Covid-19 Update

Debbie Abrahams Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

My right hon. Friend is right to praise the incredible efforts in Bournemouth, which I know he has played a very direct and personal part in delivering, and I look forward very much to visiting as soon as I can get down there—and, by the way, I agree with Sir John Bell that Bournemouth is a great place to go on holiday and I am sure my right hon. Friend agrees about that too.

On global support, of course as and when we have excess doses we will look to support countries around the world with those doses, but the number of doses that we can support around the world from our excess purchases is small compared with the spectacular support we have already given the whole world with the more than 400 million doses of Oxford-AstraZeneca vaccine that have been delivered at cost. The majority of Oxford-AstraZeneca doses have been injected in low and middle-income countries, and 98% of all COVAX jabs given so far have been that vaccine delivered on the back of British science, supported by the UK Government, Oxford university and AstraZeneca, doing this all without taking a profit. We should be very proud of that.

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

The wider the gap between the rich and poor, the bigger the difference in our life expectancy and healthy life expectancy. That has been laid bare over the last year: the UK’s high and unequal covid death toll has been driven by the rampant poverty and inequality that successive Conservative Governments have allowed to go unchecked. In January, the Prime Minister promised to implement Professor Sir Michael Marmot’s recommendations to address that and to build back fairer, so what discussions has the Health Secretary had with the Prime Minister on that, and will investigating the UK’s structural poverty and inequality be part of a covid inquiry?

[Matt Hancock]

I discussed this issue with the Prime Minister. The office for health promotion is intended to be able to tackle some of those issues, led clinically by the chief medical officer, to make sure we can strengthen the public health case around Government, because so many policies of Departments outwith the Health Department are critical in addressing the question the hon. Lady raises.

Covid-19 Update

Debbie Abrahams Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

It is incredibly important that all care workers take up the jab if they possibly can, unless they have a vital medical reason not to, because the jab of course not only protects us, but protects people we are close to, and care workers are close to people who are vulnerable—that is in the nature of the job. That is why I think it is right to consider saying that people can be deployed in a care home only if they have had the jab, and we are looking into that. We have not said that for those who work in domiciliary care—caring for people in their own homes, rather than in a care home—because those in care homes are at the highest risk of all, but I would absolutely urge anybody who is a carer, whether they work in social care or are an unpaid carer, who has not already got the jab to please do get it, to protect not just them, but those to whom they have a duty of care.

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

As the UK rolls back lockdown restrictions, the global death toll has reached 3 million, and the World Health Organisation is warning that the world is approaching the highest rate of infection so far. With three new variants in three continents, all these variants now in the UK and the reduced efficacy of the different covid vaccinations against these variants, it is clear that the UK’s success in fully emerging from this pandemic is co-dependent on how well the rest of the world is doing. I asked the Health Secretary about global co-ordination of surveillance of new variants back in February, and the World Health Organisation is now consulting on this, so can he update the House on our response to this consultation?

[Matt Hancock]

This is an incredibly important subject. I agree with the substance of what the hon. Lady asked in the question, and she is quite right to raise this. We have put in place the new variant assessment platform, allowing any country around the world to use our enormous genomic sequencing capability if they want to sequence positive cases to discover what is happening in their countries, but our borders testing system, in which all positives are sequenced, also means that we in fact get a survey from around the world through those who have travelled to the UK, and we can relay that data back to individual countries so that they understand that better. Of course, it would be far better if something like the new variant assessment platform was run on a multilateral basis globally—for instance, by an organisation such as the WHO. We are engaged with the WHO on making sure that it is available, but my view was that we needed to get on and offer this to everybody and then build a network of labs around the world that can make such an offer so that sequencing can be available in every country, because it is currently far too patchy.

Covid-19: Government’s Publication of Contracts

Debbie Abrahams Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right to highlight this amazing achievement. It reflects on the phenomenal effort of our frontline health and care workers, but also more broadly on the partnership we have seen at work in this country over the past year between the public sector, the private sector, the voluntary and charitable sector and ordinary members of the public all working together in a joint effort to beat this disease. My hon. Friend is absolutely right to highlight that.

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

As much as I have a high personal regard for the Minister, he is incorrect in his remarks. The High Court ruling last Friday made it absolutely clear that at the time of the Prime Minister’s response to hon. and right hon. Members in this House last month 100 contracts had not been published; they were outstanding. Whether intentional or not, the Prime Minister—[Inaudible]—was factually untrue; he needs to come to this place with a full apology, as warranted by the ministerial code.

[Edward Argar]

I lost a few words of the hon. Lady’s question, but I think I know what she was asking about in respect of the Prime Minister’s remarks on 22 February. May I start by saying that her kind words at the start of her contribution are reciprocated? I have known her since I came to this House and I have the highest regard for her as well; so I am grateful for her kind words.

In terms of the specifics the hon. Lady asked about in respect of the Court judgment and the Prime Minister, as I understand it on the date the Prime Minister spoke 100% of the contract awards notices—the details of the contracts are contained within them—were published, and that, I believe, is what my right hon. Friend was referring to.

NHS Staff Pay

Debbie Abrahams Excerpts

Monday 8th March 2021 Commons Chamber

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

By the end of the year, £37 billion of taxpayers’ money will have been spent on the Serco Test and Trace programme, which is not even fit for purpose. That is on top of the Government spending £10 billion more on PPE contracts than they should have spent. Given that waste, how do the Government justify the view that most of the 300,000 NHS nurses are worth only a £250 a year pay rise?

[Helen Whately]

The pay conversation that we are having at the moment is indeed about nurses—who are a fabulous part of our NHS workforce, and I cannot thank them enough—but it is also about the wider NHS workforce, which includes paramedics and health support workers, and this pay settlement will also include some doctors. More than 1 million staff are being considered in this process, and that is why the cost is closer to £1 billion than the figure the hon. Lady mentioned; it is around £750 million. The Government were absolutely right to invest in PPE to protect staff in health and social care during the pandemic at a time when there was a global shortage of PPE, and we are absolutely right to have invested in a world-beating test and trace service, which is doing a phenomenal job and is essential to our country’s recovery from this pandemic.

Covid Contracts: Judicial Review

Debbie Abrahams Excerpts

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

I agree entirely. Some of the narrative around this reminds me slightly of my days back at school and “Animal Farm”—“Four legs good, two legs bad.” The reality is that both private sector and public sector have played an incredible role in tackling this pandemic, for which we should be extremely grateful. We need both, and we need both to continue delivering in the public interest, which is what we have secured.

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

A couple of points seem to be coming up from this discussion. The first is that there were no shortages of PPE. That is patently not true. We have clear evidence that that was the case, not least from Exercise Cygnus back in 2016, but also from constituents working in the NHS who have reported this directly to me and to colleagues. The second is that the Government have published all the contracts, and the Minister has made reference to 100% of contract award notices being published. Unfortunately, we are not able to verify that. That is the key point made by the NAO, which said that there are still £4 billion-worth of contracts since November 2020 where we have no idea who they have gone to or how much for. Once again, will the Minister commit to publishing these VIP contracts, how much they were for, who they were awarded to and what for?

[Edward Argar]

The hon. Lady and I have known each other for a long time and she made her point forcefully but, as ever, fairly. She raised a number of points. In respect of PPE supplies, as I made clear to the hon. Member for Brighton, Pavilion (Caroline Lucas), the NAO report—I believe from last November—said that supplies did not run out nationally, but as I have clarified that is not to say that there were not local shortages and challenges in individual trusts, as I acknowledged to the hon. Member for Brighton, Pavilion. That is why we procured as much as we could as quickly as we could.

The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) raised Exercise Cygnus, which has come up a number of times. It is important to remember that Exercise Cygnus did not look at tackling a novel pandemic; it looked at influenza specifically. The PPE required for dealing with a disease of covid’s nature is very different from that required for flu. That exercise had, as one of its predicated actions, the swift arrival of antivirals to be delivered to tackle the flu; such antivirals did not exist until much later in the case of covid. It is important that we learned from Exercise Cygnus, but we should be careful about reading it directly across as representing a blueprint for how to tackle a pandemic of this sort.

On the hon. Lady’s final point about transparency, as I have made clear, the Government remain committed to transparency and to the publication of contracts, as required under the regulations.

Future of Health and Care

Debbie Abrahams Excerpts

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

Yes, these are very important measures and I am glad that they have my hon. Friend’s support, not least because of his extensive knowledge as a practising GP who has done so much during the crisis—the whole House is grateful for his commitment and work. On the timing of legislation, unfortunately I am not permitted to go into any further detail ahead of Her Majesty’s next visit to the other place, but the White Paper sets out the reforms that we hope to have in place by April 2022, and I hope that he can take from that some indication of our sense of pace.

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

With one of the highest covid death rates in the world, and with NHS workers under such incredible pressure, this is hardly the best time to be talking about yet another NHS reorganisation. In his response to me two weeks ago, the Prime Minister committed to addressing the key underlying causes of the high and unequal covid death toll: primarily, socioeconomic inequalities driven by 10 years of austerity. He said that he would be implementing Professor Sir Michael Marmot’s recommendations, to “build back fairer.” How do the White Paper proposals address those inequalities and their impact on our declining life expectancy and on the highest excess mortality rate in Europe?

[Matt Hancock]

I gently say that I disagree entirely with the hon. Lady’s pessimism about the ability of improvements in the health service to assist in the closing of health inequalities and the provision of care. As a Greater Manchester MP, she will understand better than most the benefits that come from that sort of integration. The idea that we should fail to act on what the NHS has itself asked for because of the challenges it is facing is completely the wrong way round. I see it entirely the other way round; it is incumbent on us to act in order to deliver the improvements that the NHS is calling for.

Covid-19 Update

Debbie Abrahams Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

Yes, I am glad to say that we are working with our EU counterparts to ensure the fair distribution and manufacture of vaccines according to signed contracts, which is the right and proper way that it should be. Thankfully we signed those contracts early and we made sure that we got solid contracts to deliver the necessary doses to the UK. I look forward to those being delivered on, and I have assurances from all quarters that that is what will now happen.

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

We know that there is a reduced antibody response against the new covid variants for vaccinated blood, but what is the level of change in vaccine efficacy, and what action is under way to update and approve new vaccines to address this? I am particularly thinking of the E484K mutation found in both the Brazilian and South African variants.

[Matt Hancock]

The hon. Lady is absolutely right to ask this critical question. We are doing a huge amount with the scientists and the pharmaceutical industry to develop modified vaccines should they be necessary. We are also monitoring the results of work to understand the efficacy of the existing vaccines against the variants of concern. We do not have a point estimate for the difference in the efficacy of the vaccine. The efficacy needs to be measured both in terms of someone’s likelihood of catching the disease and in terms of their likelihood of being hospitalised or dying from the disease. There is a significant amount of work under way to understand all those things, both in labs and in the field. For instance, AstraZeneca has a trial in South Africa that it is revisiting to understand the progress of those who were vaccinated as part of the trial. We will publish as much information as we get as soon as we credibly can. I wish I could give a number in answer to the hon. Lady’s very astute question, but unfortunately it is not scientifically credibly available yet.

Long Covid

Debbie Abrahams Excerpts

Thursday 14th January 2021 Commons Chamber

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

I, too, congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this very important debate.

It is understandable that in the middle of the covid pandemic, the focus has been on primary prevention and managing the symptoms of those who become infected, but given that, as has already been said, the covid tracker survey suggests that more than 4 million people—about 12% of the population—have symptoms beyond the acute phase, which typically lasts just four weeks, with one in 10 having symptoms beyond 12 weeks, we also need to develop healthcare management responses that recognise that covid can have effects way beyond that acute phase. On top of that, we need an appropriate societal response to long covid, where people are supported during their illness and do not feel stigmatised. That is incredibly important.

I am pleased at the speed with which NICE has brought forward its guidelines for managing long covid. I particularly like the recommended holistic healthcare approach when assessing patients with symptoms between four weeks and 12 weeks, and after 12 weeks, with the emphasis on empathy and acknowledging the impact that the symptoms may be having on the patient’s day-to-day life, including their ability to work. However, I was surprised that there was no reference to immunology or immune therapies. I hope that we have learned from the mistakes made in how we prevent, treat and care for people suffering with chronic fatigue syndrome, also known as ME, and post-viral syndrome.

We know that covid-19, like other viruses, attacks multiple systems—respiratory, cardiovascular, nervous and gastrointestinal—as it attacks epithelial cells, which are distributed throughout the body, but our body’s ability to fight the virus depends on our immune system reacting appropriately and not overreacting. The British Society for Immunology and a number of other researchers have suggested that, in addition to long-term damage to multiple organs, the pain, muscle weakness, fatigue and even brain fog often associated with long covid may be due to inflammatory issues associated with our immune system itself rather than covid.

There is still so much we do not know about the virus, and I support calls for more research, as well as for the establishment of a disease register. More research is needed, and I am a strong advocate of evidence-based medicine, but it is important that we never let the perfect be the enemy of the good.

Finally, we must ensure, as I mentioned, that we have a societal response, not just a healthcare response. Working-age people in particular must be supported by their employers and by the Government, through the DWP. We must ensure that adequate support is provided to those with long covid who are not able to work. Stigmatising those with long covid should not be tolerated.

Dementia: Covid-19

Debbie Abrahams Excerpts

Thursday 12th November 2020 Westminster Hall

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

I beg to move,

That this House has considered the effect of the covid-19 outbreak on people affected by dementia.

It is a pleasure to serve under your chairmanship, Mr McCabe. I am really happy to have been able to secure this debate with the hon. Member for Strangford (Jim Shannon) on a topic that is important to so many of us.

I am proud to be the co-chair of the all-party group on dementia and to work closely with the Alzheimer’s Society, which supports people living with dementia and their carers. We campaign on the issues that matter most to them. This debate is about the effects of covid on people with dementia and their carers. I will focus my remarks on the Alzheimer’s Society’s September report, “Worst hit: dementia during coronavirus”. The society undertook that collated work to assess the impact of the first wave of covid. I shall also discuss briefly the impact of covid on dementia research, particularly in view of the fact that we are approaching the comprehensive spending review statement later this month.

What has been the impact of covid on people living with dementia? People with dementia have unfortunately been among the worst hit by covid: they have experienced disproportionate loss of life, and those who live in care settings have been separated from their loved ones for many months. The Equality and Human Rights Commission has said in relation to older people, including those with dementia, that

“There is evidence that human rights standards may have not been upheld in the response to the pandemic…We are further concerned that equality considerations were not effectively and transparently built into decision-making at the national, regional and local level, both in terms of the immediate risks from coronavirus and the wider impact of restrictions. This may have resulted in failures to comply with the public sector equality duty.’

That is damning indeed, but on top of that, since March there has been a worrying decline in diagnosis rates for dementia, which were already low. There is some evidence that covid affects the brain and nervous system, as well as other systems in the body, and this needs to be monitored, particularly in relation to covid’s longer-term impacts.

In addition, we must not forget the family and friends who are carers, in my constituency and across the country, who have provided millions of additional hours of care during and between lockdowns. With no shielding support whatsoever, they have been feeling the strain from that lack of support during the pandemic.

To understand the scale of the problem facing people affected by dementia, I thought it would be helpful to share with colleagues information about the scale of dementia itself—of course, many colleagues will already be familiar with this information. In my local authority in Oldham, there are approximately 2,250 people who are currently living with dementia; across the UK, there are approximately 850,000 people living with dementia; and globally there are more people living with dementia than the entire population of Spain. A third of people born in the UK will develop dementia during their lifetime.

I know that most—if not all—of us here today have been touched by dementia in some way, as I was when my mum was diagnosed with Alzheimer’s disease, the most common form of dementia, at the age of 64. I want to highlight the fact that, contrary to popular belief, the majority of people with dementia—more than 60% of the total number—live well and live in the community. However, people with dementia account for over 70% of residents in care homes. This pandemic has laid bare and exacerbated inequalities across our country, and that is particularly true for people living with dementia and their carers.

Colleagues will be as horrified as I was to hear about the disproportionate death rates among people with dementia. Between March and June, over a quarter of the people who died with covid-19 in England and Wales had dementia. Dementia was the most common pre-existing condition in deaths involving covid, although it was never identified as a condition that made people clinically vulnerable. That is the reality we are presented with today, and it prompts the question whether people with dementia and their carers will now be given the proper support to be shielded. The miserly £14.60 per person that has been provided to local authorities to support the clinically vulnerable for the entirety of this second lockdown is, quite frankly, derisory.

In addition to those deaths from covid, there has been a sharp rise in excess deaths of people affected by dementia. Between January and July, 5,049 such deaths were recorded, and during the early peak of the pandemic excess deaths were double the five-year average. These excess deaths happened not only in care homes but among people living at home, with a rate 79% above the five-year average between the middle of March and the middle of September. We must ensure prompt and safe access to health and care services for people with dementia throughout the pandemic.

Why have people with dementia been dying in such high numbers? Various factors appear to be involved, with some undoubtedly contributing more than others. The risk of severe covid outcomes rises steeply with age; 94% of covid deaths between March and June were of people over the age of 60, and we know that people are more likely to develop dementia as they grow old. Evidence is emerging that suggests having dementia may increase the risk of severe covid symptoms and death when age and other conditions are taken into account.

Importantly, coronavirus can present itself differently in care home residents. A sizeable proportion—nearly one in five—of nursing home residents who tested positive for covid were either asymptomatic or had only atypical symptoms. They had no fever or cough, but often had a change in mental health status or behaviour, anorexia or digestive problems. That might also have contributed to the challenge of detecting and preventing the spread of covid in that population.

Perhaps the biggest contributor to the high death rate is where a person lives, whether in a care home or in the community. All of us here today have heard from local care homes and constituents about the serious challenges that have been faced in care homes, from unsafe discharges through to the lack of personal protective equipment and sporadic testing. Although we have made leaps forward in care home safety, I hope the Minister will commit today to ensuring that social care is on an equal footing with the NHS in terms of PPE and testing, and will respond to the issues raised by the EHRC. Looking forward, will she also ensure that the social care sector, including social care providers and experts in the third sector, as well as service users and their families, are involved in long-term developments for the sector?

I also want to speak up for the hundreds of thousands of informal carers across the UK, who are too often forgotten. It is unclear whether the lack of access to friends and families is affecting the progress of dementia, but one thing is clear: the emotional distress of not being able to see or touch our loved ones is very real. One of my Saddleworth constituents wrote to me:

“As the country pays its respects to those who fought and died for our freedom, let’s not forget that some of our war veterans, like my father, are still alive today. He like many others is locked away in a care home, having endured 8 months of separation from his family with no end in sight.”

Another constituent told me:

“My mother has been in a care home with worsening dementia for over three years. She is 96. I cannot see her and can’t even speak to her on the phone as she is almost deaf. It is heartbreaking to know that there is a very real possibility that I may never see my mother again, as visitors are barred from the care home. My mother probably believes her family have abandoned her.”

That is a dreadful thing to feel. With the roll-out of lateral flow testing, will the Minister commit to ensuring that family carers are given key worker status, are included in the care home testing protocols and have access to PPE, so that they can visit their relatives and provide the loving family care that is so desperately needed?

As I mentioned, most people with dementia live in the community, and one third live alone. I have already mentioned the amazing job that more than 700,000 carers do. Without them we know that the social care system would collapse. The pandemic has taken a significant and additional toll on many. The Alzheimer’s Society found that families and friends of people with dementia have spent an extra 92 million hours caring for loved ones with dementia during the pandemic; that is on top of the 100 hours or more a week of care that more than 40% of family and friend carers reported providing for their loved ones. For some that was on top of a full-time job. That dedicated group of people deserve more support as they struggle to care for their loved ones among their myriad other responsibilities.

Will the Minister today guarantee that where home care for someone with dementia has been stopped owing to coronavirus, it will be reinstated without any formal assessment? Will she also ensure that carers’ assessments are carried out; that short breaks are provided for people with caring responsibilities; that local authority data is collected on the provision of those services; and that the Government fulfil their commitment to do whatever it takes by properly reimbursing local authorities for the additional work that they are doing and the additional funding that they have spent during the pandemic?

I have already mentioned that people with dementia were not included in the Government’s formally shielded group in the spring. However, given what we know now about dementia being a significant clinical risk for covid morbidity and mortality, I am pleased that the Government have recognised that and are introducing a risk stratification for covid similar to that used for assessing heart attack and stroke risk. Will the Minister provide an outline of how that tool will work, including when she expects it to be available for use, and in particular what support will be available for those considered at risk?

As I also mentioned, the impact of covid had an impact on the diagnosis rate. It is well below the already low target of 66.7; it now stands at 63%. That means more people are living without a diagnosis of dementia and are unable to access emotional, practical, legal or financial advice, as well as the therapies associated with diagnosis. Memory services are adapting to open virtually, which is a welcome interim measure, but there is urgent need for a catch-up on waiting lists to ensure that the freefall in dementia diagnosis rates does not continue, and a virtual appointment is not the place to deliver a life-changing diagnosis. I will be grateful if the Minister can do all that she can to ensure that memory assessment services reopen in person at the earliest opportunity.

Finally, I want to raise the issue of dementia research as we look through and beyond the pandemic. The Conservative general election manifesto last winter pledged an extra £800 million over 10 years for dementia research—the “Dementia Moonshot”. I support that. The UK’s exceptional research into dementia prevention, therapies and care is already well under way. We have the second biggest research network on dementia in the world. We must not let that go. There are always new challenges. As I said, recent research has found that the neurological complications of covid can include brain inflammation, delirium and nerve damage. We need to be monitoring those types of effects on a long-term basis.

Unfortunately, much of the research that had been under way has been delayed during covid, with medical research charities, which do vital work to support early-career researchers, facing a 40% shortfall this year. A third of dementia researchers are already considering leaving the field. Losing that research talent would have a severe long-term consequence for dementia research, and ultimately for people with dementia. We cannot lose that innovative work. Let me give an example: the UK Dementia Research Institute’s care, research and technology centre has been developing tools and technologies to enable people to live in their homes as long as they can, reducing isolation and minimising the impact on the NHS and beds. Will the Minister confirm that the spending review later this month will fulfil the commitment to dementia research and provide the financial support that such organisations need? Research provides hope of a cure in the future, as well as developments in social care, technological innovation and public health advances to address the care needs of today.

Dementia is often an overlooked condition, but it is a condition that affects so many. People with dementia have been among the worst affected by this pandemic, and I hope the Minister will do all she can to ensure that we do not see such loss of life, strain on carers, and loneliness again as the pandemic progresses. I also hope that we see a long-term and fair funding solution for social care soon, which has the needs of people with dementia at its heart.

--- Later in debate ---

[Debbie Abrahams]

I start with heartfelt thanks to everybody who has contributed to the debate. It is so nice to be in such a high-quality debate where we all work together, and where we see and agree on the issues. Now, it is about moving forward on the solutions. There was much consensus, particularly on how we make sure that families can visit their loved ones in care homes. I have huge regard for the Minister. She has real empathy, and I am grateful to her for turning it into action, but I ask her to make a commitment. If the trial is starting next week, will she come to the House and make a statement at the end of this month, so that we know the results of that trial and when in December it will be rolled out? My hon. Friend the Member for Leicester West (Liz Kendall) makes an excellent point that this may be some people’s last Christmas. For everybody concerned, please can we do our utmost to make sure that this happens?

Covid-19 Update

Debbie Abrahams Excerpts

Tuesday 20th October 2020 Commons Chamber

[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.