(4 years, 2 months ago)
Commons ChamberNHS Test and Trace is currently tracing the contacts of about 700 people every day who have the virus, but the Office for National Statistics says that 2,500 new people are being infected every day, which means that since the programme started, up to a quarter of a million people have not been asked to isolate who should have been. It is a big achievement to get the programme going, but that is also a big gap. What are the Secretary of State’s plans to close it?
I am not sure I agree with my right hon. Friend’s figures in terms of the assumptions that underpin them. We have had this discussion and this exchange before. There are a whole number of asymptomatic cases. The critical thing about Test and Trace is to find as many of the asymptomatic cases, and as many of the positive test result cases, as possible. We need to do that over time by expanding the programme.
(4 years, 2 months ago)
Commons ChamberI will try to answer as many of the questions as I can. First, I concur entirely that we should have no truck with anti-vaccination campaigners. The reason we are working so hard with full-blown clinical trials on these vaccines is to ensure that they are safe, and if they are declared scientifically safe, anyone who is recommended to have one should have one.
The hon. Gentleman made a case on student nurses. It is wrong to suggest that student nurses and midwives are being made redundant. All student nurses and midwives are required to complete placements during their training. As part of the response to covid-19, those hours have been paid and will be until the end of the summer. NHS England has been provided with the funding for student salaries as part of our response to covid-19. The chief nurse has taken that forward.
The hon. Gentleman made a point about local authorities getting data. We have provided more data to them, and we will continue to do more. He asked about the steps that will be taken in future on lifting the lockdown. As ever, we will move carefully and cautiously. Thankfully, all the main indexes—the main ways that we measure this disease—are moving in the right direction. We are winning the battle against this disease, but we will be careful and cautious in the next steps that we take.
We are working very closely with local authorities on local lockdowns. The hon. Gentleman specifically raised the point about powers, as he has before. I have powers under the Coronavirus Act 2020, passed by this Parliament. If powers are needed by local authorities, then there is a process to raise that requirement up through a command chain that leads to a gold command, which I chair, and then those powers can be executed on behalf of local authorities if they are needed.
The hon. Gentleman asked about shielding. We will bring forward the proposals for the next steps on shielding very shortly.
Finally, the hon. Gentleman asked about the positive cases that do not go into the NHS test and trace scheme. That is largely because they are in-patients in hospital, and therefore testing and tracing in the normal sense does not apply because we know exactly where the person is and who has been in contact with them as they have been in hospital, in a controlled environment. That is the case for the large majority of the gap.
On that last point, 20% of the people with coronavirus in hospital are estimated to have caught the virus while in hospital. So when does the Health Secretary plan to introduce weekly testing of all frontline NHS and care home staff as a way of bridging the still very significant gap between the number of people we test and trace and the number of people getting the infection every week?
The Chair of the Health and Social Care Committee makes an incredibly important point. The approach we are taking is a targeted one of repeat testing, which has started already but needs to spread much further. The reason is that some people in hospital settings are at higher risk, and it is better to focus the resources for repeat testing on those at higher risk. For instance, somebody working in finance might be at lower risk than somebody in a frontline setting. The NHS has a strategy on this, and I will write to him with further details of how that is going to work.
(4 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Prime Minister’s testing turnaround target does not apply to postal tests. Given that the majority of infections can happen less than a week after the person who gives someone the virus develops symptoms, will the Secretary of State consider replacing postal testing with same-day delivery and collection of testing? If it is good enough for Amazon Prime, it should be good enough for NHS test and trace.
My right hon. Friend is right to raise this matter, because testing turnaround speeds are very important, and they are improving. The answer is that we are intending increasingly to use the routes that have a 24-hour turnaround for the symptomatic testing, which needs that rapid response, and to use the routes that have a slower turnaround for asymptomatic testing, where the timing of the test is less important. That is the direction of travel, and we intend to solve the problem that he rightly highlights in that way.
(4 years, 3 months ago)
Commons ChamberWe now go across to the Chair of the Select Committee on Health, who I understand is audio only.
Thank you, Mr Speaker. I would like to ask the Secretary of State for three pieces of data, all of which are essential for this strategy. First, what level of new daily infections do we need to be down to before contact tracing happens for all new infections? Secondly, how many daily tests will the test and trace system need? Thirdly, if we are going to introduce weekly testing for all NHS and care-home frontline staff, when will our testing capacity be sufficient to deliver that on top of test and trace?
With 21,000 contact tracers now employed, we think that that is capacity for the current level of new cases that have been demonstrated by the Office for National Statistics surveys, but I am perfectly prepared to hire more to make sure that we have spare capacity within contact tracing.
On the number of tests needed daily to service test and trace, it depends on exactly how many new cases there are. It depends on the relationship between the symptoms and the number of positive cases. There are many more people with symptoms than there are positive coronavirus cases, but the number is falling because we are moving away—well away now—from the flu season, and at this time of year the number of positive symptoms, including coughs and fever, tends to fall, because other non-coronavirus communicable diseases such as flu are falling. There is not a specific answer to that question, because it changes over time. On weekly tests, we are looking to put together a plan to ensure that we cut in-hospital transmission, which will include appropriate, regular testing of the right staff in the NHS. I shall write to my right hon. Friend with more details as and when that policy is fully announceable.
(4 years, 3 months ago)
Commons ChamberTest, track and trace is possible only with a mass testing programme, so I offer many congratulations to the Health Secretary on achieving such a challenging expansion in our testing capacity. He has always said that he follows the science in the decisions he takes, but does he appreciate that, Zoom or no Zoom, it is very difficult for us as MPs to scrutinise such decisions if he does not also publish the advice of the Scientific Advisory Group for Emergencies that he receives at the same time as he makes those decisions?
We are making public the membership of SAGE and a lot of the science. I know that my right hon. Friend is also able to scrutinise the scientists before the Select Committee on Health and Social Care, as he and his team did again this morning. The overall approach of transparency, which has been a lodestar of the Government’s response to this crisis, is important. Of course, different scientists have different views, and they make those plain, but, as he said, we are guided by the science in the decisions that we take, and that has been an important part of the response.
(4 years, 4 months ago)
Commons ChamberI hope we can speed up the answers a little. I think that answer was twice as long as the question. I know you want to make sure you are thorough, Secretary of State, but we have quite a few questions to get through.
I now call the Chair of the Health and Social Care Committee, Jeremy Hunt.
The World Health Organisation says that one of the six essential criteria for lifting a lockdown is that we should be able to track and trace every single new covid case in the community. Will that be place in the next two weeks, so that when the Cabinet come to consider whether they can lift the lockdown, they will be able to do so in a way that is compliant with what the WHO is recommending? Will the Secretary of State appoint a big hitter from outside frontline politics to make sure that happens within a short period, as he has very sensibly done with Lord Deighton on PPE?
We are ramping up our testing capacity and our capacity for contact tracing in a matter of weeks. We will have it ready to ensure that we can use that capacity as and when the incidence of transmission comes down. It is not tied to the specific decision that we are required by law to take in just over two weeks’ time. The effectiveness of test, track and trace to keep the reproductive rate of the virus down is determined by the incidence in the community, and our goal is to get to a point where we can test, track and trace everybody who needs it.
(4 years, 5 months ago)
Commons ChamberI will go through the answers to the questions the hon. Gentleman reasonably asked. He asked about the most vulnerable. A programme of work is under way to ensure that those who need support because they are staying at home—especially those who are victims of domestic violence—get that support. It is incredibly important and difficult work, but we are doing what we can in that space. He also asked about prescription charges. Only around a fifth of people pay prescription charges, so those who are the least able to pay already get free prescriptions.
The hon. Gentleman asked about Sports Direct. Sports shops are not essential retail, and therefore they will be closed. I have seen a bit of the noise that has been going on around today about Sports Direct in particular. I want to be absolutely clear that sports kit is not essential over the next three weeks, so we will be closing Sports Direct, along with other non-essential retail. He also asked about fines for corporates as well as individuals—absolutely, those fines are available if that is necessary.
The hon. Gentleman asked about protective equipment, and he is quite right to do so, because as we discussed yesterday, having protective equipment for staff on the frontline—especially those in the NHS and social care, but also in other frontline services—is very important. We are moving heaven and earth, and the military involvement is ramping up the delivery of that equipment. He asked specifically about social care. I am glad to say that the current plan is to get protective equipment to all social care settings by the end of this week, and then we will have to keep going. We have put in place a hotline. If someone needs PPE and they are not getting it, they should call the hotline so that we know where the difficulties are in getting PPE to the frontline, and we can respond to those calls and get it to them. I feel that very strongly.
The hon. Gentleman asked about testing. As we have discussed many times, we are ramping up testing as fast as we can, including buying millions of tests. My team are currently buying these tests, which we will make available as quickly as possible. He asked about there being no machines ready to buy. I do not recognise that at all. I have not seen any leak, and I would not want to comment on a leaked email—certainly not one that I have not seen. It is true that we are bringing testing machines together to provide a more efficient testing system, and I am grateful to the universities that have put these testing machines into the system. This is a national effort, and they are playing their part. We are also buying machines where we can.
The hon. Gentleman asked about staff ratios, which have been publicised this morning. It is true that we are having to change the standard staff ratios for delivery of certain types of procedure, including ventilation. The reason is that we cannot easily train somebody to intubate a patient and put them on a ventilator. We are training those who we can train to the standards necessary, but this is an incredibly difficult task, and it is therefore safer to have the doctors who are trained to do it and experienced in doing it doing it to more people, with more support staff than in normal circumstances. That is absolutely necessary to respond to the quantity of need, because this is a very specialist part of the NHS and of medicine that suddenly has much bigger demand than could ever have been envisaged outside a pandemic scenario.
I pay tribute to the staff who will be working much more intensively and who are putting their vital skills at the service of the nation in order to save lives. I am grateful to all those who have worked with the royal colleges to ensure that we get these ratios right and stretch the capabilities we have as far as we safely can in the circumstances. Finally, the hon. Gentleman mentioned abortion. We have no proposals to change any abortion rules as part of the covid-19 response.
I thank the Health Secretary for the superhuman efforts he has taken to resolve the issues around PPE in the last week. The evidence is that we are in a much better situation now than we were a week ago. He will not mind if I follow up what the shadow Health Secretary said about testing. The concern is that we appear to be testing on a daily basis virtually no more people than we were over a week ago, when the commitment was to increase the daily number of tests from 5,000 to 25,000. Given that this is a vital part of the success of the suppression strategies in South Korea, Taiwan, Singapore and Hong Kong, can he give us an estimated date when we will get back to routine covid-19 testing in the community of all suspected cases? Even if that is three or four weeks away, a date means that there is a plan, and without a date, people will not be confident that this really is the plan.
Although I was not in the Chamber, I heard the comments that my right hon. Friend the Chair of the Health and Social Care Committee made about this yesterday, and he is right to push on this issue. I am not going to give him a date today, because we are in the middle of buying the tests that are needed, especially the new tests that have just come on stream. I have been able to give him the update that we have now purchased millions of these tests, which will arrive in the next days and weeks. I will be in a position to give him a more concrete timetable, and I will make sure he gets that as soon as we can make it public.
(4 years, 5 months ago)
Commons ChamberThe Health Secretary is not in his place—understandably—but I want to start with a tribute to him. I think I am the only other person in this House who has sat behind his desk, and I can testify that even without a pandemic it takes years off your life. The Health Secretary has made himself exhaustively available. He has worked tirelessly, and no one could have done more or better to prepare the NHS for the crisis we now face. I also want to thank the shadow Secretary of State for the way that he has risen to the challenge of his role. All of us as parliamentarians are proud of the exchanges that we have had this afternoon and on many occasions.
Ordinarily, our role as MPs is to scrutinise every detail of legislation, to understand it and to try to improve it. There are many questions about this legislation, but we are in a national emergency and every day we delay could cost lives. So I support the Bill 100% and I encourage all colleagues to do the same. A week ago, the Government said we were four weeks behind Italy. That then changed to three weeks behind Italy, and today our mortality rates are just two weeks behind Italy. Our hospitals, especially in London, are filling up. We have had a critical incident at one, and others say they are running out of ICU beds. According to the papers, we have one nurse fighting for her life in an intensive care unit. One London hospital has seven doctors with the virus in just that one hospital. Yet still people are going to shops, parks, beaches and holiday homes as if nothing has changed. It may be too late to avoid following Italy, but to have any chance at all of doing so we must move now to lockdown rules that ban non-essential travel. It is time not just to ask people to do social distancing, but to enforce those social distancing rules—not next week, not this week, but right away. I support the call by the shadow Secretary of State to do that, and it is very important we do so as soon as we possibly can.
The Bill can help in two areas. The first is on protective equipment for staff. Last week, Sir Simon Stevens told the Health and Social Care Committee that there were sufficient national supplies of PPE, but there were distribution problems. Since then, I know that the Government have moved heaven and earth to try to resolve those. All hospitals have had deliveries, and I pay tribute to the Health Secretary and everyone in the Department for achieving that, but there is still a lot of concern on the frontline. The main reason for that is because on 6 March Public Health England downgraded the recommendations as to what PPE doctors should use. That appeared to be at odds with World Health Organisation recommendations. I understand that has now been clarified by Professor Keith Willett in a message sent out on Friday that does bring our advice more into line with WHO guidelines.
Most importantly, the advice now makes it clear that doctors should wear goggles if there is any risk of being sprayed, but obviously doctors would feel vastly more secure with more extensive protection, such as full-length gowns and FFP3 masks. Is not the solution just to order manufacturers to make more of that vital equipment—not just a little more, but massively more? If that needs legal powers, the Bill should give the Government those powers to require every factory that is able to devote itself to the production of that life-saving equipment to do so.
Numerous doctors have died across the world, including Dr Li Wenliang, the courageous Chinese doctor who first tried to blow the whistle on this virus. Twenty-three doctors have died in Italy. This weekend, France lost its first doctor. None of us wants that here. Given the total determination of the Health Secretary to protect our frontline staff, would he urgently look into whether we need to manufacture more of the highest-grade equipment?
Does my right hon. Friend share my dismay at my being told just now that masks and PPE that were meant to be delivered to my authority, Wiltshire, tomorrow, will now be delivered on 9 April? I am not sure what the situation is in Surrey, but that seems extraordinary. Does he also agree that it has to be the right PPE—it cannot simply be a paper face mask from B&Q, as we heard earlier? It needs to be appropriate, and people need to know how it works. When they wear it, they are likely to have to work harder, because wearing PPE is not easy or straightforward.
My right hon. Friend knows, as a clinician— and I am concerned—that in our desire to get PPE out we have not understood the vital role that local authorities play in this. Residents in care homes are extremely vulnerable, and their carers need that equipment, so I very much support his concern about that.
The second area where the Bill needs to do more is testing. A week ago today our strategy changed from mitigation to suppression. I strongly support that change in strategy. Suppression strategies are being followed very successfully in South Korea, Taiwan, Hong Kong, Singapore and China, which appear to have turned back the virus. Here, all our public focus has been on social distancing, but testing and contact tracing to break the chain of transmission are every bit as important, if not more important. Those countries that have turned back the virus rigorously track and test every case and every suspected case, then identify every single person with whom a covid-19 patient has been in contact to take them out of circulation. As a result, those countries have avoided the dramatic measures and some of the economic damage that we have seen in Europe.
South Korea has avoided national lockdown, despite having a worse outbreak than us; Taiwan introduced temperature screening in malls and office buildings, but kept shops and restaurants open—it has had just two deaths. In Singapore, restaurants remain open and schools are reopening, although working from home is discouraged. Again, in Singapore, there have been just two deaths. Ten days ago in this country, we went in the opposite direction, and stopped testing in the community. How can we possibly suppress the virus if we do not know where it is? So far, we have had 281 deaths, tragically. According to the modellers, there is about one death per 1,000 cases, which means that we have just under 300,000 cases in this country. According to the same modellers, the number of cases is doubling every five days, which means that at the end of next week we will have about 1 million cases or more in this country. Unless we radically change direction, we will not know where those 1 million cases are.
The Prime Minister talked about expanding testing from 5,000 to 10,000 to 25,000, which is welcome. He even talked about 250,000 tests a day, which would be more than anywhere in the world—I welcome that ambition, but ambition is not the same as a national plan, and we have not seen a national plan on testing.
The right hon. Gentleman may have seen reports today that some care providers are refusing to take patients being discharged from hospitals because those hospitals are unable to test them before discharge. Quite understandably, care homes are concerned about admitting patients who may be carrying the virus, given the other vulnerable people there. Does he agree that as testing is ramped up, not only health and care professionals but patients being discharged should be a priority?
I am very worried about that. A doctor in my constituency told me of exactly the same problem, and of course, the risk is that hospitals then fill up and do not have the space to treat people who urgently need hospital treatment.
We have an ambition to increase testing to 25,000 tests a day, but at the moment we are still only testing between 5,000 and 8,000 people every day. On Saturday, we tested 5,500, which is no significant increase on a week ago. It is not just South Korea that is testing more than us per head of population—Germany, Australia and Austria are as well. Now is the time for a massive national mobilisation behind testing and contact tracing.
If we have the antibody test, now is the time to become the first country in the world that says, “We are going to test every single citizen.” Now is the time to introduce weekly tests for NHS and social care staff, to reduce the risk of them passing on the virus to their patients. If the Francis Crick Institute in London is doing any research into anything other than covid-19 right now, it should stop—we need it to be designing tests. If the Sanger Institute in Cambridge is still decoding genomes, it should not be—we need it to process covid-19 tests.
And it is not just the science. Contact tracing is manpower-intensive, yet Public Health England has just 280 people devoted to this. We probably need 280 people in every city and county in the country. Every local government official doing planning applications, every civil servant working on non-corona issues and volunteers all should be mobilised in this vital national task.
As we have heard, testing is vital for NHS staff who are desperate to get back to work. Here is one tweet from a midwife called Katie Watkins, who speaks for so many:
“I know this is happening all over but had to call in sick for my clinical shift on labour ward today as my husband spiked a temperature last night. I feel fine and yet cannot go to work... Where are the tests for #NHS staff?? I could be helping but instead sat at home.”
Testing is also vital for the economy. If we are going to have a year of stop-go as we try to protect the NHS if the virus comes back, testing and contact tracing allows an infinitely more targeted approach and way to control the spread of the virus than economic measures that are much more blunderbuss and do much more damage. This Bill could help that by giving the Government powers to require any pharmaceutical company in the country to manufacture tests and any laboratory in the country to process those tests. It could stop the scandal of £375 tests being available to wealthy people in Harley Street when, in a crisis, every spare test should be used by NHS staff to get them back to work.
This Bill could help with something else being done very successfully in South Korea and Taiwan: the use of mobile phone data. In those countries, they look at the mobile phones of covid patients to identify other phones that they have been nearby when that patient was infectious. That has civil liberty implications, but in this national emergency, being able to do that would save lives, so those powers too should be in the Bill.
Finally, please do not take my word for it on testing. Dr Tedros Adhanom, the director general of the World Health Organisation, and virtually every epidemiologist at the World Health Organisation makes the same point: it is not possible to “fight a fire blindfolded”; social distancing measures and hand washing will not alone extinguish the epidemic; and
“our key message is: test, test, test.”
I know that time is short, but I want to touch briefly on two other issues. Some good points have been made about social care this afternoon. The Bill replaces local authorities’ duty to meet care needs with a power to meet care needs, except when it is a breach of human rights. Bluntly, there may be less provision of social care as a result. We understand in this House why that may be necessary, but if it lasts as long as a year, that will mean more pressure, not less pressure, on hospitals. If there was any lesson from my time as Health Secretary, it is that we need to invest in social care as well as in health. We need to ensure that these new measures do not have the unintended consequence of putting yet more pressure on hospitals that are already on the point of falling over.
My final point is on mental health. Under the measures in the Bill, someone can be sectioned not by two doctors, but by one, and that doctor does not have to know the patient. I understand why we have to take these measures, but obviously it causes huge concerns in the mental health community that someone could be locked up on the say-so of a doctor who does not even know them. I want a commitment from the Government that all cases will be reviewed on the basis of the current procedures as soon as this virus is behind us, and certainly within the first three months.
I end my remarks with a tribute to frontline staff, not from me, a politician, but from an eight-year-old constituent of mine called Tamsin. She says:
“I really want thank all the doctors and nurses who are working so hard to look after all the sick people…they are all risking their own lives to try and stop the coronavirus instead of being safe at home. I’m missing my Nana, Gamma and Grampy a lot because they have to be isolated at home but if they get sick they will need the doctors and nurses to help them get better. Doctors and nurses are amazing.”
Tamsin is right. We must not let them down.
(4 years, 5 months ago)
Commons ChamberI warmly welcome the measures announced today. People have debated when they were going to be introduced, but the Government have shown today that they have the courage to introduce very tough measures that will have profound economic consequences, which will reassure many people up and down the country. In the constructive spirit adopted by the shadow Health Secretary, I want to ask a couple of things about the measures that have been introduced.
First, the Secretary of State is advising people not to go to clubs, cinemas and restaurants. Will he also advise clubs, cinemas and restaurants to close their doors, so that there is absolute clarity that people should not, at this moment, engage in those activities? Secondly, if someone in a household is symptomatic, he is advising the whole household to self-isolate for 14 days. I understand the logic behind that, which was very clearly explained, but the World Health Organisation advice is to test and isolate every single suspected case of the virus, so would he explain why there is divergence?
Thirdly, to follow up the question asked by my right hon. Friend the Prime Minister—[Hon. Members: “Former”]—the former Prime Minister, is the advice to healthy over-70s who do not have an existing long-term condition that they should be part of a new shielding policy that is happening at the weekend, or is that shielding policies just for over-70s with an existing health condition?
On that last point, no—the shielding policy is only for those with existing health conditions. Those whom we are going to ask to participate in shielding, from next week, will receive a contact from the NHS, and we will publish the list of conditions that we consider necessary for shielding. On the point that my right hon. Friend makes about testing and isolating, I strongly agree with the World Health Organisation about the need for testing. I spoke at the weekend to Dr Tedros, head of the World Health Organisation, and we strongly agree on the need for testing. The question is how fast can we ramp up testing capability for the tests that we need—the blood tests to know who has had coronavirus and the bedside test or the home test, so that these tests can be expanded rapidly across the whole country? The first has yet to be invented, although we hope that it will be fairly soon, and the second has just been invented in the past few days, and we are in intense negotiations about rolling those out very rapidly.
(4 years, 5 months ago)
Commons ChamberI thank both Front Benchers for the highly responsible way in which they are approaching this crisis, which shows Parliament at its best. I also thank the Health Secretary for his role in getting those very generous words for the NHS into the Chancellor’s speech this afternoon; they have been widely welcomed across the NHS and were much needed.
The chief medical officer says that we would have to be “pretty optimistic” to think we could contain the virus in this country. The deputy chief medical officer says that she thinks we may hit the peak in the next fortnight. We now have more reported cases in this country than there were in Wuhan when it went into lockdown. We know that the Secretary of State will rightly follow the science, but could I ask him to give his judgment to the House as to whether he thinks we still can contain the virus in this country and, if not, whether he expects to move to the delay phase very soon so that families up and down the country can start to prepare their loved ones for any precautions they might want to take?
I want to make two comments in response to my right hon. Friend. First, I want slightly to correct the point about the deputy chief medical officer, who said that in the next couple of weeks we may see the numbers starting to rise fast to their peak. We do not expect numbers to peak in the next fortnight. We expect them to continue to rise after that. The peak would be in a matter of a couple of months, rather than a couple of weeks. This is a marathon, not a sprint. Secondly, the World Health Organisation declaring this afternoon that the virus is globally now regarded as a pandemic indicates that the WHO thinks it will spread right across the world, and that will have a significant impact on the way in which countries around the world will now take forward their plans. Of course, the expectation that this may well happen was all within the plan that we set out. We will be discussing that at the Cobra meeting tomorrow.