(3 years, 9 months ago)
Commons ChamberI 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.
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.
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—
No, no. This is the point: when we have 50,000 people being infected every single day, it is a massive logistical task, but if we are honest, we still had problems when it was a tenth of that number being infected every day. This is the moment to recognise the uncomfortable truth that this would be better done locally, with local authorities taking the ultimate responsibility. While we are making these changes to the contact tracing regime, to have only 20% of people who are infected and told to self-isolate actually complying suggests only one answer, which is that we as the state should pay their wages for the period that they have been asked to isolate. That is expensive, but it is less expensive than the cost of them not complying with the important direction to isolate.
On a more technical matter, I ask the Health Secretary to consider whether there is a way we can speed up the approval of the new therapeutic drugs that are coming online. As he knows, we generally wait until both safety and efficacy are proved before approval is given to a new drug. However, in a pandemic, would it not be right to allow the mass marketing of drugs to go ahead as soon as they are deemed safe, even though we cannot guarantee their efficacy? That could save lives, and any delay might mean that people could not get the benefits of those new drugs.
I want to finish on the issue of population testing. My right hon. Friend and I have had many discussions about this and again I know that he is sympathetic. We are in an immensely stronger position because of the huge improvements in testing capacity that he rightly celebrated in his earlier comments. However grave the situation we are in now, it would be a whole lot graver if we had not increased testing capacity from 10,000 a day to 100,000 a day, and then to 500,000 a day last week and potentially 1 million a day by Christmas. We are not far off the 2 million a day that would be needed to test the whole population every month.
Now is the time for us to tell the public how we are going to chart a course to that destination, because this is the only true light at the end of the tunnel. Charting a course to that destination means charting a course through the incredibly complex logistics and through the technology that will be necessary to record who has or has not had their positive test on time, but if we can show people that there is a date next spring by which the whole population will be tested on a regular basis, we will also be showing people that there is a way through this pandemic. In that way, our national depression would be lifted and we would be able to give the hope to our constituents that is now in such desperately short supply.
(3 years, 10 months ago)
Commons ChamberI 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.
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?
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.
(3 years, 10 months ago)
Commons ChamberAs I said in my statement, discussions with local leaders in Greater Manchester, Lancashire and elsewhere continue, and I do not want to pre-empt them. Those discussions do, of course, include what financial support is needed, but I remind the House that we have put in place unprecedented financial support for those who are affected.
The hon. Gentleman mentioned the test and trace system. The figures this morning in fact show that there has been a record high number of people who have been contacted by NHS Test and Trace, reaching more people and testing more people faster than at any other point. He might have seen yesterday that, internationally, this was commented on as an area where we have done well here in the UK. Of course, we want to make sure that we get things even faster and that we have an even greater testing capacity, but I think he would do better to reflect on the progress that has been made.
Finally, the hon. Gentleman talks about the national circuit break idea that the Labour party put forward, at least on Wednesday this week. I gently say to him that here in this House, Labour calls for a national circuit break, but we take the view that we should do everything we can to control this virus where it is rising fastest and take a more targeted approach. The Labour party cannot even get its Mayors in other parts of the country, where the cases are going up, to come out and support the proposals that are made from the Opposition Dispatch Box. What I would say is that we need to work together. We need to pull together. Everybody should come together, and that is the best way to defeat this virus.
I support today’s measures, but is not the biggest issue that we face as a country now uncertainty—uncertainty about our health and uncertainty about the future of the economy? Given my right hon. Friend’s tremendous success in expanding our testing capacity, is not now the time to announce a date—whether it is February, March, April of next year—by when every single person in the population will be tested every week, so that by then, irrespective of progress on a vaccine, irrespective of the success of local lockdowns and irrespective of other uncertainties, we have a date by when we know we will get the virus under control and we know we have some prospect of returning to normality?
My right hon. Friend and I share a passion for an expansion of testing capacity in this country. He has long tried to persuade me to set yet more goals for the expansion of testing capacity. I am very glad to say that we have hit every single one that we have put in place, such as the 100,000 in the spring, and we are on track to meet the 500,000 by the end of this month. After that, I very much hope that we can continue to expand testing capacity, and I will look at the idea that he proposes very carefully.
(3 years, 10 months ago)
Commons ChamberThe hon. Lady has long been a campaigner on this subject. We have made significant progress in terms of expanding access where it is clinically safe to do so. On this, as on so many things, I will make sure that I constantly follow the clinical evidence.
My right hon. Friend knows that for every person who tragically dies from coronavirus, at least one other person has long-term symptoms lasting more than three months, meaning that they have breathlessness and chronic fatigue and often cannot go back to work normally. In his letter to me of 14 September, he said that clinics were going to be set up so that they could get mental health support, face-to-face counselling and rehabilitation. Have those clinics been commissioned, and when will those long covid sufferers be able to access them throughout the country?
(3 years, 10 months ago)
Commons ChamberI will start by answering a couple of factual questions. As I said in my statement, as of 9 am this morning, 51% of these cases have been contacted by the contact tracing system, and their contacts are contacted immediately after the initial contact—concurrently.
The hon. Gentleman asked about the tiering system. Absolutely, extra support will go to areas where there is an increased number of cases. He asked about the criteria in the proposed approach. Of course, we cannot have fixed and specific criteria, because it depends on the nature of the outbreak. For instance, if there was an outbreak in one individual employer, we would not necessarily put the whole local area into local action. We try to make the intervention as targeted and as localised as possible, but sometimes it needs to be broad, as it is in the north-west and across large parts of the north-east. For example, the intervention in the west midlands covers four of the seven council areas of the west midlands, but not the other three, because that follows the data.
The hon. Gentleman asked about the particular IT system in question. The problem emerged in a PHE legacy system. We had already decided in July to replace this system, and I commissioned a new data system to replace the legacy one. Contracts were awarded in August, and the work on the upgrade is already under way. While, of course, we have to solve the problem immediately, we also need to ensure that we upgrade this system, and we have already put in place the contracts to ensure that that happens. In the meantime, it is critical that we work together to fix these issues, which were identified by PHE staff working hard late on Friday night. I want to thank the PHE staff who did so much work to resolve this issue over the weekend.
In answer to the hon. Gentleman’s final question, we need to ensure that we contact trace all those cases as soon as possible. In two days, we managed to get to 51% of them, and that work is ongoing.
The Health Secretary deserves enormous credit for the expansion of testing capacity that he has personally championed, but is not the underlying problem that the Lighthouse laboratories have been, and will continue to be, overwhelmed by demand? Do we not need to think about the structures and, in particular, whether the responsibility for NHS staff testing and care home staff testing should be moved to hospital laboratories and universities, in the way that was advocated this morning by Sir David Nicholson, the former chief executive of the NHS? Sometimes it is tempting to think that, by dealing with the latest problem, we will solve the whole problem, but ahead of winter and the second wave, we need to think about whether these structures are right for what we have to deal with.
The expansion of the NHS testing is, of course, critical as well. The system in question, where the problem was over this weekend, brings together the data both from the NHS systems and from the so-called pillar 2 systems. The challenge was in a system that integrates the two, rather than just on one side or the other, but my right hon. Friend makes a broader point, which is that as we expand the NHS’s capacity as part of the overall expansion of testing, we have to ensure that we use that capacity to best effect. In many parts of the NHS, increasingly, it is NHS testing capacity that is used for NHS staff testing. That system works well, because the test is local and convenient, and we are looking to expand in exactly the sort of direction that he outlines. I urge colleagues away from trying to bifurcate between the two systems. Essentially, we have a whole series of different ways to access a test, and we need to make sure that people get the tests that are easiest to access for them as much as possible.
(3 years, 11 months ago)
Commons ChamberI will support the Government today because, although I fully understand the concerns about parliamentary scrutiny eloquently expressed by my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), the biggest threat that we face as a country is not the erosion of liberty but the explosion of the virus. We now know, as we go forward into a second wave, that for every death directly caused by covid there is at least one death indirectly caused by the disruption to cancer services, the interruption of emergency care and people being discharged early from hospital.
I wish to ask the Government about measures that could reduce such indirect deaths, particularly the introduction of the routine weekly testing of NHS staff, which we have discussed many times in the House—I see the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth) smiling. In fairness to the Government, they have moved on this issue. In July, Chris Whitty told the Health and Social Care Committee that he supported the routine testing of asymptomatic NHS staff in hotspots. I would like there to be such testing everywhere, including in my constituency, where recently we seem to have seen live cases trebling, but even in the hotspots it is not currently happening with any consistency. That is a worry, because up to a fifth of staff in hospitals got the virus during the first wave and up to 11% of deaths of coronavirus patients were caused by patients having caught the virus in their own hospital. That is the context.
I recognise that some hospitals are trying to do routine testing, but it is very difficult for them to do it on a weekly basis when they cannot access pillar 2 testing, so will the Secretary of State ask all hospitals to make weekly testing happen, under their own steam if they can, or with the support of NHS Test and Trace supplying the reagents, or using pooled testing?
My hon. Friend has done a lot of campaigning to highlight that issue, as have Select Committee members from all parties. The Select Committee will publish a report tomorrow that considers that very issue and will be coming back to it.
The Government’s own figures show that at least a thousand additional cancer patients died because of the interruption caused by the pandemic. As we go into a second wave, it does not have to be the same again. The Government have rightly introduced weekly testing for people in care homes; the arguments are exactly the same for our hospitals. Patients need to know that their NHS hospital is safe and NHS staff need to know that they are not infecting their own patients. As we go into this very difficult period, please, will the Government act and make this happen?
(3 years, 11 months ago)
Commons ChamberI am grateful to the hon. Gentleman for his constructive approach in these difficult times. He and I agree that the strategy of suppressing the virus while protecting the economy and education is the right one. In so doing, it is important to act fast so as not to have to act bigger later. I also agree that no one in this House came into office to put in place restrictions like these. He asked about the importance of people following the rules that we have put in place. It is vital that all people follow the rules. The vast majority have done so throughout but, critically, enough have not, meaning that in many cases we have had to make the rules mandatory, rather than relying on people’s sense of civic duty. That is the fundamental judgment behind making self-isolation mandatory, as I announced in the statement.
The hon. Gentleman asked about testing. Of course, we have record testing capacity right now—a record 233,000 tests were done on Friday—and lab capacity will continue to grow. He also asked about the NHS testing capacity, which will also continue to grow. In fact, I had a meeting about that earlier today with Simon Stevens, the head of NHS England. The hon. Gentleman asked about pool testing and saliva testing, which are just two of the many new testing capabilities that we are bringing to bear. He also asked me to ensure that there will be no admissions to care homes without a test. That is our policy: not just no discharges from hospital into care homes without a test, but no admission from anywhere into care homes without a test. That was reiterated in the social care winter plan that we set out on Friday.
I suppose that at the heart of the official Opposition’s response, and at the heart of my response to the hon. Gentleman, is the fact that we are united in wanting to tackle this virus, and in sending the message to everyone across the country that it is critical that we all follow the rules and play our part so that we can suppress the virus while protecting, as much as possible, the things that we love.
I support the measures outlined by the Health Secretary, which regrettably are both necessary and proportionate. Last week, on World Patient Safety Day, the WHO announced a charter for health worker protection, which asks all WHO member states to commit not only to having adequate supplies of personal protective equipment and mental health support, but to ensuring that there is zero tolerance of violence against health workers. Will he commit the Government to signing up to the charter so that, as we go into a second wave, all our brave frontline workers know that this Government and this House stand four-square behind them?
Yes, I will happily sign up to the proposals that my right hon. Friend has set out. As the House well knows, his long-standing and international work on patient safety is very impressive. We must ensure that in these difficult times we protect our care workers and frontline staff—including, if I may say so, the staff at the testing centres—and that we reiterate once again our commitment to patient safety.
(3 years, 11 months ago)
Commons ChamberTo respond to the constructive questions that the hon. Gentleman raised, I welcome his comments on the use of 111 First. The purpose of 111 First is to improve access, including in terms of inequalities in the NHS, by ensuring that people get the right treatment in the right place and easier access if they do need to go to an emergency department, because the emergency department will know that they are coming. It is commonplace now in almost every part of our life to let people know that we are coming. If we are going to do something as important as visit an emergency department, it will help both the patient seeking treatment and the NHS to let them know that they are coming first. That is the principle behind 111 First. It sits alongside 999, which anybody should call in a serious incident.
The hon. Gentleman asked about the need for extra funding for the NHS, both for winter and for testing. I have just announced £2.7 billion of extra funding for the NHS, and he might have done better to welcome it. He talked about tackling the backlog of cases that inevitably built up in the first peak. The good news is that we are making progress on tackling that backlog and reducing it. Of course, there is an awful lot of work to do, and part of this extra funding will go towards that, alongside the funding to expand our emergency departments, the funding for PPE and the funding for testing that I mentioned in my statement.
The hon. Gentleman asked about PPE for care homes. We have a huge plan to ensure that care homes can get PPE, and the details will be set out shortly in the social care winter plan. He asked about family visits. The challenge of visits to those living in care homes is incredibly difficult, because nobody wants to spread coronavirus, but we also need to ensure that those who live in care homes get the support that they need and deserve.
The hon. Gentleman asked about testing. Of course there is a challenge in testing. The central point is that, contrary to what he said, capacity is at record levels and has increased week on week. The challenge is that demand has gone up faster—[Hon. Members: “No, it’s not.”] Those on the Opposition Benches can say, “No, it’s not,” but they cannot defy the facts. The most important thing for everybody across the country to hear from their elected representatives, if they are interested in helping the country get through this pandemic, is: if you have symptoms, get a test, and if you do not have symptoms, please do not come forward to get a test unless you are specifically asked to. That is what colleagues on both sides of the House need to be repeating to their constituents.
The hon. Gentleman rightly raised prioritisation—I like him, and he raised exactly the right point, which is that we choose to prioritise care home staff and care home residents. Over 100,000 tests a day of the 260,000 capacity are sent to care homes. We could solve other problems by not doing that, but we prioritise those who live in care homes because that is the right thing to do. He asked about areas where there are restrictions. We prioritise putting tests into areas of restrictions, such as Leicester, where there were over 1,000 tests yesterday. This is the core point: when something is provided for free and demand is therefore high, we have to prioritise where we put our national resources. His tone on prioritisation was almost at the point of welcoming it, and welcome it he should. He also asked about universities, and it is important to prioritise testing, where that is clinically appropriate, for universities too.
Finally, the hon. Gentleman asked about today’s contact tracing figures. Again, he played this divisive card that does not suit him at all, talking about the difference between the NHS and the private contractors. What I care about is a good service for the people we serve. The figures announced today are that 83.9% of contacts where communication details were given have been reached and told to self-isolate. That is the contact tracing working—even as the number of cases goes up—to help to control this virus. As we approach winter, I look forward to the two sides of this House coming together in the national interest, not playing these divisive cards that will simply play against the interests of those we serve, who elect us here in order to take our country through difficult times.
Today is World Patient Safety Day, which I had the privilege of launching virtually with Dr Tedros of the World Health Organisation this morning. The changes that the Health Secretary is announcing to A&Es are about patient safety. As Dr Katherine Henderson told the Health Committee, if we go back to crowded A&E waiting rooms, patients will die, so I welcome these changes. May I ask my right hon. Friend specifically about sepsis? Our A&Es have made huge progress in testing people who need to be tested quickly for sepsis when they arrive at A&E. If that is now to be done on the phone—if that is the first point of contact—it is absolutely vital that 111 call handlers are properly trained and their algorithms adjusted to ensure that we ask the right questions on sepsis. Will he undertake to do that?
I wholeheartedly support the points that my right hon. Friend has made. I pay tribute to him for his work in establishing World Patient Safety Day and thank him for his ongoing work in the international arena, both representing our country and driving forward this agenda globally. I entirely agree with his comments about 111 First. It is absolutely critical that both the online and phone systems act to ensure that sepsis is recognised, wherever that is feasible, to ensure that people get the best and safest route to care. I will ensure that that point is registered. We have put in the extra funding, which I have just announced, for 111 to ensure more clinical support for people accessing the service through NHS 111 First. Indeed, I pay tribute to him for introducing 111 in the first place. There is an awful lot of work to do here, but it will undoubtedly help patients to get a better service and help the NHS to deal with the multitude of cases that come its way.
(3 years, 11 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.
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Let us hear from the Chair of the Health and Social Care Committee.
A week ago today, the Secretary of State told the Health and Social Care Committee that he expected to have this problem solved in two weeks. Since then, in my constituency, two Farnham residents have been sent to Bristol for their tests, a councillor has been sent to the Isle of Wight for her test and a teacher who tested positive had to wait a week for her results. Is the Secretary of State, given the efforts that his Department is making, still confident that in a week’s time we will have this problem solved?
I think that we will be able to solve this problem in a matter of weeks. In his constituency yesterday, 194 people got their tests. We are managing to deliver record capacity, but as he well knows, demand is also high, and the response to that is to make sure we have prioritisation, so that the people who most need them can get the tests that they need.
(3 years, 11 months ago)
Commons ChamberThe hon. Gentleman was rather better when he was supporting the Government action in the first part of his response. He cannot seem to decide whether he is in favour of more testing, or against it. All we get is complaint after complaint, rather than support for his constituents and the people of this country in our quest to get through this virus.
First, on who is eligible for a test, precisely as I said and as he literally read out, if you have symptoms, get a test. If you do not have symptoms, you are not eligible for a test, unless specifically asked for one. [Hon. Members: “If in doubt!”] Yes, if you have symptoms and are in doubt about whether those symptoms are coronavirus, get a test. If you do not have symptoms, do not get a test. That has not changed. It is exactly the same. What has changed is that the hon. Member for Leicester South (Jonathan Ashworth) does not know whether he is coming or going.
The hon. Gentleman does not seem to understand that the way in which we build a huge project like our testing, which is at record levels, is to back all the horses. Once again, he complained about businesses supporting us in our roll-out of mass testing. That divisive approach is wrong. We support universities, businesses and the NHS to deliver more testing; we do not support the totally confused approach of the Opposition. He does not know whether he is in favour of or against more testing.
The hon. Gentleman asked about the money, and £500 million has thus far been allocated to this project, but more is likely. He asked about staff testing in the NHS. As he well knows, we follow clinical advice, but always keep it under review. Finally, he asked about schools. The policy on schools is that, if somebody tests positive, that bubble needs to self-isolate. A bubble is defined as those who are in close contact within a school setting.
I will end on a point on which we agree strongly. On this, World Suicide Prevention Day, all of us are united in support of the mental health services provided across this country, and of all those who are working hard for those with mental ill health or at risk of suicide. That is a project on which all of us are on the same side and working together to support people.
As someone who has long campaigned for mass testing, I warmly welcome the ambition behind Operation Moonshot—and the implied characterisation of the Health Secretary as this country’s answer to Neil Armstrong. However, 10 million is a huge target. Could he give the House some idea of the proportion of that 10 million that is dependent on new technologies and the proportion that we can get to with existing technologies? Mass testing is so important to getting the country back to running as normal, and while we all want those new technologies, it would be helpful to have an understanding of how much expansion we can expect on the technologies we already have.
That is an extremely clear and strong position from the Chair of the Select Committee. Of course we are expanding the current technologies. We have a plan, when we are on track for it, to get to 500,000 tests a day by the end of next month, on the current technologies. On the next generation of technologies, I am not going to put a figure on it because it depends on the technologies coming off. The very nature of backing new technologies is that we do not know which ones are going to be verified. That is why we have so many that are being piloted and so many with whom we are working. We have tests right now in Porton Down being verified. We want this to go as fast as we can, and we want it to go as large as we reasonably can, but we do not put a specific figure on it—we put all our weight and support behind this project, which will have the positive benefits that my right hon. Friend so eloquently sets out.