of the projects that we have built up in the Department over the past nine months, because I respect its views and its ability to kick the tyres. The roll-out of the vaccine is a huge endeavour, but it builds on the annual roll-out of the flu vaccine—it is just bigger and needs to be done faster.

[Mark Pawsey (Rugby) (Con)]

The past few months have been a rollercoaster ride for families, businesses and public services as they have tried to make plans for the future. The Secretary of State has rightly spoken of the need for caution about the role of the vaccine, but I think what my constituents would like to hear from him, if he is able to say, is when they can safely start to consider family events and holidays and when businesses will be able to get back to something like business as usual.

[Matt Hancock]

I understand the yearning for certainty. All I can say to my hon. Friend, in honesty, is that I want us to get back to normal as quickly as possible, and yesterday’s news is a big step forward, but it is not the only step. There are more steps that are needed. The scientists are now offering views on that sort of timetable, but the Government’s view is that we must make this happen as quickly as possible and be ready to roll out as fast as any safe vaccine can be manufactured, but we will not put safety at risk. That is a lodestar of the programme and therefore we have to await the clinical safety sign-off before we can take this to the next stage.

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

We know that those in the most deprived areas are around twice as likely to die from covid-19 as those in the least deprived areas. We also know that the most deprived people in society are less likely to take up the vaccine and health services, so will the Secretary of State tell me what plans he has made to ensure a high take-up of any covid-19 vaccine among the most deprived and if he will consider setting an inequalities target for this?

[Matt Hancock]

We are of course concerned about that and will put in enormous efforts to try to ensure that the take-up of the vaccine is as equal as possible. The starting principle is that we will roll out the vaccine according to clinical need across the whole UK, across all four nations, working of course through the devolved NHSs, which are going to be critical to actually delivering the vaccine in the devolved nations. But the procurement of this vaccine is a UK programme—we have been working very closely together—and in terms of the roll-out among deprived communities and harder-to-reach communities, we have a particular emphasis on trying to make sure that we get as equal a roll-out as possible. The starting point must be clinical need.

[Duncan Baker (North Norfolk) (Con)]

Not a day goes by when I do not hear from or try to help constituents to see a loved one in a care home, and in so many cases we know that people have not been able to see their loved ones for months and months. Given that I am the MP for one of the oldest constituencies in the country, North Norfolk, will my right hon. Friend give me his absolute reassurance that we will have enough vaccinations to support not only the vulnerable in my care homes, but those amazing workers who have done so much over the pandemic?

[Matt Hancock]

Precisely for the reasons my hon. Friend sets out, the top priority for this vaccine, according to the clinical analysis, is the residents of care homes, along with the staff who work to look after them so well. They are in the very first categorisation because they are the most vulnerable to this disease and because a care home’s nature as a generally communal environment means that they are particularly susceptible. As he represents the oldest constituency in the country, I am sure that that sort of prioritisation will mean that should this come off and if the other hurdles are passed, a lot of vaccine will be heading to North Norfolk.

[Munira Wilson (Twickenham) (LD)]

Of course the news about the Pfizer vaccine is extremely encouraging, and we are all hoping that it is proved safe and effective, and that it is approved by regulators. Let us suppose that that is the case. Given that it is being manufactured in Belgium and that, as the Secretary of State has noted, it has to be kept at minus 70° at all times until shortly before administration, what arrangements is he putting in place to ensure that there is absolutely no delay of the supplies at the borders following the end of the Brexit transition period? Any significant delay could at worst result in precious supplies being damaged and rendered useless, which could delay roll-out.

[Matt Hancock]

Of course we have looked at this risk, and I have confidence in our plans to be able to deliver the vaccine whatever the outcomes of the negotiations over our future relationship with Europe.

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

My right hon. Friend’s strategy is, as he keeps reporting to the House, to “suppress the virus” until a vaccine can be deployed, but this is still beset by so many uncertainties. Who would have thought that mink in Denmark could throw a spanner into this situation? Is the tracing capability and the ability to get people to isolate not absolutely crucial? Who should we hold accountable for whether that is operationally effective as we come out of lockdown? I say that because this is the only time we have got to make this work, otherwise we will be in another lockdown.

[Matt Hancock]

Of course it is important that we continue to build and strengthen the contact tracing system, as we are doing. My hon. Friend mentions the uncertainties, and the issue of the virus that has spread back from mink to humans is one example of that. Of course managing a pandemic is beset by uncertainty. We still have uncertainty, for instance, over whether even the Pfizer vaccine will pass the safety hurdles that we very much hope it will in the coming weeks, but managing through that uncertainty is a critical part of getting this right.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement. Is it not good to see the nation regain at least a smile in relation to the potential for a vaccine? That has to be good news for us all. Will he outline how he intends to ensure that, unlike with the flu vaccine, where there is a shortage in the nation and in my constituency, each region will receive the necessary amount of this vaccine and that rather than using estimations, the health service will allocate on the basis of priority need and not postcode?

[Matt Hancock]

Yes, absolutely; this is a UK programme and I have been working closely with my Northern Ireland counterpart, Robin Swann, who is doing a brilliant job in Northern Ireland, to make sure that we get this roll-out as effective as possible right across the whole United Kingdom.

[Andrea Leadsom (South Northamptonshire) (Con)]

Mr Deputy Speaker, happy birthday.

I know that my right hon. Friend is as concerned as I am about the impact of lockdown, particularly the first lockdown, on new families with new babies—particularly as seen in the excellent Parent-Infant Foundation report “Babies in Lockdown” and the awful news from Ofsted that some babies have been harmed more than you would expect during that period of time, potentially as a result of poor mental health and so on. So can my right hon. Friend tell us what exactly he is doing to ensure that, during the current lockdown, new families are being provided with the level of support, from partners and statutory services, that they need to help them through?

[Matt Hancock]

My right hon. Friend is right to raise that issue, and we all know how close it is to her heart. In the first lockdown, many NHS services were suspended, partly because of the uncertainty that we have just been talking about. We know far more about the virus and how to manage it the second time round, and our goal is that all NHS services stay open. That has not proved possible in the areas of the country where there is the highest prevalence, but all maternity services and services around perinatal health ought to stay open everywhere. We have had to delay some non-cancer, non-urgent treatment, but crucially, the best thing to do for this agenda that she champions is to try to keep the virus under control and try to suppress the virus as much as possible.

[Apsana Begum (Poplar and Limehouse) (Lab)]

A happy birthday from me too, Mr Deputy Speaker.

As well as age and underlying conditions, the JCVI notes that early signals have been identified of other potential risk factors, including deprivation and ethnicity, but there have been enormous amounts of research and evidence showing that black, Asian and minority groups are at risk of this virus. Given their occupations, and given the overcrowded households that they disproportionately represent, why have they not been included in the composition and order of priority of groups for vaccination?

[Matt Hancock]

Before I forget, Mr Deputy Speaker, I should say happy birthday to you as well.

The hon. Lady asks a very important question. The JCVI has looked at that issue and in its earlier iteration of its draft advice it considered the disproportionate impact that the virus has had on BAME communities. Its conclusion, having looked at it in some detail, is that the overwhelming indicator of mortality from coronavirus is age; and therefore it has based its recommendations around age and, of course, the occupational groups that directly support the most vulnerable—hence it has come up with the classification that it has. I respect the JCVI’s independence and its analysis.

[Matt Western (Warwick and Leamington) (Lab)]

Happy birthday to you, Mr Deputy Speaker.

In the past fortnight, 75 people in my constituency, workers at a food processing factory, have tested positive, and that follows a similar outbreak at Cranswick Country Foods, where 144 out of 333 tested positive just 10 days ago. Lawrence Young at the University of Warwick has shown through research that the virus remains very viable on cold surfaces. My question to the Secretary of State is simply: how often should the Health and Safety Executive be undertaking physical checks in such premises, and when should Members of Parliament be notified by local authorities that such an outbreak has happened?

[Matt Hancock]

It is down to the local authority, in the first instance, to notify a Member of Parliament, although often, if an issue is very significant, we in the Department will also work with the local Member of Parliament. The Health and Safety Executive takes a risk-based approach, so it is not possible to give a definitive answer about how often it should visit; it depends on the level of the risk.

[Mr Deputy Speaker (Mr Nigel Evans)]

Before I call Jacob Young, I would just like to say thanks for all the birthday wishes. I absolve anybody else from saying happy birthday to me. I am coming to terms with the fact that The Times added a year to my age. It is bad enough being the age I am, I do assure you, but none the less.

[Jacob Young (Redcar) (Con)]

Last week, I spoke to care providers in Redcar and Cleveland who outlined that, when it comes to testing in care homes, two groups of people are still missed out: first, agency workers, who go to and from care home to care home, currently fall outside the weekly testing programme; and secondly, family members of those who live in care homes. If we can roll out testing for those people, they could be treated as care workers and enabled to visit their loved ones again. Will the Secretary of State urgently address these two gaps in our testing programme, to help lift some hardship from the most vulnerable in our society?

[Matt Hancock]

The answer is yes, and I will add a third: visitors to care homes. I would like the testing regime to work for those people, to make visiting easier. When it comes to agency workers, we want to stop altogether people working in more than one care home, because that risks transmission. When it comes to carers who are unpaid but who go in regularly, we want to find a way for them to be added to the regular testing regime.

[Alison Thewliss (Glasgow Central) (SNP)]

There was nothing in the Secretary of State’s statement about VAT on personal protective equipment, so will he update the House on what discussions he has had with the Treasury about scrapping the mask tax?

[Matt Hancock]

That is a matter for the Treasury, as the hon. Lady indicates. The truth is that we have made PPE freely available to health and social care and other public services until the end of this financial year.

[Mr David Davis (Haltemprice and Howden) (Con)]

The weekend press carried briefing of a Government intention to distribute vitamin D to care homes and other vulnerable groups. If that is true, I congratulate the Secretary of State on this decisive, low-cost, zero-risk, potentially highly effective action. If it is true, will he tell us the dosages proposed, how quickly it will happen and whether the target groups include ethnic minorities? Is his Department reviewing and considering the Spanish trials, with a view to the use of calcifediol in a clinical context?

[Matt Hancock]

This is something that we are working hard on in the Department. I am not yet in a position to answer all those questions, except to say that I have looked at the results of the Spanish trial that my right hon. Friend mentions, not least because he sent me those results with some enthusiasm. We are looking at this very closely.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

Before I ask my question, I pay tribute to the brave staff of the Royal Free Hospital in my constituency, who featured in “Hospital” last night on BBC 2, for all their hard work during the pandemic. I understand that, when the vaccine is approved, the Government will distribute it according to who needs it most. However, before that point, will there be Government restrictions on meetings between those who have been vaccinated and those who have not? When does the Secretary of State think the vaccination will be available for the whole of the UK?

[Matt Hancock]

The hon. Lady tempts me, but I will resist the temptation. We do not know when this vaccine will be ready, because I will not allow it to be rolled out before it is clinically safe—and anyway, the independent regulator would not license it before it is clinically safe. She asked how we will treat people who have been vaccinated and those who have not been. The problem is that only when we can assess and monitor the epidemic-modifying effects of any vaccine—not only how much it protects an individual but how much it stops transmission—can we make further judgments about the non-pharmaceutical interventions, such as social distancing rules, that we have in place. We will keep that under review and monitor it extremely carefully.

[Chris Grayling (Epsom and Ewell) (Con)]

I congratulate my right hon. Friend on what he has done to secure access to supplies of what we hope will be approved vaccines very soon. He has done a fantastic job on that, as he has on the expansion of testing and the 15-minute tests. However, may I take him back to the issue of testing in the aviation sector? Prior to the pandemic, we had the biggest and most important aviation sector in Europe. Since the pandemic, that sector has collapsed, yet last week Lord Bethell told the House of Lords that the chief medical officer believes that the aviation sector is a low priority for testing. It may be a low priority in his eyes, but it is economically vital to us. I urge my right hon. Friend to make sure that those 15-minute tests are made available to the aviation sector at the earliest opportunity.

[Matt Hancock]

The expansion of testing capacity obviously opens up the number of different uses to which it can be put. We are working closely with the aviation industry—my right hon. Friend the Secretary of State for Transport is leading those discussions, but I am heavily involved in them—and I hope we can make some progress soon.

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

A constituent’s father is in a care home. He is non-verbal and relies on touch to communicate. She says:

“I have not been able to hug my dad for over eight months. I have not been able to hold his hand. I have not been able to…take his youngest grandchild to meet him.”

Eight months into this crisis, will the Secretary of State urgently set out the scope of his pilot keyworker-status scheme, accelerate its implementation and tell us when a combination of regular rapid testing and personal protective equipment will allow my constituent to safely hold her dad’s hand again and put an end to this slow torture?

[Matt Hancock]

The hon. Lady puts the point very movingly. The Minister for Care is leading on this issue with great compassion and I hope that we can make some progress soon.

[Robin Millar (Aberconwy) (Con)]

The news of a vaccine is very welcome, but it comes just as Wales is leaving its firebreak and England has entered its own lockdown. This kind of diversion has caused confusion and some anxiety, so will my right hon. Friend confirm that the vaccine will be available in all parts of the Union? Does he agree that it is the action that the UK Government have taken on things such as the pre-purchase of doses that has given us this access?

[Matt Hancock]

There is absolutely no doubt that we have worked together as a United Kingdom to put ourselves in a strong position when it comes to access to the Pfizer vaccine, and we have worked together to ensure that, should it come off, the Oxford-AstraZeneca vaccine will be available across all parts of this United Kingdom. I pay tribute to the work that I anticipate the NHS in Wales will be doing to deliver the shots into arms across Wales, but it is a UK-wide programme and is yet another example of why the UK is so strong when it works together.

[Barry Gardiner (Brent North) (Lab)]

The Secretary of State is aware that priests have been unable to administer the sacrament to those dying in care homes and rabbis have been unable to secure a minyan in order to say the Kaddish. How will his Government now try to ensure they recognise that a person’s spiritual needs are critical for their mental health and that this is just as important for people’s physical health?

[Matt Hancock]

Of course we recognise exactly that, and the hon. Gentleman puts it well. Ministers are working with faith leaders on how we can come to an arrangement, as soon as possible, to allow both communal prayer, which was discussed in the House as we brought in the regulations relating to the lockdown, and all other aspects of nurturing worship.

[Lia Nici (Great Grimsby) (Con)]

Diana, Princess of Wales Hospital in Grimsby currently has twice as many covid patients in intensive care units as we had at the height of the previous lockdown. Does my right hon. Friend agree that, despite the very good news regarding vaccines, it is essential that people in England adhere to the lockdown rules so that we can get the reproduction rate down and reopen our businesses as quickly as possible?

[Matt Hancock]

Yes, my hon. Friend puts it absolutely right, and that is the reason for the caution we in Government are showing. There is understandable excitement at the news of the vaccine, but we are cautious, because the single most important thing is that, until we have a vaccine—and we do not have a vaccine yet—people have to follow the rules in order to keep people safe. That is true across Grimsby and the whole country. I know that the team at the hospital in Grimsby are working incredibly hard in difficult circumstances, and it is tougher in Grimsby this second time than it was the first time around. I pay tribute to and thank them. The best thing we can all do to support them is to follow the rules, do our best and play our part to reduce the transmission of this disease.

[Gavin Newlands (Paisley and Renfrewshire North) (SNP) [V]]

For the vaccine to be effective, widespread take-up is required. Yesterday, the Prime Minister said a strategy to counter the utterly ridiculous and extremely dangerous anti-vaxxer misinformation was to hope people will not listen to those types of arguments. Can the Health Secretary assure the House that his Department is working on a more detailed strategy than the Prime Minister to counter this misinformation?

[Matt Hancock]

Yes.

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

The Secretary of State’s update is very welcome news for the shielding community, and I hope they will be among the first to receive the vaccine. At my meeting with the deputy chief medical officer last week, she informed me that 15,000 children are still being asked to shield this time around. What does the Secretary of State say to the parents and carers of those children, given that he has just confirmed that they will not receive the vaccine?

[Matt Hancock]

Of course, we will continue to work on a clinically-led basis with everybody across the country who needs support. The vaccines were not trialled on children, and it would absolutely be a clinical decision as to how to take this matter forward. I am very glad that the hon. Lady has had the opportunity to talk to the deputy chief medical officer, Jenny Harries, who leads on shielding policy. It is a very important and very sensitive subject.

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

The amended graphs used to justify the lockdown now show a 40% reduction in the death rate in the upper quartile as against their first presentation, so the NHS would have coped, wouldn’t it?

[Matt Hancock]

No.

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

Mid Yorkshire Hospitals NHS Trust now has over 280 covid patients. That is more than 70% higher than in April, and it has fewer staff in place to cope. It cannot use the Harrogate Nightingale, because there are no spare staff to send there. The staff are doing an amazing job, but I am really worried about the pressure they are under. Will the Secretary of State work urgently with Yorkshire hospitals to get them more support and more staff in place over the next couple of weeks, when the pressure is likely to be greatest?

[Matt Hancock]

Yes, of course. We are working with hospitals across Yorkshire and across the whole country to try to make sure that we have the most capacity available. It is true that the numbers going into hospitals across Yorkshire continue to be far too high, and there is an awful lot of work we need to do, but the most important thing is that we get this virus under control in order to bring that number of admissions down.

[James Cartlidge (South Suffolk) (Con)]

I join others in congratulating my right hon. Friend, my constituency neighbour, on ensuring that our country has its share of this very promising RNA vaccine. However, on the subject of the previous question and capacity, is not one of the key reasons for prioritising health and social care staff not just that we prioritise those who are protecting us, but that by ensuring they are first in line for the vaccine, should it come forward and be proved safe, we will help to boost hospital capacity at a crucial time of the year?

[Matt Hancock]

Yes, that is a really important point. Part of the challenge of, and the reason for, a second lockdown was NHS capacity. The more we protect those who work in the NHS, the fewer are unavailable to work, precisely as the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) said, and the more capacity we have in our NHS.

[Tim Farron (Westmorland and Lonsdale) (LD)]

As families begin to dare to hope in the possibility of a vaccine, it is vital that we prioritise mental health resilience and confidence in learning among our young people. Outdoor education centres in Cumbria and across the country are uniquely equipped and able to help with just that, yet most of those centres face closure, essentially because the Government advice remains against residential school visits, even though outdoor education centres are just as covid-safe as schools. Would the Secretary of State agree to work with the Department for Education to try to change that advice and to make sure outdoor education centres remain open?

[Matt Hancock]

I am very happy to look at that matter with my right hon. Friend the Education Secretary. It is, of course, a Department for Education lead, but I am happy to do my bit.

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

I warmly congratulate my right hon. Friend on the work that he has done on securing the vaccine. May I just bring the discussion back to the here and now, since, as he quite rightly says, there is a long way to go on that? Something that has been slightly overlooked in his statement is his announcement of the provision of 10% of lateral flow tests to local areas, which is very important. I am grateful to my right hon. Friend for doing an incredible job in keeping me and other Leeds MPs informed as the crisis has moved forwards, but will he tell me whether the lateral flow tests will have an impact on the tiering system? The numbers in Leeds are still exceptionally high, although hopefully they will change during the lockdown. Is there going to be some change in how the tiering system works? If my right hon. Friend does not have the answers now, perhaps he could write to me at a later stage, once he has given the matter some consideration.

[Matt Hancock]

I will write to my right hon. Friend on exactly this matter. Of course, the more that we can do to get the infection rates down during lockdown, the easier it will be to get out of lockdown, and places can get out in lower tiers.

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

Have the bumps from me too, Mr Deputy Speaker.

It is good to hear some good news about the vaccine on the way, and hopefully about vitamin D. Earlier in the pandemic, people with non-covid health issues were told not to suffer in silence. Now we hear that non-elective surgeries are being cancelled; I think all are off at the Queen Elizabeth Hospital in Birmingham. What is the advice now? If it is the wrong advice, could this mean the loss of lives?

[Matt Hancock]

We want as little impact on the rest of NHS activity as possible. Of course, we are having to take that action in some high-prevalence areas. That decision takes into account local circumstances; it is not a blanket, national decision as it was in March. The most important thing that we can all do to keep our NHS open for non-covid treatment is to abide by the rules and have that lockdown in place.

[Joy Morrissey (Beaconsfield) (Con)]

I pay tribute to my right hon. Friend for securing the vaccine. That is a ray of hope for us all. I look forward to hearing more about the developments in the coming weeks and months. Will he join me in paying tribute to the military, who have worked tirelessly to deploy the mass testing of the vaccine, and update the House on his plans for the military to be used with regard to the vaccine in the coming months?

--- Later in debate ---

[Matt Hancock]

Absolutely. The armed services of this country have played an amazing role during the pandemic. I have talked about a war against a virus, in which we are all on the same side. The military have done and are doing their bit, and there is a lot more that we will need from them in the future. They are involved in the mass testing and the vaccine roll-out, and I am very grateful for their support.

[Hilary Benn (Leeds Central) (Lab)]

We have learned today that mass testing of students is to take place in order to enable them to return home for Christmas, which will be widely welcomed. We have a very large number of students in Leeds. Will the Secretary of State tell the House whether that testing is going to be handled by the universities themselves or by the excellent public health team in Leeds that is led by Victoria Eaton? How will it dovetail with any roll-out of mass testing to Leeds in due course, so that all the bits of the system fit together?

[Matt Hancock]

The right hon. Gentleman asks a characteristically critical question and puts his finger on a vital logistical point. We are planning to help students to get home safely with the assistance of mass testing. In places such as Leeds, mass testing is being made available to the directors of public health. Of course, these things must be dovetailed. The universities will be in the lead on the mass testing of students, but this process, by its nature, will absolutely draw on the public health knowledge and expertise of the local council. Although each of us has become something of a public health expert over the past 11 months, the professional support from the public health team in the council will be critical to this task.

[Neil O’Brien (Harborough) (Con)]

I welcome my right hon Friend's announcement on the roll-out of mass testing for NHS staff and congratulate him on securing so many doses of the vaccine. It is wonderful news that the efficacy of the first of these vaccines seems to be so very high. I have read in newspapers over the past month countless pundits telling me that there would be no vaccine and that the right thing to do would be to let the virus rip and try to protect a few vulnerable people. Does this not show that it is right to listen to the scientists and the real experts rather than pundits who would have put millions of people’s lives at risk?

[Matt Hancock]

My hon. Friend feels strongly about this point. That is understandable, because the strategy that we have pursued has been to suppress the virus while we work on the vaccine. We are not there yet, but this progress towards a vaccine demonstrates why we followed the strategy of protecting life even though we know that there are challenging consequences for businesses and other parts of society. We have done so because we have a good degree of confidence that a vaccine will come and will make a significant contribution to solving this problem without the huge risk of its impact on taking people’s lives, especially the most vulnerable, that would be incurred if we did not suppress the virus.

[Mike Wood (Dudley South) (Con) [V]]

It is fantastic news that 10,000 rapid lateral flow tests will be going to Dudley this week and that about 30,000 more will be in use locally subsequently. What guidance will be issued to directors of public health on how those rapid tests should be targeted?

[Matt Hancock]

Guidance will be given and we are engaging directly with directors of public health. I will ensure that the teams from Stoke and Liverpool, who have been piloting this, will talk to other directors of public health, including in Dudley. We are not putting stringent rules around the use of these tests, because we want directors of public health to use them in ways in which they think will work and are important locally and then to feed back on the effectiveness of their use so that we can keep learning about the roll-out. We are sending the tests out with guidelines and instructions on how to use them, as well as logistics, but also saying to directors of public health, “Use your professional expertise and tell us how you did it, what worked and what did not and we can all learn from each other.”

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

My constituent Kellie Shiers is an emergency ambulance care assistant with North West Ambulance Service. In 2015 she was diagnosed with breast cancer. After treatment she went into remission and went back to work. During the pandemic she chose to continue to work on the frontline despite her medical history. Her yearly check-up and mammogram did not happen in April and in early October she was told that not only had her cancer returned but it has now spread into her bones. Kellie has asked to meet the Secretary of State to discuss the situation affecting her and thousands of others, but we have not had a reply to my letter sent three weeks ago. Will the Secretary of State agree to that request?

[Matt Hancock]

Yes, of course I will. It is an incredibly important subject. It underlines the fact that by controlling the virus and taking action to suppress it, we allow the other activity that the NHS needs to do, which is very important for the precise reasons that the hon. Lady sets out. I would be very happy to meet her and her constituent, listen directly to her experience and see what we can do to help.

[James Sunderland (Bracknell) (Con)]

Lockdown 2 has been very divisive across the UK, not least in Bracknell. Are there any circumstances in which my right hon. Friend might consider early easing of restrictions, perhaps in low-infection areas?

[Matt Hancock]

We always keep the data under review and we are always looking at what we can do. Our goal is to get out of this lockdown into the tiered system and we are focused on that and on getting the numbers down. Even in Bracknell, where for so long the rate of infection was incredibly low, we have seen an increase in that rate of infection and it is important to get it under control in Bracknell, as it is elsewhere in the country.

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

Because of the growing number of covid patients being treated in hospital, my local NHS would like to use the Exeter Nightingale hospital for in-patient care, but it does not currently have the staff for it to do so. What exactly is the purpose of the Nightingale hospitals when there are not the doctors and nurses to staff them?

--- Later in debate ---

[Matt Hancock]

There are of course record numbers of staff in the NHS. There has been an increase of over 13,000 nurses, for instance, in the past year, and we have the returners who have come back into the NHS. The right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) asked this question and I did not answer it, so I will now answer them both together. The Nightingale hospitals are incredibly important as additional surge capacity, but part of that surge involves the staff in the NHS having themselves each to look after a higher proportion of patients. That surge is not something we want to put in place unless we have to, so having the Nightingales there is important. They can be used—in fact, the Manchester Nightingale currently has patients in it—but it is better both for patients and staff if people can be treated in the existing hospitals, even as we expand the number of staff that are available.

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

Following the rise in the real living wage, will the Government now do the right thing for care workers, as well as for UK Government workers on outsourced facilities management contracts, all of whom have worked throughout the pandemic to make workplaces safe, and ensure that they are paid the real living wage?

[Matt Hancock]

I am absolutely delighted that the national living wage, which we introduced, now means that there has been a sharp rise in the pay of our lowest-paid staff right across the UK. I think that is something this whole House can get behind. It is true in social care, as the hon. Gentleman mentions, and in other professions, and I am really proud to have played a part in bringing it about.

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

My right hon. Friend well understands the importance of families being able to see each other this Christmas at the end of a very difficult year, and he understands the lengths that people will inevitably go to in order to be able to see families and loved ones this Christmas. Without making any predictions about what the situation will be at the end of the year, can he at least confirm today that the intention on the part of this Government is to work with the devolved Administrations so that we have one set of rules covering the whole United Kingdom, and, for the first time during this pandemic, a set of rules that are clear, consistent and fair right across the UK?

[Matt Hancock]

I really hope that the talks that are under way can come to a set of principles and a set of rules across the UK for Christmas. So many people travel across the UK, including to and from Wales, over the Christmas period, even more so than in the rest of the year, and I hope that we can bring this to fruition.

[Stephanie Peacock (Barnsley East) (Lab)]

Last week the Prime Minister said that not enough people are self-isolating when asked to. Does the Secretary of State accept that this might be because those traced by the covid app are not entitled to the same financial support as if they receive a phone call?

[Matt Hancock]

We are working on ways to ensure that those who are traced through the app also get support. The challenge is that the app is, by its nature, and by the design principles that our friends and colleagues in the tech industry insisted on, anonymous. Therefore, translating an anonymous system on the app into an identified payment is a challenging process that we are working through.

[Carla Lockhart (Upper Bann) (DUP)]

I thank the Secretary of State for his efforts with regard to a vaccine and for his commitment on equal distribution throughout the Union. Nurses and care workers in my constituency are daily on the frontline in the fight against covid, putting themselves and their families at increased risk while trying to save and protect us and the NHS. They too will play a key role in the administering of a vaccine in the very near future. Does the Secretary of State agree that the pay nurses receive falls short of what it ought to be, given the skilled and responsible nature of the role, and that a pay rise is due for UK nurses?

[Matt Hancock]

I understand the question that the hon. Lady asks on behalf of her constituents. I pay tribute to my opposite number in Northern Ireland, Robin Swann, and because this is a devolved matter, I hope that she will understand if I allow him the discretion to provide an answer to that question, rather than to answer on his behalf.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

Students and their families across the country will be very pleased with the news that students are to be offered covid tests as early as 30 November to ensure that they can go back for Christmas. Subsequent to the Secretary of State’s answer to my right hon. Friend the Member for Leeds Central (Hilary Benn), may I ask whether similar arrangements will be put in place in January, so that students can then return to study in the new year?

[Matt Hancock]

One step at a time.

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

I welcome the roll-out of mass testing and the vaccine update. It is very positive news and offers the hope that the country needs to get back to normality as quickly as possible. Given the unique challenges of infection control in university cities, which my right hon. Friend has touched on already, will the wider roll-out of mass testing be available across university cities such as York for the whole population?

[Matt Hancock]

Yes, the roll-out and the 10% of population per week availability of lateral flow tests is available to directors of public health right across the country. If that has not already been organised with York, I urge the director of public health in York to come forward and work with the team to make that happen.

[Clive Efford (Eltham) (Lab)]

The Secretary of State recognised in his statement that the task of delivering 40 million doses will be vast, and he has also said that he has orders for 300 million further doses. How far away are we from those further doses coming on board, and does not that make that a huge task to undertake at a local level? How is local government involved in co-ordinating this roll-out?

[Matt Hancock]

Yes, it will be a huge task. The NHS is leading on it, and of course the NHS reaches all parts of this country. As for the flow of the future doses that we have secured, the only one that is in immediate prospect is AstraZeneca. It would be wonderful to hear the same sort of results soon for AstraZeneca that we heard from Pfizer yesterday. After that, it is next summer before the next vaccine candidate comes on stream, so the focus of the roll-out plan at the moment is on delivering the Pfizer and AstraZeneca projects if they pass the safety test.

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

My right hon. Friend is absolutely right to prioritise those working in the health sector for the roll-out of the vaccine, but will he also consider the important role that those working in the teaching profession and in childcare play? Their being in work enables children to be in school or in care and therefore allows their parents to be economically active.

[Matt Hancock]

Of course I understand the importance of that, hence we protected education and kept schools open as much as possible through this second peak. I pay tribute to schools, which have, in, very large part, stayed open. Some children have had to go home, and we are looking to see how we can use testing to reduce the need for children in bubbles to have to isolate if an index case has tested positive in a school.

[Mrs Pauline Latham (Mid Derbyshire) (Con) [V]]

My right hon. Friend probably saw the BBC news last night featuring the Royal Derby Hospital where staff were saying that the numbers that were in hospital now were higher than in the peak earlier this year and that they were exhausted but would keep going. Is there any opportunity for the Nightingale staff, who are perhaps on standby, to come in and assist so that some of these hard-pressed doctors and nurses could have slightly more time off so that they would not be quite so exhausted?

[Matt Hancock]

I thank staff at the Royal Derby for the work that they are doing. These are difficult circumstances. One of the reasons why we brought in measures that I know are difficult was to protect the NHS from the increase in the number of cases, which in Derby, as my hon. Friend says, is now higher than in the first peak. Unfortunately, the solution that she proposes is in fact the other way around: the NHS Nightingales provide extra space and extra capacity, but we need to stretch the existing workforce to use them—to staff them—if they are needed. That is another reason to take the measures that we have taken in order to protect the NHS.

[Tonia Antoniazzi (Gower) (Lab)]

Penblwydd hapus, Mr Deputy Speaker.

A number of concerns have been raised today about staffing in the NHS, so may I press the Secretary of State to commit to ensuring that cancer professionals are not redeployed away from cancer treatment and care, so that they can beat the backlog rather than building it even further?

[Matt Hancock]

Yes, that is absolutely our goal—to keep all cancer treatment going during this second phase. So far, that has been successful everywhere; even where hospitals have had to postpone non-urgent activity, they have not postponed cancer treatment. This is incredibly important to me personally, and I strongly support the recommendation that the hon. Lady sets out.

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

I join my right hon. Friend in praising the work of the vaccine taskforce in securing so much of this first encouraging vaccine and the work it has done to have a good portfolio.

Let me turn to the joint inquiry of the Science and Technology Committee and the Health and Social Care Committee, which met this morning. We considered test and trace, but it seems to me that the third part—the isolation part—is key. This 20% figure has been bandied about, but Baroness Harding was able to give us a preliminary figure of 54% for the people who manage to observe staying at home. Does my right hon. Friend agree that we need more data about this? We need to understand how many people are staying at home—I realise it is not completely binary—but also how that varies between people who have positive tests and people who have been asked to isolate. Like my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, may I ask my right hon. Friend the Secretary of State to look at Sir John Bell’s suggestion that people who are merely contacts could be released from quarantine earlier through rapid testing?

[Matt Hancock]

I am happy to look at all those constructive suggestions. Maybe I can also take this opportunity to put on the record my thanks to the vaccine taskforce and to Kate Bingham personally for the leadership that they have shown in being able to procure the 340 million doses that they have achieved—I know that the whole country is grateful for the 40 million doses of the Pfizer vaccine in particular—and the work that they have done.

[Marion Fellows (Motherwell and Wishaw) (SNP) [V]]

What update can the Secretary of State give the House on the new strain of coronavirus identified in mink in Denmark? Aside from the travel restrictions now in place from Denmark, what steps are being taken to stop any new outbreak?

[Matt Hancock]

The hon. Lady raises an incredibly important point. We acted very fast, including working with the Scottish Government and the other devolved Governments, to take the action that we did at the end of last week. We are concerned about this outbreak. I am concerned about the fact that this virus has become virulent across the mink population, and I think that there is an international case, on public health grounds, for addressing the question of mink farming, which we banned in the UK two decades ago. It was due to come to an end in Europe in 2023 anyway. People will have their own views on animal welfare grounds—I certainly have mine—but clearly, on global public health grounds, there is a case for doing everything we can to stop the retransmission of this virus into an animal population and then back again, which can lead to the sorts of mutations that we have seen. We will do everything we can to keep people safe.

If you will indulge me, Mr Deputy Speaker, I should also put on the record my thanks to and admiration of the Government of Denmark, who have also responded to this very quickly. Our actions should in no way be interpreted as a criticism of the Danish Government, who have acted very fast; it is a painful economic decision that they have taken very swiftly to cull their mink population. We are merely acting to keep this country safe.

[Jo Gideon (Stoke-on-Trent Central) (Con)]

I really welcome today’s news that we are now much closer to the roll-out of vaccines, but, as of today, the Royal Stoke University Hospital in my constituency has more than double the number of covid patients than during the first peak, and that is combined with record-high levels of covid-related staff absence. That is of concern to me, fellow MPs in Stoke-on-Trent and my hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell). Will the Secretary of State join me in praising the heroic efforts of our NHS staff in Stoke-on-Trent and help us to deal with the situation until such time as it is improved by the roll-out of vaccines?

[Matt Hancock]

Yes. I know Stoke-on-Trent’s hospital and I think that the people who work there do a brilliant job. They are a great team that works so closely and well for the people of Stoke-on-Trent and, indeed, Newcastle-under-Lyme. Stoke has got an outbreak under control a couple of times in this virus. In fact, it had a second peak in the summer, which it got under control, so this is really the third peak in Stoke. Stoke-on-Trent City Council worked closely with us on the early roll-out of mass testing in a pilot even before Liverpool. I thank everybody at the Royal Stoke for all their hard work and I urge everyone in Stoke and across the country to respect social distancing and follow the rules, because that is the best way to support our NHS.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

Clearly, I represent a vast and extremely remote constituency in which there are groups of elderly people who are potentially vulnerable to covid-19. When the Secretary of State talks to the Scottish Government, will he make sure that such people are reached out to with the vaccine? It would be too bad if one part of Scotland were to lose out against another as it was rolled out.

[Matt Hancock]

Yes. Our principle is to roll out the vaccine across the whole of the UK according to clinical need, and that is what we should do.

[Matt Vickers (Stockton South) (Con)]

Teesside Dementia Link Services is an amazing charity run by some of the most inspiring people I have ever met. It delivers support to families and individuals dealing with dementia. It has told me of some of the pain suffered by many in our care homes who are unable to see loved ones. I welcome the recent guidance and I ask my right hon. Friend to continue to do everything he can to ensure that we safely and meaningfully reunite families.

[Matt Hancock]

I am a fan of new technology—I am not going to deny that—because it can help to improve people’s lives, and this is one example. New technology, such as testing technology and quite intricate biochemistry, will help to enable people to see their loved ones in care homes. I cannot think of a better example of how new technology can really help to improve people’s lives. I cannot wait to see that happen.

[Mr Deputy Speaker (Mr Nigel Evans)]

I thank the Secretary of State for his statement today and for answering the questions of 55 Members of Parliament. We will move on to the ten-minute rule motion, and then we will suspend for three minutes.

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

Coronavirus Regulations: Assisted Deaths Abroad

Matt Hancock Excerpts

Thursday 5th November 2020 Commons Chamber

[Mr Andrew Mitchell (Sutton Coldfield) (Con) (Urgent Question)]

To ask the Secretary of State for Health and Social Care if he will make a statement on the impact of new coronavirus regulations on the ability of terminally ill adults to travel abroad for an assisted death.

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

Issues of life and death are some of the most difficult subjects that come before us in this House, and the question of how we best support people in their choices at the end of their life is a complex moral issue that when considered, weighs heavily upon us all. My right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) asked an important question and I want to set out the precise position. Under the current law, based on the Suicide Act 1961, it is an offence to encourage or assist the death of another person. However, it is legal to travel abroad for the purpose of assisted dying where it is allowed in that jurisdiction. The new coronavirus regulations, which come into force today, place restrictions on leaving the home without a reasonable excuse; travelling abroad for the purpose of assisted dying is a reasonable excuse, so anyone doing so would not be breaking the law. These coronavirus regulations do not change the existing legal position on assisted dying.

As this is a matter of conscience, the Government do not take a position. It is instead a matter for each and every Member of Parliament to speak on and vote according to their sincerely held beliefs, and it is for the will of the House to decide whether the law should change. The global devastation of the coronavirus pandemic has brought to the fore the importance of high-quality palliative care, just as it has shone a spotlight on so many issues and, as difficult as it may be, I welcome this opportunity to have this conversation about assisted dying, as it is one of the most sensitive elements of end-of-life care.

I have the greatest sympathy for anyone who has suffered pain in dying or suffered the pain of watching a loved one battle a terminal degenerative condition, and I share a deep respect for friends and colleagues in all parts of the House who share and hold strong views. I am pleased that the House has been given this opportunity to discuss the impact of the pandemic on one of the most difficult ethical questions that we face.

[Mr Mitchell]

Thank you, Mr Speaker, for granting this urgent question, and thank you to my right hon. Friend for responding himself.

This is an issue of conscience for us as Members of this House. I respect those who take a different view from me, not least because theirs was previously my view. Colleagues may have seen, over the weekend, the news reports about a woman who this week travelled to Switzerland to end her life in order to avoid travel restrictions. As a frontline NHS worker with terminal breast cancer, she did not want to run the risk of dying in great pain and without dignity. The new regulations that have come into force today could deter anyone else from travelling to Switzerland for an assisted death. That will undoubtedly cause many more Britons to suffer as they die, due to a lack of a safeguarded law here in the UK, although I am most grateful to my right hon. Friend for clarifying the precise legal circumstances.

In the light of the radical shift of the views of the medical profession two weeks ago, the recent legislative change in New Zealand this week and groundbreaking progress in southern Ireland, along with the continuing and massive support for law reform from the British public, will the Government, from their position of neutrality, enable all of us to understand three things—first, the extent of suffering that the blanket ban on assisted dying is causing dying people and their families; secondly, the challenges that the current law is creating for healthcare professionals, police officers and other public servants; and thirdly, what the UK can learn from international evidence on the operation of assisted dying laws, and their safeguards, in the United States, Australia and Canada?

I am supporting a very tight reform that would allow someone who is terminally ill, within six months of the end of their life, and who has themselves decided that this is the end of life they want, independently certified by two doctors and confirmed as their independent decision by a High Court judge, to end their life, as is their choice.

[Matt Hancock]

I pay tribute to my right hon. Friend for the way in which he puts his case. Of course, we acknowledge the changing views of many, including many in the medical profession, and, of course, we observe the changes in the international debate. I think it is absolutely reasonable for this House to have a conversation and discussion on what is an important topic, and it is right that we locate that question within a broader discussion of how we care for people at the end of their lives, which, because of the coronavirus pandemic, has sadly become a central issue of public debate in this country.

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

I thank the right hon. Member for Sutton Coldfield (Mr Mitchell) for the way in which he has put his questions and the Secretary of State for the sensitive way in which he has responded and for the clarification he has offered to the House. I suspect there will come a point at which this Parliament will have to confront the issue. I note that the Secretary of State has said that issue should be located within a broader discussion about end-of-life care, a perfectly reasonable position which I endorse, but can he reassure me that, as part of the broader discussion, there will always be thorough and transparent consultation with the public and with faith groups, and that physicians and healthcare professionals will always be fully involved?

Members across the House will have sincerely held views, and whatever one’s views on the principle, the House should be aware that before the pandemic a person from Britain travelled abroad to Dignitas every eight days and that charities have warned that since the March lockdown some terminally ill people are ending their lives in the most traumatic circumstances because of a lack of clarity about the law—the Secretary of State has given clarity today, but until that point there was a lack of it. We know that a second lockdown will have a heavy toll on people’s mental health, especially over the winter, so can he tell us what mental health support will be made available to people facing this most awful of choices and what mental health support is available to people more broadly?

People deserve dignity in dying and palliative care needs to be improved at the best of times, but lockdown means that palliative care is particularly under pressure. Can the Secretary of State assure us that hospices will get full support throughout the lockdown, that hospice staff will get regular access to regular testing and that we have a supply of enough of the vital drugs which palliative care relies on for the lockdown period?

This is an immensely sensitive topic. I repeat that I appreciate the way in which the Secretary of State has dealt with it this morning, but many people will be deeply concerned. We look forward to working with the Government on this important issue.

[Matt Hancock]

The hon. Gentleman is quite right that this is not an issue in which there is any party politics, and there is rightly no Government position. On the specific question of assisted dying, I am glad to have been given the opportunity to clarify the impact of the coronavirus regulations on that law, but he also asked the wider question about palliative care. It is important that we support palliative care, and that we locate this question in a wider question about how people can have choice. After all, patient choice has been a growing feature within healthcare—in my view, rightly so—over the last generation. This is one area where that choice is constrained in law.

It is important that we invest in high-quality palliative care. We have put further funding into palliative care and hospices because of the pressures caused by the coronavirus pandemic. Making sure that we have high-quality palliative care services and a hospice service that we can all support fully is obviously very close to my heart.

The hon. Gentleman also asked about mental health support, and there has been increased investment in mental health support to ensure that people get the support they need in what are inevitably difficult times.

[Fiona Bruce (Congleton) (Con)]

At this time, when the whole country is making huge sacrifices to protect life, at a time of exceptionally high levels of physical and mental stress, and when many people may feel very vulnerable, does the Minister understand and accept the views of many, including in this House, that it would be completely inappropriate—indeed, insensitive—of this Parliament to go anywhere near considering making access to any form of suicide easier?

[Matt Hancock]

I respect my hon. Friend’s views, which are deeply and sincerely held, and I respect the fact that the House will debate all views. It is right that that debate is taken forward and led by Parliament, rather than by Government, as my hon. Friend just demonstrated.

[Karin Smyth (Bristol South) (Lab)]

I congratulate my co-chair of the all-party parliamentary group on choice at the end of life, the right hon. Member for Sutton Coldfield (Mr Mitchell), on securing this urgent question, and I thank you for granting it, Mr Speaker. I have sought to change the law since entering the House. In the last five years, I have learned that many colleagues are worried about safeguards. There is an assumption that the law is currently safe, but it is not. In June, here in London, a man threw himself in front of a heavy goods vehicle on the North Circular. He was suffering from throat cancer and knew his tumour would continue to strangle him. He could not bear it. He took his own life because this country denied him the option of choosing the timing and manner of his death. I appreciate that this is a sensitive and difficult issue, but is it not time that we recognise that the law is not compassionate or safe and leaves behind bereaved families and members of the public because of the absence of a safeguarded choice at the end of life?

[Matt Hancock]

The hon. Lady draws a distinction between those who have a terminal illness and the broader issue of suicide, which is an important part of this debate. I respect her sincerely held views. The exchange between my hon. Friend the Member for Congleton (Fiona Bruce) and the hon. Lady exemplifies why it is right that Parliament debates and decides on these matters.

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

Is my right hon. Friend aware that a British Medical Association survey of its members on assisted suicide and euthanasia found that 83% of those involved in providing palliative care—those who have the most experience of dealing with people at the end of their lives—would oppose any legalisation of euthanasia, and that 84% declared that they would be unwilling to participate in any such activity? Surely we should be guided, in many ways, by the professionals in this regard.

[Matt Hancock]

My hon. Friend makes another important contribution to this debate. There is inevitably a discussion within the medical profession about this important question. That should be taken into account, alongside the views, as the hon. Member for Leicester South (Jonathan Ashworth) said, of faith leaders, the public and those who face terminal disease, as Parliament debates this subject.

[Andy Slaughter (Hammersmith) (Lab)]

Terminally ill people are travelling prematurely and alone to end their lives abroad for a number of reasons, including covid. Another is that they wish to save relatives from the risk of prosecution. Will the Secretary of State liaise with his Home Office colleagues and the police, who themselves find these cases difficult, to ensure that any response is sensitive and proportionate?

[Matt Hancock]

That incredibly important and sensitive matter needs to be considered as part of the overall approach. These questions should all be brought out in a debate on this subject. That is Parliament’s role, given that this is an area of conscience on which the Government do not take a view.

[Bob Stewart (Beckenham) (Con)]

It is very sad that anyone has to go abroad to end their lives when they have a terminal illness—I find that dreadfully sad. I ask my right hon. Friend, because I am unsure of this: how many people on average go abroad to end their lives every year?

--- Later in debate ---

[Matt Hancock]

The Government do not collect data on the number of people who travel abroad for an assisted death. We would consider collecting data on assisted dying if it was felt that that would improve and contribute to a sensitive debate in Parliament on this subject.

[Christine Jardine (Edinburgh West) (LD) [V]]

We have seen that there is widespread support in this House, and the research tells us that there is widespread support in the country, for a review of the law, so will the Government look at what has happened in other countries such as New Zealand and promise that there will be a review, with a view to decriminalising the situation and bringing some compassion into the law?

[Matt Hancock]

As I said, the Government are neutral on this matter. It is a question for Parliament. There are many ways in which such a review could be brought forward, but the Government’s position of neutrality is important, because this is a matter of conscience on which there are deeply held and very sincere views on all sides. I think it should rest that this is a matter for Parliament, rather than Government.

[Rachel Hopkins (Luton South) (Lab)]

In the past two years, we have seen a significant shift in the views of the medical profession, with the Royal College of Physicians neutral on assisted dying and the British Medical Association poised to drop its opposition. Does the Secretary of State recognise that where there was widespread opposition to changing the law, there is now support for a full review of how the prohibition of assisted dying affects healthcare professionals and patients?

[Matt Hancock]

Yes. I think it is clear that there are changing views on this subject and that there is a very strong view that any change should be dealt with carefully and sensitively. In fact, the tone of this debate and discussion today reflects the seriousness and sensitivity of this topic and the need to make sure that all the issues are very carefully considered.

[Scott Benton (Blackpool South) (Con)]

Does my right hon. Friend agree that those who are terminally ill deserve the very best palliative care available, and that rather than facilitating overseas travel for those terminally ill patients, the Government should ensure that they receive world-class palliative care here in the UK?

[Matt Hancock]

Yes, I think this is a really important point, because high-quality palliative care and the question directly of assisted dying that is before the House today are not separate questions. They are intimately tied together and whatever view the House takes on assisted dying—and it is for the House—it is the Government’s intention to support and strengthen palliative care to make sure that we give the very best support for people towards the end of their life.

[Tonia Antoniazzi (Gower) (Lab)]

I welcome the Secretary of State’s clarification today to support people’s choice and their dignity in dying. He has spoken about palliative care at length, and I understand that there is further funding for hospices, but charities, such as cancer charities that support people with those choices, have had to make drastic cuts to their staffing and funding as a result of covid. What conversations has the Secretary of State been having with the Treasury, and what commitment will they make in the November spending review?

[Matt Hancock]

Obviously the hospice sector, which often relies on charity shops in order to fund its services, has had a very difficult year. We therefore have put funding support in and we always keep that under review. I applaud the fact that our hospices are funded both from taxpayers and through a huge amount of philanthropy. It leads to a stronger sector that is rooted in the communities that it serves. Nevertheless, I acknowledge that that has led to some significant challenges this year. We have put more funding in and will, of course, always keep that open to review.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

It is very difficult to tell somebody who is in pain and suffering and who wants to die that the state is going to prevent them from doing that. As a Roman Catholic, I recently changed my mind on the issue because of my constituent Mr Noel Conway, who lives in Garmston near Shrewsbury. I said to him, “Why don’t you go to Switzerland?” and his answer will stay with me forever: “No, I’m an Englishman. I want to die in England.” It is extremely important that our citizens have that right. Will the Secretary of State do me the courtesy of agreeing to a short Zoom call with my constituent Mr Noel Conway, who is getting a national reputation as a leading campaigner on the issue?

[Matt Hancock]

I would be happy to have that meeting with Mr Conway. I have spoken to others in the same circumstances who have made the case strongly. The compassion of the case cannot be overstated. I also respect the fact that many hon. Members, as has been reflected today, have deeply held views. We should make sure that the conversation happens; that there is, rightly, a debate about the topic, as there is in many other countries right now; and that it is conducted in an evidence-based, sensible and compassionate way.

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

Clearly, we are debating the most sensitive of issues, and we need more investment in the research and practice of palliative care. I ask the Health Secretary what additional resources will come forward, because at the end of October the grant funding for covid-19 and hospices came to an end. Of course, we are entering a further period of lockdown in which charity shops will be shut and fundraising opportunities will come to an end. Hospices need resourcing now, so what additional support will he bring forward?

[Matt Hancock]

The hon. Lady is absolutely right to raise that issue. We provided more than £150 million of extra funding to hospices during the first peak. Locally, many clinical commissioning groups fund their local hospice and contribute to that support, but we always keep it under review, because hospices are such an important part of the provision of end-of-life care.

[Danny Kruger (Devizes) (Con)]

I am concerned that in this discussion there is a danger of focusing too narrowly on the specific option around assisted suicide. Modern medicine can palliate the pain of dying in almost all cases, but it can also extend life, in many cases artificially, beyond what most people would consider its natural span. Before we enter into a parliamentary review, Government review or Select Committee review of the precise options around assisted suicide, should we not have a much broader conversation about how we manage death and dying in this country?

[Matt Hancock]

I agree with my hon. Friend that the question should be located within that broader debate. I understand the yearning from people not to shorten life, but to shorten a painful death. Of course, no specific proposal has been brought forward; that would be for Parliament to develop rather than the Government.

[Crispin Blunt (Reigate) (Con) [V]]

Does my right hon. Friend agree that at the heart of the issue is properly established personal autonomy over the time and manner of someone’s death when they are terminally ill? The safeguards around that have been operating for more than two decades in other parts of the world, as I saw on a visit to Oregon 20 years ago. He is right that this must be led by Parliament, but the evidence is developing all the time and the Government will have to make time for the debates and opportunities to assess that evidence. Parliamentarians should proceed on the basis of the evidence available to them, because if they choose to impose faith-based views on others, it can result in the most terrible cruelty.

[Matt Hancock]

We would consider collecting more data on these questions, because it is important that any debate is conducted based on the evidence, but it is also important that the debate takes into account all views that are sincerely held and very reasonable.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I refer the House to my entry in the Register of Members’ Financial Interests.

Is the Secretary of State aware that research indicates that individuals go through a number of psychological stages—such as shock, denial, anger, bargaining, depression and then acceptance—after they have been given a diagnosis of terminal illness? We are failing so many people right across the United Kingdom by not giving them access to adequate psychological support to enable them to reach that stage of acceptance, in themselves and for their families, and then not providing the therapeutic support that they need alongside the palliative care already mentioned by colleagues.

[Matt Hancock]

The hon. Lady makes an important contribution to the debate in respect of how we should consider these issues.

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

I respect the views, which are all earnestly held, on either side of this issue. As my right hon. Friend has said, this is a matter of conscience. I am happy to put on the record that I am with the 80% of British people who think that to bring forward assisted dying with the proper checks and balances is the right thing to do. What are my right hon. Friend’s personal views on this issue, as the Member for West Suffolk?

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab) [V]]

Thank you for the promotion, Mr Speaker.

I have always been internally torn on this issue. Setting aside my own personal beliefs and the fact that my constituency is still dealing with the very real legacy of Harold Shipman, I will always be haunted by my mum’s painful end of life in hospital, where final decisions were in effect given to me, aged 19, and to my dad, aged 48. The reconciliation of all these things is incredibly difficult, but what I do know is that the current system is too often pretty inhumane. I agree with the right hon. Member for Sutton Coldfield (Mr Mitchell) that we need a review to consider how we deliver better end-of-life care and support in England. Is that a way forward?

[Matt Hancock]

I do think it important that we consider the question of end-of-life care, and support for palliative care is important. The coronavirus epidemic has shone a light on palliative and end-of-life care in the wider public debate, and that is right and good. That is a matter for the Government, but the specific question of assisted dying is, of course, a question for this House, and we need, together, to find a way to ensure that we all serve our constituents as best we can, taking into account the best possible evidence and all the sincerely held views on this sensitive subject.

[Sir Edward Leigh (Gainsborough) (Con)]

Thank you for allowing me in, Mr Speaker.

On the piano in my home in Lincolnshire, I have a lovely photograph of Pope Francis embracing a very old and very sick woman. At the bottom it says, “Cherish life, but accept death.” I was struck by what the Secretary of State said earlier—that we do not need to extend death or suffering; we can help people through this extraordinarily difficult time. I think we do need a review. Many people are helped into death. I remember my best friend, Piers Merchant, a former colleague here. I was at his side, and as he died, morphine was being pumped into him. No doubt, he was killed by the morphine, but that was a humane and right thing to do. We need to have a review on the basis of cherishing life but accepting death, and not necessarily pounding very old and sick people with more and more operations and pain.

[Matt Hancock]

As a highly respected and very significant voice among Catholics in this country, my right hon. Friend speaks powerfully, from both a position of his faith and a compassionate position of respect for what the current rules mean in practice. The whole House, and indeed the country, will have heard his contribution and it leaves us all to ponder this question.

[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 suspended the House for three minutes.

Covid-19

Matt Hancock Excerpts

Monday 2nd November 2020 Commons Chamber

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

I beg to move,

That this House has considered covid-19.

This global pandemic calls on us all to make the best judgments that we can on behalf of our nation. This disease attacks us all because we are human, and it is only by coming together as humanity that we can solve it. It is a communitarian disease that passes from person to person among those who are closest to each other, and it is as a community that we must tackle it. The virus raises profound questions for each Member of this House, too, representing our constituencies as we do, to make the best judgments that we can in the face of uncertainty, immense challenge and with great weights on each side of the scales, in the best interests of the nation that we serve.

We have heard today from the Prime Minister of the grave steps on which the House will vote on Wednesday. We know of the real impact that those steps will have on so many lives and livelihoods. We know the hardships that would be faced and the jobs lost, and we cannot save them all, but the alternative of not acting would be so much worse.

When faced with such a deadly adversary, we cannot stand aside and let it spread unchecked through our communities when we know the devastation it would cause, not just to the NHS and not only in the mounting death toll, but I firmly believe the impact on our economy would be worse too. The devastation that the virus would wreak if unchecked would impact the NHS’s ability to treat covid and non-covid patients. For all those who need treatment in the NHS right now, the action we propose will help to ensure that the NHS has what it needs to give them the world-class care that we have all come to expect.

[Ian Paisley (North Antrim) (DUP)]

I applaud the congratulations that the Secretary of State has already extended to NHS workers. What message does he have for my constituent, Faye McDonnell, a student nurse? Will she be paid during this crisis? Will my other constituent, Kirsten Doran, a theatre nurse, be paid the increase in pay and fair pay that nurses are campaigning for?

[Matt Hancock]

Of course the NHS in Northern Ireland is the responsibility of the Administration there. I know of the issues around nurses’ pay, which has been the subject of much interest. I will not go into the individual details, but I recognise the case that the hon. Gentleman rightly makes on behalf of his constituents. We in this House support the staff of the NHS across the UK—in all four nations in all four parts of the NHS.

Across the UK, however, the case is the same. For people who need NHS treatment now, whether it is for covid or any other condition, the best course of action is to suppress the virus. Partly because of that, I therefore believe that the only strategy a responsible Government can take is to suppress the virus and support the economy, education and the NHS as much as possible until science can come to our rescue.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

We are undoubtedly in a serious situation, and I am sure that the Secretary of State agrees that we need to take political gamesmanship out of the debate. Considering the measures and the month-long lockdown that have been announced for England, does he share my concern at the actions of some of his colleagues in Wales who have worked the whole situation up into a political frenzy with regard to the ongoing lockdown in my country?

[Matt Hancock]

The hon. Gentleman invites me to get involved in political controversy in Wales while rejecting the principle of getting involved in political controversy. Having thought about it, on balance, I am going to sidestep that particular political controversy. As it happens, I strongly think that the public expect us to work together in the national interest, and that is what we propose to do.

A crucial part of that national interest is protecting the most vulnerable. When coronavirus spreads rapidly, it reaches all parts. Many of the most vulnerable can live only with care and support from those outside their home, or live in multigenerational households. We must protect the most vulnerable from the disease, and we will, with renewed shielding advice and support for care homes, but we cannot rely on that alone.

There is no quick fix to this pandemic; there is no silver bullet. What makes this fight so tough is that the virus thrives on all the things that make life worth living, such as the joy of social contact and the communal events that give us so much happiness and fulfilment, but we must persevere together to get it under control.

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

One of the key things that we will depend on after the lockdown is over—assuming that the House gives its support—is a really effective contact tracing system. The Secretary of State knows as well as I do that, in the last couple of weeks, the system has been reaching only 48% of the contacts of those who have tested positive. The Scientific Advisory Group for Emergencies says that for the system to be effective, it needs to reach 80%. In the 28 days of lockdown, what specific steps will he take to get it to 80%?

[Matt Hancock]

My right hon Friend is right; I was going to come on to that issue. Of course the contact tracing system needs to contact as many people as it can. The figures that he refers to include a huge array of different types of contact. I will update the House on the improvements that we have seen in contact tracing, including an increase in the absolute number of people who have been contacted and in the proportion.

We absolutely need the proportion to go up. A critical part of that is people’s engagement with the contact tracing system, as well as the system itself. Some of the proportion who are not reached are not reached because their contact details are not given. It is quite hard to blame the people who work in NHS Test and Trace, who are working so hard on it, for that particular reason. It is important to go into the details of why a particular contact is not made and try to improve all those details. That work is ongoing, but I accept the challenge.

[Munira Wilson (Twickenham) (LD)]

As well as boosting contact tracing rates, which are absolutely critical, I hope the Secretary of State will address the issues with the app that have been revealed this weekend; it has not been contacting people who should have been contacted. Self-isolation is also important. The Prime Minister admitted today—he finally acknowledged—that self-isolation rates are far too low, but we have heard nothing about what steps are to be put in place. We need carrots, not sticks—support and incentives for people to self-isolate. The Secretary of State mentioned multigenerational households; there are many overcrowded households, particularly in inner cities, and therefore high-risk people who cannot self-isolate at home. Has he given any consideration to setting up self-isolation support facilities that those people can go to?

[Matt Hancock]

Of course, self-isolation following contact or following a positive test, or in quarantine from abroad, is absolutely critical, and we have brought in measures to improve self-isolation, such as the £500 payment and strengthening the enforcement around it, and we are always looking for what we can do to strengthen self-isolation; the Prime Minister was absolutely right in what he said earlier, and there is a huge amount of work under way on it.

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

Two weeks ago, I asked the Health Secretary about the button that was meant to be on the app to release a reference code for people to claim the £500. The Health Secretary specifically came to the Dispatch Box to say that they just needed to press that button. That button does not exist—it did not exist then and it still does not exist today—so why did he make that intervention and how is he going to rectify the situation so people can claim that £500?

[Matt Hancock]

Yes, the button is coming; it is in development. The hon. Member for Twickenham (Munira Wilson), who made the previous intervention, also spoke about the app. There was an upgrade to the app towards the end of last week, and I want to put on record my thanks to the app team, who have done such a great job in improving the app by, as the hon. Member for Twickenham said, improving the targeting so that more people are targeted and more people get the message. The app is also now getting fewer false positives so people can have more confidence that if they are contacted by the app and told to isolate, they need to do so. The button will come.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

People up and down the country made enormous sacrifices during the first lockdown, and they were promised a world-beating contact, test and trace system. Some £12 billion has been spent on Serco to provide that. In areas such as mine with high levels of deprivation, health inequalities and high numbers of vulnerable people, people are already dying, and we do not have an effective testing and tracing system. So, given where we are, may I appeal to the Secretary of State to make resources available to areas where we have the local capacity to do testing and tracing, to help improve the system as quickly as possible in this lockdown?

[Matt Hancock]

Yes, as we have discussed many times, that is happening—absolutely—and it is the link between the national and the local that is the solution here. I will come on to testing in more detail later because I have some new things to say about it. In the meantime, the other thing we need to do, of course, is make sure that for this second peak—the second wave—we do all we can to support those institutions that are helping us through it, and first among those is, of course, the NHS.

The NHS is better prepared for this second wave, and I want to thank the NHS and everybody who works in it for their efforts over the past few months to ensure that we are better prepared. We know infinitely more things about coronavirus now than we knew as the first wave hit. Our Nightingale hospitals, for instance, stand ready and are being restarted in the parts of the country that need them. The independent sector has stepped up to the mark to help us work through the backlog of the vital elective operations and to help keep going with elective operations, even through this second peak. We have hired more staff, with 13,700 more nurses and 7,800 more doctors. We have provided £3 billion of extra funding across health and social care. Personal protective equipment is widely and freely available, and infection control procedures have been significantly strengthened, based on better understanding of transmission of the virus, including aerosol as well as droplet and fomite transmission.

[Dr Luke Evans (Bosworth) (Con)]

I am glad to hear that preparations are under way. I have had several emails from constituents in Bosworth who are worried about their routine operations; their follow-up might be lost. They remember what happened in the last lockdown, when they were not able to get that follow-up. Can my right hon. Friend confirm that all NHS appointments will be going ahead as best they can?

[Matt Hancock]

Yes, absolutely, and my hon. Friend makes a critical point. If in Bosworth someone is waiting for an operation on the NHS, they are more likely to get it if we keep the virus suppressed—in fact, if we keep it down, they will get that operation and we will get it done. Unfortunately, in the parts of the country where things have got too high, non-urgent, non-cancer elective operations have had to be cancelled. That demonstrates that, both for covid and non-covid health reasons, it is better to keep the virus suppressed.

I was halfway through my long list of the things that the NHS has been doing to prepare over the summer. At the moment, we are delivering 159 A&E upgrades; as far as I know, that is the biggest number of concurrent upgrades to emergency care in the NHS’s history. We have radically expanded telemedicine in primary and outpatient care. We are introducing 111 First, with an expanded 111 service to help people get the care that they need.

The NHS has learned how to treat covid patients better too, of course: not just by discovering treatments such as dexamethasone, in which the NHS played a critical part, but by improving clinical techniques—earlier oxygenation and later ventilation, for instance. As a result, our rate of hospital-acquired infection is down and the number of people who survive covid in hospital is up. We have been able to set an explicit goal that all cancer treatment should continue throughout this second wave, which speaks precisely to the point that my hon. Friend the Member for Bosworth (Dr Evans) made.

But even with this expanded NHS and with the better treatments, the extra investment and the brilliance of the whole NHS team, who have done and learned so much about the virus and worked so hard to prepare—even with all that—and even if the NHS were twice as big as it is now, it could not cope, and no health service could, if the virus continued to grow as it is now. We must control the virus, to protect the NHS and ensure that it is always there, to treat patients with covid and patients with all other conditions.

[Mr Steve Baker (Wycombe) (Con)]

One of the wonderful things that my right hon. Friend has done is make available so much data. I am looking at the case data for Liverpool, and there it is—daily cases by specimen date. Thank goodness the number is now falling, and on a seven-day basis, again, it is falling. I am just wondering why now anyone in Liverpool would say anything other than that the Government’s previous strategy is now working. Why on earth, then, would people in other areas that are not even as badly off as Liverpool—or indeed Manchester, where the cases seem to be stabilising—want to see an even tighter lockdown?

[Matt Hancock]

Unfortunately, in Liverpool the overall case rate includes a very high peak among students. The over-60s case rate, which is also published on the same website, shows a flattening, but a flattening at a very high level, such that Liverpool University Hospitals NHS Foundation Trust has already had to cancel non-urgent, non-cancer elective activity.

The danger of a plateauing at a high level, as the chief medical officer set out, is that if the rate starts to go up again, we are already under significant pressure in the NHS in Liverpool. The same argument goes for Tyneside, where again the overall case rate appears to be coming down, which is good news. The number among the over-60s, however, is flattening, again at a very high level, and in other parts of the country, including areas in tier 3, the numbers were going up.

It is not good enough just to control R and keep it lower than its natural rate; we have to get it below 1 to be able to change from a doubling time to a halving time of this virus. Even I—the most enthusiastic supporter of the tier system—can see that, unfortunately, cases were rising and the cases among the over-60s are rising, including in the areas with tier 3 restrictions. It is important to strip out from those data the outbreak among students. I have talked before about there being two overlapping epidemics: one among students and one among the wider community.

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

My right hon. Friend lists the many commendable achievements of the national health service in the period since the first wave, but the main contention is that this policy is for ICU capacity issues. What specifically has been done over the summer to increase that capacity?

[Matt Hancock]

There has been a significant capacity increase in critical care, which includes ICU but is not only ICU. We have a wider definition of critical care, which is important. Many people with covid do not need formal ICU intubation; they need critical care, including oxygenation, when they are not anaesthetised but on oxygen treatment. On that measure of critical care, which is the care required for covid, there has been a significant increase, including significant investment in the NHS around the country. I should have had that on my list.

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

Further to my right hon. Friend’s answers to my hon. Friend the Member for Wycombe (Mr Baker), it has been a fact for a long time that the three figures that are reported most often are the number of tests, the number of cases and, regrettably, the number of deaths. Does my right hon. Friend agree that the media and we should focus much more on the data on NHS capacity? That, rather than tests and cases, should be the message.

[Matt Hancock]

They are all important. Often, people focus on the cases, because they are one of the earliest indicators of the direction. The case rate among the over-60s is highly correlated with what happens to hospital admissions a week or 10 days later. That is why we focus on the over-60s case rate and now publish that data too, because looking at that as well as the overall case rate is important.

Nevertheless, my hon. Friend is absolutely right that although the translation of cases into hospitalisations and poor health outcomes is harder to estimate, the number of hospital admissions with covid is a concrete fact that we cannot get away from. We cannot escape the fact that that is rising and has been rising sharply. Even if we expanded the NHS enormously—we have, both in critical care and in terms of the potential capacity in the Nightingales, should it be needed, but even if we doubled the size of the NHS—once we are on an exponential growth curve, it would still be too small to cope if the virus were to run riot.

[Jonathan Edwards]

Returning to ICUs, the Secretary of State knows that nurses working in that environment are highly specialised; it takes a high degree of extra training. How confident is he, considering the potential for fatigue and for nurses to fall ill, given that this may last many months, that the line will hold against covid in ICUs?

[Matt Hancock]

With this action, I am confident that we can make that happen, but it is one of the reasons and justifications for this action that we are taking. The action is serious, and I do not deny or demur from the consequences that the action will bring. My argument is not that this action is good or anything other than regrettable; it is that the action is necessary because the alternative is worse.

I would like to address the specific point made about mental health. It is good to be here next to my hon. Friend the Mental Health Minister. There were a number of questions about mental health addressed to the Prime Minister earlier. Restrictions such as these do have implications for people’s mental health—of course they do—and we are expanding mental health support to address that. However, we also know that coronavirus itself, and the impact of high levels of covid on the NHS, has a significant impact on mental health too. The Royal College of Psychiatrists has said:

“Stricter measures to control the virus are needed to minimise Covid-related mental illness as much as possible.”

Today it said:

“The new lockdown will significantly impact mental health but allowing COVID to go unchecked would also have serious consequences for mental illness. We must ensure that people get the support they need.”

So yes, I am worried about mental health, but in my book that is another reason to bring this virus under control.

Turning to physical health, in the worst-hit areas we have already seen the cancellation of some non-urgent, non-cancer treatments, such as hip operations and cataracts. Without action to bring R below 1, the NHS would be overwhelmed, no matter what we did to expand the NHS and protect the vulnerable, and then we could no longer guarantee that solemn promise to every citizen that our NHS will be there for you when you need it. We must not let that happen.

I want to say this very directly to all those who need NHS services this winter: help us to help you. If you are asked to go to hospital, that is because it is the best place for you. I want to say this to all the staff working in the NHS: we will support you this winter. We are grateful for the sacrifices you are making and we will get through this together.

As we have learned more about this virus, we have been able to strengthen social care, too, and our winter plan sets out the work done to improve those protections, including free PPE, regular testing and the systems for safe discharge that will be so important over the coming months.

Finally, to escape the clutches of the pandemic, we must harness ingenuity and scientific prowess to make the breakthroughs that will help us turn the corner. Testing technologies are improving all the time. We are expanding our existing technologies, and since the pandemic hit we have been putting everything behind our mission to expand our testing capacity. In April, on schedule, we delivered the target of 100,000 tests a day. The Prime Minister then set the goal of testing capacity of half a million a day by the end of October, and I can tell the House that thanks to an enormous effort under the leadership of Baroness Harding and Sarah-Jane Marsh, to whom I give heartfelt thanks, we have hit our target. Testing capacity across the whole UK is now 519,770 a day—a phenomenal national achievement. We now have the largest testing capacity in Europe.

It has been a hard road. As with any new technology, there have been ups and downs, but I always knew we would get there. I am very proud of the team. The next stage is to harness the new technologies—the lateral flow tests that can take a matter of minutes, the high-throughput tests and the point-of-care tests, which are now bringing capacity into the hotspots and on the spot in our NHS hospitals. That is all part of a mass testing capacity that we are building right now, which, alongside the work on vaccines—that is progressing well—will give us so much greater protection from this disease in the months to come.

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

Before the Secretary of State moves on, just on the point about vaccines, it was reported yesterday in The Sunday Times that Kate Bingham, the chair of the taskforce, spoke at a commercial conference where attendees paid $200 to attend and revealed commercially confidential information. Certainly at the least she apparently revealed information about a vaccine being ready by Easter, which is welcome, and that the Government have done a rehearsal to get the vaccine distributed—again, that is welcome—but why has she revealed that information there? Why has the Secretary of State not revealed that information here? Members may want to take some of those things into account before they vote on Wednesday. Did he authorise her speaking at this event, and can he update us on what she said?

[Matt Hancock]

The covid vaccine taskforce is about the procurement of the vaccines. That is a matter for the Department for Business, Energy and Industrial Strategy. The Department has put out a statement and made clear the circumstances around that conference. What I would say is that I am very happy to answer any questions on vaccines. As the hon. Member says, we have procured a number of vaccines. We have procured six in total, two of which are the two leading vaccines in the world. The taskforce has done an excellent job of making sure that we have one of the strongest procurement pipelines for vaccines in the world.

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

While we are still on the subject of vaccines and the Secretary of State is answering questions, the biography of Kate Bingham on her own website on SV Health Investors says that she is in fact leaving the taskforce at the end of 2020. Who is replacing her and what confidentiality agreements will she be asked to sign on her return to an entirely profit-making business?

[Matt Hancock]

It was a fixed-term appointment in order to do that vital work, and was always due to come to a close. This comes back to the old thing that we have across these Dispatch Boxes: on the Government side of the House, we want to harness the capabilities of everybody; on the Opposition side of the House, unless a person is in the public sector, they do not seem to get the credit. I think we should welcome everybody who is willing to put their shoulder to the wheel to drive the action that is necessary to improve this country’s response.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

rose—

[Matt Hancock]

This is probably about how we should not use the private sector in test and trace, despite the fact that we have hit our target of more than 500,000 tests a day on time, as we have each of the targets for testing. I am very proud of that.

[Several hon. Members rose—]

[Matt Hancock]

I am happy to answer any detailed question about the provision of vaccines in this country.

[Daisy Cooper (St Albans) (LD)]

Does the Secretary of State accept that there are those of us in this House who like a mixed economy and who recognise the role of the private sector and of business, but that that does not undermine the need for any Government to have transparency about procurement and to protect the spending of taxpayers’ money?

[Matt Hancock]

Yes, absolutely. With comments like those, the hon. Lady should come over to this side of the House if she wants to be part of the big team effort. She obviously did not get the memo that says, “If you sit on the Opposition side, you have to attack anybody in the private sector who is helping.”

We have to pull together, because coronavirus is a powerful adversary. It has the power to overwhelm our hospitals, disrupt our economy and suspend the moments that make life so special, so we must take the hard but crucial steps to get it under control, and we will stand behind every single person who joins in this national effort. Everybody has a role to play, and as we come together once more, we must all work and make sacrifices to protect those who we love at this time of national need.

[Several hon. Members rose—]

--- Later in debate ---

[Jonathan Ashworth]

I am sure the hon. Gentleman is familiar with the minutes from SAGE, which read:

“The shortlist of non-pharmaceutical interventions (NPIs) that should be considered for immediate introduction includes:...A circuit-breaker (short period of lockdown) to return incidence to low levels.”

That is the proposal that we endorsed, and it is the proposal that was rejected on 21 September by the Prime Minister. Now the Prime Minister is putting the country into a four-week lockdown, which the Chancellor of the Duchy of Lancaster conceded yesterday could last beyond four weeks. This is fundamentally about the judgment of the Prime Minister, and indeed the Chancellor, who, we know from briefings, blocked the Government from making the choice to go for lockdown earlier.

Throughout this crisis, we have seen mistake after mistake. The preparations for this pandemic were poor and insufficient. The lessons of Exercise Cygnus were not taken on board. The country’s stockpile of PPE was allowed to dwindle, leaving frontline health and care workers unprotected and placed in harm’s way. I hope we can get a cast-iron guarantee that the same will not happen again this winter. Instead of putting the public health teams in charge of tracing, Ministers turned to outsourcing companies, with management consultants paid more in one day than care workers would be paid over four months. Week by week, the numbers followed up by the test and trace system fall. Directors of public health, who want to get on with contact tracing, complain that it takes days for them to receive the information on cases.

The app was months too late, and yesterday we learned that it has an not even been alerting people properly. The Secretary of State is supposed to be the digital whizz kid, and he could not deliver the app on time, and it has not been working sufficiently. Far too many test results are still not turned around in 24 hours, even though we know that we need speed when dealing with a virus that spreads with such severity. There have been 1,300 outbreaks in care homes since the end of August, and care staff still wait more than two days for results.

As we have heard, there is still inadequate financial support for people who need to isolate. It should be no surprise that there were reports of less than 20% of people isolating, given that they are expected to make a choice between feeding their families and their health. Rather than giving people proper, decent sick pay, the Chancellor spent hundreds of millions subsidising meals in restaurants through the summer. There is now evidence from academics to suggest that that led to the spread of the virus and seeded the virus in the early stages of this second wave. We welcome the announcement of the 80% furlough, but furloughed workers in the midlands and the north will conclude that their jobs were worth 13% less than those elsewhere.

The experiences of other countries were needlessly ignored, warnings were downplayed, and the precious advantage of time was squandered. Tragically, that has been as true in September and October as it was in February and March. The Government did not learn. It does not require a crystal ball to listen to scientists and make timely decisions in the national interest, so lessons must be learned, and this lockdown must be used wisely.

I welcome what the Secretary of State said about expanding testing capacity, but we also need to turn around the PCR—polymerase chain reaction—tests quickly for those with symptoms. They are still not turned around in 24 hours. If we are going to have extra capacity in the system, I hope there will be a commitment to turn those tests around in 24 hours for those who need them. We need to expand access to testing to more people, to rebuild confidence across society. UK universities are leading the way in piloting regular saliva testing for students, and some have extended that to the wider community. Rolling out these saliva tests across communities paves the way for weekly testing of key workers such as transport staff, care staff and, especially, NHS staff.

We have been calling for months for the Government to roll out a programme of regular, routine testing of frontline NHS staff. Surely, as we move into winter, that should be a priority. The saliva testing innovation should be brought on stream quickly to do that routine testing of all frontline NHS staff. If we could roll that out—I know that the Secretary of State agrees with me on this, and I do not disagree with him on the objective; I am urging him to use these four weeks to get a move on with it—it would allow us to identify asymptomatic carriers and protect the most vulnerable in society. Will he come forward with a plan to work with our universities on saliva testing, which he knows is very exciting and could make a huge difference?

Contact tracing has to be fixed. It has not been working properly through the call centre approach. The local directors of public health would do a more effective job, but they need to get the contacts within 24 hours, not within days. If they get those contacts within 24 hours, they can introduce as a matter of routine retrospective contact tracing, which finds where people got the virus from and identifies super-spreading cluster events. That approach has been taken in countries such as Japan, and we know that it is more effective. I know that it is happening in some hotspots, but it should be routine across the country.

As I said, we need reassurance that people will get support for isolation. In this lockdown, we will have a spending review, and the test of that spending review is how it will support our national health service and social care sector for the rest of this covid period. We entered this crisis after years of underfunding in the national health service, with capital budgets repeatedly raided—[Interruption.] There were years of underfunding in the national health service—of course there were. The national health service used to get a funding increase of around 4% to 5%. It got something like 6% to 7% a year under Labour Governments. Under this Government, for 10 years, it has got around 1%. Everybody knows that the NHS went into this crisis after years of underfunding. Everybody knows that the NHS went into this crisis with capital budgets having been repeatedly raided, which has left hospitals with a £6 billion repair bill. The NHS entered this crisis with around 15,000 beds having been cut since 2010.

[Matt Hancock]

We cannot let this stand—what a load of nonsense. The NHS went into this crisis with the highest funding level in its history, with more doctors than at any time in its history, with more nurses than at any time in its history and with the biggest hospital building programme in its history. The investment from this Government in this NHS is the highest that has ever been made by any British Government in history, and that is why it is only we who are the party of the NHS.

[Jonathan Ashworth]

The national health service has been systematically underfunded for years under this Tory Government. The NHS went into this crisis without adequate levels of PPE for frontline staff, with nurses using curtains and plastic bags to protect themselves on the wards in the face of this horrific virus. [Interruption.] They are sighing, but they sent our staff into the face of danger without the proper protection; that is what happened going into this crisis, because of years of cutbacks and underfunding of the national health service. The cutbacks and underfunding mean that we have lost 15,000 beds in the national health service since 2010, and that our public health budgets have been cut by £800 million under this Tory Government and because of years of austerity for the NHS. There are people with serious mental health problems who will be spending this lockdown in Victorian-style mental health dormitory wards because of the cutbacks in the capital funding for the NHS.

[Matt Hancock]

Come on!

[Jonathan Ashworth]

That is absolutely true.

--- Later in debate ---

[Matt Hancock]

The hon. Gentleman mentions dormitories in mental health services. Dormitories have plagued mental health services for years and years and years—and who are the first Government to not only commit, but to put the funding in to end dormitories in mental health services? It is this Conservative Government. It is not only that this Government are the Government for the NHS and that we are the party of the NHS; we are also the party investing record sums in mental health services, with the biggest increase of all the increases in funding going into mental health services, including to end the dormitories in mental health services that have existed ever since the NHS was created.

[Jonathan Ashworth]

The Government have been cutting capital budgets in the NHS, which is why we have still got those horrendous dormitory wards, including at Leicestershire Partnership NHS Trust and Derbyshire Healthcare NHS Foundation Trust. Years of Tory cutbacks have meant that clinical commissioning groups have been raiding child and adolescent mental health budgets in order to fix the wider revenue gaps in the NHS. That is because of 10 years of underfunding in the national health service. We went into this crisis with an NHS that did not have enough staff—short of 80,000. It has seen 15,000 beds cut and public health budgets cut by £800 million. Hospitals have been left with £6 billion of repair bills and with these Victorian dormitory wards that have not been updated for years. The Secretary of State cannot stand there and say that the NHS had enough investment going into this crisis, because if it had we would not have had staff without PPE.

--- Later in debate ---

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

I wholeheartedly support these measures. When we look at the starkness of the data presented to the country at the weekend, we see that the issue is not whether the lockdown is wise, but whether we use the lockdown wisely. I hope that the Health Secretary will forgive me, as his predecessor, if I set out one or two of the things we need to use the next month to sort out if we are to ensure that this is the last coronavirus lockdown and that it is a short one.

First, it will not surprise the Health Secretary that I say this, but we must introduce weekly testing of NHS staff. In the first wave, up to 11% of coronavirus hospital deaths happened to people who picked up their infection in their own hospital. For the basic principles of patient safety and staff safety, we must make sure that that does not happen a second time; otherwise cancer patients will worry whether it is safe to go to their hospital, staff will worry about whether they are infecting their own patients and we will see the NHS again descend into being a covid-only service. We had some hospitals in London where more than 40% of staff were infected in the previous wave. It would be unforgiveable to let that happen again. I know that the Secretary of State is sympathetic and would like to do this. I would just urge him to do it as soon as possible.

[Matt Hancock]

My right hon. Friend knows that I agree with him. Indeed, we are rolling this out now, but we do need to get it everywhere.

[Jeremy Hunt]

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

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

Coronavirus Update

Matt Hancock Excerpts

Monday 2nd November 2020 Written Statements

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

The Prime Minister has announced tougher national restrictions in England from Thursday. These restrictions will apply nationally for four weeks up to Wednesday 2 December. At the end of the period, we will look to return to a local and regional approach, based on the latest data.

The regulations will be debated in Parliament on Wednesday.

Subject to approval, from Thursday 5 November, everyone must stay at home, and may leave only for a limited set of reasons. These include:

For education;

For work, if you cannot work from home;

For exercise and recreation in an outdoor public place, with your household, support bubble or on your own with one person from another household (children under school age, as well as those dependent on round-the-clock care, such as those with severe disabilities, who are with their parents will not count towards the limit on two people meeting outside);

For all medical reasons, appointments and to escape injury or harm;

To shop for food and essentials;

To visit members of your support bubble;

And to provide care for vulnerable people, or as a volunteer.

In support of the regulations being laid in Parliament, we will be expanding our existing guidance to ensure the rules are clear for individuals and businesses. Single-adult households will still be able to form an exclusive support bubble with one other household, and children can move between homes if their parents are separated.

Non-essential shops, leisure and entertainment venues will be closed. Click and collect services can continue and essential shops, including supermarkets, will remain open.

People should work from home wherever possible. Workplaces should stay open where people cannot work from home—for example, in the construction or manufacturing sectors.

Shielding as practised in the spring will not currently be reintroduced. Those who are clinically extremely vulnerable should not only minimise their contacts with others, but also not go to work if they are unable to work from home.

The clinically vulnerable and those over the age of 60, should be especially careful to follow the rules and minimise contacts with others.

Overnight stays away from primary residences will not be allowed, except for specific exceptions including for work. This means people cannot travel internationally or within the UK, unless for work, education or other legally permitted exemptions.

Inbound international travel will continue to be governed by the travel corridor approach, and those currently on a domestic holiday will be allowed to finish their holidays, but are still subject to the requirements in England not to go out without a reasonable excuse.

Public services, such as job centres, courts, and civil registration offices will remain open.

Elite sport will be allowed to continue behind closed doors as currently.

The coronavirus job retention scheme, known as the furlough scheme, will remain open until December, with employees receiving 80% of their current salary for hours not worked, up to a maximum of £2,500. The cost for employers of retaining workers will be reduced compared to the current scheme, which ends today.

To reflect the recent changes to the furlough scheme, the UK-wide self-employment income support scheme (SEISS) will be made more generous—with self-employed individuals receiving 80% of their average trading profits for November.

As the Prime Minister and Education Secretary have said, keeping young people in education is a national priority so early years settings, schools, colleges and universities will all remain open. Parents and carers should make sure their children keep attending school. However, universities and adult learning providers should consider increasing online provision where possible.

Parents will still be able to access registered childcare and other childcare activities where reasonably necessary to enable parents to work or access education and training. Parents are also able to form a childcare bubble with one other household for the purposes of informal childcare, for children who are 13 or under.

Ministers are also clear that it is vital to keep the provision for non-covid healthcare needs going. Unless clinicians tell patients otherwise, they should continue to use the NHS, get scans and other tests, turn up for all appointments and collect medicines and treatments.

We are also planning a programme of mass testing which will help us get on top of this virus. We now have the immediate prospect of using many millions of cheap, reliable and rapid turnaround tests.

As a result of partnerships with NHS and university labs, new cutting-edge testing innovations and a recruitment drive boosting the UK’s coronavirus diagnostic industry, NHS test and trace has rapidly expanded testing capability ahead of winter. The target of 500,000 testing capacity per day was reached on Saturday 31 October.

Introducing these restrictions is a difficult decision. But the public have the power to deal with this pandemic, working together with the Government and following the rules and guidance.

Update on recent changes to the local alert level

In order to reduce the transmission of covid-19, the following areas moved into local covid alert level high on 31 October: Carlisle, East Riding of Yorkshire, Kingston-Upon-Hull, North East Lincolnshire, North Lincolnshire, Dudley, Staffordshire, Telford and Wrekin, Amber Valley, Bolsover, Derbyshire Dales, Derby City, South Derbyshire, the whole of High Peak, Charnwood, Luton, and Oxford City.

This means that for these areas, the following measures apply:

People must not meet with anybody outside their household or support bubble in any indoor setting, whether at home or in a public place;

People must not meet in a group of more than six outside, including in a garden or other space;

People should aim to reduce the number of journeys they make where possible. If they need to travel, they should walk or cycle where possible, or plan ahead and avoid busy times and routes on public transport.

These restrictions remain in place until 5 November, when they will then be superseded by the new national restrictions.

[HCWS549]

Covid-19

Matt Hancock Excerpts

Thursday 22nd October 2020 Commons Chamber

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

I beg to move,

That this house has considered covid-19.

The House meets today to debate the coronavirus pandemic once more. The peril of the pandemic has no short-term quick fix, but calls for ingenuity, commitment and resolve from us all. We have responded with one of the greatest collective efforts that this nation has seen in peacetime, but the fight is not over: the virus continues to spread, and cases, hospitalisations and, tragically, deaths are all rising. Yesterday we learned that Liverpool University Hospitals NHS Foundation Trust is now treating more patients than it was at the peak in April, and across the UK the number of deaths has doubled in under a fortnight. And yet, just as the situation we face is grave, so the hope of a solution is growing. With every day, my confidence in the ingenuity of science to bring resolution grows. But until that moment, we must have resolve. We are focused on finding a long-term solution, and we reject political point scoring. I call on the House to work together in the interests of our whole nation—and, indeed, the whole world.

[Chris Bryant (Rhondda) (Lab)]

I just wonder whether one problem we have at the moment is that we do not have enough capacity in the whole of the NHS to take on covid in a long-term way, as the Secretary of State suggests, and still be able to do all the things that we really need to do. How can we ramp up that capacity so that we are still treating people for cancer, for brain injury and for all the other things that we all care about?

[Matt Hancock]

The hon. Gentleman is absolutely right. He represents a seat in Wales, and this is a challenge for the NHS in all four nations of the United Kingdom. I was going to come on to this, but one thing that we have learned in the first phase is how we can do better in keeping the other services running that the NHS must and should provide, for instance for brain injuries, for cancer treatment and for heart patients. There are also those things that are not life-threatening, but that harm people’s lives—a painful hip or a cataract that needs treatment. In the first wave, as we knew so much less about this virus, many of those treatments were stopped altogether.

In the second wave, we have two things at our advantage. The first is that this is a much more regional second wave, which puts more pressure on areas such as Liverpool and Lancashire than elsewhere in the country, but that does mean that elsewhere the elective and the urgent operations can continue. The second difference is that we know much more about the virus and how it spreads, so we have separated the NHS into green sites and blues sites. Green sites are for where we have a high degree of confidence that there is no covid, using testing and asking people to isolate before going in for an operation, so that people can have more confidence. The central message across all parts of the UK is that the NHS remains open. Finally on this point, the best way we can keep the sorts of treatments that we all want to see going is to keep the virus under control.

[Mark Tami (Alyn and Deeside) (Lab)]

The Secretary of State has answered my question in part with the importance of green and red. One of the big problems in the first wave is that people were frightened, even if they feared that they had cancer or some other condition, to go into the hospitals, and we have to reassure them that they can go there and they can be safe.

[Matt Hancock]

The right hon. Gentleman is absolutely right. We have an advertising campaign, “Help us to help you”, to make the simple point to people that, if they are asked to go to hospital by a clinician, then it is safer to go to hospital than not to do so. In fact, we call them green sites and blue sites. Green means free from covid—we are as confident as we can be that they are. It is blue, not red, which means that we still want people to come to hospital, even if they have to come to A&E, because there is only likely to be, at worst, as much covid as in the general population, unless, of course, a person is in a covid ward treating only covid patients. The NHS has learned a huge amount both about the microbiology of the disease and about how to run health services in a world when covid is at large.

[Mr Steve Baker (Wycombe) (Con)]

Of course this is a dangerous disease and, of course, cases are rising, including in my own area, so it is with some humility that I have a look at the daily excess all-cause deaths in all ages in England, which show that there has been no significant excess all-cause mortality observed in week 40 overall. Is it not the case that the good news in this second wave is that the disease is not progressing as it did in the first?

[Matt Hancock]

I want to keep it that way. It is true that the all-cause mortality rates are around the typical levels for this time of year, and that is partly because non-covid deaths are actually lower at the moment than in most years, and because, thus far, we have worked to keep this virus under control. We know from the basic mathematics of compounding growth and the exponential nature of the growth of any virus that the number of deaths will increase if the number of cases increase exponentially, hence the need for the actions that we in this House have voted for.

[Bob Stewart (Beckenham) (Con)]

On that point, many of my constituents were frightened to go to hospital because they thought that they might get infected with covid. With that in mind—I am quite sure my right hon. Friend has thought of this—would it not be an idea to separate out hospitals, so that we have a covid centre of excellence, say using the Nightingale hospitals, where everyone goes, and then the normal hospitals that deal with everything else? Forgive me for raising this point, because I am quite sure that the Secretary of State has a very good answer.

[Matt Hancock]

It is a brilliant idea—so brilliant that the NHS has spent the summer working on that concept. We cannot do it as perfectly as my hon. Friend suggests, and the reason is the practicalities of the treatment of covid—for instance, if someone has covid and something else, they need a normal intensive care unit. But the Nightingale hospitals are there—in fact today, sadly, the Nightingale hospital in Manchester is reopening. For all the rest of the hospitals, we are making sure that different parts of the hospital are deemed either blue or green—essentially covid-free or at risk of covid. Some of the different buildings are covid-free or non-covid, or, in some cases, whole hospitals are covid green sites and people cannot go to them unless they have tested negative. That means we can have a high degree of confidence because, for instance, if we are treating cancer patients, we want to ensure that there is not any covid in there.

We need these long-term solutions and, like other liberal democracies around the world, we are wrestling with this question—as we have wrestled with it in the last few minutes—of how to keep people safe from the virus while protecting other important things in life: our liberties, our livelihoods and the things that we love. That is what leads us to the strategy of suppressing the virus and supporting the economy, education and the NHS. The NHS needs to be supported to do all the other things that it needs to do until a vaccine is available.

I reject the false choice that says we must pick a side and choose between a healthy economy and a healthy nation, because the two are intrinsically linked. If, God forbid, we were to let the virus unleash its full force, the damage to not just the NHS and the hundreds of thousands of lives, but our livelihoods would be catastrophic. We can only get our economy and our society going gangbusters again if we drive this virus down, so that people have the confidence that they need to live their lives to the full—and drive it down we must.

This is a deadly virus, and, yes, it reserves its biggest impact for the oldest in society, which means the rise in the number of cases among the over-60s gives me a lot of cause for concern. We also just heard compellingly from the Minister for Equalities about the impact on people from ethnic minority backgrounds, but the impact is not confined to these groups. The virus can affect anyone of any age and any background, and we have already seen worrying numbers of young, fit, healthy people suffering debilitating symptoms months after contracting covid. Yesterday, a study by King’s College London showed that one in 20 people with coronavirus is likely to have virus symptoms, such as fatigue, breathlessness, muscle pain and neurological problems, for eight weeks or more. Yesterday, I visited the cutting-edge long covid clinic at University College London hospital. I have met people in their 20s and 30s unable to work, sapped of all their energy, living with the long-term effects of a virus that has completely changed their lives. Therefore, to anyone of any age, catching covid can be very grave indeed. Long covid underpins, again, our strategy for suppressing the virus until a vaccine arrives.

[Dr Luke Evans (Bosworth) (Con)]

When my right hon. Friend came to the Health and Social Care Committee a few weeks ago, he talked about long covid and the fact that clinics were being set up to deal with it. Will he give the House an update on where that has got to?

[Matt Hancock]

These clinics are being set up—the London clinic is now open—but we need to see them right across the country. The NHS now has a programme of rolling out clinics to be able to support people and, of course to communicate with GPs. That is important because primary care is often where people arrive with long covid, because there appears to be no correlation between the seriousness of someone’s initial illness and how long they can have these debilitating consequences. In some cases, people have no symptoms of the coronavirus initially, but then find that they have months and months of fatigue, a brain fog and muscle pain, and they do not know where it came from until they are diagnosed with long covid. It is a very serious complication.

[John Spellar (Warley) (Lab)]

To enable us to get a picture, could the Secretary of State tell us what percentage of people up to 25 suffer from the condition?

[Matt Hancock]

Yes. We have two points of evidence; one is the evidence from King’s College London that shows that approximately one in 20 people with coronavirus is likely to have long-term symptoms, but the other evidence implies that in adults under 50, the proportion is more like one in 10. There seems to be some correlation that implies that it is more of a problem among younger people, but the understanding of long covid is still in its early stages and an awful lot more research is needed.

[John Spellar]

I am sorry to press the point, but it is a question of roughly what percentage is affected; not of those who contract the disease, but of the overall cohort.

[Matt Hancock]

It is very difficult to know. We estimate that approximately 8% of the population have had covid and that one in 20 people who has had it has symptoms for longer than eight weeks. Of course, the fewer people who get covid, the fewer people who get long covid, which reinforces the overall strategy of suppressing the virus until we get a vaccine. Let me turn to how we do that.

We cannot reiterate enough the importance of the basics: social distancing and “hands, face, space”. The next area is following rules on local action, which are at the core of how we and an increasing number of other countries around the world are tackling the crisis at the moment. Through our local covid alert levels, we have been able to take a balanced approach; I would like to update the House today on some further changes that we are making.

Unfortunately, we are seeing rising rates of infection in Stoke-on-Trent, in Coventry and in Slough. In all those areas, there are more than 100 positive cases per 100,000 people, cases are doubling approximately every fortnight and we are seeing a concerning increase in cases among the over-60s. We have agreed, in partnership with local leaders, to move those areas into the high local alert level, which will come into force at one minute past midnight on Saturday.

The central change is that people will not be able to meet other households socially indoors. This applies in any setting—at home, in a restaurant or in any other venue. The rule of six still applies in any outdoor setting, and although people may continue to travel to open venues, they should reduce the number of journeys where possible. I thank local leaders in the areas for the work they have done and for their co-operation. I can assure the people of Stoke-on-Trent, of Coventry and of Slough that we will support them all the way through, including with the business support that the Chancellor announced earlier today for all areas with a high local alert level.

We are also formally beginning discussions with Warrington about moving into the very high alert level, owing to a continuing rise in cases there.

[Andy Carter (Warrington South) (Con)]

I thank the Secretary of State for the ongoing dialogue with me as a Warrington MP and with my colleagues in Warrington. I was particularly concerned this morning after having seen Public Health England data about the rapid rise in the infection rate among the over-60s in Warrington. Could he say a little more about that information?

[Matt Hancock]

I am worried about the rise in cases, especially among the over-60s in Warrington. We have seen that case rate continuing to rise, despite the hard work of people locally, since Warrington was moved into local alert level 2. There is an excellent local hospital in Warrington, but it is dealing with a very high number of cases and is working with other local hospitals to ensure that everybody gets the treatment they need. I pay tribute to my hon. Friend, who has provided great leadership in his local community. I hope that with everybody supporting these measures and taking the actions necessary, we can keep these restrictions in place for as little time as possible, but I am absolutely convinced that we need to make progress. I have announced today that we will formally start the talks; I hope that we can reach an agreement and resolution soon.

The virus moves quickly, so we must respond quickly and in a targeted way like this to keep it under control. As part of local discussions, local authorities including the Local Government Association have asked for stronger enforcement powers, and I agree. To support businesses who are doing the right thing it is fair that we take action against those business who are doing the wrong thing. Firm enforcement helps make these restrictions fairer for all. We want to put in place stronger regulations to give local authorities further powers to take further action in their area. The proposals that we will bring forward will mean that councils will be able to act without delay and use closure notices to shut premises on public health grounds to help suppress the virus. We will work with local authorities in the coming days on the details of these proposals so that we can act in a firm and fast way against the minority who are breaching these life-saving rules.

These changes will help us fight the virus in the here and now but we are also making progress on long-term solutions. The long-term solution is not to give up, as some would have us do, or wish the virus away; it is to harness the science and the ingenuity of innovation while supporting people through.

First, on testing, thanks to exceptional work from so many people we have built a critical national infrastructure of diagnostic testing. Today’s testing capacity is now over 370,000. Alongside this expansion of the current technology, I want to update the House on mass testing. I know there have been many questions about this project. Last week, we began rolling out new testing technologies to hospitals based on the point-of-care LAMP—loop-mediated isothermal amplification—test. That will allow the regular repeat testing of NHS staff and patients. I am delighted to be able to tell the House that yesterday we began the roll-out of lateral flow tests to schools and universities. Lateral flow tests do not require a lab or a machine; the kit gives a result within minutes. We have successfully purchased many millions of these tests and they will allow us both to find the virus where it spreads and to reduce the disruption that virus control measures inevitably create.

If we can deliver a mass-testing solution so that pupils in a bubble do not have to isolate for a fortnight when one in the bubble tests positive, we will not only help control the spread of the virus but we will protect education better and help schools, teachers and parents to live their lives much closer to normal. These tests will also allow directors of public health to have more rapid access to testing capacity and we are starting the roll-out to councils, including today with the council in Stoke-on-Trent.

The second area to touch on is vaccines. Progress continues on the development and the deployment of vaccines, and we are determined to give those developing vaccines all the support they need. I can inform the House that we are initiating human challenge trials to speed up the development of the coronavirus vaccine and to improve further its safety. We are contributing £33 million to back these trials, joining forces with academia and industry. A human challenge trial involves taking a vaccine candidate that has been proven to be safe in trials and giving it to a small number of carefully selected, healthy adult volunteers who are then exposed to the virus in a safe and controlled environment closely monitored by medics and scientists. That gives us the chance to accelerate the understanding of promising vaccines that have been through the clinical trials so that we can improve on their safe development. The UK is one of the only countries in the world with the capability to run that kind of programme, and we should all be proud that, once again, we are leading on this global effort.

Our response to this lethal virus has been one of the greatest collective endeavours that this nation has seen. Thanks to those efforts, we are better prepared this time round. As a nation, we built the Nightingale hospitals in just nine days. As a nation, we came together as one to protect the NHS, and it was not overwhelmed. Now the NHS is better prepared still. As a nation, we built the biggest testing capability of all our peers, and we have made huge and historic advances in vaccines and treatments. We understand this virus infinitely more than at the start of this pandemic but we are not there yet—not when the virus is spreading at pace. So we must each of us look at what we can do, the role we can play and what actions we can take. We have seen throughout this pandemic that we are at our best when we come together. We know that with science on our side ultimately we will prevail.

[Several hon. Members rose—]

--- Later in debate ---

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

Given the numbers who are interested in the debate and given that I have enjoyed the indulgence of the House now for four days in a row—I am not sure what I will do next week; I might just come here and make a speech for the sake of it—I will try to be brief. I also apologise to the House, because I have a long-standing commitment and so I will not be here for the wind-ups. I apologise to the House for that discourtesy on this occasion. I have spoken to Mr Speaker about it, and he understands the particular circumstances.

I noticed that the Secretary of State has updated the House on Slough, Stoke-on-Trent and Coventry, but he did not mention anything about Nottinghamshire and West Yorkshire, and he will know that they are candidates that are widely speculated as the next to go into the tier 3 lockdown restrictions. For example, in parts of Nottinghamshire, localised infection rates are 370 per 100,000 in Gedling and 362 per 100,000 in Rushcliffe. In West Yorkshire, the rate is 307 per 100,000 in Wakefield and in Calderdale. Given that, he must be considering the future of West Yorkshire and Nottinghamshire.

I am just aware that we are going into the parliamentary recess. I do not know whether I can invite the Secretary of State to say anything now, because Members from those areas will be concerned that with Parliament not sitting next week, they might not have an opportunity to put their points to him or get their points on the record. If he does not want to say anything now, it would be important if the Minister of State could offer some reassurance to people in those parts of the world as to what might be happening.

[Matt Hancock]

As previously announced, discussions are under way. We want to proceed in consultation with and working with the local areas. With the parliamentary recess next week, we will find a way to ensure that colleagues are appraised of the situation, preferably in advance of any announcement.

[Jonathan Ashworth]

I am truly grateful for that reassurance, because the Secretary of State will understand that many people in those areas will be concerned and Members will want to get their points of view on the record on that front.

The virus has caused a pandemic because it exploits ambivalence and takes advantage of our human vulnerabilities. It undermines our biological defences and spreads through human social behaviour and clustering. We know that people with long-term chronic conditions in particular are vulnerable, and we know that there is a greater burden of illness in our more disadvantaged areas, which covid cruelly exaggerates. We know that as we entered this crisis, we had less resilience as a society. We entered with life expectancy falling for some of the poorest and stalling nationwide, and life expectancy is a summary of our overall health.

In the past 10 years, the amount of life in good health has decreased for men and women. Our child mortality rates are some of the worst in Europe, and poor health and chronic illness leave communities acutely vulnerable to disease, so it should come as no surprise to any of us that some of the boroughs currently fighting the most virulent fires are some of the very poorest in our country, with the very worst life expectancy.

I welcome the progress being made on diagnostics, therapeutics and vaccinations, which the Secretary of State has updated us on today. We welcome the expanding of mass testing, including the saliva testing and the lateral flow testing. I hope, by the way, that the Secretary of State will invest in our great universities, which are developing some of this saliva-based testing, because they will need the equipment and the labs to process it. He will probably need to invest in robotics and artificial intelligence to do some of that, because there are not enough staff to do it at the moment, and I hope that is part of his agenda. As well as all that, because the virus is now endemic, we will need a health inequalities strategy to get on top of this virus for the long term.

In the immediate term, we also need to adjust our behaviours to bring infection rates down, which is why I have supported the difficult restrictions that the Secretary of State has had to impose, and it is why we are saying we need clarity all the time from Government. But people also want to know that there is light at the end of the tunnel, because it is still not clear to families in Bury, Heywood and Penistone and all those other places that have been put under lockdown in recent days how they will escape it.

We still do not know whether the restrictions across the north will be lifted when the national R falls below 1 or when local regionalised R values fall below 1. We still do not know whether restrictions will be lifted across the north when hospital admissions stabilise. Yesterday, the Prime Minister said that decisions are

“based on a number of things including the R—also, of course, rates of infection, rates of admission to hospital and other data.”—[Official Report, 21 October 2020; Vol. 682, c. 1053.]

He did not tell us what that other data is. Perhaps the Minister responding to the debate can outline how an area in the north in tier 3 gets out of those restrictions. I know that the areas will be reviewed every four weeks, but what are the criteria to inform those reviews?

I represent Leicester, where we are in tier 2, but we have been in a version of restrictions for 114 days. We went directly from national lockdown to local lockdown. In fact, we endured tougher restrictions than those currently designated for tier 3. Our hospitality closed, our non-essential retail closed and—I did not agree with this—our schools closed as well. All those measures together did help to bring infections down in Leicester to about 55 per 100,000—to be frank, many Members would bite your hand off for 55 per 100,000 now—and even at 55 per 100,000 we remained in a version of lockdown.

Now, months later, after all the sacrifice we took in Leicester—after months with our businesses closed, with the mental health impact of people not being able to see their loved ones and families denied the opportunity to visit a care home to see their grandmother or mother—our infection rates in Leicester are 219 per 100,000. The Secretary of State will therefore have to forgive me when I express some scepticism that his approach will work and suppress the virus to the levels sufficient to bring the R value down, because although the early restrictions in Leicester did have an impact, after months we are still under restrictions with infection rates over 200 per 100,000.

The Secretary of State updated us on the situation we are in. He has been good at updating the House repeatedly; I have no criticism of him at all on that front. The growth rate in the virus is slower than in March—it is more muted, thanks to the great sacrifices of the British people, with hand hygiene, social distancing and everything we are doing—but it is not plateauing. We are dealing with an autumn resurgence, and for all the heat and fallout we have had across the House this week, the truth is that the virus is at worrying levels everywhere. The national R is between 1.3 and 1.5. The R across the south-east is between 1.3 and 1.5, across the south-west between 1.3 and 1.6, and across the east of England between 1.3 and 1.5.

Of course, admissions to critical care are currently concentrated in the north and the midlands, but while at this stage in the first wave those admissions to critical care were beginning to come down, they are continuing to go up. It is right that improvements in care mean that people are less likely to die. That is a good thing, and we all celebrate that, but general and acute beds are filling up with covid patients across the north and across the midlands.

We know that the Prime Minister has rejected a circuit break for now—he does not rule it out indefinitely. We think he should have taken advantage of next week’s half term. He decided not to do that. But we should remind ourselves that SAGE advised the circuit break on 21 September. A month later, on 21 October, we had these grim statistics: 191 deaths; 996 hospital admissions; 6,431 in hospital; 629 on ventilation; 26,688 tested positive; and 249,978 cases in the past 14 days. Many will ask how much of that could have been avoided, had the Prime Minister gone along with SAGE’s advice a month ago.

Today, the Chancellor said in his statement that we have to find a balance between saving lives and protecting livelihoods, but I do not believe that the two are in conflict. It is not a trade-off. Actually, I do not believe the Secretary of State thinks it is a trade off—the tone of his remarks was very different from that of the Chancellor earlier. Saving lives and protecting livelihoods go hand in hand. I worry that the approach the Government are currently taking—while understandable, because nobody wants to be in a lockdown, and none of these decisions are easy or do not have negative consequences; I think we are all mature enough across the House to appreciate and understand that—means that there will, by necessity, have to be tougher, deeper action in the weeks to come, not only in autumn. Winter has not hit us yet.

Professor John Edmunds of the London School of Hygiene said yesterday in one of the Select Committees that

“there’s no way we come out of this wave now without counting our deaths in the tens of thousands…I think we are looking at quite a bleak situation unless we take action…I don’t think we should be taking action just specifically in the highest risk areas, but I think we need to take action everywhere”.

A similar sentiment was expressed by Sir Jeremy Farrar, who is also on SAGE. For balance, Professor Van-Tam said at the press conference this week that he disagreed, but also that

“we may have to push on the pedal a little harder”

to get it under control.

I know the Secretary of State is a decent man. He has been very good throughout this crisis in talking to me privately; one would expect a Secretary of State and a shadow Secretary of State to have those discussions. Whenever I have asked for briefings, all the way back to January, he has ensured that the chief medical officer would give me confidential briefings, as I am sure that every Member across the House would understand and appreciate. So I know he is a decent man. I know he is not playing games or anything like that. I know that these are difficult judgment calls of extraordinary gravity. I know there is no easy solution. Everything has trade-offs; everything has negative consequences. But we also know that unless we take decisive action, the consequences could be even worse. No one should pretend to the House that that is not the case. There is a worry that by not taking action now, we will, in the words of Professor David Hunter, an epidemiologist at Oxford,

“all wind up in tier 3 eventually.”

According to Times Radio yesterday, Government sources were telling it that the Government are now planning a three-week circuit break next month across all tier 2 and tier 3 areas. If that is the case, then the Government should probably level with us so that we can all start preparing for it.

This is not just about minimising harm and deaths from covid. As the Secretary of State said in responding to questions from my hon. Friends, we have a huge responsibility and duty to minimise harm and deaths from non-covid conditions as well. We have to avoid the situation that we were in in the spring, when the immense lockdown, which was actually a number of different interventions all at once, meant that to build surge capacity in the national health service, we had to cancel elective operations to free up general and acute beds, and much important diagnostics work and treatment got delayed. That has left us with a situation today where 110,000 people are waiting beyond 12 months for treatment, compared with just 1,600 in January; 3 million people are waiting for breast, bowel or cervical screening, and more people are waiting for treatment.

My worry is that we will end up building a greater backlog in treatment if we do not act. General and acute beds are filling up. We have a number of hospitals cancelling electives already. Bradford has just suspended non-urgent surgery. Birmingham is talking about suspending non-urgent surgery. It is happening in Nottingham. We know that Merseyside is under considerable pressure; the Secretary of State outlined it. It has just been revealed in the Health Service Journal that we are heading into this winter with 2,000 fewer beds than we had last winter. Today the Royal College of Emergency Medicine has warned that over half of A&Es across the country are caring for patients in corridors due to the lack of beds—and we are not even in winter yet. Our overcrowded A&Es are not ideal at the best of times, but during a covid pandemic it is obviously highly dangerous to be treating patients in corridors of A&Es. The president of the royal college, Katherine Henderson, has pointed out that this situation

“will put more lives at risk than it ever did before.”

If the Government really want to drive down infections, suppress the virus and ensure that general and acute beds are not overwhelmed and more operations are not cancelled, then they have to seriously consider what steps they need to take to go further. Unless the Secretary of State or the Minister is going to get up at the end of this debate and say, “Actually, we’re going to do a circuit breaker over half-term next week”, I accept that the Government have probably missed that window of opportunity now, but at some point they will have to take further action.

We could have avoided much of this if test and trace had been more effective. The Secretary of State is spending £12 billion on this programme. Twelve billion pounds is a colossal amount of money. Some of it is going on consultants who earn £7,000 a day, but where on earth is the rest going? We are throwing around figures in this covid debate, and we are becoming quite complacent and relaxed about them, but £12 billion is an extraordinary amount of money; we could probably run the NHS for a month or so on that. We learn today that the system is contacting only 59.6% of contacts, which is the equivalent of failing to contact 101,000 people. That is not world beating; it is a world-beating shambles. I really hope that the Government look at stripping all the failing private outsourcing firms, such as Serco, of these contracts and putting local public health teams in charge. That would be much more effective.

[Jonathan Ashworth]

Absolutely. There have been problems with the app. When I am in Leicester, it tells me that I am in an area that is both medium and high alert. Leicester has been under lockdown for 100 days, so how can the app say that in the part of Leicester where I live?

[Matt Hancock]

I thought that the hon. Gentleman’s comments were very thoughtful until we got to the unnecessary political knockabout. I want to make a couple of factual points about the app. It only takes the first two segments of someone’s postcode, some of which spread over two different alert levels, so that is why it describes the situation in Leicester as it does. When it comes to making sure that people press the button on the app to access the £500 self-isolation payment for the low-paid, that button is there on the app.

I want to leap to the defence of Test and Trace, because in the past fortnight the number of contacts and cases that have been reached has doubled. In slightly more than the last month, the distance travelled to get a test has halved, and the turnaround time for tests that are sent to care homes—those tests are critical for saving lives—has come down. More than 50 statistics on Test and Trace are published every Thursday, and of course the hon. Gentleman can look through them, find a couple that are going in the wrong direction and complain about them, but I think it is better to have a balanced opinion.

[Jonathan Ashworth]

That was a spirited defence, but the statistics have been bad every week. The Secretary of State knows that, because I have raised it with him every week.

[Matt Hancock]

What happens is that every week, the hon. Gentleman looks through the 50 statistics and finds the ones that are not going in the right direction. I am merely pointing out that the system is doing much more than it ever has. One place where the huge amounts of money that we are putting into Test and Trace go is into the record amount of testing capacity, which is now more than 370,000. I think he should stand up and thank all the people who are delivering on this colossal effort.

[Jonathan Ashworth]

I am very happy to thank the people who are working in Test and Trace.

[Matt Hancock]

U-turn.

[Jonathan Ashworth]

That is not a U-turn. Thanking the staff is not a U-turn. The Opposition are on the side of the workers; the Secretary of State is on the side of the bosses. Of course we are happy to thank the staff who are working on Test and Trace, but he cannot seriously look at the statistics and tell us that the system is effective. The Chancellor of the Duchy of Lancaster did not defend it. When he was asked about the statistics on “The Andrew Marr Show” on Sunday, he said that

“any test and trace system of whatever kind has less utility”

when the virus is accelerating. If the Secretary of State thinks that there is a good set of statistics, perhaps he should send it to the Chancellor of the Duchy of Lancaster, who took a different line on Sunday.

Let me come to a conclusion, because I know that many people want to speak in this debate. [Interruption.] The Secretary of State tells me to leave out the knockabout, but he is the one who started it off. The problem is that we went into this pandemic with an underfunded NHS, public health cut back and less resilience as a society. This will not be the only pandemic that we have to deal with. Climate change, urbanisation and deforestation mean that we are likely to see more viruses jump from animals to humans. The big challenge for us as a society when we come through this pandemic, as we will, is that we have to start building the health security to protect us for the future, because unfortunately, all of us across the House will be dealing with more of these pandemics in the years to come.

--- Later in debate ---

[Matt Hancock]

Hear, hear!

[Anne McLaughlin]

I see that the Health Secretary agrees with me somewhat. Everybody on these islands is tired at the moment, but those making the tough decisions do not have the option to give in to the tiredness. I might not always agree with everything they are doing—I do not generally agree with most of what they do—but I understand that everybody is an expert these days.

Some of what the Government did in response to the pandemic was good. Furloughing was not just good; it was fantastic. I am not going to qualify that. These islands were not alone in having the idea, but it was a great idea. When I sat and watched the Chancellor’s initial response, I thought he was fast, flexible and responsive. I felt at that point that ideology had gone, that politics had been taken out of the situation and that the Government were simply doing what they could to support people as best they could. In fact, I remember thinking that when the Chancellor appeared on “Spitting Image” he would be wrapped in the red flag, so socialist were some of the furloughing policies.

We also heard about people slipping through the net. As everybody keeps saying, we are in unprecedented times. We had those Paymaster General calls every day, and much of what we reported was acted on initially. It was a terrible time, but it was a good time for politicians to work together in the interests of the four countries of these islands.

Not everything was acted on, however, and not everyone was supported. Some of those gaps were never filled. I want to mention two things in particular. First, my constituency has many wholesalers who chose not to furlough their staff because they wanted to play their part in responding to the pandemic. They wanted to ensure the flow of food and drink, particularly to hospitals. I know something was said in the statement earlier today, which I have not yet seen, but they have felt for a long time that they did not receive a response.

I wrote to the Chancellor to ask about that and I just want to say something about the responses I have been getting. The hon. Member for Blaenau Gwent (Nick Smith) made a point of order about this earlier. Some of the responses have no reference—when we put a reference, they do not include it when responding. One of the complaints made in the point of order was about a six-word response to a question. I got an eight-page response to something, but I have no idea what the question was because, as I said, it did not give a reference. In addition, it seemed to be eight pages of “Isn’t the Government great?” which is just not acceptable. I do not know why the replies are like this. I wonder if it is an attempt to stop us asking questions in the first place, because I am certainly giving up sometimes.

The people who have formed the campaign organisation ExcludedUK have not given up. I am part of the all-party parliamentary group on the ExcludedUK. They have been incredible, but they are in a really difficult position and I, too, would have been in their position had I not won my seat in December. I was self-employed but I had not been self-employed for long enough. I will not go into the details, but I know that if I were one of them right now, I would not be living in the home that I have lived in for 10 years. I do not know what would have happened to me, so I identify with them and want to keep supporting them.

It was really good that the Government added £1,000 a year to universal credit, although it had been cut to the extent that that simply brought it back up to 2011 levels. On the other hand, I did not expect a Conservative Government to do that, so I am glad that they did. However, they need to extend it and they need to add it to legacy benefits. I implore them to do that and to extend the furlough scheme. Whenever that is mentioned in this place, Government Members shout, “For how long can we do that? We can’t sustain it forever!” But it would not be forever, and even though we do not know exactly how long it would last, we can estimate and reasonably suppose that by next summer there will be some kind of normality, so why not extend it until then, if needs be? In the past few months, I have noticed some terrible situations with employers and I have many examples. I already gave some examples when I spoke in the debate on whistleblowers a while back, but I want to raise one situation today, because I am hoping that Government Members will do something about it. It is a very serious matter. The employer is the Government. Whoever took the decision that I am going to tell the House about should be ashamed of themselves.

There are three service centres in Glasgow for the DWP and the situation concerns people working in those service centres who do not have to do face-to-face. I am telling the House what is happening in Glasgow, but I am sure this will not just be the case in Glasgow; I imagine that it is widespread across these islands. Workers were on a work-from-home pilot scheme. Some teams were allowed to work four days a week at home and one day in the office. Others worked three weeks at home and one week in the office.

On 23 September, the Prime Minister and the First Minister both gave the instruction that anybody who could work from home should work from home. Naturally, those workers expected that they would be allowed to work from home full time, but they were refused permission to do that. Some of the workers, who are all kitted out at home, are having to bring their equipment into the office on that one day of the week or that one week of the month, despite what the Government were saying people should do. They were constantly being told that it was fine, it was safe and that there was no danger to them. Well, that was not what the Government were saying.

On the week ending 9 October, it was announced that two members of staff in that building had tested positive. On 12 October, another three members of staff were reported to have tested positive. On 15 October, a further two members of staff tested positive—seven cases in less than a week. On 19 October, Monday of this week, there was another case and on 20 October, Tuesday, there were another two. So that is 10.

I am sure that Members can understand the fears that those workers were experiencing, but I will tell them who did not understand—or maybe they did and just did not care. Last Friday, a senior manager at the DWP held a Skype meeting with the teams to reassure them that the office was safe and to remind them that the pilot could not be changed and there could be no flexibility, despite what the Prime Minister and the First Minister were telling employers to do. I understand that the tone was more threatening than reassuring. The senior manager warned that if workers continued to raise concerns the pilot might be cancelled and they would all be forced to work in the office full time. She “hoped” that that would not have to happen. That is workplace bullying and I hope the Secretary of State will raise it with the Secretary of State for Work and Pensions. I certainly will be raising it.

Yesterday, just to bring everyone up to date, staff were told that the pilot had been suspended. That is good in the short term, because all those who can work from home are now doing so full time, but there is no information and no answer to their questions about how this situation will progress. Given threats that speaking out might mean that the pilot is cancelled and everyone will be forced to work in the office, one can be forgiven for thinking that that is what is going to happen. So I just want to ask a few questions. Why, if they could work from home and are equipped to work from home, were they forced to work in the office? Of the 10 testing positive so far, how many were part of the work-from-home pilot? How can a Government agency be given permission to ignore the restrictions that everyone else is rightly following? Will management punish the “unruly dissenters” who complained about it by forcing them all to work in the office, as was suggested by the senior manager? Do the Government understand the message that the workers are getting, which is, “You don’t matter, you have no power”?

Well, not only do they have no power, but their MP seems to have no influence. My attempts to represent my constituents started on 4 October, when I had a meeting with DWP senior managers. I had just been made aware of the situation—the meeting was about something else—so I said I urgently needed to know who to contact to raise the issue on behalf of the employees. They got back to me yesterday, 21 October, after being prompted three times. I waited 17 days and their response was, “You might need to give us some more information.” If I cannot represent those employees as an MP and make any difference to their lives, and they cannot as workers, who else can?

Madam Deputy Speaker, you are looking at me like you want me to stop—[Interruption.] No? Oh, that’s excellent.

Covid-19 Update

Matt Hancock Excerpts

Tuesday 20th October 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. The virus remains a perilous threat. Yesterday, Europe recorded its 7 millionth coronavirus case. Deaths in Germany and Italy have doubled in seven days, and here, today’s Office for National Statistics figures show that weekly deaths linked to coronavirus have risen to their highest level since the start of July. Cases among the over-60s continue to rise, and as the deputy chief medical officer Jonathan Van-Tam made clear earlier, it is the penetration of coronavirus into older age groups that gives the NHS the greatest cause for concern.

We must act where the virus is spreading. In the parts of the country where it is spreading the fastest, it is our sombre duty to take the action necessary to protect people’s lives and protect the NHS. Coronavirus is not a short-term problem that can easily be fixed. It requires difficult decisions in these difficult times. Our goal is to get life back to as normal as possible, to support the NHS, to keep children at school and to shelter the economy as much as possible, and to do that by suppressing the virus until a vaccine is available.

It has been clear for some days that further action is needed across parts of England. Last Monday, we were able to reach an agreement with the leadership of Liverpool city region, across party lines, to take the action needed, with a package of financial support and co-operation. Yesterday, I announced to the House a similar agreement reached with Lancashire. In Lancashire, Liverpool and across the country, we continue to work closely with local leadership.

In Greater Manchester, there have been more coronavirus infections already in October than in July, August and September combined. The average daily hospital admissions in Greater Manchester are now higher than they were on 26 March, and there are now more covid-19 patients in Greater Manchester hospitals than in the whole of the south-west and south-east combined. As a result, we need to take further action to protect lives and livelihoods in Greater Manchester.

So, informed by that data, we have made the difficult decision to place Greater Manchester into the very high local covid alert level, coming into force at one minute past midnight on Friday. This means that pubs and bars must close, unless they are serving substantial meals; households cannot mix indoors or in most outdoor settings; in some public outdoor spaces, groups must be limited to the rule of six; and we strongly advise against travel into and out of the area. In line with the extra measures taken in Lancashire, casinos, bingo halls, betting shops, adult gaming centres and soft play areas must also close.

I know that these restrictions are tough, so we are putting in place a comprehensive package of support. That includes the job support scheme, which ensures that those affected by business closures are still paid. Once topped up with universal credit, those on low incomes will receive at least 80% of their normal income. We have also made available up to £465 million to help local authorities implement and enforce restrictions. Greater Manchester will receive £22 million of that. We will also work with local authorities to allocate testing and introduce local contact tracing.

Over the past 10 days, we have sought to reach an agreement with local leaders. Unfortunately, we were not able to reach an agreement in Greater Manchester, as we have in Lancashire and the Liverpool city region. As well as the support that I have outlined, we made a generous and extensive offer to support Manchester’s businesses. That offer was proportionate to the support we have given the Liverpool city region and Lancashire, but regrettably, the Mayor rejected it. Of course, we do not want businesses in Greater Manchester to be disadvantaged, so that offer remains on the table. Our door is open to further discussions with local leaders in the coming days about business support.

I understand the impact of these measures, but we must take these decisions to save lives and, ultimately, livelihoods in Greater Manchester. To everyone in Greater Manchester, I say this: throughout these difficult times for your great city, we will be by your side. The best thing we can do now to protect our loved ones and get back to normal as fast as possible is for everyone to come together and follow these new rules and for all to play their part in tackling this deadly virus.

The path through a pandemic is never straightforward. It requires all of us to make difficult decisions and tough sacrifices to get the virus under control. I know that these local restrictions are hard and are another sacrifice, in a year full of sacrifices, but we must not waver now. We must persevere, as we work so hard on the long-term solutions that will see us through, and come together, once again, so that we can look after the people and the communities we love. I commend this statement to the House.

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

As always, I thank the Secretary of State for advance sight of his statement, but I am afraid that tonight people across Manchester, the boroughs of Greater Manchester and towns such as Stockport, Leigh and Bury, where I grew up, will be watching the news in disbelief and they will be worried if they are affected by these closures. They will be asking, “Why was it right to cover 80% of wages in March and then now, in the run-up to Christmas, to cover just two thirds of wages in October?” What happened to that Chancellor who plastered across social media soft-focus selfies boasting that he would support jobs and incomes and do “whatever it takes”? Tonight, that Chancellor is forcing people on the national minimum wage to live on just £5.76 an hour. He has gone from “whatever it takes” to now taking from the lowest paid. How does he expect families to pay the bills and the rent, to put food on the table and to pay for school lunches when a third of their income has been snatched away, literally overnight? Where is the Chancellor? He should be here to defend the consequences of his decisions, which will mean a winter of hardship across the north.

I grew up in Greater Manchester. My dad worked in casinos in Salford and my mum worked in bars in Manchester. I know that across Manchester people will want to do the right thing, but they will not be able to if a third of their income is stripped away. The leaders of Greater Manchester were prepared to compromise. They offered to settle for £65 million to support jobs and livelihoods, but the Government insisted on £60 million. Rather than finding the £5 million extra, the Prime Minister pulled the plug on negotiations and then this afternoon took £38 million off the table. What a petty, vindictive, callous response in a national crisis. The Prime Minister may think he is punishing the politicians, but in fact he is punishing the people of Greater Manchester. This is the Prime Minister who has blown £150 million on face masks that were not suitable for frontline NHS staff, blown £130 million on testing kits that turned out to be unsafe and had to be recalled, and is spending £7,000 a day on consultants as part of his failing £12 billion Test and Trace programme.

Given that Test and Trace is broken and the virus is out of control, I have always accepted that greater containment measures are needed, but for measures to be effective they need to command the consent of the people impacted and people need to know how long these measures will last. The Secretary of State did not tell us that in his statement.

Yet these restrictions have been called into question by the chief medical officer, who said that they will not enough, and they are restrictions that the Prime Minister admitted last week give us only “a chance” to bring the national R down. So how will the sacrifices that the Prime Minister is forcing on the people in the north bring down infection rates in the south?

The Secretary of State knows that, to bring the R below 1, further measures will be needed. He knows that more areas are likely to go into tier 3. This is about so much more than Greater Manchester. People will watch tonight and say that if the Government are prepared to inflict this level of harm on their people in the middle of a pandemic in one part of the country, they will be prepared to do it to people in all parts of the country. The result will be a winter of hardship for millions of people. This is not a game; it is about people’s lives. People need proper financial support. This is a national crisis and we will not defeat this virus on the cheap.

[Matt Hancock]

I regret that the hon. Member, who so often is so reasonable, is choosing to play political games with political rhetoric tonight. As I said in my statement, the offer of support is on the table. To the people of Greater Manchester, I say that the offer of the same support as was agreed with the Labour leadership of the Liverpool city region, and I commend them for their work, and the leadership of Lancashire, and I commend them for their work, is and remains on the table. I look forward in the coming days to working with the local councils right across Greater Manchester and, of course, the Mayor, if he is willing to come back to the table, to make sure we have that package of support for businesses in place.

Crucially, it is incumbent on us all to send the same public health messages to our constituents, wherever we represent around the country, but in particular in areas where cases are rising, as in Greater Manchester, to ensure that we are clear about the part that everybody needs to play to keep this virus under control. The public are looking for that sort of public health messaging, rather than political games, in these difficult times.

[Sir Peter Bottomley (Worthing West) (Con)]

I think it is fair to say that the shadow Secretary of State has been moderate. He has not repeated his party leader’s call for a national lockdown, and people in areas where the virus has not jumped up very high will be grateful for that.

My father’s family came from Greater Manchester, and were they there now I think they would ask that the Mayor make an agreement with the Government, because public help and public health go together. If it is a proportionate offer, we have not heard the reason why it is inadequate in one place. If we want employment in the future, we need to have employers, and help is going to be needed for those who need and are struggling to keep their businesses going.

I want to make one more point to my right hon. Friend. Down in Worthing, we are not getting our test results back all the time very fast. It is important that we do, because a father or mother who has a child who may have symptoms may not be able to go to work as a teacher, and that ends up penalising all the children in the class. I hope my right hon. Friend will be able to say what is happening.

[Matt Hancock]

I strongly agree with my hon. Friend, who puts it very clearly: the people of Greater Manchester would expect their local leaders to come to the table. That offer of support for local businesses remains there, alongside the support for strengthening test and trace and enforcement in Greater Manchester. I urge all the leaders of the nine boroughs of Greater Manchester to pick up the phone and work with us to make sure we can deliver this. Of course, that offer remains open for the Mayor if he wants to return to the table.

On the point about the testing in Worthing, I will absolutely look into whether there was a specific problem. The test turnaround times have come down as the capacity has rapidly expanded, and I will make sure I get back to my hon. Friend as soon as possible.

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

While there may be a small minority who do not think of those around them, the majority of people try to follow the advice to reduce the spread of covid. We know that the virus spreads where people are in close contact. This is about not just pubs and nightclubs; it includes those in overcrowded housing, those in exposed jobs where working from home is not an option, and those on zero-hours contracts who simply will not get paid if they are not working. Does the Secretary of State not think it is a bit inappropriate for politicians with well-paid and secure jobs to suggest that rising covid cases in certain areas are just due to some form of misbehaviour requiring tougher penalties?

People want to do the right thing, whether due to restrictions or because they are infected themselves, but sometimes they feel that they have no option but to continue going out of the house. Although in general surveys the vast majority of people say that they would isolate if they caught covid, a study from King’s College London shows that less than 20% of those who develop symptoms go on to isolate. That was associated with financial hardship, social deprivation, having dependent children and working in key jobs that cannot be carried out from home. Why is the Chancellor not continuing the full furlough scheme when we are heading into a second wave and the hardest winter that the NHS will ever have faced? There are still millions of people who have not received any support since March. Does the Secretary of State not recognise that, for those on low wages and in insecure work, the choice between staying at home and feeding their family just does not feel like a choice at all?

[Matt Hancock]

I agree with the hon. Lady that the majority of people try to follow the advice, and that the vast majority of people want to do the right thing. We introduced the £500 payment for those on low incomes precisely to support people to do that. We introduced it right across the UK, working with the Scottish Government, and there are signs that the uptake of that has allowed people to complete isolation when they need to, in order to keep others safe.

[Jacob Young (Redcar) (Con)]

My right hon. Friend and his Department have engaged with me and my Tees Valley colleagues a number of times in recent weeks, and I thank him for that. He is well aware of my deep reservations about further restrictions on my constituents’ lives, liberties and livelihoods, particularly due to the mental health impact of these restrictions. Can he confirm that, while discussions are ongoing, there are no current plans to move Redcar and Cleveland into tier 3 restrictions? Will he also commit to working with me, Redcar and Cleveland Council, my Tees Valley colleagues and the Tees Valley Mayor, Ben Houchen, on any future changes?

[Matt Hancock]

Yes, we have been working very closely with the Tees Valley. The level 2 restrictions there were not something that we put into place lightly, but we followed the data. We will continue to follow the data and take the action that is needed—but only the action that is needed—and to engage with my hon. Friend and with the Mayor of Tees Valley, who is rising above party politics to do the right thing for the Tees Valley. The point that I would make to my hon. Friend, in addition to the points that he made, is that the impact on mental health is undoubtedly worse if the virus gets out of control, even though the measures that are taken are difficult ones. The Royal College of Psychiatrists has been very clear that the best thing for mental health is for us to keep the virus under control, although of course we need to mitigate the consequences that flow from the measures we sometimes have to take.

[Mr Pat McFadden (Wolverhampton South East) (Lab)]

Today marks a low point in the handling of this situation. Instead of reuniting people behind their approach, the Government have imposed this decision, leaving a bitter taste. There are other decisions still to come, and other regions are watching what has happened today, including my own in the west midlands. Can the Secretary of State assure the House that, as significant economic support is withdrawn at the end of this month, any decision on whether national restrictions are required will not be taken because that is cheaper and a means of avoiding adequate support for the businesses and workers concerned, because if that is the case, the public health measures and the economic measures will be pulling in two different directions?

--- Later in debate ---

[Matt Hancock]

Yes, absolutely. The extra support that we put into areas that go into tier 3 is a reflection of the need to ensure that that support is there when action has to be taken for public health reasons in order to control the virus. I spoke to the Mayor of the West Midlands just before coming into the Chamber, and we will work closely together to ensure that we keep the virus under control in the west midlands, where, in very large part, the local leadership has worked closely together, again across party lines, to do what is right for the people of the west midlands.

[Tom Hunt (Ipswich) (Con)]

Today, Jonathan Van-Tam said in answer to a question that a national lockdown right now would be inappropriate for places such as East Anglia. Does my right hon. Friend therefore disagree with the decision of the Labour party and Ipswich Labour that now is the time to close down the entire hospitality sector in somewhere like Ipswich with low levels of covid, which employs thousands of my constituents?

[Matt Hancock]

I agree, of course, with what Professor Jonathan Van-Tam said. He is a very fine scientist and a brilliant man. Right now, no one is looking for political differences for politics’ sake. What people are looking for is for people to come together to make the right decisions in the national interest or the local interest, and to take these decisions as locally as possible to make sure that we support people as much as possible: take action where it is necessary, but make sure that we do not take action where it is not necessary.

[Liz Twist (Blaydon) (Lab)]

Earlier, the Prime Minister said that he was still talking to the north-east. May I reiterate that, in the north-east, we believe that we should remain in tier 2 and are working hard to that end? What we do need is financial support for the test and trace work already being carried out effectively locally and financial support for our hospitality, leisure and retail sectors, which are taking the strain of current restrictions. Will the Secretary of State now fund the test and trace work being done so effectively locally, and urge the Chancellor to provide a financial support package for our hospitality, leisure and retail sectors within tier 2 to support our economy and local people?

[Matt Hancock]

We are working very closely with the local leadership in the north-east and with colleagues. It was very good to see the hon. Lady on a Zoom call recently to discuss this. It is important that we take the action if it is necessary, but there are early signs that the number of cases in the north-east is starting to flatten. In the first instance, that is happening among younger people, and I am still worried about the number of cases among the over-60s, who, of course, are the people who are most likely to end up in hospital or worse. So we will keep a very close eye on the situation, but we have no imminent plans to make a change. If the clinical advice were to change and we needed to move urgently, then, of course, we would seek to do that with the support of the local area.

[Sara Britcliffe (Hyndburn) (Con)]

In the last four weeks, the number of covid patients admitted to intensive care units in hospitals in some parts of the country has increased sevenfold. I agree with my right hon. Friend that we must act now to control the spread of the virus, but can he assure me that the Government are doing all that they can to keep cancer treatments, elective surgeries and other vital diagnostic services going?

[Matt Hancock]

I absolutely can give my hon. Friend that assurance. I had a meeting on this with the NHS only this week. The good news is that the backlog from the initial lockdown has been reduced: the number of very long waiters for cancer treatment—those waiting more than 104 days—has been reduced by 63%. We are working to keep that coming down. The best way that we can make cancer treatment available to everyone, and the best thing in terms of cancer treatment, is to keep the rate of coronavirus down. On the point about fairness, representing a Lancashire seat as she does, I think it is really important that the proposals that we are making for Greater Manchester, the subject of the statement this evening, are equivalent to those that were made for Lancashire. It is only fair that, between different geographies, we have the same levels of support, especially in neighbouring geographies such as Hyndburn and Manchester.

[Mike Hill (Hartlepool) (Lab)]

I, too, am working hard with Tees Valley colleagues to keep the area out of tier 3, but my constituents in Hartlepool are confused and seething with anger. They are concerned about moving to tier 3 with all the health and economic impacts that that will bring. We are not in tier 3 yet, but if we get there what exit strategy does the Secretary of State have for ending lockdown?

[Matt Hancock]

I agree with the hon. Gentleman on his assessment: Hartlepool is in tier 2 at the moment and I hope that we can keep it there, but we will keep it under review. The best exit strategy for anywhere that wants to go into a lower tier is for everybody to follow the rules, respect social distancing and try to get the case rate coming down, but, of course, for the whole nation—indeed for the whole world—the best exit strategy is a combination of mass testing and a vaccine, and we are working incredibly hard to deliver both as quickly as feasibly possible. We need a long-term solution to covid as well as the short-term action that we are having to take.

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

Greater Manchester has lived under harsh additional restrictions for three months. May I put it to my right hon. Friend that lockdowns themselves cost lives as well as livelihoods, and that they take a terrible toll on mental health, particularly of the young? Does he accept that it is better to do these things, if they must be done, by consent? In that regard, will he confirm that these measures will be brought to the House for approval, and that in any case they will end with the sunset after 28 days?

[Matt Hancock]

I agree with my hon. Friend that these things are better done by consent, and in the parts of the country where the whole local area has supported the measures, through getting the right messages out to people about their personal responsibility, we do tend to get a better response and see the case rate starting to come down. That is one of the many reasons why we worked so hard to try to get an agreement across Greater Manchester and why I regret that we have not been able to, although, as I say, our door remains open. On the point about consent, of course these measures will be brought to the House, and they sunset after 28 days. We keep them under review, because we would not want to keep these measures in place a moment longer than they are needed.

[Christine Jardine (Edinburgh West) (LD)]

None of us doubts the grave threat to public health and the difficulty of dealing with it, but there is also now a widespread real threat of poverty, so whether the £60 million is on the table or off the table is immaterial; it is not what the elected representatives of Greater Manchester say they need. Do the Secretary of State and his Government appreciate that the people of Greater Manchester feel tonight that they have been abandoned by this Government, and that my constituents in Edinburgh West and people up and down the country will be wondering whether they will be abandoned next?

[Matt Hancock]

No. On the contrary, we are putting extra support into Greater Manchester, and we are willing to continue with the support akin to the support that we agreed with the leadership of the Liverpool city region and with Lancashire, as my hon. Friend the Member for Hyndburn (Sara Britcliffe), who has now gone from the Chamber, set out. The unprecedented level of support across the whole of this pandemic has been possible only because of the UK acting together and working together. I hope that we can continue to work with the hon. Member for Edinburgh West (Christine Jardine) and her party to make sure that we get through this as best as we possibly can, suppressing the virus and supporting jobs and the NHS.

[John Redwood (Wokingham) (Con)]

More action is needed to help livelihoods and save incomes, so will the Government share and, if necessary, develop their work with the commercial and public sectors on how air-conditioning systems, ventilation systems, heating systems and air-extraction systems can be adapted or improved so that more commercial and public buildings can be kept open for proper use?

[Matt Hancock]

Yes, absolutely; that is an incredibly important strand of work. It is being led by the Business Department, but I keep a close eye on it and, in fact, had an update on it this week, which I would be very happy to discuss with my right hon. Friend.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for all that he is doing. There are many underlying health conditions, including respiratory illnesses. I declare an interest as chair of the all-party parliamentary group on respiratory health. Given that respiratory illnesses are one of the leading causes of death in the UK—that includes covid-19, of course—what reassurances can he offer me and those people who suffer from them that referrals for severe asthma, chronic obstructive pulmonary disease and other respiratory illnesses will not be forgotten but will be maintained, and that further unnecessary deaths will be avoided?

[Matt Hancock]

We work very hard on this point. To answer both this question and a question from my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady) that I did not did not answer, of course we take into account the overall health impacts: direct covid deaths; the impact of covid on our hospitals, which means it is sometimes harder to treat other illnesses, although that is now much better than it was in the first wave and the NHS is very much open; and the impact of measures on other conditions. The best way through this from a health point of view, taking all these things into account, is undoubtedly to keep the virus down, but also to try to ensure that the NHS, right across all four nations of the UK, is open for all other conditions and that if someone is asked to go to hospital then it is the safest place for them to go.

[Alexander Stafford (Rother Valley) (Con)]

I understand that talks are ongoing about South Yorkshire, which includes Rother Valley, going into a stricter lockdown. Before any decision is made, will my right hon. Friend agree to get agreement between councils and local MPs, so that local views, concerns and support can be agreed in advance, especially around mental health and local businesses?

[Matt Hancock]

Yes, I am happy to agree with my hon. Friend. We were discussing on Sunday morning the challenges in South Yorkshire, where cases are going up fast and action needs to be taken. Talks are ongoing in a highly collegiate and constructive way. I pay tribute to the way that he stands up for his constituents in Rother Valley and makes the case directly to Ministers day after day about what is best for the area and represents them so clearly.

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

In lockdown, people need the financial support to do the right thing and stay at home to stop the virus. In Wales, where we are in national lockdown, the Labour Government have provided £300 million. That is £100 per person to help them stay at home to beat the virus. But in Manchester, the Prime Minister has provided £22 million. That is £8 per person, instead of £100 per person in Wales. How can that be right? Will the Secretary of State and the Chancellor ensure that, wherever people live across the United Kingdom, they have enough money to stay at home to beat the virus, without inflicting massive poverty?

[Matt Hancock]

We have put substantial funding into not only Greater Manchester but Wales, which goes directly to businesses that are affected and have to close and directly to individuals, through the furlough scheme, the job support scheme and universal credit, which is available to all those who lose their jobs and people in low-paid work. In addition to the funding that remains on the table—and I urge the local leadership in Greater Manchester to come back to the table—there is widespread support available.

[Andy Carter (Warrington South) (Con)]

Warrington finds itself as a tier 2 island in the north-west, parked between Manchester and Liverpool. Our infection rate remains stubbornly high, though, and admissions to Warrington Hospital have now exceeded the peak of the first wave in April. Does my right hon. Friend agree that any further measures for Warrington should protect the NHS and save lives but also support local livelihoods and the economy?

--- Later in debate ---

[Matt Hancock]

Yes, I absolutely agree with the approach that my hon. Friend sets out. I am worried about the number of cases in Warrington and about the impact on Warrington Hospital, which is an excellent hospital. Of course, Warrington is not an island, because Cheshire as a whole has seen case rates rise. It is an area that we are worried about, and we are working with local leadership to ensure that we take appropriate measures and put in place the support needed.

[Afzal Khan (Manchester, Gorton) (Lab) [V]]

It is impossible to describe today’s events without using unparliamentary language, but out of deference to you, Mr Speaker, I will settle for “a complete shambles”. Today, this Government made a choice not to protect the poorest people in Greater Manchester through the punishing reality of the winter to come. Does the Secretary of State really believe that we will get through this pandemic by subjecting communities to punishing financial negotiations? Do the Government truly value pennies more than lives? The Government are playing poker with people’s jobs, homes and lives. Is the Secretary of State proud to be a member of this Government?

[Matt Hancock]

Contrary to the way that the hon. Gentleman described it, the Government have put forward the same proposals in Greater Manchester that were agreed in Lancashire and in Liverpool. Unfortunately, the Mayor of Greater Manchester walked away from the table, but the offer is there. I urge all local leaders, including the hon. Gentleman, to take forward that offer to resolve this and for us all to work together for the benefit of the people of Manchester.

[Jackie Doyle-Price (Thurrock) (Con)]

My right hon. Friend told the House that these measures are about the increase in infection among the over-60s, who are more vulnerable to this dreadful disease. What assessment has he made of whether that infection is being spread in the community, as opposed to care settings? If it is in the community, what messages should we give to the rest of the community about the need to make sure that they protect their loved ones?

[Matt Hancock]

I think there is a duty for all of us to send messages to the communities that we serve that people need to take personal responsibility to try to reduce the spread of the virus. There have recently been some cases in care homes, but far fewer, and it seems that the actions that we have taken and the very hard work of the care home sector over the summer—the staff who work in care homes—has reduced transmission. In most care homes there are more staff than residents, and they live in the community, so it is almost impossible to stop any infection getting into all care homes when the level of infection in the community rises. Having said that, the core of this second peak is in the community, where every single one of us can act to take more responsibility to help to slow the spread of the virus.

[Kerry McCarthy (Bristol East) (Lab)]

My constituents, like everyone else’s, have suffered huge anxiety over the past six months, worrying about their health and livelihoods. The chaos that has unfolded today in relation to Greater Manchester will have done nothing to allay their fears. They are also angry about the money that has been squandered on personal protective equipment purchases, on consultants, and on the failing Test and Trace system, which my hon. Friend the shadow Secretary of State raised with the Secretary of State. The right hon. Gentleman did not answer my hon. Friend’s questions then—would he answer them now? Why is Manchester not entitled to the money it needs to get by in this crisis, when so much money has been wasted elsewhere?

[Matt Hancock]

The money that we are proposing, and put on the table for Greater Manchester, is exactly the same as the amount that was agreed with the leadership of Liverpool and of Lancashire. There is support there to help people through what are—the hon. Lady is quite right—very difficult times. I hope that we can resolve this, but we needed to act after 10 days, with infections still going up. It was our duty to act, even though we could not yet get the agreement of the local leaders, but I hope that that will come.

[Richard Thomson (Gordon) (SNP) [V]]

One of the ways in which we can hope to pick a path out of this crisis is with improved and faster testing. The Health and Social Care Secretary and the Prime Minister have spoken in past days about new testing technologies being piloted with NHS staff. If that technology is found to be effective, what is the right hon. Gentleman’s timeline for rolling that testing out to wider groups, and will those tests contribute to the half a million daily tests that the Government say will be conducted by the end of the month?

[Matt Hancock]

The answer is yes and yes. They will be there to benefit everyone across the whole United Kingdom.

[Mary Robinson (Cheadle) (Con)]

I was hugely disappointed that the Mayor of Greater Manchester failed to reach an agreement with the Government, thus compounding the uncertainty facing my Cheadle constituents. We need to find a way forward. My right hon. Friend will know that I have consistently advocated on behalf of Stockport Council and for my constituents in Cheadle, referring to testing and tracing and covid compliance in the hospitality sector, and I have pressed for a borough-by-borough approach that reflects our lower case rate. Tonight, I have written to the leader of Stockport Council, urging her to act on behalf of my Cheadle constituents and work with the Government to negotiate a local authority-specific financial package that supports and protects Cheadle residents and businesses. As we consider the next steps, will the Minister continue to work with our local leaders and me to secure a fair deal for our area?

[Matt Hancock]

My hon. Friend puts the case very clearly, and she is right. We do not want businesses in Stockport to be disadvantaged, so an offer, proportionate to the support that we have put into Liverpool and Lancashire, is on the table. I will take away her proposal and talk to my right hon. Friend the Secretary of State for Housing, Communities and Local Government, who is engaged in those talks right now, about her suggestion of a borough-by-borough approach. We remain open to a GM-wide approach, but so far we have not been able to get the agreement of the Mayor for the support that is on the table for the businesses of Greater Manchester.

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

I welcome the Secretary of State’s announcement that he has no plans to move the north-east into tier 3. He is right that in County Durham covid numbers are plateauing, especially if students are taken out. Will he, though, address the point raised by my hon. Friend the Member for Blaydon (Liz Twist)? When will he give the extra resources to local directors of public health to do local test and tracing? When will local directors of public health get timely information from national Test and Trace, so that they can chase up those cases? At the moment they are getting the information up to 48 hours after the case—

[Matt Hancock]

rose—

[Mr Speaker]

Order. The Secretary of State should let Members finish before he stands.

[Matt Hancock]

The questions were so good, Mr Speaker, that I was enthusiastic to answer them as quickly as possible. I am a fan of fast turnaround times, and hope I can ensure that the data gets turned around even more quickly in County Durham. When it comes to the case rate, yes, there have been good signs, but I am still worried about the case rate among the over-60s, and the discussions with local leaders continue. I absolutely take the right hon. Gentleman’s points on board, though.

[Derek Twigg (Halton) (Lab)]

In view of the fact that the Secretary of State is in favour of fast turnaround times, may I ask him this? Given that Lancashire and now Manchester in tier 3 will be able to keep their gyms open, will he either use the Government’s powers, or give powers to local council leaders in Halton and Merseyside, to reopen gyms in that area?

[Matt Hancock]

The hon. Gentleman makes an argument that my hon. Friend the Member for Southport (Damien Moore) has consistently made. Why do we not have a conversation about it and see whether we can make any progress?

[Andrew Jones (Harrogate and Knaresborough) (Con)]

We know that infection rates are at different levels throughout the country, and that restrictions cause issues for people who suffer from health conditions other than covid and have a huge impact on the economy, but closing pubs in Harrogate or Newquay will not make case levels fall in Manchester or Newcastle, so does my right hon. Friend agree that a blanket national lockdown is wrong and that local interventions are what we need now to tackle this crisis?

[Matt Hancock]

Yes, I wholeheartedly agree. The localised and regional approach is increasingly being taken up around the world—for instance, in France. Indeed, Sweden, which has often been discussed in this House, has put in place a system very similar to ours for exactly the sorts of reasons that my hon. Friend has set out.

[Mr Clive Betts (Sheffield South East) (Lab)]

As the Secretary of State will know from the Zoom call we had on Sunday morning, for which I thank him, the Mayor and leaders of the Sheffield city region are engaged with Ministers and officials on a number of asks in order that a move to tier 3 could be considered. Those asks are about extra help for businesses that are not completely shut but have a substantial reduction in income, and more help beyond the £500 scheme for people who are asked to isolate. The Secretary of State can correct me if I am wrong, but it seems from his answers to previous questions that he is saying that the offer made so far to Lancashire and Merseyside is the final offer that anyone else could expect to receive, and that no one else will get any more, particularly in revenue or resources, than has been offered to those areas. Is that true or not?

[Matt Hancock]

That is an overinterpretation of my comments. The discussions with the local leadership in South Yorkshire have been very constructive, very positive and all focused on the public health need to get this virus under control in South Yorkshire, and then the support that needs to go alongside that. They are being led by my right hon. Friend the Secretary of State for Housing, Communities and Local Government, and I would not want to fetter the privacy in which those discussions have rightly taken place. We should leave it to the local leaders and my right hon. Friend to try to come to a conclusion.

[James Grundy (Leigh) (Con)]

I am sure that the Secretary of State is as disappointed as I am that the Greater Manchester Mayor has been unable to reach agreement with the Government today. Will he and other right hon. colleagues now commit to meet me, other Greater Manchester colleagues and council leaders in Greater Manchester to find a fair and workable agreement?

[Matt Hancock]

Yes, absolutely. Support proportionate to the support made available to Lancashire is on the table. We are willing to meet anybody from Greater Manchester to help make this happen, and it is best done as a team effort. The offer was there on the table. I, like my hon. Friend, regret that it was not taken forward. However, I hope that council leaders in Wigan, colleagues from across the House and, if he wants, the Mayor will come back to the table and work together for the people of Greater Manchester.

[Mr Toby Perkins (Chesterfield) (Lab)]

The Health Secretary’s attempt to divide and rule the Mayor and the Members of Parliament in Manchester is absolutely transparent. It is shameful that some of those Conservative colleagues, who have been working collectively, should collapse like they appear to be doing today. Does it not say everything about this Government that they should believe £7,000 a day is an adequate amount to pay consultants to work on his failing track and trace programme, but £8 per head is more than enough for people in Manchester and right across the north and the midlands to go into this tier 3 after the tier 2 programme has not worked?

[Matt Hancock]

On the contrary, we are working hard across party lines and trying to rise above that sort of political attack to work for the benefit and the public interests of everybody in this country.

[Tom Randall (Gedling) (Con)]

In Gedling, which does not have a large student population, there continues to be a worryingly high number of coronavirus cases. It is concerning to hear that the general picture appears to be moving upwards in the population, particularly among the over-60s, where we know the risks are higher. Does my right hon. Friend agree that this demonstrates the importance of acting fast, with targeted action if it is available, to help save lives?

[Matt Hancock]

Yes, I strongly agree. I praise my hon. Friend’s leadership in his local community in making this case. The number of cases in Nottingham and increasingly across Nottinghamshire is worrying. Nottinghamshire went into level 2 last week, and talks are ongoing about what more might be needed. I praise the people of Nottinghamshire for what they are doing to try to slow the spread of this virus. It may be that more needs to be done, and we will be driven entirely by the data, working closely with the local authorities.

[Mike Amesbury (Weaver Vale) (Lab)]

Cheshire leaders and, indeed, the Warrington leader have met the Department and written to the Prime Minister asking for local resources for the local test, trace and isolate system, as well as a substantial financial package of £42 million to support our hospitality sector—people have mirrored that point across the Chamber—but they have yet to receive a reply. Given the urgency of the situation, please will the Secretary of State do his utmost to make sure that that reply goes to the leaders? Finally, as a Mancunian by birth, I find the spitefulness from the Prime Minister disgraceful. The Prime Minister should do the right thing by the people of Greater Manchester.

[Matt Hancock]

The Prime Minister is seeking precisely to do that and he, like me, very much hopes that the local leadership in Greater Manchester will do their bit. When it comes to Cheshire and indeed Warrington, which we talked about earlier, I am worried about the cases. I will make sure that the engagement that the hon. Gentleman and his councils seek happens as soon as possible.

[Dame Cheryl Gillan (Chesham and Amersham) (Con) [V]]

Can I commend the Secretary of State for his localised approach, and for the calm way in which he is dealing with some unwarranted attacks on both him and the Prime Minister?

The Epilepsy Society is based in Chalfont St Peter in my constituency. It provides specialist care to a number of vulnerable residents and has, according to one relative, worked wonders in keeping residents safe and secure. However, visits from relatives cannot take place as the incidence of covid-19 grows, and the home is now locked down again. With 60-minute tests now available down the road at Heathrow airport, could we not arrange for this type of testing for close relatives so they could visit their loved ones? It would make all the difference in the world to my constituents and many others in long-term care.

[Matt Hancock]

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

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

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

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

[Matt Hancock]

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

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

What estimate has the Secretary of State made of the number of excess deaths above the long-term average in each of the last few weeks?

[Matt Hancock]

We have, thankfully, seen that the number of excess deaths is around the level of the long-term average. I want to keep it that way and that is why we are taking the action that we are, so that this does not get out of hand like we saw in the first peak.

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

There is a pattern here, is there not? Whenever the Government cannot agree a deal, it is always somebody else’s fault. In this case, it is Andy Burnham’s fault for simply standing up for what Greater Manchester needs—not what we want; what we need. Maybe I am also overinterpreting the Secretary of State’s comments, but in his answer to my hon. Friend the Member for Sheffield South East (Mr Betts), he suggested that there might be different offers for different areas. Greater Manchester was asking for a carefully costed package to meet our needs and our requirements. Why can the Government not give Greater Manchester what we need?

[Matt Hancock]

The offer that was made to Greater Manchester was proportionate to the support that we have already given to and agreed with the local leadership in Liverpool and Lancashire, and I regret that the Mayor rejected it. We want to support businesses across Greater Manchester, so we are open to further discussions about business support with local leaders, including the council leaders, as my hon. Friend the Member for Cheadle (Mary Robinson) suggested, and I hope that we can make some progress.

[Dame Diana Johnson (Kingston upon Hull North) (Lab) [V]]

Andy Burnham has said that, on covid-19, we need to

“carry people with us, not crush their spirit.”

Does the Home Secretary think that he has carried the people of the north with the Government as they watch bully boy tactics and punishment beatings being used against the legitimate concerns of local leaders from all parties to try to protect the livelihoods of the poorest people and local businesses in Greater Manchester? How does that bode for other areas such as the Humber, which may well need more help as they move into higher tiers?

[Matt Hancock]

In areas that we are already in discussions with, such as South Yorkshire, West Yorkshire, the north-east and Nottinghamshire, right across the board those discussions are constructive, positive and focused entirely on the wellbeing of people locally. I hope that in Hull cases stay relatively low and we do not have to go into a higher tier. There are no plans to do so at the moment, and I urge the people of Hull to keep following the rules and keep the coronavirus down in Hull. What I would say is that in every other part of the country, we have had highly constructive talks that have not involved this sort of party political point scoring. I urge that approach from everybody.

[Anthony Browne (South Cambridgeshire) (Con)]

In my constituency, the latest figures show an infection rate of just 54 per 100,000—about half the national average and one tenth of the rate in Liverpool—so I think it is absolutely right that the Government are not following a national lockdown but are instead following a regional, local approach. In those areas that do need to go to tier 3, it is absolutely right that the Government give additional financial support, but it is also right, surely, that the Government treat them fairly and equally. The Government could not give greater support to one area, Greater Manchester, than to Liverpool or Lancashire, because then the local leaders who are refusing to take the action necessary to lock down the virus will be given greater financial rewards than the leaders who are taking the steps necessary.

[Matt Hancock]

This point about fairness is really important. Imagine how it would feel to be running a business or to be somebody who lives in Liverpool when there has been an agreement across party lines for the support that comes with the measures that are necessary, and then, after a very public disagreement, instead of the constructive work that we really hope to achieve, the result was a deal that was not proportionate and fair. Fairness is absolutely at the heart of what we are trying to achieve. That is why it is right that we have the extra offer of support that continues to be on the table. We want to strike a fair deal, but we have to take these measures to keep people safe.

[Naz Shah (Bradford West) (Lab)]

In his statement, the Secretary of State said to the people of Manchester, “We will be by your side”, and that his response requires all of us to make a sacrifice. I put it to him that that is not entirely true, because it is constituencies like mine that are making the real, tough sacrifices in facing restrictions for nearly three months because of his and his Government’s failings. Just so we are aware, will this Government try to play poker with the people of Bradford and their financial support, like they did with Manchester before putting it into the highest tier?

[Matt Hancock]

We work very closely with the council in Bradford. Of course I am very happy to talk to the hon. Lady about what might be necessary. It has been very difficult for Bradford these past few months: I absolutely appreciate that. Bradford—certainly the city of Bradford, which she represents—has been in measures for a long time and has had extra restrictions. I hope that we can bring the number of cases down so that we can release some of those restrictions, and that is best done by working together.

[Jack Brereton (Stoke-on-Trent South) (Con)]

I welcome the setting up of a second local national testing centre locally in Fenton Manor in my constituency. I thank the city council and health professionals for the work that they have been doing locally. Will my right hon Friend continue to support this excellent work and continue to grow the testing capacity?

[Matt Hancock]

Yes, 100%. My hon. Friend makes a very good point. The extra testing capacity that we are seeing across the country does not happen by magic; it happens by the hard work of his constituents and others who are playing their part in the testing regime.

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

The Secretary of State talks about fairness, but today we find out that Greater Manchester is effectively getting a third of the level of financial support that the Government gave to Lancashire. It is a failure that his Government cannot negotiate a decent package of support with our Greater Manchester Mayor. Andy Burnham has argued for that decent financial support for people who work in businesses that are going to be closed down by Government restrictions, and for resources for locally led test and trace. He was right to do that. I urge the Secretary of State to think again. This is too important a time in this pandemic to fail to work with the devolved local government system that his Government created.

[Matt Hancock]

I think it is time to put aside short-term political point scoring. The deal on the table that the Mayor of Greater Manchester walked away from was a fair deal that had been agreed, proportionate to the deal that had been agreed with leaders in Liverpool and in Lancashire. I know I keep repeating this point, but it is absolutely at the centre of what it is to be fair, which is about treating people in similar situations in a similar way. I think that the British people understand that. Hence we enter into these local discussions in good faith, and everywhere else they have been engaged with in good faith. I hope that is the way that they can continue in Greater Manchester in future.

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

I want to be fair to my right hon. Friend, who is motivated at all times by the best of intentions, but I gently say that those of us who have a contrary view to all of the Government’s policies are not in immediate tow with the Mayor of Greater Manchester, nor are we in tow with the Labour Opposition. I feel a deep sense of disappointment at this collective failure that we have seen today and, quite frankly, my constituents in Hazel Grove deserve better. I shall resist the urge to lose my temper—tempting though it may be—because these exchanges deserve a greater elevation of tone, but I say this: the definition of insanity is to continue to do the same thing over and over again in the hope that it will turn good. We have had three months of interventions in Greater Manchester, which have yielded very little results indeed. I cannot help but fear that the medicine is worse than the disease.

--- Later in debate ---

[Matt Hancock]

We are starting to see some of the local action that we have already taken just starting, potentially, to work, and we have seen in Bolton that the cases were shooting up before we took action and then levelled off. So there is evidence of this approach working, and I look forward to working with my hon. Friend to make sure that we can get out of these measures, which I appreciate he is unenthusiastic about, as soon as possible.

[Mr Speaker]

We are heading to Manchester for our final question, from Lucy Powell.

[Lucy Powell (Manchester Central) (Lab/Co-op) [V]]

Thank you for squeezing me in, Mr Speaker. Can I say that it was not just the Mayor, but all the leaders and most of the MPs across Greater Manchester? We are a city united this evening, but should not any economic support package be based on need, not on some unpublished, arbitrary formula that no one has any idea what it consists of? If it was based on need, it would take account of the fact that business density and the economy of Greater Manchester is bigger than in other areas and that we have many more low-paid workers—that is something that the Secretary of State should know if he is talking about fairness— so businesses in Manchester will actually receive a lot less than businesses elsewhere. Can I tell him tonight that his Government have really misjudged the mood up here, and any less than is needed coming immediately to Greater Manchester for these new restrictions would rightly be seen as spiteful and political and nothing whatsoever to do with public health?

[Matt Hancock]

I think it benefits all of us to rise above the politics and try to work together. As I say, the offer that was made remains on the table and I look forward to working with the hon. Lady, who I know—as my hon. Friend the Member for Hazel Grove (Mr Wragg) said—works with the best of intentions, and I hope that we can work together to try to tackle this dreadful disease.

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

[Mr Speaker]

Would those who wish to leave the Chamber please do so before I start the next motions?

Pandemic Preparedness Exercise: Report

Matt Hancock Excerpts

Tuesday 20th October 2020 Written Statements

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

Today, I am publishing the report into Exercise Cygnus.

Exercise Cygnus was a national exercise that took place in 2016. It looked at how well prepared the UK was to respond to a serious flu pandemic. The aim was to test systems to the extreme, to identify strengths and weaknesses in the UK’s response plans, which would then inform improvements in our resilience.

The Department of Health and Social Care (known as the Department of Health at the time) 12 other Government Departments, NHS England, Public Health England, local public services, several prisons, and staff from the Scottish, Welsh and Northern Ireland Governments took part in the exercise. Overall, it involved more than 950 people and culminated in a three-day national level tier 1 exercise in October 2016.

Exercise Cygnus was not designed to consider other potential pandemics, or to identify what action could be taken to prevent widespread transmission.

The report was commissioned by the Department of Health and Social Care and produced independently by Public Health England.

The Government accepted all 22 recommendations from the report and have acted on each to improve pandemic response plans. For example, developing a free-standing Pandemic Influenza Bill. This meant the Government were ready with legislative proposals that could rapidly be tailored to form the basis of what became the Coronavirus Act 2020.

Many of these workstreams have provided a good foundation during the current covid-19 pandemic, helping speed up our response and save lives. I will deposit copies of the report in the Libraries of both Houses and it will be available on gov.uk.

[HCWS526]

Covid-19 Update

Matt Hancock Excerpts

Programme motion
Monday 19th October 2020 Commons Chamber

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

I would like to make a statement on coronavirus. As winter draws in, the virus is on the offensive: 40 million coronavirus case have now been recorded worldwide. Weekly deaths in Europe have increased by 33% and here in the UK, deaths have tragically doubled in the last 12 days. The situation remains perilous.

While the disease is dangerous for all adults, especially with growing evidence of the debilitating consequences of long covid, we know it is especially dangerous for older people. Cases continue to rise among the over-60s, who are most likely to end up in hospital or worse. I am very worried that the cases per 100,000 among the over 60s is 401 in the Liverpool city region, 241 in Lancashire and, in Greater Manchester, has risen over the past week from 171 to 283. That is why the Government have been working so hard to act, and I am very glad that we have been able to agree, across party lines, the necessary measures in Liverpool and Lancashire, and we are working hard to reach such an agreement in Greater Manchester.

We are doing everything in our power to suppress the virus, support the economy, support education and support the NHS until a vaccine is available. That is the right strategy, charting a path that allows for the greatest economic and social freedom while protecting life. The director general of the World Health Organisation said last week:

“Allowing a dangerous virus that we don’t fully understand to run free is simply unethical.”

I agree. I know that this is difficult and I know that it is relentless, but we must have resolve, see this through and never stop striving to support the science that will one day make us safe.

I was at Chelsea and Westminster Hospital this morning meeting NHS colleagues who are caring for patients with such dedication, as they always do. I heard from them how important it is for everyone to support the NHS by keeping the virus down so that the NHS is not overwhelmed by covid patients and it can deliver all the essential non-covid care that people need. I am glad to report that the number of people experiencing a long wait for cancer treatment has been brought down by 63% since its peak in July. I want to thank all the cancer teams who are working so hard to ensure people get the cancer screening, diagnostics and treatment that they need, even in these difficult circumstances, but the best way to protect cancer treatment and all the other treatments in the NHS is to keep the prevalence of coronavirus down.

In doing this, of course, we are taking as localised and targeted a way as possible. Our local code alert level system means that we can have different rules in places such as Cornwall, where transmission is low, and Liverpool, where transmission is high and rising. On Thursday, I updated the House about several areas of the country that we are moving into the high alert level and today I would like to inform the House at the earliest possible opportunity that Lancashire has now moved into the very high alert level. Infection rates in Lancashire are among the highest in the country and are continuing to rise rapidly, including in the over-60s as I mentioned. Both the number of cases and the number of hospital admissions are doubling almost every fortnight, and the number of covid patients in intensive care beds in Lancashire has already reached nearly half the number seen at the height of the pandemic earlier this year. So we knew we had to take rapid action to suppress the epidemic in Lancashire.

We have always said that we stand side by side with any local area that agreed to move into this third tier and offer substantial support to local authorities, including for testing, tracing, enforcement and business support. I would like to thank local leaders in Lancashire who have been working with us so constructively, and I am sure that their willingness to put politics aside in the national interest, and in the interests of the people whom we serve, will save lives and protect livelihoods at this difficult time.

Following the successful introduction of measures in Liverpool and Lancashire, talks continue this afternoon with Greater Manchester, led by my right hon. Friend the Secretary of State for Housing, Communities and Local Government. This week, further discussions are planned with South Yorkshire, West Yorkshire, Nottinghamshire, the north-east and Teesside.

Sadly, over the weekend, we have seen very directly the impact of this disease. I was shocked to learn on Saturday of the sad death from coronavirus of Bill Anderson, the brother of Liverpool Mayor Joe Anderson. My heart and, I am sure, the sympathies of the whole House go out to the Anderson family and the people of Liverpool, who have lost a brother. All our thoughts are with our colleague, the hon. Member for Bolton South East (Yasmin Qureshi), who is in hospital with pneumonia after testing positive for covid-19. We wish her a speedy recovery and send all our support to the NHS in Greater Manchester, which is caring for her and so many others.

I would also like to provide an update on testing—another vital line of defence. We are testing more people than any other country in Europe. We are now doing over 300,000 tests a day, up from 2,000 a day in February, and we have opened over 500 test sites, including new walk-in centres in Dundee on Friday, in Edinburgh on Saturday and in Newcastle this morning.

Alongside that important work, we are working hard to discover and evaluate new testing technologies that are simpler, faster and cheaper. Some of these tests can produce a result as quickly as in 15 minutes, and we will make them available to local directors of public health as part of our strategy for local action, starting with areas in the very high alert level. We are rolling them out across hospitals and care homes, to test patients and residents yet more regularly and keep people safe, and for schools and universities, so that we can keep education open safely through the winter. These tests have shown real promise, and we are both buying them now and ramping up our ability to produce them at scale here in the UK. We will stop at nothing to support this extraordinary scientific and logistical endeavour, which can give us hope on the path back to normal life.

Finally, I would like to inform the House that on Friday, we laid regulations to support the roll-out of both the flu vaccination and any covid vaccination. While, of course, no vaccine technology is certain, we must be prepared to deploy a vaccine as soon as one is safely available. The new regulations provide for a wider range of clinically qualified people to administer vaccines and for the Medicines and Healthcare Products Regulatory Agency to grant a UK licence for a vaccine before the end of the transition period, should that be necessary. We wish all our scientists well in this vital work, and we will give them all the support they need.

We are once again at a decisive moment in our fight against coronavirus. While our scientists work round the clock on the solutions that will finally bring this crisis to an end, we must all play our part, come together and work together to keep people safe, suppress the virus and save both livelihoods and lives. I commend this statement to the House.

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

May I start by sending my party’s condolences to Joe Anderson for the sad loss of his brother from this horrific virus? I also send our best wishes to my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for a speedy recovery.

As always, I thank the Secretary of State for advance sight of his statement. The virus continues to grow nationwide. The R rate is between 1.3 and 1.5. An increasing number of care homes across the country have seen outbreaks, with 214 in the last week. Admissions to critical care continue to rise nationwide—yes, at a slower rate than in the first wave, but at this stage in the first wave, critical care admissions were starting to fall because of the lockdown. They currently continue to rise.

We welcome the progress that is being made on saliva testing and LAMP—loop-mediated isothermal amplificationn —testing. It will allow us to introduce wider mass testing, which is a vital tool in taking on this virus. I pay tribute to the universities that are developing great testing innovations, such as Southampton University, and Leicester University in my constituency. What is the timescale for the advances in testing that the Secretary of State is talking about? Is the plan still for millions of tests a day? There was speculation back in September that his plan was for 10 million tests a day by February, so can he tell us what the daily testing capacity will be by the end of the year? We have seen delays in the pilots. Salford was supposed to be testing 250 people a day using saliva testing, but that has now been refocused. It is vital that testing of all frontline healthcare workers is now introduced to help the NHS get through the winter, so will the Secretary of State urgently speed up the validation of pooled polymerase chain reaction testing in the Lighthouse labs? It is not yet happening in those labs, and we really need it to be.

This virus spreads with speed, so testing must be quick, yet results are still not turned around in 24 hours. Again, when will they be turned around in 24 hours? Contacts must be traced quickly, and those who are traced must be given support to isolate, yet we have—to be frank—a badly designed system that is failing to trace sufficient contacts, costing £12 billion and paying consultants £7,000 a day. The Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, the right hon. Member for Surrey Heath (Michael Gove) justified these failings yesterday on “The Andrew Marr Show”, saying that when the virus is accelerating,

“any test and trace system of whatever kind has less utility”.

After spending £12 billion, Ministers now just shrug their shoulders and say, “Well, the virus is accelerating, so contact tracing is less useful.” It is simply not good enough. The country is facing further restrictions because test and trace failed, so again, I urge the Secretary of State to fund local public health teams to do contact tracing everywhere and follow international best practice, such as Japan’s, where they focus on investigating clusters using retrospective contact tracing. We need that backward contact tracing everywhere, not just in the places that are hotspots.

This virus exploits clustering and social interaction, and I have always accepted that socialising in closed spaces, especially with poor ventilation, is a driver of transmission. However, for interventions to be effective, the consent of local people is needed and economic support is vital, yet we are now in a situation where the Bishop of Manchester—a bishop, for goodness’ sake—describes Liverpool as “feeling cheated”, Lancashire as “feeling bullied”, and Manchester as “angrily determined”. If the Secretary of State is seeking to impose greater restrictions on Greater Manchester, surely it needs financial support so that people’s livelihoods are not put at risk, so can he tell the Chancellor to spend less time admiring himself on Instagram and instead deliver a financial package to safeguard jobs across Greater Manchester?

The Prime Minister has promoted the tier 3 restrictions because they mean that, in his words, “there is a chance” to bring the R number down, but how do these restrictions in the north arrest growth in the virus across the rest of the country? The R number across the south-east is 1.3 to 1.5; across the south-west, it is 1.3 to 1.6; and across the east of England, it is 1.3 to 1.5. Cornwall, Devon, Suffolk, Somerset and Ipswich have recorded covid rates per 100,000 in recent days that are higher than the average rates across Greater Manchester when it went into lockdown in the summer, so to get the national R number below 1, more intervention will be needed than is currently proposed. Is it not in the national interest to now follow the advice of the Scientific Advisory Group for Emergencies, and adopt a two to three-week circuit break?

Last week, when asked about a circuit break, the Prime Minister said, “I rule out nothing”. He also said that he “stands ready” to apply those measures if necessary. However, the Minister for the Cabinet Office yesterday ruled out a circuit break, so for clarity, have the Government now completely ruled out a circuit break in all circumstances? The cost of delay could be a deeper, longer, fuller lockdown. Is the Secretary of State now ruling that out?

I say to the Secretary of State that we have a window of opportunity. For much of the country, it is half term next week. If it is politically easier for him, he does not have to call it a circuit break: he can call it a firewall or a national moment of reset. Whatever he calls it, we need something, because the longer the Prime Minister dithers, the harder it becomes to take back control of this virus, protect the NHS and save lives. We urge him to act before it is too late.

[Matt Hancock]

I absolutely will address the questions that the hon. Gentleman raised. On the first set of questions about testing, I might have missed it, but I think he omitted to support and congratulate the work of everybody involved in getting more than 300,000 tests a day delivered—on track to a capacity of more than half a million tests a day by the end of this month. He rightly asked about batch testing, which is currently being trialled.

The hon. Gentleman asked us to fund local contact tracing everywhere. We have put those funds into each local authority, but of course we put the most support into the areas that need it most. The Government’s approach of targeting the support and measures on the areas where they are needed most is at the core of how we—as he put it—retain the consent of people while we go through these difficult actions.

To be truthful, the hon. Gentleman is far closer to and more supportive of the Government’s position than he feels able to express at the Dispatch Box, not least because he asked for economic support. Let me just leap to the Chancellor’s aid and defence. The Government have put in unprecedented economic support to help people through these difficult times—billions of pounds of aid and further aid forthcoming. The hon. Gentleman asked in particular for economic support when an area goes into tier 3, which is exactly what I announced in respect of Lancashire. That is of course part of the discussions that we have with local authorities when further actions are needed.

So, there absolutely will be more economic support from the Government, yes; more work with local authorities to deliver the local approach that is needed, yes; and more testing capacity, yes. These are all the things that the Government are delivering and it behoves the hon. Gentleman to acknowledge and support them, as clearly we are all trying to deliver the same thing, which is to suppress the virus and save lives.

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

I congratulate the Secretary of State for Health and Social Care on the news about LAMP—loop-mediated isothermal amplification—and lateral flow testing, which is potentially the most significant news about the fight against the virus that the House has heard for many weeks.

Given the dangers of conflicting public health messages when local leaders and national leaders say different things, is it not time to consider aligning incentives by saying that local leaders have the responsibility to bring down the R rate and giving them the powers and resources to do that if necessary, but also saying that if they fail to do that, they will be stripped of those powers to allow the Government to—to coin a phrase—take back control?

[Matt Hancock]

The approach we are taking, which is working effectively in almost every local area, is to work with local leaders. We are doing that across party lines, whether in Liverpool or Lancashire, as I mentioned, or in South Yorkshire, the north-east and Teesside, where the discussions are collaborative and consensual. That is the way we need to deliver the public health messages that are best delivered with everybody speaking with one voice and all working together to tackle the virus. That is not to mention London, where there has been a similar approach.

I would merely point out that over the past week in Greater Manchester the rate of infection among those aged over 60, which is the group most likely to end up in hospital, has risen from 171 per 100,000 to 283, so it is absolutely vital, from a public health perspective, that we act.

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

The economic impact on areas under the tightest covid restrictions is significant, particularly for the hospitality industry, where many young workers are employed. Covid will be with us for some considerable time, so we need to learn to adapt and live with it as safely as possible. As I have highlighted previously, covid is spread by airborne particles as well as droplets, so ventilation is key to reducing the risk of spread. There are ventilation systems that incorporate antimicrobial technology, which could reduce spread in indoor settings. Last week, I asked the Secretary of State whether he would speak to the Chancellor about promoting their installation by removing VAT and making them tax deductible. He did not answer, so I ask him again: does he recognise the importance of ventilation in the battle against covid? If so, will his Government use their taxation powers to help to make hospitality settings more covid-secure and avoid their being repeatedly shut down?

[Matt Hancock]

Absolutely we will support hospitality businesses and all the sectors of the economy. My right hon. Friend the Chancellor has supported the hospitality industry more than any other. In fact, the UK Government are supporting businesses right across the whole country. When the Scottish Government take action on public health grounds in a devolved way, the UK Government then come in with the economic support. That is yet another example of how much stronger we all are working together. I will take away the hon. Lady’s detailed point and talk to the Treasury. It is, of course, a question for the Treasury rather than for me as Health Secretary, but I just underline the importance of us all working together across Scotland and across the whole of the UK, and of the economic firepower of the UK Exchequer supporting people right across this land.

[Sara Britcliffe (Hyndburn) (Con)]

In Hyndburn and Haslingden—and, in fact, across Lancashire—we have some of the strongest people I have ever met. We will do everything we can to get our infection rate down, because that is what we do when times are tough: we come together. However, morale is low and mental health is suffering as people cannot see their families and some have been unable to see their loved ones in care homes since March. Will the Secretary of State outline what the Government are doing to mitigate that situation, and what steps are being taken to try to facilitate safe visits, given that there is no clear end date?

[Matt Hancock]

My hon. Friend has shown real leadership in Hyndburn in very difficult times. This has not been easy for the people of Lancashire. In Hyndburn, there have been restrictions for some time and I appreciate how hard that is, but I think everybody will look to the way my hon. Friend has tried to support people as much as possible, contacting me day and night with the cases of individual constituents, and has put herself at the service of her constituents. The people of Hyndburn are very well represented.

On the specific point that my hon. Friend makes, absolutely we must ensure, just as places have to go into level 3 restrictions when we are concerned about the ability of the NHS to cope if things get further out of hand, that so too will we reduce those restrictions as soon as we can safely. We will do that not necessarily across a whole county, but on a district-by-district level if that is what the data says should be done. That is something we are constantly looking at. For now, the single most important message to everybody in Hyndburn and across Lancashire is: let’s pull together, follow the rules and get this under control.

[Ian Mearns (Gateshead) (Lab) [V]]

I thank the Secretary of State for the meeting he had with north-east MPs on Friday. I can tell him that, if the data is accurate, the signs over the weekend are that we are moving in the right direction.

I understand that SAGE highlighted that the impact of further potential restrictions will be felt very differently by different communities. SAGE suggests the need for immediate planning to refine measures to minimise potential harms and to mitigate impacts on vulnerable groups. Given the Government’s commitment to the levelling-up agenda, what are the Government’s plans to reduce the real risk that measures taken to respond to covid will continue to increase inequality and worsening levels of poverty and deprivation? In the north-east, we are not out of the woods by any stretch of the imagination, but can I urge the people of the north-east to carry on doing the right things?

[Matt Hancock]

The hon. Gentleman speaks for everyone across the north-east. The cross-party working has been first rate and I pay tribute to all colleagues from the north-east who have been working so hard. The message to everybody in the north-east is that there are early signs that the measures are starting to work, but we are not there yet, so let us all stick with it, work together, support each other, support the NHS and absolutely we will bring in the economic support to ensure both that we help businesses as much as possible, help employers and help individuals through this crisis. After that, the levelling-up agenda is vital to unite the whole country.

[Stephen Hammond (Wimbledon) (Con)]

How correct my right hon. Friend is that the most effective actions are those that are local and targeted. Will he confirm that he will look at tier 2 reviews in the light of regulation 8 in part 4 of the Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020, so that we can target on a local basis? Given that so many cases are asymptomatic, could he say when he expects the new test to be more widely available across the community?

[Matt Hancock]

My hon Friend makes an incredibly important point, which is that the regulations are written on a borough-by-borough basis, and if we can take specific boroughs out of the regulations sooner, based on the data, then we will do so, and we have done. In fact in some cases we have taken part of a district or a borough out of the regulations when that is what the data has shown. I can give him that assurance.

On the testing, we are rolling out the tests as fast as we can. The use case is one of ensuring that more NHS staff are tested on an asymptomatic basis; there is more testing in care homes, where it is important to protect the most vulnerable; there is more support in education, to make sure we can keep education as open as effectively possible; and there is asymptomatic testing in areas where there is a big outbreak. All of that will be there to support outbreak control and get this virus under control.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

The Welsh Government have today announced a stringent two-week firebreak to try to bring the R number down. Central to the strategy, of course, must be sufficient economic support for businesses and livelihoods. Will the Secretary of State press the Chancellor to ensure that the Welsh Government have sufficient financial flexibility to pursue their chosen public health policy?

[Matt Hancock]

Yes, of course. The Welsh Government respond to the circumstances in Wales as they see fit, according to the devolution settlement. As I was saying to the hon. Member for Central Ayrshire (Dr Whitford), we are absolutely prepared, ready and engaged in supporting communities and businesses right across the UK and in supporting individuals who, through no fault of their own, fall on what can be incredibly hard times because of the impact of coronavirus.

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

The Secretary of State knows that pubs, bingo halls and gyms have gone to enormous lengths to ensure that they offer a safe environment, and many of us in Greater Manchester and elsewhere are sceptical that closing those institutions would make a significant difference to the spread of the virus, but can I ask him why the Government will not extend the additional resources for Test and Trace independently of those measures? Surely, it would be beneficial to do so.

[Matt Hancock]

Across Greater Manchester and across Trafford, we had extended further support for Test and Trace before the tier system came in. We have engaged to make sure that we get the benefits of local teams accessing and, because they have boots on the ground, finding people whom the national team simply cannot find, and that will continue. Of course, the negotiations and the discussions about the future of what extra we need to do in Greater Manchester continue. I know that my hon. Friend requires further persuasion that some of the actions that appear to be starting to work elsewhere should be put in place. I would gently point him to the fact that we did manage to level off the increase in infections in Bolton when we brought in firmer measures, but they have since then started to go up again after we removed those measures. Nevertheless he is absolutely right—absolutely right—that the best way we can tackle this is by people taking personal responsibility for reducing their social interaction to reduce the risk of spread, and I hope that we can all metaphorically link arms and get that message across.

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

Small businesses in a tier 2 area such as Newcastle may not be asked to close, but they will face severe reductions in revenue due to local restrictions affecting football, for example, in the centre of our great city. The Secretary of State talks about unprecedented support, but these are unprecedented challenges for viable jobs in our city centre. In addition to what he has already mentioned, what local economic support will he offer to businesses in Newcastle?

[Matt Hancock]

If we do need to bring in further measures in Newcastle, then there is absolutely further support that is available, and there is already the unprecedented economic support that my right hon. Friend the Chancellor has set out.

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

Most of the MPs in Essex have reluctantly felt the need to support the tier 2 measures that are now being applied, but we are very concerned about the effect of this on the hospitality sector, in particular. Is it not very important that we align the economic interests of our constituents with the public health interests instead of polarising the debate such that one is either in favour of the economy or in favour of controlling the virus? May I also emphasise that one of the reasons why public confidence in the Government’s strategy is somewhat in decline is that we have yet to see the transformation of the leadership of test and trace, which I have discussed with the Secretary of State many times?

[Matt Hancock]

Where I agree with my hon. Friend is that there is no trade-off between health and economic measures, because if the virus gets out of hand, then we will end up with a worse economic hit as well. I know he agrees with that because we have discussed it many times. He, like other Essex MPs, may not like the fact that we have to collectively put in place these measures in Essex, but it is the right course of action.

[Charlotte Nichols (Warrington North) (Lab)]

As Warrington’s neighbouring Liverpool city region and Lancashire are in tier 3, with Greater Manchester expected to follow shortly if financial support is agreed, we need confidence that if we are asked to follow suit, there is robust evidence for the required closure of hospitality businesses, leisure businesses and salons. Will the Secretary of State commit to publishing the specific UK transmission data for these sectors compared with other workplaces—or are they merely a soft target?

[Matt Hancock]

We published further data late last week on exactly the question that the hon. Lady asks. We have the backward contact tracing in place that the hon. Member for Leicester South (Jonathan Ashworth) asked for—I apologise for not answering his question on that—and we have seen the evidence from that. The critical thing, though, is for us all to recognise that in places like Warrington and the surrounding area, where the number of cases is going up—and the number of cases among the over-60s is going up, which is particularly worrying—we do need to act, and to act together if at all possible.

[James Murray (Ealing North) (Lab/Co-op) [V]]

The October 2020 “World Economic Outlook” published by the International Monetary Fund clearly states that

“the short-term economic costs of lockdowns could be compensated by stronger medium-term growth, possibly leading to positive overall effects on the economy.”

The Government clearly disagree with the IMF’s assessment, but can the Secretary of State tell me whether he or his colleagues have carried out any analysis of the economic impact of a national circuit break?

[Matt Hancock]

Of course we look at all the impacts of all the policies, but we know that the more targeted a policy can be, both in terms of the measures and the geography, then the less disruption it will have. If the hon. Gentleman’s concern is with a national circuit break, that is not the policy of the Government; the policy of the Government is to have a localised approach. He might therefore want to have a word with his own Front Benchers.

[Andrew Selous (South West Bedfordshire) (Con)]

The Secretary of State quite rightly finished his statement by saying that we must all play our part in getting the virus down. Does he think it was that shared population-wide commitment in Wuhan in China that has seemingly got life back to normal? What lessons are there from what China has done that we could usefully apply here in the UK?

[Matt Hancock]

I would be cautious about some international comparisons, because life is not exactly back to normal and there are restrictions still in place. For instance, we have seen today Sweden introducing restrictions on a regional basis, which is similar to the approach that we have here. There is a lot of debate about international comparisons, and we do look across the board, but I am not sure it is true to say that life is back to normal in in Wuhan. We need to get the science to come to our aid and help us to get life back to normal here as quickly as possible.

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

This weekend, I spoke to pub landlords, café and bar owners and staff across our towns, and they all said that business had plummeted since Wednesday, when we became a tier 2 area. They were all cutting staff hours, some were considering closing completely, and none of them was getting additional support, because the tier 2 job support scheme simply does not work for them. Does the Secretary of State not understand that in order to sustain support for additional health measures, he has to listen to the people who are most affected by them? Will he look again at support for tier 2 and tier 3 and make sure that jobs and businesses get the support they need?

[Matt Hancock]

Again, I am going to come to the defence of my right hon. Friend the Chancellor, who has put in these support packages on a scale that has never been seen before. The right hon. Lady is right to raise the concerns of those in her constituency, but the combination of all the schemes that are available to businesses is something of a scale that this country has never had.

[Dr Julian Lewis (New Forest East) (Ind)]

How many separate covid vaccines are undergoing trials at present in the United Kingdom, and what is the planned duration of the trial period for each?

[Matt Hancock]

There are three vaccine trials under way in the UK: the AstraZeneca trial, which is frequently discussed; the Imperial College trial; and a trial of the Novavax vaccine. The period of the trial is dependent on the clinical results and on the data. Of course, of those three, the AstraZeneca trial is the most advanced and is in phase 3 trials. We are closely in contact with all of them to ensure that they get the support they need.

[Munira Wilson (Twickenham) (LD)]

I was alarmed, as were many public health experts, to read reports over the weekend that test and trace data is being shared with the police. Even a source in the Secretary of State’s own Department said that that will put people off getting tested. I hope the Secretary of State agrees that that is the exact opposite of what we need. Public trust and confidence in test and trace is critical, and transparency of the use of personal data is central to that, so will he publish today the memorandum of understanding that he and his Department have signed with the National Police Chiefs’ Council?

[Matt Hancock]

It is very important that people come forward for testing. As the Chancellor of the Duchy of Lancaster said yesterday, of course, the vast majority of people not only come forward for a test, and want to come forward for a test, when they have symptoms, but want the isolation arrangements to be enforced fairly so that everybody isolates when they need to. That is the reason that we have taken the approach that we have, which I set out to the House several weeks ago.

[James Daly (Bury North) (Con)]

Since the beginning of the pandemic, there has been no recorded covid-19 outbreak in public houses in my constituency. Taking into account low national rates of transmission in pubs, when my right hon. Friend is in negotiations with colleagues from Greater Manchester, will he think very carefully before closing these covid-secure environments, which have spent thousands to ensure that they are secure, and cease introducing extra restrictions that will make trading an impossibility?

[Matt Hancock]

Nobody has stood up for the pubs and hospitality businesses in Bury more than my hon. Friend, and he makes an important argument about outbreaks. We also have to look at the backward contact tracing data, and at where measures to bring the virus under control have worked. I will happily have a further discussion with him to try to make sure that we can get the right set of measures and the right balance.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his regular attendance in the Chamber and for his responses to questions. Will he outline the procedures and criteria for the vaccination schedule, bearing in mind that news reports state that a fully tested vaccine will be available in the near future? Does he agree that frontline workers in shops need to be part of the list of priority recipients, after the medically vulnerable, NHS staff and those in the caring profession?

[Matt Hancock]

Of course, no vaccine technology is certain, but the longer we go without bad news, the better things are, because we would hear if things had not gone well, so things are therefore progressing. The Joint Committee on Vaccination and Immunisation produces a prioritisation based on clinical advice and its clinical judgment on who ought to get the vaccine in what order. This is a really important question to ensure that we roll out the vaccine fairly and on an agreed basis. I will ask the Committee to look at the hon. Gentleman’s specific request to make sure that is taken into account. The Committee’s advice is very important for the Government decision that I hope the whole country can then get behind.

[John Howell (Henley) (Con)]

I make no apology for again bringing up the question of co-trimoxazole since I believe the drug can help very much in the fight against covid. Following the successful trials in India and Bangladesh, has there been any progress here?

[Matt Hancock]

My hon. Friend is right to raise that question, and I will write to him with a full update once I have taken advice from my clinical advisers and from Professor Jonathan Van-Tam, who leads on this area.

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

At the weekend, Mrs Helen Perry, one of my constituents, contacted me to say her son and three of his flatmates at Northumbria university had tested positive for covid. They are all self-isolating, but despite that are being bombarded up to 10 times a day by NHS Test and Trace. It is the same story for Mr Brian Sayer and his family, who are self-isolating because a family member has tested positive. In Brian’s words, “We’re not stupid people; we don’t need pointless telephone calls every other day”, and Mrs Perry says, “What a waste of time and money.” When will the Secretary of State admit that the national system has failed, and when will he hand over testing and, more importantly, tracing to local directors of public health, who know their areas and their communities and know how to do test and trace properly?

[Matt Hancock]

The hon. Gentleman is completely wrong on two fronts. This has been a very consensual statement so far, and the hon. Gentleman—

[Mr Jones]

Right honourable.

[Matt Hancock]

The right hon. Gentleman has played a constructive part in getting the public health messages across in Northumberland, but he is wrong on two fronts. First, when NHS Test and Trace contacts people to remind them to self-isolate, that is based on the analysis we have done of what helps to ensure that people stay self-isolating.

[Mr Jones]

Ten times in one flat?

[Matt Hancock]

Yes, repeatedly, absolutely; I make no bones about it.

[Mr Jones]

Ten times?

[Matt Hancock]

Yes, because the isolation of people and their staying isolated is important. The right hon. Gentleman can complain that we are doing too much, but that is not normally the complaint I get from the Opposition.

The second point is that that must be, in the right hon. Gentleman’s words, handed over to local authorities. No, no, no; there has got to be teamwork with local authorities. It is teamwork that will help us get through this, not this attempt to separate people and say, “One side’s good, one side’s bad.” We are all on the same side in this fight against the virus.

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

Further to this consensual statement, we are all keen to be guided by the science, so what scientific behavioural assessment has been made of the effects of closing covid-secure venues on the likelihood of people meeting in one another’s homes instead, thus spreading the illness further? If my right hon. Friend has not got the information immediately to hand, perhaps he would care to write to me, as is the fashion.

[Matt Hancock]

I can answer the question. My hon. Friend makes an important point. The indirect evidence is that the number of hospital admissions due to people being over-inebriated has reduced since we brought those measures in, which is one indication that people are generally following the rules and, as I did, going home at 10 o’clock to make sure. The vast majority of people are following the rules.

[Tonia Antoniazzi (Gower) (Lab)]

As the chair of the all-party parliamentary group on cancer, I thank the Secretary of State for a recent meeting regarding the Catch Up With Cancer campaign. I, too, pay tribute to those delivering frontline cancer services throughout the pandemic, but the 63% figure that he mentioned does not reflect the totality of the backlog, as the NHS has announced new figures since then. In August, the number of people waiting more than 52 weeks in England continued to surge to more than 110,000—the most in 12 years. The only way that the backlog will go away is through action and resources being deployed to tackle it. What progress has he made to address the need for a boost to cancer services, so that cancer does not become the forgotten “c”?

[Matt Hancock]

The hon. Lady is absolutely right to raise that issue. In my statement, I said that we have managed to reduce the backlog among the longest waiters, those who wait more than 104 days, by more than 63% and among those waiting more than 62 days by 44%. There is further work to do—of course there is—but the NHS has made significant strides on the backlog of people waiting for cancer treatment, and I pay tribute to all the work that it has done.

[Greg Clark (Tunbridge Wells) (Con)]

The concern that many of us have is that restrictions can be imposed in a day, but take months to lift. In London, the restrictions were imposed not because of a higher level of infections, admissions to hospital or deaths, but because of a rapidly increasing rate of infection. If it turns out, when the Secretary of State conducts his fortnightly review next week, that the rate of increase of infection is no greater in London than in places in a lower tier, will he rescind those restrictions and return it to a lower tier?

[Matt Hancock]

My right hon. Friend makes an important point and, in a way, highlights that it is not just the case rate that matters; it is also the rate of change of the case rate, the over-60s case rate and the impact on hospitals. In the case of London, cases are over 100 per 100,000, which is a worrying level, but I really hope that the measures, and the people of London and all those who work here, can bring the case rate down so we can get out of it as fast as possible. Team London is, in fact, working on a proposed strategy for coming out of level 2, but the first thing that everybody in London has to do is follow the rules to get the rate of increase down, because it is only then that we can even start to consider the next steps.

[Liz Twist (Blaydon) (Lab)]

Earlier this year, at the start of the pandemic, the Government committed to give the NHS whatever resources it needed to deal with coronavirus. The NHS has that money for dealing with covid-19, but it will need more to enable it to catch up on all the conditions that need to be treated now that treatment is taking place. Will the Secretary of State commit to provide the funding and resources needed to carry out those vital treatments?

[Matt Hancock]

We have put in the extra resource that the hon. Lady mentions, which is important. Not only has the extra resource gone in, but we are hiring people to do the work and building the buildings in which it can be done. She raises an important point about the need to recover the backlog. I am really glad that in areas such as cancer and many others, the backlog is being worked through, but there is still more work to do.

[Chris Grayling (Epsom and Ewell) (Con)]

I support my right hon. Friend’s targeted approach. It is absolutely wrong, in my view, to close businesses and lock people in their homes in a broad-brush way in areas where the risks are much lower than elsewhere. He is following the right strategy.

I echo the comments of my right hon. Friend the Member for Tunbridge Wells (Greg Clark) about London. Many of my constituents have businesses across the border in south-west London, where it is not the case that the rate is over 100 per 100,000. There are large swathes of south-west London where it is well below that. Can the Secretary of State make sure that it is possible, as quickly as possible, to disaggregate those areas of London where the problems are less and to move back to a situation where those businesses can operate normally?

[Matt Hancock]

As my hon. Friend the Member for Wimbledon (Stephen Hammond), who is no longer in his place, said at the start of this session, it is important to take a borough-by-borough approach, and I commit to doing that. Unfortunately, there are parts of south-west London, such as Richmond, that have an elevated case rate above 100. In London, this work has been done effectively and across party lines, working with the leaders of local councils and boroughs, as well as with the Mayor, but I will absolutely take into account the point that my right hon. Friend makes.

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

A number of families in my constituency are worried about the impact that isolation is having on their family members with dementia who are living in care homes with no visits allowed. In one case, a constituent’s mother phones her daily and threatens to take her own life because of the lack of contact with her family. The Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately), told the Select Committee on Health and Social Care last week that there would be a pilot for visiting in care homes, but that could be months away. The Secretary of State has talked today about visits when restrictions are reduced, but this situation is desperate for some families, so can he tell us when we can have regular meaningful visiting for every care home resident?

[Matt Hancock]

The hon. Lady raises a point that is heart-rending and important, as is the protection of care home residents from this disease. The situation is not quite as she said, in that we have different restrictions in different areas according to local circumstances, with a great deal of delegated authority to the local director of public health to make judgments on the extraordinarily difficult balance between allowing visitors—for exactly the sorts of reasons she set out—and protecting people who live in care homes from catching the disease. When the case rate is high in the community, that naturally increases the risk in care homes, not just because of visitors but because the staff working in care homes live in the community. I am sure she will agree that the best thing we can do is to keep the prevalence of coronavirus down, because that will help to protect the people in care homes as well.

[Mark Pawsey (Rugby) (Con)]

This time last week, I think the whole House welcomed the introduction by the Prime Minister of the three covid alert levels to provide some certainty about the levels at which measures would be introduced and what measures would apply in a given area. Rugby is currently on a downward trajectory, with fewer than 100 cases per 100,000, so can my right hon. Friend reassure my constituents that by sticking to the rules, we will remain in tier 1?

[Matt Hancock]

Yes. One of the advantages of the tier system is that it not only involves a clear set of actions that need to be taken if the cases go up, as happened in London last week, but also helps to motivate people in level 1 areas that in order to stay in level 1, the best thing to do is to follow the rules, to respect social distancing and to play their part in the reduction of the spread of the virus. Everybody who is living in a level 1 area can help to do their bit to stay in level 1 by following the rules on hands, face and space and following social distancing. My hon. Friend is absolutely right to point that out for Rugby, but the point applies right across the whole of England in areas covered by level 1.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP) [V]]

Given that the national minimum wage already falls far below the real living wage, does the Minister think that people will be able to survive this winter with their workplaces closed and receiving only two thirds of that amount? Will the Government not give consideration to the calls from the Scottish Government and English regional leaders to do the right thing and offer more assistance?

[Matt Hancock]

I am really proud to have been part of the Government who introduced the national living wage to increase the level of support for the lowest paid across the whole United Kingdom. That is one example of the UK Government working to improve the support and pay available for the lowest-paid people in Scotland and across the whole of the rest of the United Kingdom, alongside the unprecedented economic support that my right hon. Friend the Chancellor has put in during this crisis.

[Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)]

I wholly applaud my right hon. Friend’s approach of localised lockdowns, but does he agree that in an area such as Gloucestershire, where, mercifully, the number of cases is still relatively low, the tracking and tracing and advice on self-isolating could be improved by involving both national and local resources?

[Matt Hancock]

Yes.

[Derek Twigg (Halton) (Lab)]

The Secretary of State said at the Dispatch Box last Tuesday, in support of the new three-tier system, that

“we are now acting to simplify and standardise the rules at a local level.”—[Official Report, 13 October 2020; Vol. 682, c. 198.]

At that point, Liverpool was put into tier 3, and the gyms were closed in Merseyside and Halton, but when Lancashire went into tier 3 on Friday, gyms there were allowed to remain open. What is the reason for that difference? He should straight away authorise the reopening of gyms in Merseyside and Halton. There is no evidence to support keeping them closed.

[Matt Hancock]

That decision was taken in consultation and agreement with the local area. Part of the work with local areas on this has been to agree the exact details of the package in level 3.

[Dame Cheryl Gillan (Chesham and Amersham) (Con) [V]]

At the moment, the only defence against the virus is modifying people’s behaviour. Cases of covid are rising in Buckinghamshire, and we want to stay in tier 1. Our NHS trust and council have taken the initiative and filmed a strong local public health message, which is now on YouTube and social media and is recorded by Dr Tina Kenny, our medical director, asking local people to follow the rules to reduce the spread of this highly contagious virus. Will the Secretary of State commend this communication from our local health trust and council and encourage other health authorities and clinicians—who people trust and have confidence in—to engage directly with their populations to send these vital messages out?

[Matt Hancock]

Yes. I applaud the work that has been done across Bucks to deliver public health messages and try to get the whole community to support the action that we all can play our part in and that my right hon. Friend rightly raises.

[Bill Esterson (Sefton Central) (Lab) [V]]

The Health Secretary really should admit that Serco has failed. If it was shared fairly across the country, the £12 billion for Serco would mean £300 million for the Liverpool city region alone. When will he give that level of funding to local public health teams, and when will he instruct Dido Harding to give local teams the data that is currently held by Serco, so that they can do the job that Serco has failed to do?

[Matt Hancock]

Given that we hit 300,000 tests a day for the first time over the weekend, I would have thought that the hon. Gentleman might have looked at the data and the improvement that is happening. [Interruption.] Opposition Members say, “not testing”. They used to complain about testing, and now that is going well. Contact tracing is getting better, and last week—[Interruption.] Last week, contact tracers in this country contacted more than double the number of people than the week before. Instead of having a go at all the people who are helping to solve this massive problem, the Opposition should get in support of them.

[Robbie Moore (Keighley) (Con)]

It has been demonstrated that far-ultraviolet C light emitted by krypton-chlorine lamps inactivates covid-19 on surfaces, as well as when coronavirus is airborne. Some fantastic research is being undertaken to look at that, notably by St Andrews University in Fife and Ninewells Hospital in Dundee, but also by a business in my constituency. Could my right hon. Friend outline how this potentially game-changing mechanism for inactivating the virus has been explored at Government level?

[Matt Hancock]

I have seen that research, and I would be happy to meet my hon. Friend to discuss how it might be applied.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC) [V]]

Diolch, Madam Dirprwy Lefarydd. Wales is to go into lockdown on Friday. Scotland, Northern Ireland and regions of north England are already in similar measures. The firebreak restrictions in Wales are tailormade for the health needs of Wales, but the Treasury’s support schemes are based on political considerations and what best serves the south of England. Will the Secretary of State commit to bringing forward the job support scheme by eight days—only eight days—and increasing the level of support to that of the first furlough scheme, so that more people in Wales can afford to stay safe?

[Matt Hancock]

Of course, the furlough scheme continues until the end of the month and the job support scheme replaces it. That is the reason for the timing. It is the premise of the right hon. Lady’s question that the job support scheme, like the furlough scheme, supports every single part of these united isles. It supports the whole UK, including Wales. It is the UK Government coming to the aid of every single person in difficult times. That is the approach we should be taking—supporting everyone, wherever they live in this great country.

[Mr Peter Bone (Wellingborough) (Con) [V]]

I thank the Secretary of State for yet again coming to the House to update us on the situation. I should think the whole House would like to congratulate him on being on target for 500,000 tests a day—that is quite remarkable. Some scientists say that 1% of those tests are false positives. In other words, 5,000 people a day who are reported to have covid-19—up to a quarter of them—might not have the disease. Does the Secretary of State have any suggestions for how that might be improved?

[Matt Hancock]

My hon. Friend asks an important question. The false positivity rate for the current technology—the PCR test—is much lower than that. The analysis of the false positivity rate published by the Office for National Statistics says that the impact of that rate is small. One of the exciting things about the new generation of technologies is that the false positivity rate is yet lower, further reducing the problem my hon. Friend sets out.

[Julie Elliott (Sunderland Central) (Lab)]

The Secretary of State has had a good relationship with local authorities in the north-east and Sunderland, which I represent, but once again the request for funding for Test and Trace and for financial support has not been answered. He gave me a commitment last week that he would get an answer, as did the Prime Minister, and it still has not happened. In the meantime, people are nervous and businesses are on the brink of going under in the north-east. It is a very worrying time. Will the Secretary of State please talk to local authorities in tier 2 about the support that is needed on the ground to help communities and businesses survive this terrible crisis?

[Matt Hancock]

My right hon. Friend the Secretary of State for Housing, Communities and Local Government is having exactly the discussions that are needed to respond to the circumstances in, for instance, the north-east. The hon. Lady will understand that it is for him, rather than me, to discuss council finances with the councils. We are putting in extra support for Test and Trace, and linking up the data systems within the north-east. I will again leap to the aid of my right hon. Friend the Chancellor about the extent of the support he has put into areas that are particularly affected by the virus, including those with level 2 and 3 restrictions, and areas right across the country.

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

Last week, the borough of Barrow in my constituency went into the high tier. I thank my right hon. Friend and his team for the work they have done to engage with local leaders. South Lakeland in my constituency remains in the medium tier. Constituents and businesses in towns such as Ulverston are concerned that people are travelling from one tier to the other and not sticking to the guidance and the rules. What advice would my right hon. Friend give on the importance of sticking to those rules in order to turn the tide on the virus for all of us?

[Matt Hancock]

My hon. Friend makes an incredibly important point: everybody needs to follow the rules to give Barrow the best chance of coming out of level 2 restrictions. If people live in a level 2 area, those rules apply to them even if they travel to a level 1 area. If people live in a level 1 area and travel to a level 2 area, when they are there the level 2 restrictions apply. I hope that is very simple for everybody to follow. He has provided great leadership in Barrow in describing so clearly why it is important for everybody to follow the rules. If we do, we can get this virus under control and get Barrow back into level 1, where I am sure everybody who lives there will want to see it.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I have heard the Secretary of State say that he welcomes the Chancellor’s support, and he refers Members to that, but does he understand the impact on the ground, especially on small businesses? A constituent of mine in Clapham is a supplier to the hospitality sector and more than 50% of his business is with pubs, restaurants and hotels. He says that if there is a further downturn in this tier 2, he will not be able to stay afloat. The Government must listen to these small businesses and understand the real-world impact the situation is having. So will he ask the Chancellor what additional provisions the Government are going to put in place right now to help the hospitality sector?

[Matt Hancock]

Of course I will speak to my right hon. Friend the Chancellor about that. I come from a small business background, so I fully understand the challenges people face, including the cash flow ones. Nobody wants to have these restrictions in place for a moment longer than is necessary. If she has the concern that she understandably raises, perhaps she can help to explain why this localised approach of having only the restrictions needed for that area in place is the right one.

[Antony Higginbotham (Burnley) (Con)]

Burnley has had additional restrictions in place for longer than most areas and is now in tier 3, the very high level. Although that is really difficult for residents and businesses, everyone wants to do the right thing, in order to bring the infection rate down. To do that, we need a sense of optimism and light at the end of the tunnel, so will the Secretary of State outline what the exit strategy is from tier 3 into tier 2 and then into tier 1? Will he also offer some reassurance that once the rate is down we have a way of containing it so that we do not move back up?

[Matt Hancock]

Yes. My hon. Friend has spoken for Burnley with such passion throughout this crisis. It has been very difficult for Burnley, which has now seen the highest case rate among the over-60s in the whole country. It is so important, to protect people in Burnley, that everybody follows the rules there. First, we have to get the case rate and the cases among the over-60s falling. Once that starts to happen we can talk about when we can start to relax the restrictions—I do not want to have them in place for a moment longer than is necessary. With the expansion of testing that we are seeing, I hope we will be able to have more tools at our disposal to hold the virus down once we have got it down again.

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

Rebuilding confidence in Test and Trace is critical, yet the Secretary of State has taken the potentially counterproductive step of arranging for data to be shared with the police for enforcement. That could deter people from getting a test in the first place, as the chief medical officer has reportedly indicated. So will the Secretary of State acknowledge that a more effective strategy would be to ensure that people have the financial security they need in order to be able to follow the rules in the first place? Following on from the question from the hon. Member for Twickenham (Munira Wilson), will he answer on whether this memorandum of understanding exists? If it does, will he publish it? If he will not do so, will he explain what he is hiding?

[Matt Hancock]

There is no health data that is transferred, but of course once this House has voted for an enforceable rule, it is important for all of our constituents and communities that we enforce it. So that is a necessary consequence of the House having voted for the self-isolation rules to be made mandatory, which I think was the right decision. On the financial support that the hon. Lady asks for, we have put in place £500 per self-isolation to support people on low incomes to make sure that they are able to do the right thing.

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

To prevent further restrictions being placed on York, we have to lock down this virus, not lock down people and the economy. We know that the key to this is local contact tracing, and the reality is that the shadow contact tracing undertaken by my local authority has been more accurate, more effective and more responsive. That is the key to getting on top of this virus, so when will the Secretary of State release all the data to local authorities and give them the resources they need so that they can do the job properly and get on top of the virus?

[Matt Hancock]

We are absolutely putting more resources into contact tracing in York. It is only because of the combined effort of the national and local team that we are able to do the work that she describes, because the national system can deal with the cases who are easy to get in contact with, or who prefer to do contact tracing over the internet, rather than on the phone, which is a lot of people. That means that the local authority, as in the case that the hon. Member describes, can do its work locally, so it is about having a team effort.

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

People will have seen images of packed rugby stadiums in New Zealand last week after the country announced that it had effectively ended domestic transmission of coronavirus. It followed a zero-covid strategy and has had a tiny number of cases over the recent period. As we face another wave of unnecessary deaths here, life is returning to normal there, so is the Secretary of State embarrassed that other countries have managed to drive down cases while his Government are failing?

[Matt Hancock]

We are doing everything we possibly can to suppress this virus. There have been some countries, and there have been some parts of this country, that have explicitly followed an eradication strategy. Unfortunately, there is not anywhere where that has worked permanently, and we have seen flare-ups in all parts of the world that have pursued an eradication strategy. The critical thing here is to suppress the virus, to get it under control, to keep it under control and for everybody to play their part.

[Mary Robinson (Cheadle) (Con)]

A further week has passed without agreement with Greater Manchester. However, Stockport Council has set up a pandemic response team working in the community, promoting covid-safe behaviour at pubs, bars, businesses, hairdressers and so on. Last week, it visited hundreds of businesses and found very good covid compliance. As the Secretary of State works to reach an agreement in Greater Manchester—I wish him the best of luck with that and hope it goes well—will he also consider a borough-by-borough approach and take into account the work done by local authorities with the leisure industry to try to get transmission rates down?

[Matt Hancock]

I know that many of the local authorities in Greater Manchester—in fact, all of them—have taken very seriously their statutory responsibilities to get the virus down, and I pay tribute to my hon. Friend, who has been assiduous in her work to support her local community to do the right thing. I just hope now that we can come to an agreement with the GM leadership in the same way that we have come to an agreement with the Liverpool leadership and the Lancashire leadership. We are working with the West Yorkshire leadership, across the different boroughs there, with the South Yorkshire leadership, with the leadership in the north-east and with the leadership in Teesside in a highly constructive way, and I hope that we can do the same with Greater Manchester.

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

My right hon. Friend has heard across the Chamber the real challenges that the hospitality industry is facing, especially in tier 2. Further to the comment from my hon. Friend the Member for Keighley (Robbie Moore) about emerging technology in air sanitisation, especially using UV, will the Secretary of State go further than in the promise to my hon. Friend and get a roundtable together as quickly as possible, so that we can work together and bring this technology forward—I have constituents who are ready to bring it forward—so that we may be able to get it into the hospitality sector more quickly and hopefully give the sector some relief?

[Matt Hancock]

Nobody has done more to support the pubs of Leeds than my right hon. Friend, and he is doing it again today, so let us turn the meeting into a roundtable. I will make sure that that happens in the next fortnight, and we will do all the work to bring this new technology to bear.

[Alison McGovern (Wirral South) (Lab)]

Can I return the Secretary of State to care homes? He knows the utter dilemma that the care homes, their staff, their residents and all of their families face between allowing the infection into the home and causing such damage to the welfare of residents by not allowing visitors. He said earlier, in response to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), that he was empowering directors of public health, which in some ways is welcome, but it needs a much more thought through plan than that and the Department of Health should be offering much more policy support. The Opposition have worked hard on a plan for care homes, so will he say what his Department is proactively doing?

[Matt Hancock]

The hon. Lady puts the sensitivity of this dilemma very appropriately. We have published a winter plan for care homes, which sets out our approach in this area and we are working on the implementation of that plan. I would be very happy for the Minister for Care, who leads on this, to meet her to discuss how we can make sure that that is best done most effectively in her area.

[Jason McCartney (Colne Valley) (Con)]

Having been out in my Colne Valley constituency this weekend, it is clear that local people want the tier system to work, but that does mean that we need more financial support for tiers three and two, especially for hospitality, where custom is really down. Will the Secretary of State also lay out a clear framework for timescales and for how areas move within tiers so that businesses and communities in West Yorkshire can plan ahead?

[Matt Hancock]

I would love to be able to give timeframes, but, unfortunately, one thing about this disease is that it moves fast and sometimes we have to move fast, too, so it is better to say that I will always keep that under review. The critical thing is that, once this House has voted for an area to go into tier three, there will be an automatic review of that legislation after 28 days, and it will need to be proposed again—it is sunsetted after 28 days—which means that people can have confidence that it will be reviewed, but, of course, if we can review it quicker than that, then absolutely we will. I take my hon. Friend’s point on the financial support, and, again, I will discuss it with the Chancellor.

[Mr Ben Bradshaw (Exeter) (Lab)]

Why are the Government still forcing people arriving in this country from countries with far lower covid rates than us into a compulsory 14-day quarantine when it is absolutely crucifying the travel industry? Those people are far more likely to be infected here than they are in the countries they are arriving from.

[Matt Hancock]

We keep the countries on the quarantine list under review—absolutely we do—and that is a weekly exercise that is led by my right hon. Friend the Transport Secretary.

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

There is now compelling evidence to suggest that vitamin D may be useful in reducing mortality and morbidity from this disease. It is safe, it is cheap, and it is already recommended by the Secretary of State’s Department for certain groups. Given our need to tackle this disease, and given that vitamin D requires three months to build up sufficiently to protect against respiratory infections, what advice will he give urgently on the use of this particular intervention?

[Matt Hancock]

We are increasing the communications to people about the benefits of vitamin D, and as I said to the House on Thursday last week, we are also instituting further research into the points that he, as an experienced and qualified medical professional, sets out so clearly.

[Ms Angela Eagle (Wallasey) (Lab)]

I am sure the Secretary of State will agree with me that to be effective, rules must be understandable and simple. Why in Merseyside, which is currently in tier 3, were all the gyms forced to close, but soft play was left open, and in Lancashire all the gyms were left open and soft play was closed? Surely that does not make any sense at all. Will he publish the evidence that he has and be consistent across tiers? Either all the gyms are open or they should all close. Which is it to be?

[Matt Hancock]

The baseline for tier 3 is set across the board, and then further measures are set out in consultation and agreement with the local area.

[Damien Moore (Southport) (Con)]

Following on from that question, the gyms in Lancashire are open, but the gyms in Merseyside are closed. The deal that was struck for us was not a good deal for my constituents in Southport. Will the Secretary of State review these restrictions as soon as possible and get our gyms open? They are part of the solution, not part of the problem.

[Matt Hancock]

Nobody has stood up for the gyms of this country more than my hon. Friend, and he has made this argument endlessly to me. He stands up for Southport, and I will take that point away. As I said to the hon. Member for Wallasey (Ms Eagle), those decisions were taken in agreement with the local area, and we want—as much as possible—to make agreements with local areas so that we can all give out the same public health messages that if everybody follows the rules, we are more likely to get this under control and get the Liverpool city region out of tier 3 altogether.

[Maria Eagle (Garston and Halewood) (Lab)]

I thank the Secretary of State for his kind words about Bill Anderson, the brother of the Mayor of Liverpool, who sadly died of covid. He was my constituent and was a doughty campaigner for the livelihoods and welfare of seafarers, and he will be very sadly missed by many of us.

In Liverpool, the Government’s Test and Trace system is reaching only 59% of contacts and in Knowsley, 57%—both well below the 80% target. The percentage of contacts reached has fallen over the last month by 3.5% in Liverpool and 9% in Knowsley, just as both areas have been placed in the very high tier 3 restrictions. Why are those figures so low, why are they declining and what will the Secretary of State do to improve that performance, because we really need it to be better?

--- Later in debate ---

[Matt Hancock]

The proportion of contacts that are reached that are in what are called complex settings in the system—for instance, in care homes it is relatively easy to find all the contacts by the nature of the setting—has itself fallen, as the number of cases has risen. If we look at the effectiveness of the system as a whole, both national and local, at reaching people in the community, we see that it has been broadly flat, as has the proportion reached in those complex settings where it is much easier and often the proportion is close to 100%. The challenge has been that as the number of contacts in the community has risen, so the overall proportion of those who are harder by their nature for the contact tracing system to reach has gone up. That is the direct explanation for the figures that the hon. Lady describes. The best solution to that problem is the combination of the national and local systems working together, and we are putting in place closer connection and extra financial support, both in Liverpool and Knowsley, as she sets out.

[Ms Nusrat Ghani (Wealden) (Con)]

I commend my right hon. Friend for overseeing 300,000 tests a day across the country. Will the Minister thank care workers who do such tremendous work in care homes in Wealden? He will know our concerns about winter flu coming to care homes as well. I had a long meeting with care home providers across the constituency and they are incredibly pleased with the access to testing, but one care home in Uckfield complained that 25% of tests were not picked up by a courier—I know that my right hon. Friend will want to nip that in the bud immediately.

[Matt Hancock]

Throughout this, and even with the challenges with demand for testing that we saw last month, we kept the tests going to care homes because people who live in care homes are the most vulnerable. No matter what we do to protect care homes from coronavirus, the higher the number of cases in the community, with staff living in the community and, of course, people visiting where visits are allowed, there is more likelihood of a case getting into a care home. It is a sad fact of life. We do everything we possibly can to prevent that, as do the brilliant care staff who work in her constituency, to whom I pay tribute. On the particular point about a courier being late for a pick-up, I will look into that immediately and see if we can resolve that.

[Mick Whitley (Birkenhead) (Lab)]

On the Wirral, over a third of the people who have been in contact with someone with covid-19 have not been contacted by Test and Trace. Will the Secretary of State concede that outsourcing of Test and Trace is simply not working, and its responsibilities should now be given to the local public health teams?

[Matt Hancock]

No, I think it should be a team effort.

[Scott Benton (Blackpool South) (Con)]

Although many of my constituents recognise that the decision to place Lancashire in tier 3 was indeed justified on public health grounds, it will nevertheless leave many of them, and those who own businesses, significantly worse off. There has to be a clear pathway out of tier 3 for those local authorities currently under such restrictions, so will my right hon. Friend clarify the basis on which the continuation of the restrictions will be reviewed and how often it will take place?

--- Later in debate ---

[Matt Hancock]

We will formally review the restrictions that are in place in Blackpool, alongside the rest of Lancashire, every 28 days, but that is a maximum, because if we manage to get the cases coming down before then, we will take areas out of level 3 restrictions. The goal for everybody in Blackpool should be to do their bit, play their part and follow the rules. Let us try to get the number of cases down so that we can restore some of our freedoms and, of course, support the businesses across Blackpool that are understandably struggling.

[Christian Matheson (City of Chester) (Lab) [V]]

I echo the words of my hon. Friend the Member for Garston and Halewood (Maria Eagle) and thank the Secretary of State for his tribute to my dear friend Bill Anderson, who will be a great loss to my whole region and to the maritime community.

The specific geography of Chester means that many of our businesses, which were viable until only a couple of weeks ago, are now being damaged on one side by the restrictions and the lockdown on the other side of the river—the Welsh border—which runs through Chester, and on the other side by the imposition of tier 3 in Merseyside. Chester is being crushed from both sides, but both Wales and Merseyside are being heavily supported financially, whereas that support is not available to businesses in the middle in Chester. Will the Secretary of State consider that effect and provide financial support so that we do not get crushed between two lockdowns?

[Matt Hancock]

Of course I understand the point that the hon. Gentleman makes. I know Chester well, and it has more pubs per head of population than any other city in the country, so the hospitality industry there is incredibly important. We are giving as much support as we possibly can, but we always keep these things under review. I look forward to working with the hon. Gentleman to support the people of Chester.

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

I thank my right hon. Friend for his work. Will he give an update on the availability of the Roche reagent that Scunthorpe has seen a shortage of? Can he reassure me that those who need an urgent blood test can get one and that the lack of reagent will not affect covid tests?

[Matt Hancock]

Yes, I hope I can reassure my hon Friend on both points. First, we have largely resolved the problem of the supply of Roche kit for non-covid tests—mostly blood tests. There has been a huge amount of work on that and I thank my team and the Roche team for solving the problem with the warehouse in Kent. Secondly, I absolutely reassure my hon. Friend that the situation does not affect covid tests: although Roche supplies around 5,000 covid tests a day, they were protected throughout.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

At the beginning of last week, my constituents in Lancashire were already bound by local restrictions. Last week, the Secretary of State made it clear that Lancashire was being put into tier 2 restrictions, which was a relaxing of the restrictions that my constituents had been under at the beginning of the week; by Friday, my constituents were told that we were going into tier 3. This hokey-cokey of restrictions has left my constituents, who want to play by the rules, really confused as to what the rules are, even though they want to abide by them. I level with the Secretary of State: the communications that come from his Department need to be clearer.

I wish to ask the Secretary of State about support for businesses. Viable businesses in Lancashire are now knocking on the doors of our district councils to ask for financial support, but those district councils have not been told under what criteria they will be able to distribute that support and have not had the cash released from Government. When will the Secretary of State get a grip on this situation?

[Matt Hancock]

Again, I will defend the honour of my right hon. Friend the Chancellor, who has put in huge amounts of economic support. On the first point, one of the reasons to go to the tier system and one of the reasons I think it was, at the time, widely welcomed across the House, was to have a system where people can much more straightforwardly understand the rules. I say to everybody living across Lancashire that the very high alert level in Lancashire is because we urgently need to get the case rate down. The thing everybody should do is follow the rules and restrictions that are in place. They are there for good reason and they are agreed across Lancashire. What we can all best do together is work together to get those rates down.

[Katherine Fletcher (South Ribble) (Con)]

I thank my right hon. Friend for his statement and for recent private meetings. The good people of Lancashire and South Ribble get that this is all about saving lives—full stop. However, they are weary of restrictions that have been going on for weeks and they are worried about their jobs. Can he assure me and them that we will be in the tier 3 restrictions for only as long as it takes to save lives?

[Matt Hancock]

The tier 3 restrictions are put in place when the local NHS is at risk of being overwhelmed. We will not keep people in restrictions for one moment longer than we need to. Nobody wants to have the restrictions in place. They are there for a reason and that reason is clearly set out, which, as my hon. Friend said, is to save lives with the minimum negative impact while protecting the economy and education, and supporting the NHS as much as possible. That is the strategy and I think it has very widespread support both in this House and among the public. The measures we put in place to deliver that have been put in place with the deepest reluctance. The single best thing that you, Madam Deputy Speaker, my hon. Friend or anybody in this country can do is abide by the rules and be cautious about social interaction—hands, face, space. That way, we can all help to restrict the spread of the virus and get it under control while we support our scientists to come forward with the innovations that will eventually get us out of all this.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. There will be a suspension of some minutes to allow safe exit and entry.