Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 14th June 2021 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. I congratulate Sir Richard Sykes on his new role and I thank Dame Kate Bingham.

Tonight’s announcement was both predictable and, sadly, predicted. Many of our constituents and local businesses will be deeply disappointed. Our constituents did what was asked of them. They queued up for vaccination. We praised them in this House. The Secretary of State shed tears on the news and boasted, “Cry freedom,” on the pages of The Spectator. Yet we are now in the grip of a delta wave that is spreading with speed, and our constituents face further restrictions.

The Prime Minister’s complacency allowed this variant to reach our shores. On 25 March, there were warnings of a new variant in India. It is reported that Ministers first learned that the delta variant was in the UK on 1 April. The Government red-listed Pakistan and Bangladesh on 9 April, but did not red-list India until 23 April, by which point 20,000 people had arrived from India. Our borders were as secure as a sieve, and all because the Prime Minister wanted a photo call with Prime Minister Modi. It is astonishing that these Ministers promised to take control of our borders and conspicuously failed to control our borders at the very moment it mattered most.

Not only did the Prime Minister open the back door to this variant; he failed to take measures to suppress it when he could. It has been growing in prevalence among school-age children, yet mandatory mask wearing has been abandoned in secondary schools, and the Secretary of State has never explained why, despite being repeatedly asked. We know that isolation is key to breaking transmission, yet, 16 months on, people are still not paid adequate financial recompense to isolate themselves. When asked at the Select Committee last week, he claimed that people would game the system. The only ones who gamed the system are the mates of Ministers, Tory donors, spivs and speculators who made a fortune supplying duff PPE.

The Secretary of State seeks support for extending restrictions by pointing to plans to go further on vaccination. We will support extending restrictions in the Lobby, but even after extending the doses that he has outlined, there will still be large proportions of the population left unprotected, having had one dose or none—exposed to a variant that, if left unchecked, could accelerate and double every week, putting us on track for tens of thousands of infections per day by the end of this period. That will mean more hospitalisations, more long covid, more disruption to schools and more opportunities for variants to emerge. Will the Prime Minister lift restrictions in those circumstances, as he appeared to promise tonight, or will infection rates and hospitalisations have to fall before he does so?

Vaccination will get us through this in the end, so what is the Secretary of State’s plan to bring down infections and to extend vaccination rates in hotspot areas? We have learned that in Leicester surge vaccination has been abandoned. In parts of the north-west—in Chorley, Mr Speaker, in Tameside, in Salford and in Wigan—the dose numbers have gone down. Has vaccination surging been abandoned in those hotspot areas?

Finally, we are likely to see more infections in the coming days, and we are likely to see more contacts of infected cases in the coming days. Will the Secretary of State finally give those people isolation support so that they can isolate and quarantine themselves from the rest of society?

The chief medical officer said tonight that we would be lifting restrictions if it were not for the delta variant. The Prime Minister should have moved at lightning speed to prevent the delta variant reaching our shores. Instead he dithered, and tonight he is responsible for this delay.

[Matt Hancock]

I think that in that response, we saw a lifting of the veil on the Opposition’s position. The right hon. Gentleman knows that he has supported the Government’s position for a very large part of the crisis. We will be grateful for their support in the Lobbies, and quite rightly, because the Labour party has clearly accepted the logic of the position.

However, the logic of the questions the right hon. Gentleman just raised moved towards a position of never escaping from restrictions. I want us to escape from restrictions, and the vaccine is the way for us to escape from restrictions. The truth is—it is not the easy thing to say, but it is the right thing to say—that in this country and around the world, covid-19 will be with us and we will have to learn to live with it in the same way that we have learned to live with other deadly diseases like flu. The vaccine will help us get to a state in this country in which we can manage it and live our normal lives. The logic that the right hon. Gentleman set out is one in which we never escape.

It was a logic based on flawed thinking about how things work in practice, because the right hon. Gentleman’s other argument was that this is all due to the Government not taking decisions on India, based on information that we did not have at the time. His argument is that he has now seen in the published data that there was a problem in India—too right! And as soon as we saw the data, we acted on it. The whole case that he set up was that on 2 April we should have acted, but on 2 April neither the original B1617 Indian variant strain, nor the B1617.2 delta strain, had yet been designated a variant under investigation or a variant of concern.

Captain Hindsight over there is arguing, “Never escape from restrictions, and base your logic and evidence on things that haven’t been recorded yet.” That is no way to run a pandemic. Instead, we will put the interests of the British public first. We will take a cautious and irreversible approach. We will take difficult decisions if they are necessary, but we will get this country back on the road to recovery.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 8th June 2021 Commons Chamber

[Matt Hancock]

It is very important that, across the country, the UK is open, the NHS is open and that people can come forward and get treatment if they need it. As my hon. Friend knows, I work closely with the delivery of the NHS in Wales. The NHS there is of course the responsibility of the devolved Administration, but I am happy to take up his concern with the new Welsh Minister for Health and Social Services to see what we can do.

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

We have seen reports today of how exhausted NHS staff are. The Secretary of State for Environment, Food and Rural Affairs said in the media this morning that he was not sure what more the Government could do to support NHS staff. Obviously, the Government could give them a pay rise, but will the Secretary of State for Health and Social Care also commit today to extending free hospital car parking for NHS staff beyond the pandemic?

[Matt Hancock]

Of course, we have made hospital car parking free for staff during the pandemic. That is one of the many, many things that we have put in place to support staff. Staff wellbeing support and mental health support have also been incredibly important, learning, as we have done, from the support that we give to others in public service who go through traumatic episodes. The right hon. Gentleman is quite right that there is a wide array of things that we need to do to support NHS staff on the frontline.

[Jonathan Ashworth]

I wanted a commitment to extend the relief of hospital car parking charges beyond the pandemic.

The Secretary of State knows that waiting lists are at 5 million and that 432,000 people are waiting beyond 12 months. Once we are through this pandemic, the priority must be to bring those waiting lists down, but he is about to embark on a reorganisation of the NHS with his integrated care legislation. Local boards permit the private sector to have a seat on them. Virgin Care has just been given a seat on the integrated care system in Bath and North Somerset. He once promised that there would be no privatisation on his watch, so will he instruct that ICS to remove Virgin Care from its board?

[Matt Hancock]

The right hon. Gentleman is absolutely right that integrating the health service with services provided by local authorities, such as social care, is absolutely critical, and I know that he supports those proposals that have come from the NHS. When it comes to delivering services in the NHS, what matters to patients is that they get high-quality services, for instance, to deal with the backlog, and what matters is getting those services as fast as we possibly can. People care much less about who provides the service than they do about the service getting delivered, and that is the approach that I take, too.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 7th June 2021 Commons Chamber

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

I am grateful to the Secretary of State for advance sight of his statement. I am also grateful that he has confirmed that the Government’s approach continues to be driven by the data, not by dates. We face some uncertainty, as we often have done throughout the past 15 months, but we do know that the delta variant is now the dominant variant in the UK. We know that 73% of delta cases are in unvaccinated people. We know that one dose offers less protection against this particular variant, and we know that, although hospitalisations are low, an increase in hospitalisations will put significant pressures on the NHS as it tries to deal with the care backlog. We also know, of course, that long covid is significant and debilitating for many people.

I am an optimist and I strongly believe that, ultimately, vaccination is our way through this. Can the Secretary of State go further on vaccination? Is he able to do more to drive up vaccination rates in those areas that have seen the delta variant take off and where uptake remains low, such as Blackburn or my own city of Leicester? Can he narrow the timeframe between the first and second dose, given that we know that one dose is not as protective as we would like? We have seen that Wales will be vaccinating everyone over 18 from next week. Can he tell us when England will follow?

Yesterday, the Secretary of State talked about the outbreaks among schoolchildren and young people. We know that children can transmit the virus and that children can be at particular risk of long covid. In that context, may I ask again why mask wearing is no longer mandatory in secondary schools? I am pleased that he has asked the JCVI to look at vaccination for children; it is something that I have I pressed him on a number of times at the Dispatch Box. Can he give us a timeframe on when he expects the JCVI to report on that front?

The Secretary of State talks about the G7. The pandemic has certainly shown that in an interconnected world where climate change and biodiversity loss drive zoonotic spillovers, working internationally to prevent future outbreaks is in our interests. None of us is safe until all of us are safe. That is not a slogan; it is the fact of the situation that we are in. That means working internationally. For a start, it means not cutting international aid, but it also means working globally on our vaccination efforts. He will have seen today that Gordon Brown, Tony Blair and other ex-world leaders have put forward a G7 burden sharing plan that would vaccinate the world. Will the Government support it?

Finally, I welcome what the Secretary of State said about research. Research and science are our way through this pandemic, and our way through to curing so many other diseases and ailments. However, he will know that while we are in this pandemic—while GPs and frontline staff are stretched—patients are unaware that a whole load of GP-held patient data is about to be transferred to NHS Digital.

Now, I am not opposed to NHS data being used for public good research, but some of the most sensitive personal data shared with GPs by patients in confidence several years ago—potentially when in a state of vulnerability, such as termination of pregnancy, matters of domestic or sexual abuse and issues of substance misuse or alcohol abuse—is set to be shared with NHS Digital and potentially to be used by commercial interests, and yet hardly anyone knows about it. There are worries about safeguards and patient confidentiality. Given the secrecy, the haste and the difficulties in opting out, will the Secretary of State now consider abandoning this plan, pausing it for now and launching a transparent consultation process with patients and clinicians on how confidential data can best be shared for research purposes?

[Matt Hancock]

First, the right hon. Gentleman raised the question of ensuring that we reduce transmission among children. It is true that the increase in case rates has predominantly been among children, especially secondary school-aged children. The testing regime among secondary school-aged children has been enthusiastically taken up by schools across the country. It is very important, as we return from half-term, that that is reinstated in full—that every child is being tested twice a week. It made a big difference in helping to keep schools open. If somebody tested positive at home before they went in, it meant that the whole bubble did not have to go home. It also prevented transmission up to older people, who might be more badly affected. Testing in schools is incredibly important to ensure that we can keep as much education as possible between now and the summer.

The right hon. Gentleman asked about the JCVI advice on children’s vaccination that will be available in a matter of weeks. I know that the JCVI is working hard on it now. I will of course come to the House, Mr Speaker, to explain the proposed approach as soon as we have that formal advice.

Finally, the right hon. Gentleman asked about the use of patient data. I am glad that he said how important he thought research based on data is within the NHS, because it is life-saving. It has been used incredibly powerfully during the pandemic. In fact, one of the reasons why the UK is the place where we discovered some of the life-saving treatments for covid, such as dexamethasone, is the powerful use of data. Just that discovery of dexamethasone, which happened through the use of NHS data, has saved over 1 million lives around the world.

The right hon. Gentleman raised the issue of data, which he said belonged to GPs, being passed to NHS Digital. The truth is that data about his, my or anybody else’s medical condition does not belong to any GP; it belongs, rightly, to the citizen—the patient. That is the approach that we should take. I absolutely agree that it is important to do these things right and properly, but I am also very glad that the vast majority of people are strongly on side for the use of their data to improve lives and save lives. That is the approach that we are going to take in building a modern data platform for the NHS, so that we can ensure that we use this modern asset to improve individuals’ care and to improve research and therefore all our care, while of course preserving the highest standards of safety and privacy, which will be enhanced by a more modern use of data. I am glad that he is on side for the use of data in the NHS, but you have to be on side when that is actually put into practice. It is not just warm words; it is about making it happen.

Covid-19: Government Handling and Preparedness

Debate between Jonathan Ashworth and Matt Hancock

Thursday 27th May 2021 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care, if he will update the House on the pandemic preparedness of the Department of Health and Social Care.

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

What we have done to handle this coronavirus pandemic has been unprecedented in modern times. Throughout, we have been straight with people and this House about the challenges that we as a nation face together. The nation, in my view, has risen to these challenges. Of course, there were unprecedented difficulties that come with preparation for an unprecedented event.

This pandemic is not over yet. Our vaccination programme has reached 73% of the adult population, but that means that more than a quarter still have not been jabbed; 43% of adults have had both jabs, but that means that more than half are yet to get the fullest possible protection that two jabs give.

Yesterday, we saw 3,180 new cases of coronavirus—the highest since 12 April—but thanks to the power of vaccination, in which I have always believed, the link from cases to hospitalisations and deaths is being severed. About 90% of those in hospital in hotspot areas have not yet had both jabs, so the continued delivery of the vaccination effort and the ongoing work to control the virus through testing, tracing and isolation are vital.

Yesterday, we saw the opening of vaccinations to all those aged 30 and above. I am delighted to tell the House that the vaccination programme is on track to meet its goal of offering a jab to all adults by the end of July. It has met every goal that we have set. Setting and meeting ambitious targets is how you get stuff done in Government.

As a nation, we have many challenges still to come. I know, and one of the things I have learned, is that the best way through is to work together with a can-do spirit of positive collaboration. The team who have worked so hard together to get us this far deserve our highest praise. I am proud of everyone in my Department, all those working in healthcare and public health, the armed forces who fought on the home front, the volunteers who stood in cold car parks with a smile, colleagues across the House who have done their bit and, most of all, the British people. Whether it is the science, the NHS or the people queuing for vaccines in their droves, Britain is rising to this challenge. We have come together as one nation, and we will overcome.

[Jonathan Ashworth]

Families who lost loved ones will have noticed that the Secretary of State, in his opening remarks, did not respond to any of the specific allegations from yesterday—allegations that are grave and serious: that the Prime Minister is unfit for office; that his inaction meant that tens of thousands needlessly died. We had allegations from Dominic Cummings that the Secretary of State, specifically, misled colleagues—an allegation from Mr Cummings, Mr Speaker—on our preparedness and lack of protection for people in care homes.

The allegations from Cummings are either true, and if so the Secretary of State potentially stands in breach of the ministerial code and the Nolan principles, or they are false, and the Prime Minister brought a fantasist and a liar into the heart of Downing Street. Which is it? Families who have lost loved ones deserve full answers from the Secretary of State today. Is he ashamed that he promised a protective shield around care homes and more than 30,000 care home residents have died? Why were 25,000 elderly people discharged from hospitals into care homes without any test? Did he tell Downing Street in March that people discharged from hospital had been tested, even though it was not until 15 April that there was a requirement for testing to take place?

In public, the Secretary of State has often claimed that little was known of asymptomatic transmission at the time, so testing was not necessary, but the Scientific Advisory Group for Emergencies in January flagged evidence of asymptomatic transmission. A study in The Lancet in February flagged it. On 5 March, the chief medical officer said that

“there may well be a lot of people who are infected and have no symptoms”,

so why did the Secretary of State not insist on a precautionary approach and test all going into care homes?

On 6 May, at the Dispatch Box, the Secretary of State claimed that it is

“safer for them to go to a care home.”

Yet 12,000 people had died in those early months. How could he justify that comment? In April, he told the House:

“What is important is that infection control procedures are in place in that care home”.—[Official Report, 19 May 2020; Vol. 676, c. 494.]

However, care homes, like the NHS, struggled with the most desperate of personal protective equipment shortages. He was telling us in March from the Dispatch Box that supplies were extensive, but apparently in private, in Downing Street, he was blaming Simon Stevens for the lack of PPE.

The reality is that the Secretary of State and his Department were responsible for PPE, and the National Audit Office report said that the supplies were inadequate. Some 850 healthcare workers died. How many could have been saved had they had PPE? Families lost loved ones and have been let down by the Government, the Prime Minister and the Health Secretary, but the truth matters. Those families and the country deserve clear answers from the Health Secretary and the Prime Minister today.

[Matt Hancock]

The allegations that were put yesterday and repeated by the right hon. Gentleman are serious, and I welcome the opportunity to come to the House to put formally on the record that these unsubstantiated allegations around honesty are not true, and that I have been straight with people in public and in private throughout. Every day since I began working on the response to the pandemic last January, I have got up each morning and asked, “What must I do to protect life?” That is the job of a Health Secretary in a pandemic.

We have taken an approach of openness, transparency and explanation of both what we know and what we do not know. I was looking at it this morning. Since last January, I have attended this House more than 60 times. With the Prime Minister, we have together hosted 84 press conferences. I have answered 2,667 contributions to this House and answered questions from colleagues, the media and the public, and we will keep on with that spirit of openness and transparency throughout. As well as coming to the House today, I will answer questions and host another press conference later.

Sometimes what we have had to say has not been easy. We have had to level with people when it has been tough—when things have been going in the wrong direction. Also, we have learned throughout. We have applied that learning both to tackling this pandemic and ensuring that we are as well prepared in the future as possible, but beyond all that what matters remains the same: getting vaccinated, getting tested, delivering for our country, overcoming this disease and saving lives. That is what matters to the British people.

A Plan for the NHS and Social Care

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 19th May 2021 Commons Chamber

[Matt Hancock]

Yes, my hon. Friend is absolutely right. I thought that his exchanges with the right hon. Member for Leicester South were disappointing, because we know that the Opposition spokesman supports the use of the private sector in the NHS, because he was the guy behind the private finance initiative projects of the last Labour Government. Mr PFI there is a huge fan of the use of the private sector in the NHS, but he cannot admit it, because of the people sitting behind him, and the right hon. Member for Ashton-under-Lyne (Angela Rayner) sitting next to him, keeping watch over him from the hard left of the party.

[Jonathan Ashworth]

For goodness’ sake, I was not responsible for a single PFI contract. Actually, I remember that it was for the previous Chancellor of the Exchequer, George Osborne, that the right hon. Member was the chief lickspittle and bag carrier in signing off PFI contracts when he was first appointed to the Treasury. He can go through all the Treasury documents and he can FOI it until the cows come home, and he will find that I was not involved in any PFI contracts when I worked in the Labour Government, but I was responsible for helping invest in the NHS, which brought waiting lists down to their lowest level ever.

[Matt Hancock]

Well, it did not actually, because after 2010 we then had to bring waiting lists down, and we brought them down. The 52-week waits came down to just 1,600 before the pandemic, and it is our task and our mission to make sure that we get them down once again. However, this will take time and it will take all the resources that are possible—yes, extra staff, and that is happening; yes, extra capital investment, and that is happening; and yes, extra diagnostics, and that is happening. We have to use all the capacity of everything that we can—north and south, revenue and capital, public and private. What people care about and what our constituents care about is whether they can get the problem fixed, and last year has demonstrated that without doubt. So on the Government side we will use everything in our power to support the NHS. It is only those on the other side of the House who have the ideological divisions, and that just demonstrates once again that we are the party of the NHS.

In March, we committed £7 billion for further funding for healthcare services, including £1 billion to address backlogs from the pandemic, and that has taken our additional funding for covid-19 to £92 billion. We are also helping the NHS to recover medical training, and today I can confirm to the House an additional £30 million for postgraduate medical training. The formula for beating this backlog is looking closely at the demand as we emerge from the pandemic, putting in the right resources to meet this demand and putting in place an ambitious programme of improvement in the NHS.

That brings me to the third thing I want to talk about, which is how we are going to build back better. The Queen’s Speech outlines improvement in almost every area of healthcare, applying vital lessons that we have learned from the pandemic, including from the successful vaccination programme, when the whole health and care system has worked as one in the face of challenge and adversity. The vaccination programme brought a jigsaw of academics, the private sector, volunteers, the NHS, civil servants and many more, and put this together, revealing a bold picture of what is possible in this country when we pull together. That is the spirit and the energy that will underpin our reforms, and all of them have a common thread, which is to improve the health of the nation, based on the principle that prevention is better than cure.

Turning to our health and care Bill, as outlined in Her Majesty’s most Gracious Speech, one of the lessons of the crisis is the importance of integrated working. We knew this before, but it has come right to the front of mind. For years, people in the NHS at all levels have called for stronger integration within the NHS, and between the NHS and others they work so closely with, such as local authorities. The Bill will allow for a more preventive, population health-based approach to how we spend NHS money, helping people to stay healthy in the first place, and that is at the core of our Bill.

The right hon. Member for Leicester South asked about the new integrated care systems. They will bring together decision making at a local level between the NHS and local authorities to ensure that decisions about local health can be taken as locally as possible. The Bill will tackle much of the bureaucracy that makes it harder to do the right thing and free up the system to innovate and embrace technology as a better platform to support staff and patient care.

Her Majesty also set out our commitment to reform adult social care, and we will bring forward proposals this year to give everyone who needs care the dignity and security they deserve. Throughout the pandemic, we have sought to protect the elderly and the most vulnerable, and this will remain our priority as we look to end the care lottery and ensure that people receive high-quality, joined-up care.

This country understands the importance of the NHS and social care, but I also think that there has never been a greater appreciation of the importance of public health. Never have the public been more engaged, and never have we learned quite so much in such a short space of time. We must capture the lessons of the pandemic on how we do public health in this country and put that together with the innovations of the last decade—in data, genomics, population health, science and research.

One of the lessons that we have had to learn quickly is that health security and health promotion each need a single-minded focus. The people who get up in the morning and think about how we increase healthy life expectancy must be different from the people focused on fighting novel pandemic threats. Each is important and each needs dedicated focus. We have split these functions into two purpose-built organisations so that we are better at both.

The new UK Health Security Agency will have a dedicated focus on responding to the current threats, planning for the next pandemic and scanning the horizon for new threats in good times as well as bad. Of course, pandemics do not respect administrative boundaries. The UKHSA’s role is specifically to promote and protect the security of the United Kingdom as a whole.

Next, the job of our new Office for Health Promotion will be to lead national efforts to improve and level up our health—addressing the causes of ill health, not just the symptoms, such as through our plans to tackle obesity and make healthier choices easier and more accessible, and through supporting our colleagues in primary and community care. General practice, after all, is at the forefront of all population health measures and GPs are the bedrock of the NHS. General practice will be central to our levelling up the health of the nation because we know, and they know, that prevention is better than cure. A greater proportion of our efforts will now be directed at preventing people from becoming patients in the first place.

All of that brings me to mental health reforms. To truly level up health and reduce health inequalities, we must level up every part of our health, including mental health. I am determined to see mental ill health treated on a par with physical ill health, and to ensure that support is in place for those struggling with their mental wellbeing. We have provided record levels of funding for mental health services, especially to meet the additional burdens of the pandemic, but we need a better legislative basis—a mental health Act fit for the 21st century.

We are modernising the Mental Health Act to improve services for the most serious mental illnesses and support people so that they can manage their own mental health. The new Act will tackle the disparities and iniquities of our system and improve how people with learning difficulties and autism are supported. Ultimately, it is going to be there for every single one of us if we need it.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 17th May 2021 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. May I start by congratulating the Leicester City football team on winning the FA cup on Saturday? The winning goal from Tielemans was one of dreams. Leicester City fans boast that Foxes never give up and nor do I, so let me turn to the matters before us.

Yesterday, the Secretary of State warned on the television that the B.1617.2 variant could “spread like wildfire” among the unvaccinated, but does he accept that we could have avoided this? Our borders have been about as secure as a sieve, and the delay in adding India to the red list surely now stands as a catastrophic mis-step. One month ago in this House, I urged him to act quickly in response to this variant. The Wellcome Sanger Institute data today shows a rapid increase in this variant, to 30% of all sequenced cases in the UK, and that excludes cases from travel and surge testing. Alarm bells should be ringing, because although the Secretary of State offers reassurance that vaccines are effective, we have also heard Professor Anthony Harnden of the JCVI recently warn us that vaccines are “almost certainly less effective” at reducing the transmission of this variant.

I entirely appreciate that when questioned I suspect that the Secretary of State will not be able to give a cast-iron assurance about opening up on 21 June, and I am not going to try to push him into a corner; we all understand that we are dealing with uncertainties and we have to be grown up about these things. But we do need a plan now to contain this variant urgently. He is said to be considering local lockdowns. As he knows, I speak as a resident of long locked-down Leicester. Before he takes out his mallet to try to whack moles again, may I suggest a number of things for him to try first?

First, will he consider surge vaccination in all hotspot areas and go hell for leather to roll out vaccinations to everyone? I listened very carefully to what he said about vaccination increases in Bolton, and I hope that also includes Blackburn. Is he saying that everyone over 18 in those areas will now be eligible for vaccination? As he knows, that is something that public health directors on the ground have been calling for, and I hope we listen to them.

We have had these debates in the House before, and the Secretary of State knows that even if we drive up vaccination as high as it can possibly go among adults, there are still about 20% of the wider population—children —who remain unvaccinated, which means the virus can still spread. The Centers for Disease Control and Prevention in the US are moving to vaccinate children. Will he update us on what progress he is making on that front here? On children, the Secretary of State knows that in many secondary schools, mask wearing is no longer necessary. Will he assure us that he thinks that is the right response in the light of the data he unveiled today?

Secondly, the Secretary of State has announced extra surge testing, but he knows by now that surge testing must be backed up by proper sick pay and decent isolation support. That should have been fixed in the Queen’s Speech last week.

Thirdly, more venues are opening up today. Many will be spending a lot of time disinfecting surfaces, like we do in here, which is good and important, but we know so much more about this virus now. We know about airborne spread of the virus, so why are we not supporting venues more with ventilation? What are we doing to help supermarkets, shopping centres and larger venues where air circulates around the building to put in place covid-secure air filtration systems?

Fourthly, what the Secretary of State said about the NHS and the uptake of beds is welcome, but NHS staff, as he knows, are exhausted and fear another surge. What modelling has been shared with NHS leaders, and what are they doing to prepare for any surge in admissions?

Finally, the surge in this variant reminds us that we are not safe until everyone is safe. That is not a slogan; it is a fact. Some 3.3 million lives have been lost globally to this virus, and Dr Tedros Adhanom Ghebreyesus from the World Health Organisation warns that we are on track for the second year of this pandemic to be far more deadly than the first. Only 0.3% of vaccine supply is going to low-income countries. Trickle-down vaccination is not an effective strategy for fighting this deadly virus. Not only do we have a moral responsibility to play our part internationally, but that also reduces the risk of new variants bouncing back at us and setting us back.

At this critical time, when we need to work internationally to defeat this virus, why are we the only G7 nation cutting its aid budget? How can the Secretary of State defend cutting our contribution to vital science and research projects? Given the total silence from the Government on President Biden’s support for the temporary lifting of patent protections to increase vaccine production, should we assume that the Government do not agree with President Biden?

[Matt Hancock]

Let me address the hon. Gentleman’s substantive questions. The first was about the surging of vaccines and testing into hotspots. We saw in south London earlier in the month and last month that that sort of surge testing can work. We had an outbreak of the South African variant in south London. We put in more than 200,000 tests, and we effectively managed to contain that outbreak. That is the approach that we are taking in Bolton and Blackburn, and we will also take that approach if we see a further spread in other areas of the country. We have been working very hard on that to ensure we have that capacity and can do that effectively. We do that, of course, hand in glove with the local authorities in question, which know the communities on the ground.

We are also making sure we have the vaccines available, but I want to be absolutely crystal clear about the approach to vaccination. The hon. Gentleman asked about vaccinating all over-18s in Bolton and Blackburn, but that is not our approach. I have looked into it in great detail, and we have taken clinical advice. The approach is to make sure that we get done as many second vaccinations as possible, as many first vaccinations as possible among the vulnerable groups, and then as many vaccinations as possible among those aged under 50 in the eligible groups. We have taken that approach because that is what is likely to save most lives. That second jab is vital. The first jab for anybody over 50 could mean the difference between life and death. The very strong focus is to get the vaccine to all those over 50 who have not yet taken the first jab. I am glad to say that reports from both Bolton and Blackburn suggest that uptake among people who are eligible, but who have not yet taken the jab, has increased since we saw the rise of the B1617.2 variant in those areas. It is effective in proving to people that the jab really does work to protect them. That is what the data shows.

The hon. Gentleman asked about children. I have been closely following the results of the clinical studies from Pfizer that show that the vaccine is safe and effective among children between the ages of 12 and 18. We have procured enough Pfizer to be able to offer that jab to children should that be clinically approved here, but given that we are at the stage of opening tomorrow to people aged 37, there is some time to go before we get to 18-year-olds. We are on track to meet the target of offering the vaccine to all those aged 18 and above by the end of July, so we have a couple of months before we need to make and operationalise a decision. We want to be very, very careful and sensitive about whether and how we offer the vaccine to children.

The hon. Gentleman asked about important wider measures. He mentioned ventilation. We have put in place guidance for businesses in terms of strengthening the rules around ventilation, and that, too, is important. He did a bit of a Captain Hindsight act on the Indian variant. He did not seem to mention that we put India on the red list before this variant was even deemed a variant under investigation, let alone a variant of concern. Indeed, we put India on the red list before countries such as Germany and Canada stopped flights from India. We have a strong policy of restrictions at the border and we will remain vigilant.

The final point to which I wanted to respond was on the global moral responsibility to vaccinate everybody in the world. The hon. Gentleman is absolutely right that we have a global moral responsibility. I argue that, thus far, the United Kingdom has done, and will continue to do, more than any other nation. It is about not just the huge sums that we have put into COVAX, but the way that we delivered the Oxford-AstraZeneca vaccine around the world. As of this morning, 1.47 billion vaccines have been delivered globally, 400 million of which have been the Oxford-AstraZeneca vaccine. AstraZeneca has charged a profit margin and a margin for intellectual property of zero—no charge for intellectual property, no profit for AstraZeneca. Costs, of course, need to be met, but we have taken nothing for the money that we put into the vaccine’s development. This is the biggest gift that this country could give to the world. A total of 65% of those 400 million doses have been delivered into the arms of people in low and middle-income countries, including more than 150 million in India. On the COVAX facility, which is the biggest global effort to vaccinate in low and middle-income countries, it has delivered 54 million vaccines so far, 53 million of which have been done with the Oxford-AstraZeneca vaccine.

This country can be hugely proud of the contribution it has made. It is far bigger so far than that of any other country. We took the view from the start that we do not need to change our IP rules, we do not need to change the law, we just need to get on and get the vaccine out to as many people around the world as possible, at cost. Everybody in this House should be very, very proud of what AstraZeneca and Oxford University have done with the support of the UK Government. That is how we save lives around the world.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 19th April 2021 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. Let me start by saying that I have no doubt that Downing Street was reluctant to cancel the Prime Minister’s trip to India. As a Member of Parliament for Leicester, I am immensely proud of our deep ties and bonds with India, but it was the correct thing to do in the circumstances, because we must always be vigilant and driven by the data, and variants are the biggest threat to our progress.

Tackling the variants demands that vaccination continues to be rolled out successfully; I again pay tribute to all involved. Uptake levels are improving, as the Secretary of State said, but they are still too low in some minority ethnic communities. Will he provide extra resources to the local communities that need them to drive up vaccination rates?

We will look carefully at the details for vaccinating social care staff, but the Secretary of State will know that every attempt throughout history to force mandatory vaccination has proved counterproductive. Why does he think this attempt will be any different?

Even with high levels of vaccination across the population, there will be significant groups who are unvaccinated—children, for example. The virus will be endemic, as the chief medical officer has recently confirmed. Papers from the Scientific Advisory Group for Emergencies model a third wave this summer. How do we avoid that? May I suggest to the Secretary of State that one way that we could do that would be to pay higher sick pay and expand its scope? Some of the poorest and the lowest paid will continue to suffer and be left exposed to the virus unless we fix that. We should not just glibly accept these health inequities; it could mean that urban areas are left behind, remaining under restrictions with higher infection rates. For the millionth time of asking, will he please fix sick pay?

Let me turn to India, which has the most cases in the world at the moment—more than 250,000 confirmed cases a day, I think, and going up. That is one of the world’s steepest surges, right now. Uploads of Indian sequencing to the global open access database show that the new double mutant B1617 variant has become dominant in India in the past few weeks, out-competing our home-grown Kent strain. As of today, COVID-19 Genomics UK reports 135 cases of B1617 in the UK and 115 in the last 28 days. It has been the fastest growing variant in the UK in the last three weeks. Most of those variants are imported, so we welcome the Secretary of State’s announcement about adding India to the red list, although I hope that there will be support and help in place for constituents such as mine who are legally in India and want to return.

We also now have cases in the community that are not linked to international travel. I understand that the Secretary of State is carrying out analysis of those samples, but surely we now need to start surge testing and designate B1617 as a variant of concern. How long will it take before we have more definitive evidence that it is more infectious or immune-escape? We already know that this variant carries mutations of concern in other variants. If we have learnt anything in the past 12 months, it is that this virus ruthlessly exploits ambiguity and that we must act fast when the situation is controllable, because in a few weeks’ time, it might not be.

The Secretary of State did not mention vaccine passports in his statement. Does he anticipate that vaccine passports will soon be needed for football games or concerts? As he said, Leicester City have made it to the FA cup final, and they are a team challenging for Europe on merit who always put fans first. Many who are anticipating going to a football match later this year will be wondering this: if they need a vaccine passport, will it be based on one dose or two? He may have seen data from Israel or the Centres for Disease Control and Prevention in the US which suggests that people are still infectious after one vaccine dose, so can he update us on that front?

Finally, I turn to the latest Sunday Times revelations about the lobbying by Greensill and Cameron of the Secretary of State and the very highest NHS officials about the payday financing scheme. This was not an act of altruism to staff in a pandemic but an investment plan to package up loans to sell to investors, with the former Prime Minister, not nurses, in line for a payday windfall. Cameron wrote in one of his emails:

“As you can imagine, Matt Hancock”

is

“extremely positive about this innovative offer.”

They sought a partnership with NHS Shared Business Services, which is jointly owned by the Department. They sought access to the personal and financial data of thousands of NHS staff. They wanted their electronic records for their own commercial gain. Their plan was to expand into the social care sector, where staff are on low pay or zero-hours contracts, and because the market is fragmented and made up of private providers, the supposed non-profit offer would presumably not apply.

There were meetings and communications with a parade of the most senior NHS officials, including former Health Minister Lord Prior and Baroness Harding. At least 30 trusts may have spent valuable time considering the adoption of this untested payday lending scheme, and it is all because the Secretary of State succumbed to the lobbying of his old boss Cameron. So again I ask him, will he publish all the text messages, all the emails and all the correspondence with David Cameron? Can he tell us how many NHS leaders and officials Cameron and Greensill lobbied and met? How many NHS trusts in total were approached about this expensive, unneeded scheme?

While we are on the issue of NHS Shared Business Services, can the Secretary of State also tell us why he never declared his own links to Topwood, the confidential document shredding firm which was still on Friday night, until it was curiously taken down, using the NHS logo on its website to promote itself? With so many accusations and allegations of sleaze and cronyism, these are basic questions that deserve clear answers. NHS staff deserve a pay rise and support, not these payday loan apps forced on the NHS by speculators trying to make money out of the pandemic. How can he possibly defend it?

[Matt Hancock]

Let me address the final point first. As I said to the House last week, my approach was and is that local NHS employers are best placed to decide whether to take up offers of pay flexibilities, and Ministers are not involved in decision taking in NHS Shared Business Services. When it comes to the other matter that the right hon. Gentleman raised in terms of my declarations—which are known to him and to everybody else only because I have followed the rules in letter and spirit and made that declaration—I agree with the Leader of the Opposition, rather than him, who said that he was not suggesting that any rules were broken.

I turn to the covid-related matters. I welcome the right hon. Gentleman’s support of the decision to put India on the red list, which is not one that we take lightly. He is right to ask about surge testing, to make sure that we limit the spread as much as possible of the variant first found in India, and I can confirm that we will be doing that.

I welcome the right hon. Gentleman’s support for vaccinations, which he has demonstrated at all turns. It is partly because of the unanimity across the House among all parties on the importance of vaccination that we have this absolutely spectacular level of uptake. He says that every attempt at mandatory vaccination is counterproductive. I gently point him to the fact that surgeons needs to have a vaccine against hepatitis B. Vaccination that is tied to work in fact has a longstanding precedent in this country.

The right hon. Gentleman asks many questions about certification, but he knows that a review of it is under way at the moment, being led by my right hon. Friend the Chancellor of the Duchy of Lancaster, who I am sure will have heard his representations and questions, and will be able to address them in the review.

Finally, the right hon. Gentleman says that we must avoid a third wave by sticking to the rules, and he is right. We should avoid a third wave if we can, and the way that we can do it is by sticking to the rules and getting the jab. That is why the vaccination programme is so important. It is why the road map is cautious and, we hope, irreversible. That is the plan, and with the 10 million second vaccines and the progress in the vaccination programme that we have seen in the last few days, weeks and months, I am very pleased to say that we are on track.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 13th April 2021 Commons Chamber

[Matt Hancock]

I warmly welcome my right hon. Friend’s enthusiasm and support for that project, which the Prime Minister set out at a high level to the Liaison Committee. We are working hard, including with stakeholders, and the Minister for Care has held a number of roundtables on the subject. We want this to be an open and broad programme, to ensure that we get the right answers to these long-standing questions.

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

Will the Secretary of State explain why, following a private drink he had with Lex Greensill and David Cameron, Greensill was handed an NHS payroll financing contract that sought to convert income from NHS staff pay packets into bonds to sell internationally, and effectively to make money on the back of NHS staff in a pandemic? Why was that contract given without tender? Why was that meeting not declared? What pressure did the Secretary of State put on officials to hand that contract to Greensill?

[Matt Hancock]

Ministers were not involved in the decision by NHS Shared Business Services to facilitate the provision of salary advances in pilot schemes. I attended a social meeting organised by the former Prime Minister, and given that departmental business came up, I reported to officials in the normal way.

[Jonathan Ashworth]

This is part of a wider pattern of behaviour. We see PPE contracts going to Tory donors, and a pub landlord WhatsApping the Secretary of State and receiving a testing contract. We see a US insurance firm taking over GP contracts, and one of its bosses gets a job in Downing Street. It is cronyism and it stinks. If the Secretary of State thinks he has done nothing wrong and has nothing to hide, will he publish all the minutes, emails, correspondence and directions that he gave to civil servants, and all his text messages with David Cameron, so that we can see exactly what went on with the awarding of this contract?

[Matt Hancock]

Yesterday the Government announced a review into this matter, and I will of course participate in that in full. It is important that Governments engage with external stakeholders and businesses and, as was raised in the previous question, it is important that that happens, and happens in an appropriate way within the rules, which is what happened in this case.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Thursday 25th March 2021 Commons Chamber

[Matt Hancock]

I will just make a little more progress.

We are also suspending three further provisions, although they may need to be restored and called on if required. As well as that, we have completed the six-month statutory review on covid-secure regulations for businesses, the collection of contact details and self-isolation, and concluded that they remain necessary at this time. The Coronavirus Act is temporary, time-limited and proportionate to the threat we face, and we are keeping measures only where they are necessary as we exit this pandemic, and then we can do away with this Act for good.

Throughout the pandemic, this House has also found a way to meet. I cannot wait for the time when this Chamber will be full and rowdy once again as the cockpit of our democracy, where we can almost literally take the temperature of the nation. I may pay for that when I say something particularly unfortunate, but I prefer it, and I think everybody in this House does. After widespread consultation and on the basis of detailed public health advice, my right hon. Friend the Leader of the House has tabled a motion to extend virtual participation and the current proxy voting arrangements until 21 June, the proposed date for the removal of all legal restrictions on social contact. We thank you, Madam Deputy Speaker, and through you the other Deputy Speakers, Mr Speaker and the House authorities for the work that has been done in these unprecedented times to keep people safe here.

The measures before the House today show how we will put the pandemic behind us and restore life to normal. We are on the road to recovery, but we are not at the finish line yet, and by passing these measures, we can keep protecting lives and livelihoods while we get our nation back on its feet once more.

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

On a specific point, which I rather hoped the Secretary of State would cover but I anticipate will not, we are obviously very concerned about variants in Europe and the surge that we are seeing there. Is it the Government’s intention to impose restrictions on those coming in from France or Germany—to add either France or other European countries to the red list—or to impose testing on hauliers coming into the country?

[Matt Hancock]

All these questions will be answered as part of the work of the global travel taskforce, which the Prime Minister has announced will be published on 5 April, so I recommend that the right hon. Gentleman waits until then. In answering that final question, I commend the motions to the House.

Health and Social Care Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 18th March 2021 Commons Chamber

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

As always, I thank the Secretary of State for advance sight of his statement.

Our constituents will be worried, anxious and disappointed at the news on vaccination last night. It has been an unspeakably horrific year. We have one of the worst death rates in the world and our economy has taken a massive hit. Many key workers under the age of 50, such as teachers and police officers, who through the nature of their work are not at home, are going out and are more exposed to risk, had been hoping that vaccination for them was not far away. Of course, we understand why there will be delays in supply, but this is not fantastic news and nor, frankly, is it expected news.

On Saturday, the Government, or Government sources at least, were briefing The Daily Telegraph about a “bumper boost” and that everyone over 40 would be offered their first vaccine by Easter. Last week, the Business Secretary was hinting that all adults could be vaccinated by June, saying:

“There is no reason why we can’t be optimistic.”

On Monday, Nottingham and Nottinghamshire clinical commissioning group began inviting those in their 40s for vaccination, and a similar invitation went out from Bury CCG. We are grateful for the Secretary of State’s update today, but it will be a surprise to many.

The Secretary of State did not mention Moderna supplies today. I understand that supplies from Moderna will start in April. Is there any prospect that, if Moderna supplies come on stream, new appointments can be offered in the light of that?

About 11 million people received their first dose between January and February. I listened carefully to what the Secretary of State said. Can he clarify for the House and our constituents: is he offering them an absolute guarantee that all those will get their second dose within the 12 weeks throughout April? Our constituents will be keen to get that absolutely clarified.

The vaccination programme will need to ramp up to about 3.5 million doses a week from May to ensure that everyone under 50 is vaccinated by mid-July. Is the Secretary of State confident that these supply issues will be fixed by May? Is there any prospect of doing more than 3.5 million jabs a week from May? We heard today from Adam Finn of the Joint Committee on Vaccination and Immunisation that infection rates may rise as a result of the delays. Does the Secretary of State anticipate that any of the stages, any of the dates, in the road map for easing out of lockdown will be pushed back, given that we are rightly judging the road map by data, not dates?

On behalf of the official Opposition, I take this opportunity to support the AstraZeneca vaccine. Of course, where people are worried and have concerns, those worries and concerns must be addressed, not dismissed. But this is a concern at the moment. Yesterday, for example, I was told that hundreds of people failed to show for appointments at the ExCeL centre and we think that is because of concerns and misinformation circulating online.

There are parts of the country where infection rates remain relatively high and vaccination rates are relatively low. I see that in my Leicester South constituency. Will the Secretary of State pull together a cross-party taskforce of community and local leaders to look at tackling these vaccine hesitancy issues? I again offer to work with him on that on a cross-party basis.

Children make up about 21% of the population. That is a large segment of the population that will be lacking immunity. Obviously, research and trials are ongoing, but does the Secretary of State have a timeline for when he hopes to vaccinate children? Does he anticipate, for example, being able to vaccinate children this autumn, as Anthony Fauci in the US has suggested could well happen over there? Even as vaccination rolls out, the virus continues to circulate, and new vaccine-evading variants could emerge. We may need booster jabs in the autumn, and the winter will be challenging, which is why driving up vaccinations across the whole of the population is so important.

On the Budget allocations that the Secretary of State has announced for the next six months, I welcome the extra funding, of course, but can he guarantee that the NHS will continue to get additional funding after the six months if it is needed for covid care? As he has said, people are waiting longer for treatment, with more than 300,000 people waiting over a year, risking permanent disability or loss of livelihood, and with thousands waiting too long for cancer treatment, risking loss of life. We should not have to choose between cancer care and covid care. We are also facing a mental health epidemic as a consequence of this crisis. Crucially, because of years of underfunding, bed cuts and understaffing, when we entered the pandemic we already had growing waiting lists, our A&Es were in crisis and we were missing cancer targets. Can he tell us when he expects to bring down those waiting lists and meet the various cancer targets again?

Finally, the Secretary of State did not mention NHS pay today. He claps NHS workers and nurses, but he is introducing a real-terms pay cut for our NHS staff. Can he tell us whether he will implement any recommendations of the independent pay review body? If it recommends an increase above 1%, can he assure us that the funding will be additional to what he has announced today? In truth, if he really wants to value NHS staff, he should withdraw that pay cut now.

[Matt Hancock]

I welcome the right hon. Gentleman’s support for the vaccines, the vaccine roll-out and the clinically-led approach that we have taken in this country, and I mean that as more than simply a polite gesture. It is vital in this country that we have such a strong cross-party consensus, which includes all parties represented in this House, behind the vaccine programme and behind the science. The science means, of course, that we should and we do publish any side-effects, and we are open and transparent about that, but also that we make an assessment as to the benefits and how those benefits weigh against any side-effects. It is absolutely clear from the data we have seen so far that the vaccines are safe and that they make us safer than not getting vaccinated. That is an absolutely critical fact, and the MHRA will shortly set out more details; it is properly for the independent regulator to set out those details.

The right hon. Gentleman asked about supplies from Moderna. We expect supplies from Moderna in the coming weeks, and I am grateful to Moderna for the work that it has done. Of course, we have always been cautious about setting out future supply details, and the experience of the last 24 hours makes me even clearer that it is far better for us to set out clear commitments to the public in terms of when people can be vaccinated. This means that all over-50s now can come forward and that we are committed to and on target to offer to all over-50s and groups 1 to 9 by 15 April.

However, we know that supply figures move up and down. We have seen that throughout the roll-out, and it is part of the normal management of this roll-out. The commitment I can give the right hon. Gentleman is that, for those who are coming forward for second doses, those appointments will not be delayed because of these supply issues. Also, appointments that are already made will not be cancelled because of supply issues. I therefore say clearly to any member of the public who is watching: the vaccination programme is on track to meet the targets we have set out, and if you get the call from the NHS—whether you get it through a letter, a text, a telephone call or even, these days, an email—take up the offer and get the jab.

The right hon. Gentleman rightly asked about the road map. We are on track for the dates in the road map, and there is no impact on the road map from the changes to vaccine supply that we have been detailing in the last 24 hours.

The right hon. Gentleman asks about the vaccination of children and the autumn vaccination programme. Neither of these is certain. The vaccination of children is currently being assessed in a number of different clinical trials and it is very important that we consider the results of those before making any decision. It is likely that we will need a vaccination booster programme in the autumn, not least to deal with new variants, but that is again not yet certain.

Finally, I am very glad that the right hon. Gentleman welcomed the extra funding that we are putting into the NHS. He asks whether, after six months, there will be more funding if needed for covid purposes. The Chancellor has been absolutely clear from the start of this crisis that the NHS will get what it needs to deal with covid. That is very important, as is the work to restart the NHS in areas where it has had to be paused and, critically, the work that colleagues across the NHS will be doing to recover the backlog of elective work and make sure that everybody can get their appointments and operations in a timely way on the NHS once more. That is the work of the months ahead and I look forward to supporting NHS colleagues in delivering on it.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 2nd March 2021 Commons Chamber

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

As always, I thank the Secretary of State for advance sight of his statement. On the Brazilian variant, in January and February cases here were running at tens of thousands a day and we were in lockdown—we are still in lockdown—because of our own home-grown new infectious variant, yet people were allowed to fly in from abroad, bringing the P1 Brazilian mutation with them. Throughout history, epidemic after epidemic has exploited international travel. Surely it is obvious that tougher border controls should have been in place sooner.

I welcome the progress that the Secretary of State has made on identifying the batch, but how on earth can a test be processed that does not collect the contact details? What mechanisms will be put in place to fix that in the future? Twenty-two billion pounds has been allocated to this system, and it feels as though someone has vanished into thin air. Can he assure us that it will not happen again?

I note that the Secretary of State said that there is no information to suggest wider spread of this variant, but he will recall that John Edmunds from SAGE told the Home Affairs Committee in January that for every identified South African variant, there were probably another 30 unidentified. Can the Secretary of State tell us whether he has received any estimates of the number of unidentified cases in the wider community?

I welcome the tremendous progress that has been made on vaccination and driving infection rates down. It is a testament to the NHS and everybody involved in the vaccination programme, and to everybody who is playing their part in this lockdown. We also know that the virus can quickly rebound and that mutations could evade vaccination. We are in a race against evolution, so we have a long way to go. To be frank, nowhere is covid-safe until everywhere is covid-safe. None of us wants to yo-yo in and out of lockdowns, so will the Secretary of State guarantee that the lockdown easing will, as promised, absolutely be based on data, not dates, and that the assessment time between each step is not compromised? I welcome the extra surge testing, but what is the current timeframe for genetic sequencing? How can it be sped up?

Overall trends are coming down, and that is welcome, but infections in some areas remain stubbornly high. The national average is 100 cases per 100,000, but in Leicester, my city, the infection rate is one of the highest in the country at 222 per 100,000. In Ashfield, the infection rate is 246 per 100,000. In Hyndburn, the infection rate has increased to 162 per 100,000. In Oadby and Wigston, it has gone up. In Watford, it has gone up. In Worthing, it has gone up. What steps will be taken to ensure that areas such as Ashfield, Leicester, Watford, Worthing, Hyndburn and so on are not left behind when the national lockdown restrictions begin to lift, or will those places remain in localised lockdowns? Will the local authorities be given extra resources to do more door-to-door testing and retrospective tracing? Will workplaces in those areas be inspected by the Health and Safety Executive to ensure they are covid-secure? And of course, will people finally be given decent sick pay and isolation support?

Many areas such as Leicester are facing a double whammy of relatively high infection rates and relatively low vaccination rates. What further action will now be taken to drive up vaccination rates among hesitant communities? Will the Secretary of State fund faith groups, community groups and local public health teams to develop more targeted and tailored local vaccination campaigns?

Tomorrow’s Budget cannot be about the Chancellor’s Instagram account; it has to be about the NHS and social care accounts. Can the Secretary of State guarantee that tomorrow we will get an increase in public health allocations to help public health teams plan their local covid response over the next year? Will our NHS heroes get the pay rise they deserve? With 224,000 patients waiting more than 12 months for treatment, will our NHS get the resources it needs to deliver the patient care that patients and our constituents deserve?

[Matt Hancock]

The right hon. Gentleman is quite right to thank all those who are responsible for the vaccine roll-out. It has been an absolutely remarkable effort. He is right to say that the NHS has played its part—it has played a central part—but it has been more than the NHS. It has been the brilliance of the logistics, in particular, of our armed services. It has been the volunteers who have come forward in their droves. It has been the regulator and the partnership with private industry, and I think that this model of a combination of academic excellence and partnership between Government, regulator and private industry is one on which we can build. I know it is a model that they do not like much on the Opposition side of the House—

[Jonathan Ashworth]

I like it.

[Matt Hancock]

The right hon. Gentleman says he likes it. We always knew that he was misplaced over there. His problem is that sometimes his rhetoric is aimed more at his Back Benchers than what he thinks is right. I urge him to listen to his conscience and to back us and the businesses that are making this vaccination roll-out happen, and to put that support into practice.

The right hon. Gentleman asked about sequencing—again, done by a brilliant combination of academics, Government and private businesses. We are now sequencing a third of the positive tests in this country. That is not yet a full survey of all the positives, although we are working towards that, but it does mean that we are able to spot the variants much more than anywhere else in the world. We currently provide around 40% of the total global sequences of this disease—this virus—and we are driving up that sequencing capacity.

The right hon. Gentleman asked about increasing the uptake of vaccination. He was quite right to, and we are working with faith groups and local directors of public health and others. Councils have a very important role to play alongside pharmacists and, of course, GPs in increasing the vaccination uptake. However, the vaccination uptake has been very, very high—higher than I expected—and I am really thrilled about that.

Finally, the right hon. Gentleman asked about making sure that the road map follows data, not dates. We have rigorously set out the gap between the steps to ensure that we can see the effect of one step before we take the other. That is with the goal of having this road map as a one-way route out of restrictions so that we can all get back to the freedom that we crave.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 23rd February 2021 Commons Chamber

[Matt Hancock]

The good news is that, thanks in part to the work that my right hon. Friend did when he was in my shoes, we now have a record number of doctors in the NHS and he will have been as pleased as I was to see the record number of applicants to nursing places as well, because we need both more doctors and more nurses. I am delighted that, during the pandemic, we have increased numbers very substantially. On nurses, we are on track to meet our manifesto commitment to 50,000 more nurses, and we have seen a significant increase—just under 10,000—in the number of doctors too, so there is significant progress. Of course there is more to be done, and of course we will need to set out the route to that, as he suggests. The time is not quite right now, because right now there are still very urgent needs and pressures, thanks to the pandemic—I am sure that he and the Select Committee understand that—but this is undoubtedly a question that we will return to.

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

Everybody knows—apart from the Secretary of State, it seems, from this morning’s media—that there were PPE shortages. The National Audit Office reported on it, we saw nurses resorting to bin bags and curtains for makeshift PPE, hundreds of NHS staff died, and his response was to pay a pest control firm £59 million for 25 million masks that could not be used, to pay a hedge fund based in Mauritius £252 million, again for facemasks that were inadequate and to pay a jeweller in Florida £70 million for gowns that could not be used. So will he take this opportunity to apologise, and will he commit to recovering every penny piece of taxpayers’ money from those companies that provided us with duff PPE?

[Matt Hancock]

Well, I am going to start by congratulating the hon. Gentleman—the right hon. Gentleman—on his appointment to the Privy Council. I appreciate the work that he has done in support of the Government and in support of the nation during this pandemic. Although occasionally he turns to rhetoric and narrow questions that he knows there are perfectly adequate answers to, he has generally during this pandemic, in the face of temptation—I mean this very genuinely—done the right thing and supported the right messages to people where they need to be made across party lines. So I congratulate him and thank him for that.

On the specifics of the question the right hon. Gentleman raised, of course, where a contract is not delivered against, we do not intend to pay taxpayers’ money, but of course, also, we wanted to make sure that we got as much PPE as we could into the country. While of course there were individual instances that we all know about and that highlight how important it was to buy PPE, there was, as the National Audit Office has confirmed, no national level shortage, and that was because of the incredible work of my team and the amount of effort they put into securing the PPE and doing the right thing.

[Jonathan Ashworth]

I dare say the Secretary of State has just finished off my political career with that fulsome praise but, on the substance of the point, I think he confirmed that he will—[Interruption.] When did it start? [Laughter.] I think he was saying in that answer that he will not be trying to recover money that he has paid out for duff PPE, but can I ask him about a different issue, which again comes down to public scrutiny and accountability? In London, a week or a week and a half ago, GP services with 375,000 patients were taken over by the US health insurance corporation Centene. There was no patient consultation; there was no public scrutiny. This is arguably a stealth privatisation, with huge implications for patient care. Will he step in, halt the transfer, ensure it is fully scrutinised and prevent takeovers like this happening in the future?

[Matt Hancock]

On the right hon. Gentleman’s first point, such a reasonable and sensible man is, of course, always welcome on these Benches, and I might ask, since his wife is taking the Labour party to court: why doesn’t the whole Ashworth family come and join us on this side?

On the substantive point the right hon. Gentleman raises, of course what matters for patients is the quality of patient care. We have seen again and again, especially throughout the pandemic, that what matters to people is the quality of care. That is what we should look out for, and that is, I know, what doctors, nurses and other staff, in primary care and right across the board, are working so hard to deliver on.

Future of Health and Care

Debate between Jonathan Ashworth and Matt Hancock

Thursday 11th February 2021 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. I suppose we should also thank Andy Cowper for advance sight of the White Paper.

We are in the middle of the biggest public health crisis that our NHS has ever faced: staff on the frontline are exhausted and underpaid; the Royal College of Nursing says that the NHS is on its knees; primary care and CCG staff are vaccinating and will be doing so for months ahead, including, possibly, delivering booster jabs in the autumn; and today, we learn that 224,000 people are waiting more than 12 months for treatment. This Secretary of State thinks that now is the right moment for a structural reorganisation of the NHS.

We will study the legislation carefully when it is published, but the test of the reorganisation will be whether it brings down waiting lists and times, widens access, especially for mental health care, drives up cancer survival rates, and improves population health. We are not surprised that the Secretary of State has ended up here. We warned Ministers not to go ahead with the Cameron-Lansley changes 10 years ago. It was a reorganisation so big that we could see it from space. It cost millions. It demoralised staff. It ushered in a decade of wasted opportunity and, of course, he voted for those changes and defended them in this Chamber, so, when he stands up, I hope that he will tell us that he was wrong to support them.

We have long argued for more integrated care, but how will these new structures be governed, how will they be accountable to local people, and how will financial priorities be set, because when something goes wrong, as tragically sometimes it does in the delivery of care, or when there are financial problems, such as the ones that we have seen at Leicester’s trust, where does the buck stop?

The Secretary of State is proposing an integrated care board tasked with commissioning, but without powers to direct foundation trusts, which spend around £80 billion and employ around 800,000 staff. He is suggesting a joint committee of the ICS and providers as well, but who controls the money, because it is from there that power flows? Both of those committees will overlap with a new third additional committee, the integrated care system health and care partnership, which includes local authorities, Healthwatch and even permits the private sector to sit on it. All these committees must have regard for the local health and wellbeing board plans as well. How will he avoid clashing agendas and lack of trust between partners, as we have seen at the ICS in Bedfordshire and Luton, for example? Nobody wants to see integrated care structures that cannot even integrate themselves. Legislation alone is not the answer to integration. We need a long-term funded workforce plan; we do not have one. We need a long-term, cross-governmental health inequalities plan; we do not have one. We need a sustainable social care plan; we were promised one on the steps of Downing Street and we still do not have one.

When the Secretary of State voted for the Cameron reorganisation 10 years ago, it was presumably because he wanted, in the words of the White Paper at the time, “to liberate the NHS”. Now he is proposing a power grab that was never consulted on by the NHS. It seems that he wants every dropped bedpan to reverberate around Whitehall again. He is announcing this just at the very moment when the NHS is successfully delivering vaccination, which is in striking contrast to the delivery of test and trace and of PPE early on where he was responsible. Again, we will look carefully at the legislation, but why is he so keen for these new powers? Why is he repealing his responsibility to set an annual mandate and bring it to Parliament?

The Secretary of State wants to intervene now in hospital reconfiguration plans, but why is he stripping local authorities of their power to refer controversial plans to him? With his new powers, will he reverse outsourcing? Will he end the transfer of staff to subcos? Will he bring contracts back in-house and block more outsourcing in the future? He is ditching the competition framework for the tendering of local services, while potentially replacing it with institutionalised cronyism at the top instead.

Fundamentally, how will this reorganisation and power grab improve patient care? The Secretary of State did not mention waiting times in his statement. It is mentioned once in the leaked White Paper. How will he bring waiting lists down? How will he improve cancer survival rates and widen access to mental healthcare, and by when? How will this reorganisation narrow widening health inequalities, and by when? Given that the Prime Minister insists that lessons cannot be learned from this pandemic until the crisis is over, why does the Secretary of State disagree with that and consider this reorganisation so urgent now?

[Matt Hancock]

I will take that as cautious support. I know that the hon. Gentleman sometimes has to say these things, but I am very glad that he leaves the door open for yet more enthusiastic support in the future, not least because of all the questions that he just asked. The proposals on the table—the proposals in the White Paper—are addressed directly to make the improvements that he calls for.

The hon. Gentleman raised an important point about the vaccination programme. The vaccination programme is one of the largest and also one of the most successful civilian operations that has happened in this country, and that is because of the teamwork among the NHS, local authorities, the Department and the brilliant civil servants who work in the vaccine taskforce. It is that combination, that teamwork and that integration which is making the programme the great success that it is.

The hon. Gentleman asked about timing, and I say to him: why argue for delay? Why stop work to integrate? Why stop work to ensure the NHS is more accountable? When people are working so hard in the NHS for us, why should we not work hard in this Parliament to give them the legislative support that they need and have asked for? That is the question he needs to answer if he wants to continue an argument for delay. If not now, when? There is no better time than immediately, so I hope that he will, on reflection and on reading the White Paper, come forward with enthusiastic support.

I absolutely look forward to debates about the details and the implementation. I look forward to the parliamentary passage of a significant piece of legislation in the future, and I look forward to the hon. Gentleman’s engagement on that, but the removal of bureaucratic barriers cannot wait. The increase in the integration of the system should not have to wait, and accountability for this enormous amount of taxpayers’ money to this House, and through this House to the citizens whom we serve, is something that should be welcomed right across this Parliament, and I hope that it will be.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 9th February 2021 Commons Chamber

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

I thank the Secretary State for advance sight of his statement. I again start by congratulating all involved in the vaccination roll-out. Vaccination needs to reach everyone, and we need to drive up vaccination rates among the over-70s. There have been reports today that over-70s have been ringing up to get an appointment but NHS computer systems are not yet ready to accept appointments over the phone. Will he look into that for us?

What is the plan to drive up vaccination levels in minority ethnic communities? I am sure the Secretary of State is as worried as I am about vaccination rates among diverse communities. I know the Government announced some funding for local authorities to tackle vaccine hesitancy in minority ethnic communities, but a city such as Leicester—my city, and one of the most diverse in the country—was not on the list. Will he rectify that?

At last night’s press conference, the Secretary of State said that the way we deal with new variants is to respond to them as they arise, and that the first line of defence is to identify them and stop spread. However, our first line of defence is surely to do everything we can to stop new variants arising in the first place. That means securing our borders, to isolate new variants as they come in. He announced a detailed package today, but he has not announced comprehensive quarantine controls at the borders. Why are more than half of the countries where the South African variant has been identified not on the so-called red list? According to newspaper reports, he wanted to go further, with more extensive quarantine arrangements. I want that as well, and the British public want that as well, so I will work with him to make that happen, so that we can strengthen our borders and fix any holes in this nation’s defences.

The Secretary of State knows that mutations occur so long as the virus can replicate and transmit, and the greater the spread, the greater the opportunity. We have the South African variant and the so-called Eek—the E484K mutation—and the B.1.1.7 strain has been identified as well. Is it not the cold reality that the virus is now here for some time, and therefore that, for vaccines to succeed in protecting us, we need to do more to protect those vaccines by cutting transmission chains and spread, especially when lockdown eases? Last year the Secretary of State said, in launching Test and Trace, that it would

“help us keep this virus under control while carefully and safely lifting the lockdown nationally.”

But it did not keep the virus under control, did it? How will it be different this time? Will retrospective testing and tracing—the enhanced tracing he outlined for areas where there are variants—be routine everywhere?

Extra testing where there are new variants is of course welcome, but for many who cannot work from home on Zoom calls and laptops, who are poor or low paid, who live in overcrowded housing or who are perhaps care workers currently using up their holiday entitlement when sick so as not to lose wages, a positive test is not only a medical blow but a financial one. Last Tuesday, the Secretary of State boasted of the £500 payment, yet more than 70% of applications for financial support are rejected. By Wednesday, his own head of Test and Trace was pointing out that 20,000 sick people a day do not isolate. Indeed, two months earlier, Dido Harding had already said that people are not self-isolating because they find it very difficult, and that the need to keep earning and feed a family is fundamental, so is it any wonder that infections are falling at a slower rate in the most deprived communities? We need that financial support that his own scientific advisers have called for and that has been shown to work internationally. If he thinks I am wrong, will he tell us why he thinks Dido Harding is wrong?

We know that this virus can be transmitted through aerosols. Has the Secretary of State looked at installing air filtration systems in public buildings such as schools? Given concerns that the new Kent variant may shed more viral load through coughing and sneezing, will he update the guidance on face masks, as Germany has done, with FFP2 masks required on public transport and in shops? Will he ensure that higher-grade PPE for frontline NHS staff becomes the requirement, as the British Medical Association, the Royal College of Nursing and unions have called for?

Finally, next week is Children of Alcoholics Week, a cause very close to my heart. Indeed, I will be running the London marathon again to raise money for an alcoholics charity—[Interruption.] If it is on. I am looking forward to the Secretary of State assuring me that it is going to be on, and perhaps he can run it with me. The number of excess deaths from liver disease is up 11% in the pandemic—a huge increase—and many children are in lockdown in homes under the shadow of alcohol abuse. Will he look at providing more support for those organisations that are helping children through this difficult time of lockdown when dealing with parents with substance misuse problems?

[Matt Hancock]

I was listening very carefully to the hon. Gentleman, and I think I take that as support for the measures we are bringing in.

On the specific points the hon. Gentleman raises, he is absolutely right that further driving up vaccination rates is critical. I am delighted by the vaccination rates and the uptake of over 90% in all of the groups over the age of 75, and rapidly rising now—above 75% and rising fast—in the 70 to 74s. I agree with him very strongly on the need to keep driving up the uptake of the vaccine. The Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), is leading the efforts across the NHS and local authorities to try to make sure that we can increase vaccination rates further. Nevertheless, the take-up has been absolutely superb so far, and there is still more to do.

I will absolutely look into the points the hon. Gentleman made about Leicester. I know that it is close to his heart and a very important matter.

I will commit to the hon. Gentleman to keep the red list up to date. It is important that we take the measures that are necessary to protect this country. There are countries around the world on a so-called green list that have very low rates of infection and no known variants of concern. I am absolutely in favour of keeping the red list up to date, but I also think it is important that we are proportionate when there are countries that do not have a record of variants of concern. However, we will use the fact that we will sequence every positive test from somebody who comes through the border as a global system of vigilance to make sure that we are always looking for those variants of concern.

The hon. Gentleman raised the issue of financial support. I reiterate that the £500 support is available for anybody on low incomes, so people should come forward for testing in all circumstances. I am absolutely delighted at the level of testing as well. There is now an average of over 650,000 tests a day done in this country, which is obviously a very substantial number.

The hon. Gentleman raised the point about air filtration systems, which are important. I will point him to guidance from the Business Department on air filtration systems and on PPE—we have taken clinical advice and follow the clinical advice on the correct levels of PPE.

Finally, I know that the issue of children of alcoholics is very close to the hon. Gentleman’s heart and to those of many colleagues across the House, so I will absolutely look at how we can ensure that the extra funding we have provided in this space continues to support the vital work not just of those in the NHS, but especially of charities that do so much in this space. The invitation to run the marathon with him is a very interesting one. I am not sure I have enough time for training this year, but it is certainly something I would like to do at some point in the future.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 2nd February 2021 Commons Chamber

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

I am grateful, as always, to the Secretary of State for advance sight of his statement. I thank you, Mr Speaker, for putting in place the arrangements for testing on the estate. I am sure that Members and, crucially, staff on the estate are extremely grateful for that initiative. I also extend my best wishes to the Lord Speaker on his birthday today.

The news that the South African variant has been identified in eight different local authority areas is alarming and suggests significant community transmission. Can I just ask the Secretary of State to run through the timelines? When did these 11 cases test positive, and how long does the genetic sequencing take? When was he told of the cases? Can these processes be made speedier? I am told, for example, that the Ealing case tested positive in late December.

The variants bring into focus the importance of border controls. Times Radio reports that hotel quarantine arrangements will not be in place until 15 February. Why the delay? According to The Times, the Scientific Advisory Group for Emergencies warned two weeks ago that tougher quarantine restrictions for everyone entering the UK were needed. The Government dispute that interpretation, so will the Secretary of State publish the SAGE minutes from 21 January?

I welcome the extra testing, but may I suggest the Secretary of State goes further, because people move beyond their postcode boundaries? They go shopping and many still have to go to work. Will he therefore roll out testing in neighbouring postcodes? He wants to come down hard on this variant, but is not the lesson of mass testing, such as in Liverpool, that people are hesitant to take a test if they are not compensated for any loss of income associated with self-isolation? We are fighting this virus with one hand tied behind our back, asking the low paid to go hungry in order not to spread the virus. Transmission chains will not be broken without decent sick pay and isolation support.

We have seen the Kent B117 variant spread with speed. Public Health England’s latest technical briefing reports that B117 sequences with the E484K mutation seen in the South African variant have now been identified. That is very worrying, because this is the mutation thought to be behind the partial vaccine evasion. Surely that suggests that further action will be needed. For example, Germany, Austria and France are recommending FFP2 face masks on public transport and in shops. The Chair of the Select Committee, the right hon. Member for South West Surrey (Jeremy Hunt) has also suggested that. Will the Secretary of State now review the evidence and look at that measure?

On vaccination, I again congratulate the NHS. Not all care homes have been vaccinated—those with a covid outbreak have not, for understandable reasons—but will the Secretary of State tell us how many such care homes are outstanding? There have been reports of some care staff turning down vaccination, so can he tell us how many care staff have been vaccinated? Will he ensure that the NHS collects data on the numbers turning down vaccination, so that we can target and overcome the vaccine hesitancy more effectively?

Public health services have an important role in tackling vaccine hesitancy. When will public health directors know their allocations for the next financial year? UNICEF has warned:

“Children are not the face of this pandemic. But they risk being among its biggest victims”.

I accept it was inevitable that schools would close given community transmission levels, but that does not make it any less devastating. We are depriving young people of social interaction and of play with their friends. Learning is not the same and mental health problems are increasing. There will be children in homes where there is violence or where drink abuse or substance misuse is prevalent.

Children’s health must always be a priority. On current plans, how many teachers will be vaccinated as part of bands 5 to 9, and how many teachers and support staff will have to wait until the period between Easter and summer to be vaccinated? Last September, it was reported that 25,000 teachers had been off sick related to covid, further disrupting children’s learning, so how can the Secretary of State ensure that we do not see the same disruption again from March when it is hoped that schools will return?

Finally, this is indeed National HIV Testing Week. Over the weekend, I binge-watched “It’s a Sin”, and I was in tears. Thankfully, HIV is not a death sentence today. People living with HIV are in phase 6 for vaccination, but only if they have disclosed their HIV status to their GP. Many have not and still do not want to because of the stigma that we saw portrayed in “It’s a Sin”, so will the Secretary of State ensure that people living with HIV are able to access vaccination at their HIV clinic?

[Matt Hancock]

To answer the hon. Gentleman’s many questions, he is absolutely right to raise the importance of coming down hard on the cases of new variants that we have discovered here in the UK. These are cases that have been seen over the past two months. The action that we are putting into place is to make sure that we stop further spread, and further spread in the community, alongside the action taken to ensure that there is no spread from those who have a history of international travel. As he knows, we have brought in tougher action at the border and we stand ready to do more.

The hon. Gentleman asks for the SAGE minutes to be published. They are published regularly. He also asks about the neighbouring postcodes to those where a new variant case has been found, where it is a new variant of concern. We absolutely do that where it is epidemiologically sensible. For instance, if the case is found on the border of a postcode, obviously we go across that border. We also investigate linked premises—for instance, if somebody had a child at a school or is going to work in a particular workplace—and, working with the director of public health, we will ensure that testing is directed there as well.

The hon. Gentleman raises the issue of isolation payments. We have the £500 isolation payment in place, so nobody should, as he put it, go hungry because they have to isolate. What is critical in these areas is that people stay at home unless they absolutely have to go out. It is imperative that people follow the rules to get these new variants completely under control.

He asks about the care home success. I am delighted that we have been able to reach so many care homes. I said in my statement that we have reached 10,307 care homes in England. There are 110 care homes where the vaccination programme is still outstanding because they have had outbreaks and, for clinical reasons, the vaccination programme cannot start there, but it will as soon as it is clinically possible.

The hon. Gentleman also asks about the data being shared from the vaccination programme. That data is now routinely shared with local directors of public health, precisely for the reasons that he set out—so we can reach more parts.

Finally, he ends on the question of education. Of course we understand how challenging the impact of this lockdown is on those with children who have to be schooled at home. That is why the Prime Minister said that schools should be the first thing to open when it is safe and possible to do so. Sadly, that time is not yet, but the more that we all follow the rules that we have set out so clearly, the quicker that time will come.

Vaccine Roll-out

Debate between Jonathan Ashworth and Matt Hancock

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

Typically, I have come forward at least once a week, and I am very happy to do that and to respond to questions at any time. I am very glad that the technology is working and I can do that while self-isolating at home, as I am now.

On the substance of the questions asked by my hon. Friend the Member for Bexhill and Battle (Huw Merriman), the first thing I would say is that I am absolutely delighted that there are new centres opening in Sussex—in Ticehurst village hall this week—so that the roll-out can reach all parts. I will consider the point that he makes about cohorts 5 to 9, which will need the first dose of the vaccine at the same point as we start the second dose for those who have been vaccinated from the start of January. When we restart with the second doses, it will be important to make sure that they are available as close as possible to the largely elderly population who will need them, and I will take away the point that he raises.

The challenge on the contract is tied in with the first and third of my hon. Friend’s questions. The challenge is essentially that we have a lumpy supply. The manufacturers are working incredibly hard to deliver the supply as fast as possible, and I pay tribute to them and their work. It is challenging, however, and therefore it is not possible to give certainty as far out as many GPs and those who are delivering on the ground would like. The worst thing would be to give false certainty. We do try to give information about what is coming next week, but until the supply smooths out, as I am sure it will over time, going further out than that would give false certainty. The worst thing would be to have GPs across the country booking in large numbers of people and having to reschedule those appointments unnecessarily.

I will take into account the point that the Oxford-AstraZeneca vaccine is easier to deliver in rural areas, and the request for some people to be able to do that. At the moment, however, we must use the contract that we have.

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

Yesterday I visited the vaccination centre at Leicester racecourse, and it was inspirational to see the joy on the faces of those who were vaccinated and the pride of the staff and volunteers doing the vaccination. The figure of 4.6 million is indeed welcome, and it is a reminder that when the NHS is put in charge and tasked with implementing a large-scale project across our communities, it gets on with it and delivers. The Secretary of State has a target to vaccinate care home residents by the end of the week. Will he update us on progress towards that target?

Today we have had the latest Imperial survey, and the findings are alarming. It is especially concerning that infection rates are so high in London, and yet London and the east of England appear to be behind the rest of the country on vaccine roll-out. Will he tell us what action is being taken to speed up vaccination across London and the east of England? The Imperial survey also highlights the disproportionate infection rates among key workers and those from black, Asian and minority ethnic backgrounds. Once the nine priority groups are vaccinated, is it the Secretary of State’s expectation that we will then move to prioritise key workers—teachers, police officers, firefighters, transport workers, supermarket staff—who are more exposed to the virus at the moment?

The Secretary of State will know that there are 11,000 community pharmacists. That could mean up to 30,000 pharmacists at the heart of delivering this vaccine. We should be using them not just because of the volumes of doses they can administer, but because they have years of experience of building trust and vaccine acceptability within hard-to-reach groups and minority ethnic communities. I was speaking to pharmacists this week in Dudley who were telling me this. They also, by the way, raised concerns about the wider supply of the consumables needed to administer the vaccine. Can he guarantee that there will be no delay or shortages in the delivery of this wider kit?

The new variants remind us that we have to go further and faster on vaccination and work harder to break transmission chains. Early analysis suggests the South African B1351 variant brings a reinfection risk that means vaccines may need to be redesigned. Has the Secretary of State got a contingency plan in place?

Finally, yesterday’s death numbers were truly horrific. Vaccination has to go hand in hand with measures to suppress this virus. That means further containment measures. Not everybody can work at home comfortably or isolate themselves. The system is still expecting families to go hungry to stop spreading infection. Can I urge the Secretary of State again to fix sick pay and give people proper financial support so that they can isolate and we can drive infection rates down?

[Matt Hancock]

I agree with the hon. Gentleman that the NHS is doing a great job, supported by so many people. In particular, I want to thank the volunteers who have stepped forward—tens of thousands of them—and are now working to deliver the vaccination programme alongside NHS staff and, of course, members of our armed forces. In fact, there are several Members of this House who are, as we speak, supporting vaccination in vaccination centres, and some of them are doing vaccinations themselves. I am very grateful to all the volunteers.

The hon. Gentleman raises the question of pharmacies and, absolutely, pharmacies are going to be incredibly important, especially for reaching into those communities that may be otherwise harder to reach. The NHS as a whole is highly respected and trusted in all communities of this country so is well placed to do that, and pharmacy colleagues within the NHS particularly so, because they are often the closest to their communities. As I have set out, we have opened 65 vaccination centres that are pharmacy-led this week, with more to come.

The hon. Gentleman asks about the residents of elderly care homes. I am delighted to say that 63% of residents in elderly care homes have now received the vaccination. That is a really significant increase over the last week. We are on track to deliver on our goal of vaccinating elderly care home residents by the end of this month, and I hope sooner than that.

Finally, the hon. Gentleman asks about the question of the need—potential need—for vaccine redesign if there is a new variant that is not effectively dealt with by these vaccines. Obviously, we are vigilant on that and keep it under close review. I am glad to say that the early indications are that the new variant is dealt with by the vaccine just as much as the old variant, but of course we are vigilant on the new variants we are seeing overseas. He mentioned the South Africa variant, and there is also a variant of concern that was first identified in Brazil, and of course we are vigilant on those matters, too.

What I would say in summary is that all of these things just support the need for everybody to follow the rules and stay at home. It is critical that everybody does their bit to try to stop the spread of this virus while we get the numbers under control and bring them down, thus protecting the NHS and getting this death toll down, because it is far too high.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 12th January 2021 Commons Chamber

[Matt Hancock]

Clearly, the IT underpinnings of this project are critical. The Pinnacle system is working well, but we are constantly monitoring it to make sure that it supports the roll-out of the vaccine.

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

Our sense of encouragement at the roll-out of the vaccine is tempered by our deep alarm at the situation we are in. Over 80,000 people have died. On current trends, we are likely to see more deaths in this wave than we saw in the first. Millions still have to go to work and the virus is now more infectious. Those still going to work of course include NHS staff, and the British Medical Association says that 46,000 of them are off sick with covid. Can the Secretary of State go further and faster, and ensure that frontline NHS staff receive the vaccination in the next two weeks? Will he provide daily updates on the numbers of NHS staff who have been vaccinated?

[Matt Hancock]

We do now provide daily statistics on the roll-out of the vaccine, and we will provide more data as the system matures and the roll-out advances. The hon. Gentleman is absolutely right to raise the challenges that the NHS is facing today. Although the roll-out of the vaccine is proceeding well and we are on track to hit the targets that we have set, we must also stress to everybody the importance of following the rules that are in place to control this virus and reduce the pressures on the NHS, which are very considerable at this moment.

[Jonathan Ashworth]

We all understand that, until vaccination is rolled out more generally, we will continue to see hospitalisations. The NHS is currently in a crisis: beds are filling up; intensive care unit surge capacity is being maxed out; ambulances are backed up outside hospitals; and there are warnings about oxygen supplies. Hospitals were not built for these demands on oxygen, so can the Secretary of State assure us that there are contingencies in place, and can he guarantee that no hospital will run out of oxygen in the coming weeks?

[Matt Hancock]

There are very significant pressures on the NHS. On the specific question about oxygen supplies, the limitation is not the supply of oxygen itself; it is the ability to get the oxygen through the physical oxygen supply systems in hospitals. That essentially becomes a constraint on an individual hospital’s ability to take more covid patients, because the supply of oxygen is obviously central to the treatment of people with covid in hospital. As we have a national health service, if a hospital cannot put more pressure on its oxygen system, we take people to a different hospital. I assure the hon. Gentleman that there is no constraint that we are anywhere near on the national availability of oxygen—oxygenated beds. As he knows and as we have seen reported, sometimes patients have to be moved to a different location—as local as possible, but occasionally across the country—to ensure that they get the treatment that they need.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 30th December 2020 Commons Chamber

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

As always, I thank the Secretary of State for advance sight of his statement. I totally understand why he has had to come to the House this afternoon to move further areas into tiers 3 and 4. As he says, almost the whole of England is now in a form of lockdown. My constituents in Leicester and, I am sure, constituents in Greater Manchester will be deeply worried that our areas have now been in a form of restrictions for months and months. It is having a huge impact on families and small businesses in cities such as Leicester and, I am sure, areas in Greater Manchester. He has also moved Liverpool into tier 3. Liverpool was the great success story, so is it his view now that mass lateral flow testing is not enough to contain the spread of this virus? Our constituents will be asking how long he expects these lockdowns to be in place.

We will vote for the regulations tonight, because the situation we are in is truly horrific. As he has outlined, the virus is out of control. Yesterday, over 47,000 cases were reported in England. In the last two weeks, nearly half a million cases were reported in England. There are now more patients in hospital—over 20,000—than at any time in this pandemic, with admissions rising day by day, including almost 2,000 on Christmas day. Hospitals are close to or at surge capacity. We see ambulances queuing up outside hospitals because there are not enough beds for patients. We have London hospitals requesting to transfer patients in need of intensive care to Yorkshire. Frontline healthcare workers warn of oxygen supplies running low. Can the Secretary of State assure us that there will be no disruption in oxygen supplies through this second wave?

Our NHS staff are exhausted. Morale is low. Staff absence is said to be double its normal level. Leave for many is cancelled. And this time, there is no evening applause on our streets; just long, dark, hard nights for our NHS staff. The Nightingales were opened at great expense and fanfare, but now we hear that some of them, such as London’s, have been emptied. Will they be used? If so, given the staff shortages across the NHS, how will they be staffed? There are reports today that only one in eight retired NHS staff—just 5,000 out of an eligible 30,000 who applied—have been brought back to help. Should we not be making full use of this resource, especially to help with vaccination?

Today’s AstraZeneca news is indeed a tremendous boost, and I congratulate all involved, but can the Secretary of State confirm how many doses we currently have ready to go? We are in a crisis now. Mass vaccination needs to start straightaway. We need to go hell for leather to get these jabs rolled out with no delay. We have already lost more than 600 healthcare workers to this horrific virus, including a disproportionate number of black, Asian and minority ethnic staff. Frontline NHS staff need the protection of the vaccine ASAP. Will the Secretary of State set a clear target for when all NHS frontline staff will receive the life-saving jab, and can he tell us when all care home residents and staff will be vaccinated? He will recall that I raised with him the situation facing those with terminal illnesses. Will he clarify the JCVI’s guidance for that group today?

This is a race against time, because the more the virus circulates, the more opportunities there are for further variants to emerge. The new B.1.1.7 variant is 56% more transmissible and is the dominant strain in London and the south-east and east of England. The New and Emerging Respiratory Virus Threats Advisory Group minutes from 18 December suggest it could add at least 0.4 to the R. Given that the first lockdown brought R down to about 0.6, and the second down to about 0.8, it will surely be harder to bring infections under control, so harder measures will be needed. Will the Secretary of State publish in realtime the advice he receives from the Scientific Advisory Group for Emergencies on the restrictions needed?

This is a global crisis, but let us be clear: this is a national emergency. Our national health service is becoming overwhelmed. I hope that tier 4 restrictions are enough, but many believe that even tougher restrictions are now inevitable. Does the Secretary of State agree? We need not put more lives in jeopardy when vaccines are so near. Let us give the achievements of our scientists the best chance to save lives. The country sacrificed so much in 2020. Let us not repeat the same mistakes. We must start 2021 by right now doing everything it takes to save lives and support our NHS. Only then can we look forward with confidence and hope.

[Matt Hancock]

The hon. Gentleman is quite right that this virus has thrown up problems and challenges right around the world; we have seen the impact in other countries in some of the news from other parts of Europe today. He is also right that, thanks to the approval of this vaccine, alongside the Pfizer-BioNTech vaccine, the end is in sight. That should give us hope that, while we have difficult weeks ahead of us, we can see the route out of this pandemic and normal life returning, with all that that means and entails.

The hon. Gentleman talked about the pressures on the NHS, which are significant. One advantage of having a national health system is that when one area of the country faces particular challenges, others can come to its mutual aid. That is in process—it is happening—and means that people are sometimes taken across the country to receive care where there is spare capacity. That is necessary; it is how the system works when it is under significant pressure.

The hon. Gentleman asked about the vaccination of NHS staff. I can confirm that, thanks to the decision announced by the regulator today, we will be able to accelerate the vaccination of NHS staff already in priority group 2, as well as of the over-80s and of care home residents and staff. He asked about the number of vaccines we have available. I mentioned in the statement that we have 530,000 across the UK available for deployment in the first week of January. The NHS is doing a fantastic job of constantly increasing and expanding the scale of its operation.

Finally, the hon. Gentleman asked what more can be done in areas where rates are very high and continuing to rise. The true answer is that it is on all of us—it is about how everybody behaves. If we collectively decide to stop this by taking personal responsibility and not coming into contact with others unless absolutely necessary, we can slow the spread of this virus. The tiers restrictions are of course necessary, but ultimately it is about how we all behave. That is how we will get through the next few weeks together, and then the vaccine can come and save us.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 14th December 2020 Commons Chamber

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

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

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

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

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

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

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

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

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

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

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

[Matt Hancock]

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

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

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

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

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

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

Covid-19 Vaccine Roll-out

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 8th December 2020 Commons Chamber

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

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

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

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

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

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

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

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

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

[Jonathan Ashworth]

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

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

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

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

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

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

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

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

[Matt Hancock]

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

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

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

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

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

Coronavirus Vaccine

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 2nd December 2020 Commons Chamber

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

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

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

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

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

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

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

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

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

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

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

[Matt Hancock]

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

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

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

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

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

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

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

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

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

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

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

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 26th November 2020 Commons Chamber

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

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

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

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

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

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

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

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

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

“a less effective TTI”—

test, trace and isolate—

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

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

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

[Matt Hancock]

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

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

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

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

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

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

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

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 17th November 2020 Commons Chamber

[Matt Hancock]

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

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

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

[Matt Hancock]

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

[Jonathan Ashworth]

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

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

[Matt Hancock]

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

Coronavirus Regulations: Assisted Deaths Abroad

Debate between Jonathan Ashworth and Matt Hancock

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

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

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

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

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

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

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

[Matt Hancock]

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

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

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

Covid-19

Debate between Jonathan Ashworth and Matt Hancock

Monday 2nd November 2020 Commons Chamber

[Matt Hancock]

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

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

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

Today it said:

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

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

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

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

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

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

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

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

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

[Matt Hancock]

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

--- Later in debate ---

[Jonathan Ashworth]

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

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

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

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

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

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

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

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

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

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

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

[Matt Hancock]

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

[Jonathan Ashworth]

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

[Matt Hancock]

Come on!

[Jonathan Ashworth]

That is absolutely true.

--- Later in debate ---

[Matt Hancock]

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

[Jonathan Ashworth]

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

Covid-19

Debate between Jonathan Ashworth and Matt Hancock

Thursday 22nd October 2020 Commons Chamber

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

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

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

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

[Matt Hancock]

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

[Jonathan Ashworth]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

to get it under control.

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

“all wind up in tier 3 eventually.”

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

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

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

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

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

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

[Jonathan Ashworth]

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

[Matt Hancock]

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

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

[Jonathan Ashworth]

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

[Matt Hancock]

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

--- Later in debate ---

[Jonathan Ashworth]

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

[Matt Hancock]

U-turn.

[Jonathan Ashworth]

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

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

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

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

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 20th October 2020 Commons Chamber

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

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

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

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

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

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

[Matt Hancock]

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

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

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Programme motion
Monday 19th October 2020 Commons Chamber

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Matt Hancock]

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

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

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

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

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 15th October 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. Given what we know about the rising prevalence of the virus and rising admissions to critical care, I totally understand why he has had to make difficult decisions today on tier 2 restrictions for London and other areas, including Erewash, Essex, Barrow and Chesterfield. I hope he will agree that decisions like these are most effective when made in tandem with local leaders. On that point, can he update us on the current position with respect to Greater Manchester and Lancashire? Should we anticipate further announcements later today?

While I do not quibble with or object to the public health interventions that the Secretary of State is making, I am afraid that they are still not backed up by the financial package needed to mitigate their impact on jobs and livelihoods. More people will fall into poverty and destitution. Families across Bury and Bolton and small businesses across Burnley, Hyndburn and London have been failed by the Chancellor, so I urge the Government to introduce a stronger package of financial support for areas in tier 2 and tier 3.

The British people have a made tremendous sacrifice already, and we are heading into the bleakest of winters. Much of this could have been avoided if the misfiring £12 billion test and trace system had been fixed over the summer. Today, new figures show just 62% of contacts being reached. That is the equivalent of 81,000 people not reached circulating in society, even though they have been exposed to the virus. That is another record low. Yesterday, we learnt that consultants working on test and trace are being paid more than £6,000 a day to run this failing service. In a single week, the Government are paying those senior consultants more than they pay an experienced nurse in a year. Can the Secretary of State explain why such huge sums of money are being paid to consultants to run a service that is only getting worse?

The Prime Minister said yesterday that these new restrictions will bring the R rate below 1, but while the virus growth has accelerated in northern regions, the embers are burning bright nationwide. Let me repeat to the House—Tory party staff are welcome to clip me again for Twitter; it will save my staff the trouble—that a full national lockdown stretching for weeks and weeks, like we had throughout April, May and June, would be disastrous for society. We are urging the Secretary of State to adopt a short, time-limited two to three-week circuit break, to take back control of the virus, to reboot and fix test and trace, to protect the NHS and to save lives.

SAGE has recommended a circuit break. NHS Providers is

“urging politicians to listen to the scientific advice and move as fast and as decisively as possible”.

The SPI-M sub-group of SAGE says that a circuit break of two weeks will save almost 8,000 lives. For all the ponderous blustering and carping from the Prime Minister yesterday, he told the House—with some haste, as if he did not want his Back Benchers to hear it—“I rule out nothing” with respect to a circuit break. The Prime Minister has not ruled it out, which we welcome, so what are the Government’s criteria for a national circuit break? How many hospital admissions? How much non-covid care delayed? Dare I say, how many more deaths?

Action is needed now. Plans need to be put in place today. Everyone accepts that the Government were too slow in the spring. How certain is the Secretary of State that his Government are not making the same mistakes again with more catastrophic consequences? This is a moment in history—look around, Health Secretary, and explain why not a circuit break now, because if we do this in a few weeks’ or a few months’ time, more lives and livelihoods will be lost. In the national interest, I offer to work constructively with him today to deliver the circuit break that is now needed.

[Matt Hancock]

As 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.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 6th October 2020 Commons Chamber

[Matt Hancock]

My right hon. Friend makes an incredibly important point. I know very well the impact of long covid; it is something that I understand deeply. We are in the process of setting up those clinics and there will be further information on this very shortly.

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

Given that the Office for National Statistics has said today that deaths have increased three weeks in a row, and given the rising prevalence of the virus, can the Secretary of State understand the upset and the anger over the Excel spreadsheet blunder? Can he tell us today what he could not tell us yesterday: how many of the 48,000 contacts—not the index cases, the contacts—have been traced and how many are now isolating?

[Matt Hancock]

We have obviously been continuing to contact both the index cases and the contacts. The total number of contacts depends on how many contacts each index case has. That information will of course be made available in the normal way when it has been completed. However, we cannot know in advance how many contacts there are because the interviews with the index cases have to be done first.

[Jonathan Ashworth]

So essentially thousands of people who have been exposed to the virus could be wandering around not knowing they have been exposed and infecting people, and the Secretary of State cannot even tell us if they have been traced.

Let me move on to something else. I listened carefully to what the Secretary of State said about a vaccine yesterday in light of the news that the Government are aiming to vaccinate about 30 million people—just under 50% of the population. There has been an expectation that the whole of the population would be vaccinated, not least because he said at the Downing Street press conference that he “would hope, given the scale of the crisis, we would have the vaccine and everyone would be given the vaccine.” Those are his words. We accept the clinical guidance. However, can he tell us how long it will take, for the 50% of people who will not be vaccinated, for life to return to normal for them?

[Matt Hancock]

As the hon. Gentleman well knows, decisions on the distribution of any vaccine have not been taken. The Joint Committee on Vaccination and Immunisation is the body that advises the Government on the appropriate clinical prioritisation of vaccines. It has published an interim guide, which he well knows about and we have discussed. That sets out the order of priority as an interim measure, but we await the data from the clinical trials of the vaccine before we will come to a clinically validated full roll-out plan. We are putting in place the logistical plans now, but on the decisions as to the clinical order of priority, we will take the evidence from the Joint Committee.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 5th October 2020 Commons Chamber

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

I thank the Secretary of State for giving me advance sight of his statement. In recent weeks, we have had people being told to travel hundreds of miles for a test; we have had hundreds of children out of school unable to get a test; we have had tracers sitting idle, watching Netflix; and we have had care home tests taking days to be processed. Yesterday, we had a Health Minister saying that this could be a moment of national pride like the Olympics, and we have had a Prime Minister in a complete muddle over the rules. Now, at one of the most crucial points in this pandemic, we learn that almost 16,000 positive cases went unreported for a week. That means that as many as 48,000 contacts have not been traced and are not isolating. Those thousands of people, blissfully unaware that they have been exposed to covid, are potentially spreading this deadly virus at a time when hospital admissions are increasing and we are in the second wave.

This is not just a shambles; it so much worse than that. It gives me no comfort to say it, but it is putting lives at risk, and the Secretary of State should apologise when he responds. No doubt he will complain about my tone, or say that he will not have any divisive talk, but people want answers. He has just said that over half the 16,000 people have been spoken to by tracers, and they have presumably handed over their contacts, but when will the other 49% be spoken to by contact tracers? How many of the contacts have now been traced and spoken to, and how many are isolating? Why did nobody notice this issue until Friday night? Why did it take until 9.30 on Sunday evening for this to become public? The Prime Minister was clearly aware of the problem, because he said on “The Andrew Marr Show” yesterday morning that there had been a

“failure in the counting system, which has now been rectified”.

Speed is of the essence when dealing with a pandemic, so when were local directors of public health informed? The Secretary of State says that this is an ongoing issue, so it has not been rectified, as the Prime Minister said on “Marr”. When will it be fully resolved?

Public Health England sources say that they report the data when they get the data from test and trace. Can the Secretary of State confirm that the data could not be handed over to PHE because of the size of the Excel spreadsheet files? Was this an issue at one particular Lighthouse lab, or across all the Lighthouse labs? Why are critical databases in a national pandemic being hosted on Excel spreadsheets? Why are they not using specialist database software? The right hon. Gentleman likes to boast of his background in software development, so did he sign off this system? Was he aware of it? The Department of Health and Social Care is responsible for the integrity of pillar 2 testing data. His Department is the data controller, so he is ultimately responsible for this mess. It is a mess made up of fragmented systems passing data back and forth between his Department, PHE and outsourcing companies such as Serco and Deloitte, and it is costing us £12 billion. Surely now is the time not to renew Serco’s contract and instead give responsibility and resources to NHS labs and local public health teams to deliver testing and tracing.

The Secretary of State says that the data does not impact decisions that have been made about local restrictions, but areas already under restrictions such as Bury, Hyndburn, Burnley, Manchester, Liverpool and Newcastle have seen increases as a result of this data. Will those areas and others under restrictions now be given extra help and resources to battle the virus? Infection rates in other parts of the country that are not under restrictions, such as Newark and Sherwood, are climbing higher with this new data, so should we expect more local restrictions this week?

The Secretary of State says that he is set to bring in a new three-tiered system to replace the confusing network that is in place. Will he update the House on what the new criteria will be for an area going into restriction and leaving restriction? So far, it has been a bit like “Hotel California”—you can check out, but you can never leave. Families deserve answers.

The Prime Minister told the House on 20 May that we would have a “world-beating” system in place by June. It is now October. The system is neither competent nor improving. Problems are getting worse. The Government are failing on the basics. When will they finally fix this mess?

[Matt Hancock]

I 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.

Covid-19 Update and Hospitality Curfew

Debate between Jonathan Ashworth and Matt Hancock

Thursday 1st October 2020 Commons Chamber

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

I thank the Secretary State for giving me advance sight of his statement. The Imperial study today is indeed encouraging, but, as the chief medical officer said yesterday, we have a long winter ahead. We know that sustained contact, especially in crowded, poorly ventilated spaces, is a driver of infection, and pubs and bars are an obvious risk. I heard what he said about the 10 pm rule, but my concerns relate to everybody leaving the pub at the same time. What action will he take so that we do not see a repeat this weekend of people piling out into city centres, packing out public transport and sometimes piling into supermarkets to buy more drink?

We completely understand the need for local restrictions, including in Merseyside, as the Secretary of State has just announced. It was probably too late for colleagues from Merseyside to get on the call list this morning, but they would be keen to press him further on the financial support for Merseyside. The region is hugely reliant on hospitality and leisure, and we know that these restrictions exact a heavy social and economic toll. Areas need financial support, otherwise existing inequalities, which themselves have a health impact and allow the virus to thrive, will be exacerbated.

People need clarity as well. Areas such as Leicester, Greater Manchester, West Yorkshire and Bradford have had restrictions imposed on them for months now. Millions of people in local lockdown areas across the north and midlands just need some reassurance that an end is in sight. Many want to know when they will be able to visit their loved ones and whether they will be able to visit their families over the coming school half-term, for example. Can the Secretary of State confirm whether he has now ruled out the so-called circuit break taking place across the October half-term, as was mooted in the newspapers last week?

Some of the heaviest increases in infection appear to be taking place in areas where restrictions are in place, so why are the interventions not working? Why are the moles not getting whacked? Yesterday, the Prime Minister suggested that the success of Luton in leaving restrictions was because of people pulling together. I have no doubt that people are pulling together across Bolton, Bury, Rossendale, and so on, but what additional help will they receive to drive the virus down?

I believe that Ministers lost precious ground in fighting the virus by not having an effective test, trace and isolate regime in place by the end of the summer. Testing and tracing is key to controlling the virus. Increasing evidence now shows the importance of backward contact tracing in controlling outbreaks. Is backward contact tracing routinely happening in areas of restriction, and will the Secretary of State publish data on backward contacts reached? We also support the Health Committee’s calls today for routine testing of all NHS staff. Will he finally set a date for introducing it?

Problems remain with testing generally. I have just heard of a case in the Rhondda where people have booked appointments and turned up at a testing centre, but Serco has pulled the testing centre out and is saying that it needs the Secretary of State to intervene in that area if it is to be reopened. Will he do that?

On 8 September, the Secretary of State told the Health Committee that the problems with testing would be resolved “in the coming weeks.” That was more than three weeks ago, yet it still takes 30 to 31 hours to turn around in-person tests, 75 hours for home test kits, and 88 hours—more than three and a half days—for test results in the satellite test centres, which are predominantly used by care homes, so he has not resolved the problems. When will he?

Today we have learned that Deloitte, which is contracted by the Government to help to run test and trace, is now trying to sell contact tracing services to local councils. The Government’s own contractor, one of the very firms responsible for the failing system in the first place, now sees a business opportunity in selling information and services to local authorities. Authorities should be getting that anyway, and this is in the middle of the biggest public health crisis for 100 years. Is this not an utter scandal? How can it be allowed? Does it not once again show that directors of public health should be in charge of contact tracing?

Finally, this week GPs warned of significant problems with flu vaccine supplies. Boots and LloydsPharmacy have stopped offering flu jab appointments due to issues with supplies. Can the Secretary of State confirm that we have enough flu vaccines available for all who will need one this winter?

[Matt Hancock]

I welcome the hon. Gentleman’s support for the measures that we have had to take and for the £7 million of extra financial support for the councils affected—not just Merseyside, and Halton and Warrington, but Hartlepool and Middlesbrough—which is on the same basis as the support for the seven north-east councils announced at the end of last week.

It is true that some parts of the country have come through a local lockdown. In fact, we have lifted many of the measures that were in place in Leicester, for instance. We were not able to lift all the measures, and the case rate there then went back up again, although it has now appeared to have stabilised. Luton is another example where there was a significant local outbreak that was brought under control.

The hon. Gentleman asked about increased testing. Increased testing is, of course, going into Merseyside, and we can do that because we have record capacity, which has increased yet again this week. He also asked about backward contact tracing; absolutely we have backward contact tracing in these areas. And that is one of the reasons we know that, sadly, the highest likelihood of picking up coronavirus outside our own households comes from social settings. Public Health England will be publishing further information today on backward contact tracing to understand how this virus spreads.

The hon. Gentleman asks about the speed of test results. I am glad to say that the turnaround time for test results in care homes is speeding up. He asked about Deloitte and its contact tracing capabilities. Deloitte has done an incredible job in helping us put together the contact tracing and backward contact tracing that we have, and of course it should offer its services to local councils too. He says that local councils should have more impetus and more involvement in contact tracing, but when a company with great experience in contact tracing comes forward to offer its services, he criticises it. He cannot have it both ways. Of course, these services cost money and they have to be delivered, and I pay tribute to Deloitte, which is doing a brilliant job.

Finally, the hon. Gentleman asked about flu jabs. It is absolutely true, as he says, that there is a record roll-out of flu jabs. There are enough for everybody in a priority group who needs them. I stress that this is a roll-out: nobody needs to have a flu jab before the start of December, but people can have it in September or October and it will then cover them for the winter, so we are rolling this out and more appointments will become available in good time. We have 30 million jabs in total, more than we have ever had before and almost double what we typically have had in the past, and those are available. I am really glad to say that record numbers of people are coming forward to get flu jabs, and I welcome that, but, as the Royal College of General Practitioners has said, people will need to have patience. For those in the target group—the over-65s and those with clinical conditions—flu jabs are available, and it will take us the coming weeks in order to ensure that people who need those flu jabs can get them.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 21st September 2020 Commons Chamber

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

I welcome advance sight of the Secretary of State’s statement, and we particularly welcome the action that he has taken on childcare. There can be no doubt that the presentations that we saw today from the chief medical officer and the chief scientific adviser were stark and deeply concerning. The Secretary of State yesterday described this, and he repeated it today, as a tipping point. I agree that we are at a perilous moment.

The exponential growth in the virus cannot be ignored. This virus takes lives, and it leaves many with long-term debilitating conditions. Every reasonable action must be taken to save lives, minimise harm and keep our children in school. That means a suppression strategy to drive infections down, so will the Secretary of State reject those siren voices telling him that the virus has lost potency or that we should let it rip through the herd while the vulnerable shield?

We support the local restrictions that the Secretary of State has had to impose, including in Chorley, Mr Speaker, and we understand why he has made that decision. Neither he nor I came into politics to place upon individuals a heavy burden of curtailments on our freedoms, and while we, as the official Opposition, would always welcome greater parliamentary scrutiny of the restrictions, we will continue to work constructively on a cross-party basis where restrictions are necessary to arrest the spread of this virus.

May I also say to the Secretary of State, ever so politely of course, that the tone of his remarks yesterday rather gave the impression that he was blaming people for breaking the rules and allowing the virus to grow? The reality is that people have done everything that they were asked to do. They have missed birthday celebrations, weddings and funerals. They have sent their children back to school, quite rightly. They have gone back to work. They have done what they were asked to do; in return, Ministers were supposed to fix test, trace and isolate, so that we could, in the words of his own Government adverts,

“get back to the things we love.”

Before the summer, the Government commissioned the Academy of Medical Sciences to scenario plan. It modelled that the R value could rise to 1.7 in September—that is what Imperial College currently estimates it to be—and it recommended significantly expanding the capacity of the test, trace and isolate programme to cope with increasing demands over the winter. Ministers were warned, but pillar 1 and pillar 2 testing capacity did not increase significantly over the summer.

In recent weeks, only half of all tests have been received in less than 24 hours. The Secretary of State has repeated his point about asymptomatic people asking for tests. Will he publish the pillar 2 data, which breaks down how many of the people asking for those tests were symptomatic and how many were asymptomatic? Many parents report going to walk-in centres with their sick children when they themselves had no symptoms and being given a test. Was that a national policy and has that national policy been abandoned?

We welcome the recognition that people need financial support to isolate. We have been saying that for months, but, as I understand it, it is available only to those low-paid workers who are also on benefits and not to all low-paid workers, so will the Secretary of State consider expanding the eligibility criteria?

We have always said that when testing breaks down, tracing breaks down and the virus gets out of control. We are now facing a second wave of infection. We do not want a second wave of ministerial mistakes. All of us want to avoid a further national lockdown. Lockdowns or circuit breaks exact a heavy social and economic price, especially on the poorest and more vulnerable, but controlling the virus and protecting the economy are linked objectives, not in conflict with one another.

I understand that the Secretary of State will tell us that we have to anticipate the Prime Minister’s statement, but can he confirm that during a lockdown, if we have one, he will use the time wisely, expand NHS lab capacity, put public health teams in the lead on contact tracing, quickly assess the university pilots on saliva testing, and validate polymerase chain reaction pool testing, so that when those lockdown restrictions are lifted we can contain the virus in the future?

I welcome what the Secretary of State said about prioritising NHS staff, care workers and teachers, but can he clarify why he has issued guidance to hospital trusts placing restrictions on the numbers of tests that they can carry out, and how he will protect care homes? According to reports today, many care homes have had to wait over two weeks for their test results, and data from Public Health England shows that more than 200 care homes have had an outbreak of covid in the last two weeks. Will he ensure that no one is discharged into a care home without having a covid test? Given where the virus is, what is his advice to the shielding community? What protections is he putting in place for those from black, Asian and minority ethnic communities, given that there are disproportionate numbers from those communities in intensive care units today?

None of us wants to see another lockdown or circuit break, and we will of course understand if one becomes necessary, but test, trace and isolate should have been fixed. That failure has left us vulnerable and exposed. Now we must act with speed to save lives and minimise harm.

[Matt Hancock]

I 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.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 17th September 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of his remarks.

The capital investment for 25 A&Es will be welcome. On the piloting of the 111 triage ahead of A&E, given inequalities in accessing healthcare for the poorest and disadvantaged, how will the Secretary of State ensure that it does not worsen health inequalities? If it leads to greater demands on primary care, will GPs be given extra resources as a consequence?

The NHS is facing a likely second spike, winter pressures and a monumental backlog in non-covid care. The Chancellor promised to give the NHS “whatever it needs”. Does that promise still stand, and will the NHS get the funding it now needs to tackle the growing backlog in non-covid care?

On social care, can the Secretary of State guarantee that care homes will not face the same personal protective equipment shortages they faced at the start of the pandemic? Does he also accept that restrictions on family visits cause huge harm to residents? Does he rule out re-imposing nationwide restrictions on family visits?

The Secretary of State said little about testing this afternoon. Back in May he stood at the Dispatch Box and told the House that

“everyone aged five and over with symptoms is now eligible for a test. That applies right across the UK, in all four nations, from now. Anyone with a new continuous cough, a high temperature or a loss of, or change in, their sense of taste or smell can book a test”—[Official Report, 18 May 2020; Vol. 676, c. 380.]

“We have”, in his words, “now got testing for all”.

Yet, four months later, for the British people, it has become not so much “test and trace” as “trace a test”. Just when many fear we are on the cusp of a second deadly spike, the Prime Minister admits we do not have enough capacity. Rather than fixing the testing, the Secretary of State is restricting it. In the exchanges on Tuesday, 33 Members from across the House raised issues around testing in their constituencies. He responded with the local figures—it was a very good debating trick, and well done to the specialist adviser for producing the briefing—but that will have been no comfort to constituents advised to travel hundreds of miles for a test when ill. It will have been no comfort to parents with a poorly child and themselves sick with worry and unable to get a test. It will have been no comfort to those turned away from walk-in centres and now presenting at A&E asking for a test. It will have been no comfort to the 25,000 teaching staff not in schools teaching our children because they cannot get a test. People want to know when the Secretary of State will fix testing and deliver on his promise to make testing available to everyone.

The Minister in the media this morning said there would be priorities for testing, so can the Secretary of State outline what his rationing plans are? Care England says that weekly testing of all care home staff is still not happening. Will care home staff get testing under his imminent rationing plan? What about people living in areas of restrictions, including the north-east? Will the north-east get all the mobile testing sites it requests? What is happening in university towns, with thousands of students set to come to universities across the country in the next two week? Will there be extra testing in those areas? In July, he pledged 150,000 asymptomatic tests per day by September. Has that commitment now been abandoned?

We should not be in this mess. We warned the Secretary of State that without fixing testing and isolation, infections would rise. Rather than capacity being increased over the summer, pillar 1 and 2 lab capacity remained broadly flat. He is now setting up more commercial Lighthouse labs. Why not invest in the 44 NHS labs instead? There are still problems in these commercial labs, aren’t there? There are huge numbers of voided tests across the commercial labs. Randox had 35,000 voided tests across August. Today’s stats show test turnaround times for testing in these labs getting longer. Serco is still failing to trace 80% of contacts. At what point will the Secretary of State step in and strip poor-performing outsourcing firms of their lucrative public sector contracts?

When testing breaks down, case finding breaks down, isolation breaks down, and we lose control of this virus. The British people made great sacrifices—they missed family celebrations, they could not say their final goodbyes to loved ones at funerals—and honoured their side of the bargain. In return, the Government were supposed to deliver effective testing and tracing. The Government failed. Now we have vast swathes of the country under restrictions. Where do we go next? The Prime Minister yesterday said a second lockdown would be disastrous. Obviously, we all want to avoid a second lockdown, but the British public deserve some clarity. Is the Secretary of State completely ruling out a second short national lockdown in all circumstances? Infections are rising at pace, but it is not clear what the actual strategy of the Government now is. It is all very well talking about camel humps and moonshots, but we need a plan to fully suppress the virus. It is urgent that he fixes testing and tracing and gives people isolation support to avoid further restrictions. Otherwise we face a very bleak winter indeed.

[Matt Hancock]

To 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.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 15th September 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care to update the House on his response to coronavirus.

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

Coronavirus exists only to spread, and yesterday the World Health Organisation once again announced a record number of cases globally. France and Spain have both reported daily figures of over 10,000 positive cases and increasing hospitalisations. Here in the UK, we saw around 2,600 new cases yesterday, and last week medical advisers advised that R is above 1. The epidemic is growing.

There are signs that the number of cases in care homes and the number of hospitalisations is starting to rise again, so last week we acted quickly, putting in place new measures—the rule of six, which came into force yesterday. We do not do this lightly, but the cost of doing nothing is much greater.

Testing also has a vital part to play. Everyone in this House knows that we are doing more testing per head of population than almost any other major nation, and I can tell the House that we have now carried out over 20 million tests for coronavirus in this country. As we expand capacity further, we are working round the clock to make sure that everyone who needs a test can get a test. The vast majority of people who use our testing service get a test that is close to home, and the average distance travelled to a test site is now just 5.8 miles —down from 6.4 miles last week; but the whole House knows that there are operational challenges, and we are working hard to fix them.

We have seen a sharp rise in people coming forward for a test, including those who are not eligible. Throughout this pandemic, we have prioritised testing according to need. Over the summer when demand was low, we were able to meet all requirements for testing, whether priorities or not, but as demand has risen we are having to prioritise once again. I do not shirk from decisions about prioritisation. They are not always comfortable, but they are important. The top priority is, and always has been, acute clinical care. The next priority is social care, where we are now sending over 100,000 tests a day, because we have all seen the risks this virus poses in care homes. We will set out in full an updated prioritisation, and I do not rule out further steps to ensure our tests are used according to those priorities. It is a choice that we must make.

Finally, to defeat this virus in the long term needs effective vaccines and treatments. I am delighted to say that over the weekend the trial of the Oxford vaccine restarted, and I can tell the House that we will now be trialling a promising new antibody treatment on coronavirus patients in the UK. The challenges are serious. We must work to overcome them, optimistic in the face even of these huge challenges, and to keep this deadly virus under control.

[Jonathan Ashworth]

I am grateful for advance sight of the Secretary of State’s answer. That was decent of him.

Yesterday LBC revealed that there were no tests available in covid hotspots, including Rochdale, Pendle and Bradford. Over the weekend in Bolton, where infections are the highest in the country, a mobile testing centre failed to turn up. Meanwhile, in Bury hundreds queued for five hours for a test. In Walsall, a father with his sick child travelled 76 miles to an appointment in Wales, only to find on arrival that tests had run out. Increasing numbers of teachers and pupils are not in school. In hospitals, operations are cancelled while NHS staff are stuck in limbo, waiting for tests.

The Secretary of State blames increased demand, but when tracing consistently fails to reach 80% of contacts, when less than 20% of those with symptoms self-isolate properly and there is a lack of financial security, infections rise. When schools reopen and people return to workplaces and social distancing becomes harder, infections rise. Extra demand on the system was inevitable. Why did he not use the summer to significantly expand NHS lab capacity and fix contact tracing?

Just as demand is increasing, the ability to process tests is diminishing. Post-graduate students working in the Lighthouse labs are returning to university, so why did the Secretary of State not plan for the inevitable staff shortages in the Lighthouse labs? Those commercial pillar 2 labs, The Sunday Times revealed at the weekend, have a huge backlog of 185,000 tests. Thursday’s data revealed that 65,709 test results were not returned by the end of the week. Care home residents now wait an average of 83 hours for their result. The Prime Minister promised us a 24-hour turnaround for results, so what is going on? What is the current backlog and what is the timeframe for clearing it?

We were promised a world-beating system, so why are we sending tests to Germany and Italy for processing? But, most importantly, people want to know when they will get a test and when this mess will be fixed. Today there will be thousands of ill people trying to book a test, only to be told none is available. When will people be able to book a test online again, or has the online booking system been deliberately disabled? When will ill people no longer have to travel hundreds of miles for a test that should be available on their doorstep? When will pupils and teachers out of school get access to testing, so they can get back to school? When will NHS staff have access to regular testing, so they can focus on their patients and not be sitting at home?

We are at a perilous moment. Imperial College estimates the virus is doubling every seven to eight days. We all want to avoid further restrictions or another national lockdown, but when testing and contact tracing break down, the growth of the virus cannot be tracked. The Prime Minister promised us whack-a-mole, but instead his mallet is broken. The Secretary of State is losing control of the virus; he needs to fix testing now.

[Matt Hancock]

Well, the good news, in responding to that, is that capacity for testing is at a record high. The hon. Gentleman raised the issue of testing in the top 10 local authorities—well, I have got the figures here. Yesterday, we processed 9,278 tests just in pillar 2—so outside of the NHS testing capacity—in just those top 10 local authority areas. Just yesterday, we processed 1,428 tests in his own local authority area.

The good news is that capacity is at record levels and that a record number of people are able to get tests. I do not deny that it is an enormous challenge. When a service is free, it is inevitable that demand will rise. The challenge is to make sure that we prioritise the tests that we have as a nation for those who most need them, as I set out in my answer.

The hon. Gentleman asks about the backlog, which is actually falling and is less than one day’s processing capacity. He also asked about our being able to have testing capacity so that we can re-enable the economy and get things going. As he well knows, there is a huge effort to expand—using the next generation of technologies —the tests that we need to deliver to reopen parts of the economy, and we will deliver on that.

We will deliver on the challenges of today. I do not deny those challenges, but I face the facts in order to deliver on those challenges, rather than simply complaining. The hon. Gentleman should welcome the record capacity and the contact tracing, which are playing their part in responding to the virus.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 10th September 2020 Commons Chamber

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

As always, I am grateful for my advance copy of the statement.

We welcome the restrictions that the Government have imposed—indeed, we would have welcomed them on Tuesday afternoon, had the Secretary of State confirmed what was being said on Twitter that morning. Case numbers have been rising sharply in recent days across all ages and sadly the number of hospital admissions is beginning to increase as well. We all want to avoid a second national lockdown. Lockdowns extract a heavy social and economic price on those already suffering, and we should also remember, especially today, which is World Suicide Prevention Day, the mental health impact of lockdowns.

Before I comment on the substance of the Secretary of State’s remarks, I want to ask about schools. We have had many examples across the country of classes and whole year groups—hundreds, possibly thousands, of pupils—starting the new term as they finished the last term: at home and not in education. Is it really the Government’s policy that if there are one or two positive cases in a year group, the whole year group is sent home for two weeks? If so, are parents and carers eligible for sick pay and financial support, given that they will have to take time off work to look after their children?

We were promised a world-beating test, trace and isolate regime by now. The Secretary of State says we have one. On Tuesday, I highlighted the deteriorating performance in finding contacts. He said that I had muddled my figures. Full Fact said I was right and he was wrong. I will leave it to him to judge whether he wants to correct the record. I would rather he just correct Test and Trace. In one study, researchers found that 75% of infected people did not adhere to the self-isolation rules. I know he is piloting extra support, but we need a system now, urgently, so that those who are low paid and in insecure work can isolate without fear of losing their jobs. We need a system immediately. We have been calling for it for months.

On testing, the Secretary of State told us a few moments ago to get with the programme. We just want him to deliver testing for our constituents. We have had example after example of people being told to go hundreds of miles. In Telford, the borough has been gridlocked because the system has been telling everybody to go to Telford. Yesterday, the Secretary of State was touring TV studios trying to dampen demand, even though he had previously said in the House in July to people with symptoms:

“If in doubt, get a test.”—[Official Report, 20 July 2020; Vol. 678, c. 1864.]

He was telling people to get tests.

Given that the Secretary of State had encouraged people to get tests, and with 8 million pupils returning to school, with thousands going back to workplaces, as his Prime Minister has insisted on, surely it was obvious there would be extra demand on the system, so why did he not plan extra resource capacity to process tests? It is not the fault of ill people asking for tests; it is his fault for not providing them. We have had no apology today to our constituents who have been told to travel hundreds of miles for a test.

Having failed to provide the tests that people need and, by the way, having failed to provide wider diagnostic tests—the waiting list for diagnostic tests hit 1.2 million today, the highest on record—the Secretary of State now wants to deliver 10 million tests a day as part of his so-called Project Moonshot. I have long been pushing him for a strategic mass testing regime, and from the start the World Health Organisation has told us to “test, test, test”, but we are all fed up with undelivered promises and “world beating”. Mass testing is too important to become another failed project. It is all well and good the Secretary of State talking about moonshots, or the Prime Minister telling us that we will be tested every morning, but even better would be simply to deliver the extra testing that is needed now, not just the headline figures.

I have some specific questions. First, the Prime Minister told the nation that he wants this in place by the spring. The chief scientific adviser pointed out that it would be

“completely wrong to assume this is a slam dunk that can definitely happen”.

How quickly will this be delivered, and how quickly will the pilots in Salford and Southampton be assessed?

Secondly, what is the cost? According to The BMJ—the British Medical Journal—leaked documents suggest that the cost will be £100 billion. Is that correct? If not, will the Secretary of State tell us his estimate of the cost of processing 10 million tests a day, and will he tell us how much has been allocated to Project Moonshot?

Thirdly, who will deliver that? There are universities piloting projects, such as the University of Leicester rolling out LAMP—loop-mediated isothermal amplification —testing, so what discussions has the Secretary of State had with them? However, it has been reported that he has already signed agreements and understandings for the delivery of this project with GSK, Serco and G4S. What procurement processes have been undertaken, and will he tell us whether that is correct?

Fourthly, what are the priorities? The Secretary of State is still not testing the loved ones of care home residents who are desperate to see relatives, and when will the Government actually deliver the routine testing of all frontline NHS staff, which we have been demanding for months? Effective testing depends on quick turnaround, local access and effective contact tracing. Given that he has not even been able to deliver those basics, how on earth do we expect him to deliver this moonshot?

[Matt Hancock]

The 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.

--- Later in debate ---

[Matt Hancock]

Someone who has symptoms can of course apply for a test in a drive-through centre or to have the home test. Of course, those are available; it is just that demand has gone up, especially demand from those who do not have symptoms. Those who do not have symptoms but have been in close contact with someone who has tested positive should not be applying for a test, because, as was mentioned earlier, they may get a false negative and actually need to self-isolate. We are really clear about who should be getting a test and who is eligible for a test. In a way, though, my hon. Friend’s question demonstrates why mass testing is also so important—it means we can roll out testing even further. The hon. Member for Leicester South used to be a great supporter of Tony Blair—

[Jonathan Ashworth]

I am.

[Matt Hancock]

In that case, maybe he needs to have a word with the former Prime Minister. Tony Blair is a big fan of mass testing. It is a pity the hon. Gentleman does not know which way he is looking.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 8th September 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. There can be no question but that the rise in case numbers in recent days is deeply worrying, and I agree that this is no time for complacency, that those who suggested this could be over by Christmas were foolish, and that we should be taking every reasonable measure possible to utterly suppress this virus. It is indeed a very dangerous virus and I am pleased that he and his Department have recognised the condition of long covid—we probably need a better term for it—whereby many people get long-term conditions as a result of the virus. I am pleased about the emerging research into that.

We have been seeing the trends in young people catching the virus for some time, in Greater Manchester, and indeed in Leicester, where the lockdown was due to the trends among young people. Many have warned that we could be facing a resurgence as we move into winter.

The Secretary of State has just announced the closure of pubs and other parts of the hospitality sector across Bolton. Has that been discussed and agreed with the Mayor of Greater Manchester? Can I ask the Secretary of State a very practical question? He may not realise it, but I grew up in Radcliffe, which is next to Bolton. What happens if people in Bolton want to go for a drink and end up going to Radcliffe or Bury, or indeed Chorley—which will be of interest to Mr Speaker? Will they be allowed to travel to neighbouring areas for a drink? How will restrictions be enforced? Given the action that the Secretary of State has taken on the hospitality sector in Bolton, is he keeping that sector under review in other hotspot areas? What guidance has he issued to pubs, restaurants and so on in those areas?

I am grateful for what the Secretary of State said about Leicester, and we have made great progress in the city of Leicester, but we still have in place the rule that people cannot congregate in private gardens with their extended family. Can I ask him again to set out the evidence for that? Can he update us on when Leicester will next be reviewed, because infection rates have come down?

Universities are set to return imminently, yet the SAGE analysis was not published until last Friday. Will the Secretary of State urgently produce a national plan for reducing transmission of the virus in the higher education sector? On schools, we have seen several outbreaks in recent days, including at the school the Prime Minister visited in Coalville a few weeks ago to promote the opening up of schools, yet the exact circumstances in which a school ought to close if a pupil displays symptoms are still unclear. In what circumstances does the Secretary of State believe a school should close?

The Secretary of State may recall that I warned him early on that one of the biggest barriers to self-quarantining would be not fatigue but personal finances. Does he accept that the Government need to go much further in helping people who need financial or housing support to self-isolate? Otherwise, he will never get on top of infections in areas characterised by low pay, child poverty and overcrowded housing. Does that not help to explain the poor record of contact tracing in these areas? In Bolton, contacts were reached in only 57% of non-complex cases; in Oldham, only 50%; in Blackburn, only 47%; in Bradford, only 43%. Nationally, only 69.4% of contacts are now reached and asked to self-isolate. [Interruption.] These are the latest statistics—his own statistics that he publishes. What is world-beating about that?

There was little explanation in the Secretary of State’s statement of what has gone wrong with testing in recent days. He tells us we have capacity for about 300,000 tests a day and that about 100,000 of those are antibody tests. What is the current capacity for testing? How many PCR tests are available at the moment? Yesterday, he said no one should have to travel further than 75 miles for a test, but for many people, such as the 20% of home careworkers on zero-hours contracts, taking a 150-mile round trip for a test simply is not feasible. At the moment, it is not even possible! Last night, it was reported that there were no tests in London. People in Kent were asked to travel to Cardiff. In Denton, they were advised to visit Llandudno. In Leicester, someone was advised to head north to Edinburgh. Helpfully in Devon, people were told they need only travel 20 miles, but unfortunately that involved crossing the sea to get to Swansea. Now, I know the Secretary of State thinks he walks on water, but many of our constituents cannot.

In the Health Select Committee earlier, the Secretary of State admitted that it would take weeks to fix these problems, yet last week he was boasting of plans for 10 million tests a day as part of his Operation Moonshot. When he cannot get the basics right, never mind Moonshot—people will think he is on another planet. His testing regime has been a fiasco in recent days, yet we have had no apology from him today. Is not the core of the problem that he did not listen to the experts? They all advised him to invest in public health teams and NHS labs. Instead, he gave contracts to outsourcing firms such as Deloitte, Serco and G4S, which had no experience in testing and tracing. He should now accept that that was a mistake and invest in public health teams.

We must do everything reasonable to suppress this virus, but in recent weeks we have had muddled messages, failed testing and ineffective contact tracing. Winter is coming, and the Secretary of State needs to get a grip.

[Matt Hancock]

I will certainly answer the questions posed by the hon. Gentleman, but as for his proposal to dismantle the testing system that we have built so painstakingly over the past six months using not only the NHS and PHE, but all the testing capacity of the nation, that is one that I and the British people will reject. We need to build our capacity, and we need to build on what we can do. We have built one of the biggest testing capacities in the world over the past six months, and I will reject all narrow, partisan calls to dismantle a testing capacity that is working.

Of course, with the increase in demand for tests that we have seen in the past few days, there have been challenges, which we have acknowledged, and we are working day and night to fix them. The long-term solution, using the new technologies that are coming on stream, is a critical part of ensuring that we can expand testing capacity still further.

I am afraid that the hon. Gentleman got into a bit of a muddle on contact tracing, saying that under 70% of contacts are traced. That is simply untrue and below the number that we publish weekly—we published the latest figure last Thursday.

Some of the hon. Gentleman’s questions were sensible. On schools, he is quite right that having clear guidance on how we approach schools and on what schools should do in the event of an outbreak is important. That guidance has been published and sent to schools. In the first instance, of course, a school should work with their local director of public health to minimise the impact of an outbreak.

The hon. Gentleman also asked about financial support for those who have to self-isolate, and we have put that in place. We have rolled that out in areas of the north-west, and we are watching the progress effectively.

The hon. Gentleman rightly asked about Leicester, where, of course, he has both national responsibilities and a local interest. The local lockdown in Leicester has resulted in a significant drop in the number of cases, and we will take a formal review of the measures in Leicester on Thursday. I will be certain to talk to him in advance of that and take his local intelligence and views into account.

The hon. Gentleman asked for a plan for higher education. An enormous amount of work has been done with all universities to ensure that the sector can open safely in the coming weeks.

Finally, I am glad that the hon. Gentleman started his response in a constructive form in respect of the measures that we must take in Bolton. I have communicated with the Mayor of Greater Manchester and he has had a briefing from the official team—that has been offered. The statutory responsibility of course lies with Bolton Council, with which we have been working very closely to put into place measures that in essence build on the measures that Bolton Council has been putting in place. I put on the record my thanks to those in Bolton Council—its leader, David Greenhalgh, who has been doing an excellent job, as well as the director of public health and the chief executive—because it has been a difficult challenge in Bolton.

Thankfully, what we have learnt from this sort of local action elsewhere in the country is that we do not see large-scale numbers of people travelling to other areas nearby where there is a problem. We have not seen that yet. Of course, we remain vigilant on that and on all these measures, but I am sure that the people of Bolton will understand how significant this problem is and will follow the guidance and, indeed, the new laws that we will bring in to back up the proposals we have made today.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

Nobody has done more for the cause of patient safety in this country than my right hon. Friend. We are seeking to put the health service investigatory branch into law at the earliest legislative opportunity. He will know that, as a Minister, I could not possibly pre-empt what Her Majesty might say in a few months’ time in the other place, but I will say that, in the same way that we introduced the Health Service Safety Investigations Bill just before the election, it is our full intention to legislate for it at the earliest chance.

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

I listened carefully to the Secretary of State’s response to the hon. Member for Southend West (Sir David Amess). Can he guarantee that he has currently sourced enough flu vaccine to vaccinate all 50 to 64-year-olds by Christmas?

[Matt Hancock]

We have the biggest flu vaccination programme in history, and we set out very clearly when we announced the plans our proposals, which are that we will vaccinate those who are clinically most vulnerable—that starts with the over-65s and those with another health condition that causes them to be particularly vulnerable to flu—and then move to vaccinate the 50 to 64-year-olds. We set that out several weeks ago. It is exactly as clinically recommended, to make sure not only that we have the biggest flu vaccination in history but that we get it to the people who really need it first.

[Jonathan Ashworth]

I think the Secretary of State was saying there that he cannot guarantee vaccinations for all 50 to 64-year-olds. We are heading into a difficult winter. He knows that; the whole House will know that. One area of the health service that is particularly under pressure is rehab services and community mental health services, because they often now treat people who have had covid and have long-term conditions associated with having covid, yet many local areas are currently putting local community and public health contracts out to competitive tender. That could mean staff being made redundant. It could open the door to Virgin Cares coming in. At the very least, it is distracting and wasteful. Will the Secretary of State halt all competitive tendering of community and public health contracts until the end of the pandemic?

[Matt Hancock]

What I will do is ensure that we put in the best possible resources to improve the public health of the nation. That is our goal; that is our policy. It of course follows on from the policy that was put in place by the Government of which the hon. Gentleman was a behind-the-scenes part. He knows very well that I admire the work that he did when he was trying to expand the provision of health services. No matter where those health services come from, what matters is the quality of the service that people get on the frontline, and that is what we on the Government Benches will be focused on.

Coronavirus Response

Debate between Jonathan Ashworth and Matt Hancock

Monday 20th July 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. Before I move to the substance of his remarks, will he tell the House whether it is true that the chief nursing officer was dropped from the Downing Street press conferences because she refused to stick to the No. 10 line on supporting Dominic Cummings? Did the Secretary of State really acquiesce in the silencing of the chief nursing officer at the height of this pandemic?

We in this House would all be immensely proud if a British vaccine and British drug led the world away from this deadly disease, and this is encouraging and exciting news. Will the Secretary of State ensure that there is equitable access to a vaccine when it is developed? He has my commitment that when a vaccine is available, I will stand shoulder to shoulder with him in taking on poisonous anti-vax propaganda. However, we also have to understand that there have been many false dawns in the history of infectious disease, so what happens if a vaccine does not become available? What scenario planning is the Health Secretary doing, should we be confronted with that awful prospect?

On Friday, the Prime Minister suggested that it could all be over by Christmas and that people must start returning to work by 1 August, but the chief scientific adviser said on Thursday that there was “absolutely no reason” for people to stop working from home, so will the right hon. Gentleman now publish an explanation of the scientific basis for the change in guidance with respect to home working?

On Thursday in the House, the Health Secretary insisted that we went into lockdown on 16 March, having previously told the House on 2 June that

“lockdown began on 23 March.”—[Official Report, 2 June 2020; Vol. 676, c. 704.]

The CSA revealed that SAGE advised the Government to lock down ASAP on 16 March, and Professor Ferguson has said that had lockdown been implemented sooner, we would have saved thousands of lives. The Prime Minister understandably wants to avoid a second lockdown—we all do—but if SAGE advises again on the need for a second lockdown, will it be implemented immediately, and on what criteria will he judge whether a second national lockdown is needed?

Last week, the Prime Minister also suggested that social distancing could be eased in November, predicated on a low prevalence of the virus. Can the Health Secretary define what low prevalence means, and is that the only threshold we need to meet if social distancing is to be removed by Christmas? There were no details last week about when relatives could visit care homes, even though the Secretary of State said on 9 July that an announcement was imminent. He will know that this is causing huge anxiety and upset for many families. Can he give us clarity today on when relatives can visit their loved ones in care homes?

The Prime Minister did indeed announce extra NHS funding, which is welcome, but there was no extra funding for social care. Can the Health Secretary tell us whether social care will get any more resources for this winter? We have always said—and we agree with him—that mass testing is the way in which we have to live with this virus and avoid going into a second lockdown, so we welcome the commitments to increased testing. We also know that local lockdowns may well be necessary in the future—indeed, that is the Government’s preferred response to outbreaks—but it is vital that local areas receive patient-identifiable test data on a daily basis. Why did he tell the House last week that local authorities were getting that data when in fact they were not? I think he is announcing today that they will start getting that data—he refers to “enhanced” data—but local areas could have possibly avoided lockdowns and outbreaks earlier had they had that data.

Local areas still need more clarity. In Leicester, we still do not know what metrics will be used to decide whether Leicester will be released from lockdown. Can the Health Secretary confirm, with respect to Leicester, that given the infection rate there and in neighbouring Oadby and Wigston, a decision on their future will be taken at the same time? And given that we are talking about local lockdowns—we will study the regulations carefully—will he deliver on his promise to provide support for businesses that are subject to a local lockdown, such as in Leicester?

It now appears that Blackburn is overtaking Leicester in terms of infection rates, so what does the Health Secretary make of the remarks of the director of public health in Blackburn, who said at the weekend that Test and Trace is failing and, in his words, is

“contributing to the increased risks of Covid-19”

because half of contacts are not reached? Nationally, 71% of people are being contacted, not the 80% that is needed for it to be effective. Indeed, in the Serco call centre element of Test and Trace, only 53% of cases are contacted, and a smaller proportion of contacts are identified in the most deprived areas. We still do not have an app either, despite the right hon. Gentleman’s promises, with Whitehall sources now briefing that he has a

“tendency to overpromise and only sometimes deliver”.

What a wicked, unfair thing to say about the Health Secretary! Seriously—which bit of all this is actually world beating, other than possibly the £10 billion price tag?

Today’s vaccine news is encouraging, but we still have a long way to go. We need mass testing and we welcome the Health Secretary’s commitments on that front, but will he also undertake to expand the rapid testing consortium, so that more British suppliers can be involved? Many complain about test kits and say the regulator takes ages when they give their test kits to be signed off and that emails go unanswered. We need an effective tracing regime. Rather than the ad hoc system we have at the moment, with all that money going to privatised firms, why does he not put local directors of public health in charge, backed up with primary care? We need to be preparing now for the second wave. We already have one of the highest excess death rates in the world. Lessons need to be learned. I hope the Secretary of State is learning them.

[Matt Hancock]

The hon. Gentleman was doing so well when he was supporting what we were saying. I am grateful to him for support on what we are doing on vaccines. I am also grateful to him for his offer to stand shoulder to shoulder against the anti-vaccination movement. Those who promulgate lies about dangers of vaccines that are safe and have been approved are threatening lives. We should all in this House stand shoulder to shoulder against the anti-vax movement.

The hon. Gentleman asks what happens if there is no vaccine. If there is no vaccine—no vaccine can be guaranteed—then the next best thing is good treatment. We have the first treatment here in the UK, dexamethasone, and we have promising news of another today. We put all the support we can behind finding treatments. In fact, the UK recovery trial is the biggest—I would argue, the most effective—treatment clinical trial for covid-19 in the world. From the start, we backed our science. We supported our science, and with the help of the NHS we are able to do scientific research here with great rigour.

The hon. Gentleman mentioned the SAGE advice from March about lockdown. The SAGE advice that the CSA was referring to was implemented. That was precisely the point I was making on Thursday and I did so very straightforwardly. It was implemented straight away. If he looks at that SAGE advice and what happened, that is what he will find. I seem to remember that at the time he supported the action. Maybe now he is looking in the rear-view mirror. He should spend a bit more time looking forward, not backwards.

On social distancing, as on Leicester, the hon. Gentleman asked about the data and thresholds. We use all our data. We use all the data available to make these judgments. We do not put numerical thresholds on any particular figure. We use all data and we make judgments based on them. He also asked about data being made available to local authorities. On Thursday last week, I said I wanted to provide more data to local authorities and was going to provide more data to local authorities. We have done that today. We had provided patient-identifiable information based on postcode-level testing. We are now able to provide full information, including the name and address of those who tested positive, to local authorities where they have signed a data protection agreement.

The hon. Gentleman talked about the effectiveness of NHS Test and Trace. He needs to stop for a moment and recognise the enormous impact of NHS Test and Trace, and the 180,000 people it has been in contact with to advise them to isolate. On Blackburn, yes, it is hard sometimes in certain areas to find all the contacts, so we will be sharing with the local area the information on those whom NHS Test and Trace has not been able to contact, so that local directors of public health will be able to support the action there. Again, I think his tone on that, sniping from the sidelines, ill becomes that enormous effort and the previous work he did to support those measures across party lines.

Finally, the hon. Gentleman asks what we have learned. I would say that the thing he needs to learn—I have certainly learned it—is that things go best when we get the work of the public sector and the private sector coming together. He does not even believe his own attempt to divide us, but uses his argument just to play to his base. Honestly, there are more important things going on. We have set out a direction. We are going as hard as we can down that direction of travel, and we have announced to the House further action in that direction of travel. He should get alongside.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Thursday 16th July 2020 Commons Chamber

[Jonathan Ashworth]

The hon. Gentleman says from a sedentary position that there is not a health risk, but the Government are withdrawing these kits. And how many people have these unsafe kits been used on and why were the certifications not checked before these kits were used? These kits tend to be used in many care homes. We want care home residents to be tested regularly. We want care home staff to be tested regularly. Can the Secretary of State guarantee that those care homes will now get alternative kits rapidly?

Today we have seen more testing data come out. The Prime Minister promised that tests would be delivered within 24 hours by the end of June. I think the figures today show that only 66.9% of them are. On the tracing data, we see that only 71% of people are being contacted, not the 80% that we were promised. Is not it the truth that we now have swabs being recalled, contact tracing not meeting the targets and Serco call centres with people not doing anything? It is all costing £10 billion and the Health Secretary is now bringing in McKinsey. Why is he throwing good money after bad? Why does he not invest in public health services, primary care and local health teams instead to do this testing?

[Matt Hancock]

The hon. Gentleman has spent weeks complaining about capacity to do things such as contact tracing and now complains that we have too much capacity. He should decide on a position and stick to it. On the point about Randox and the kits on which we put a pause, the reason is that they had a CE stamp and, on investigation of the certification of that stamp, the certification was not forthcoming, so physical checks were done and we found that the swabs were not up to the standards that we expect. This is limited to the Randox element of the testing system, not the broader testing system that we have. I explained the clinical position, which is that there is no evidence of any harm having been done and that there is full access to testing, because we have plenty of other test kits available.

The hon. Gentleman asked about test and trace. Ninety-nine per cent. of the tests that need to be done quickly are returned the next day. More broadly, he asked about the comments of the chief scientific adviser to the Select Committee. The 16th of March is the day that I came to this House and said that all unnecessary social contact should cease. That is precisely when the lockdown was started. It is unusual to be attacked for saying exactly the same as the chief scientific adviser.

On the questions with respect to Leicester, the hon. Gentleman rightly raises the Leicester fortnight. Schools have effectively risen for the summer in Leicester already. Of course, I would urge holiday companies that people in Leicester might have booked a holiday with to reimburse them at this point.

The hon. Gentleman mentions the problem and challenges of insecure work in Leicester, and he is absolutely right to do so. This is a long-standing problem, and I think the whole House would strongly support action to ensure that illegal insecure work is stamped out. My right hon. Friend and colleague the Home Secretary is taking action where appropriate, but, of course, the public health response is vital.

Finally, the hon. Gentleman asked about the public health advice on geography. Given that there were no cases in many areas of the county that are part of the conurbation of Leicester over the past week, it was, I think, a reasonable recommendation to me by the county council to lift the lockdown in those areas. I gave the Mayor of Leicester the opportunity to put forward any changes he might have wanted to within the city boundary, but he declined to do so.

Based on public health across the whole city of Leicester, within the city geography, incidence of this disease is higher than a sustainable level, and we absolutely need to bring it down. It is on the basis of that advice, and working with and listening to local leaders, that we took the decision on the geography of the lockdown in Leicester. I end by again paying tribute to people in Leicester, who are enduring the lockdown longer than others; it is their fortitude that will help to get their city safe again.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 7th July 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care, if he will make a statement on coronavirus.

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

We are bringing coronavirus under control. Yesterday’s figures showed 352 new cases, the lowest since lockdown began. That is down from over 5,000 a day at the peak. Two hundred and nine patients are currently in mechanical ventilator beds with coronavirus, down from 3,300 at the peak. The latest number of deaths recorded in all settings in the UK was 16. New figures this morning show that for the last two weeks, the number of people who have died from all causes has been lower than the normal average for this time of year.

Because we are bringing the virus under control, we have been able to restore some of the things that make life worth living. This weekend, restaurants, pubs and hairdressers were buzzing with activity for the first time in months, and yesterday we were able to ease restrictions for the 2.2 million people who have been shielding across England so that they can now spend more time outdoors in a group of up to six, of course while maintaining social distancing.

Our plan has always been to lift the national lockdown while taking ever more targeted action to suppress the virus. We are seeing a similar approach in other countries, such as Germany, Spain and Australia, where overnight they locked down Melbourne. Last week, we took difficult but vital decisions about Leicester. Since then, we have been working with Leicester and Leicestershire, and I am pleased to say that together, we have brought down the seven-day infection rate from 135 to 117 cases per 100,000 people.

In reopening hospitality, we have also introduced contact tracing for customers. This system is working. I want to thank all those who are making the system work, and to pay tribute in particular to three pubs that have taken specific action: the Lighthouse in Burnham-on-Sea, the Fox and Hounds in Batley, and the Village Home in Gosport. They have all closed for a deep clean and staff testing after, in each case, a customer tested positive. They are doing the right thing by their customers and their communities. This is NHS Test and Trace working precisely as intended. Three pubs shut so that others can be open, and I think the whole House is grateful.

Coronavirus has been the worst global pandemic in a generation. Here, we protected the NHS. We built the new Nightingale hospitals in 10 days. At all times, treatment was available for all. Our medical research has discovered the only drug known to work. We have built, almost from scratch, one of the biggest testing capabilities in the world. We are getting coronavirus cornered, but this is no time to lose our resolve. The virus exists only to spread, so we must all stay alert and enjoy summer safely.

[Jonathan Ashworth]

I am grateful to the Secretary of State for that answer. He is quite right: we are through the peak, but we must not be remotely complacent, as thousands could still die from this virus over the coming months and into next year.

I welcome the news about Leicester, and I am grateful for the way in which the Secretary of State and his officials have kept me updated. What is the exit strategy for Leicester? How does an area that has gone into a local lockdown escape it? I understand that in Germany, local lockdowns are lifted at around 50 cases per 100,000. Will he apply similar criteria here in the United Kingdom? I think people in Leicester, and potentially in other towns and cities that could go into lockdown, would welcome that clarity.

Of course, the pillar 2 data has been an issue of some contention. Much of it has now been delivered, but there are still complaints that the way in which the data set has been delivered is incomplete. Directors of public health need pillar 2 community data in real time on a daily basis. They need the total number of tests undertaken, as well as those that are just positive, and they need patient-identifiable data so they can put in place the extensive contact tracing needed to keep all our constituents safe.

In Leicester, there has been speculation that the textile trade or food manufacturing has been responsible for the outbreak—we still do not actually know why we had the outbreak in Leicester—but many of the places where there have been outbreaks, whether Kirklees or elsewhere, have usually been characterised by low pay, insecure work and lack of decent sick pay. Will the Secretary of State look again at sick pay entitlement, because people will not isolate unless they are given that financial security?

The Secretary of State said on “The Andrew Marr Show” on Sunday that asymptomatic transmission is a problem. We agree. Could he explain why he is not routinely testing healthcare workers? The position now in this country is that premiership footballers are tested twice a week, but NHS staff are not routinely tested.

Finally, on care homes, the initial guidance from the Government downplayed the risk to care homes. Care providers were sent conflicting guidance throughout the outbreak. Staff could not access testing until mid-April and are still not tested routinely. Personal protective equipment supplies have been inadequate. Thousands of families have lost their loved ones in care homes to this disease. Care workers themselves have died on the frontline. Can the Health Secretary understand why people are so insulted by the Prime Minister’s remarks, when he said:

“too many care homes didn’t really follow the procedures.”?

Can he appreciate the hurt that has led to care home providers today describing those comments as “clumsy and cowardly”? Can he tell us which care homes did not follow procedures and what those procedures were that were apparently not followed? Will he take this opportunity now to apologise for the Prime Minister’s crass remarks?

[Matt Hancock]

First, the hon. Gentleman rightly asks about the process needed to bring Leicester out of lockdown and back to the level of freedom enjoyed in the rest of the country. What we said, when we took the measures just over a week ago, is that we needed to see 14 days of data, so we propose to make announcements on the next steps on 18 July. Of course, if further measures are needed in the meantime to tighten up we would take them immediately, but, as I said in my statement, the good news is that the data are currently moving in the right direction.

The hon. Gentleman asks specifically about a figure for the point at which such a local lockdown might be lifted. We are not going to use or give a specific figure, because both the level and the rate of change matters. If the level were lower but going up, that could be a worse situation than a higher level that is under control and falling. We have to look at both the level and the rate of change.

I am glad that the hon. Gentleman said that data are being delivered. He mentioned some more detailed data and I am very happy to look into those proposals.

The hon. Gentleman mentions asymptomatic testing and the asymptomatic testing of NHS staff. As this House debated 10 days ago now, we have worked with clinicians to come forward with a scheme that is supported by those clinicians for the regular testing of NHS staff. That scheme is now agreed and in place. Of course, we constantly monitor it and we monitor the number of cases among NHS staff. I am content with that scheme, which was set out almost two weeks ago.

The hon. Gentleman also asks about care homes. Throughout the crisis, care homes have done amazing work. The Prime Minister was explaining that because asymptomatic transmission was not known about, the correct procedures were therefore not known. We have been constantly learning about the virus from the start and improving procedures all the way through. I pay tribute to the care homes of this country, which have done so much to care for the most vulnerable throughout the crisis.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Monday 29th June 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of the statement, and also for the many direct conversations we have had in recent days about the situation in Leicester. I hope the House will forgive me if I ask a number of questions about the situation in Leicester; it is the city that I represent, but I hope the House will understand that many of the points that I raise would be applicable to their own local areas should they also see an outbreak in their own constituency.

The Prime Minister talks of his “whack-a-mole” strategy to suppress local outbreaks. We were alerted to the situation in Leicester 11 days ago, and tonight we now have from the Secretary State the whack-a-mole strategy. Does the Secretary of State agree that if we are, as a nation, to ease from lockdown smoothly, those areas that do see flare-ups will need greater speed in the response? Otherwise, we risk no moles getting whacked.

Ministers, Public Health England and other agencies must work closely with local government leaders—that has happened in Leicester and we are grateful for that—and local directors of public health need rapid and ongoing access to testing data. Can we resolve whatever the issues are around the data-sharing protocols, so that if we see flare-ups in other cities, local authorities can get data speedily? Will the Secretary of State look into ensuring that the testing data also captures ethnicity and occupation? For a city like Leicester, it is crucial to capture that level of intelligence.

People in Leicester were concerned, anxious and scared yesterday to read in the newspapers and see on TV screens news that we were going into some form of lockdown, based on anonymous briefings. Grandparents who had recently formed bubbles to see their grandchildren were asking me whether they had to withdraw again. Parents were asking whether they could send their children to school today. Those shielding were particularly worried. I have been around politics for a long time so I understand that things get leaked and so on, but I urge him to appreciate that on something of this seriousness and sensitivity, people need crystal-clear clarity and not briefings from over-eager advisers—perhaps; I do not know.

The Secretary of State has announced a number of extensions to the lockdown measures. I support those extensions, given the outbreak in Leicester. Will he just clarify what powers he has to enforce those extensions and whether he needs to bring forward any legislation or any statutory instruments? I welcome the fact that there will be a two-week review. Will he undertake to keep the Members of Parliament updated on that, and will he come back to the House to announce the outcome of that review?

This decision will impact many Leicester businesses, which were preparing to open up on Saturday. Many feel that they are now in limbo, so will they be eligible for adequate financial support for this extension period, and will employees affected be eligible to stay furloughed as well?

We know that this virus thrives on inequality, and that a disproportionate number of black and Asian people die from this disease. A disproportionate number of the poorest are also most likely to become infected and die from this disease as well. It means that a city such as Leicester is particularly at risk. The Secretary of State will know that Leicester is a proudly diverse city, but we also have one of the highest child poverty rates in the country. Those who are in work are often in low-paid, precarious employment. Our housing is overcrowded. Our public services have been cut back and years of austerity have taken their toll. Saving lives and keeping people safe across Leicester is always my priority, so I support the measures that he has announced, but we also need extra support, extra testing and extra resources to protect people in our city. I am grateful for the extra testing stations that he has put in Spinney Hill Park and Victoria Park. Will they remain in place for the duration of this outbreak? I note what he said about an extra walk-in centre, and I welcome that, but could he also provide the city with thousands of home-testing kits, so they can be distributed to local people?

I welcome the extra resources for Leicester and Leicestershire to translate literature into the many languages that we are proud of in Leicester. The Secretary of State will also know that, for those who are asked to isolate, financial security is absolutely crucial to the success of contact tracing. Where people live in multi-generational households, which we have a lot of in Leicester, will he provide accommodation for those who need to isolate away from home? Will he also ensure that workplace inspections happen to check that people who need to isolate have not been forced back to work? Furthermore, given that schools are closing, people who live in Leicester but work outside of Leicester will now have childcare responsibilities. Can they be furloughed and their employment rights be secured? Will he consider giving Leicester City Council facemasks to distribute to every resident? I am pleased that he accepts that the extension to restrictions cannot just apply to the tightly drawn Leicester City Council boundaries, but must include the wider Leicester urban area as well.

There will be many other cities and towns with similar demographic profiles to Leicester: Birmingham; parts of Manchester; parts of London; Bradford; and Coventry. What extra resources and testing capacity will the Secretary of State now put into those areas and what extra support and testing capacity is he putting in place to support the many occupations that are particularly at risk, such as taxi drivers and bus drivers?

Finally, tonight, the World Health Organisation has warned that the virus is still spreading at speed and that those countries that have opened up are beginning to see a resurgence. The virus remains deadly. It causes significant long-term harm and still demands a resolute response. If that means restrictions have to remain in place or be re-imposed, whether in Leicester or elsewhere, then so be it.

[Matt Hancock]

I want to put on record my gratitude to the shadow Secretary of State and his Leicestershire colleagues in this House, who have all worked in a constructive manner to try to make sure that we get the right answers here and then we communicate them in the right way to the people of Leicester. He, after all, is both a Leicester MP and the shadow Secretary of State.,

I set out in my speech the action that we have already taken over the past fortnight to support Leicester City Council and Leicestershire County Council to tackle this outbreak. We have been acting on it since it first came to our attention. It is clear now that further action is necessary. He talks about the debate that has been in the media. All I can say is that, within two hours of the final decisions being taken, I have come to this House. I am grateful to you, Mr Speaker, for allowing me to come to the House at this unusually late hour in order to set out the decisions immediately.



The hon. Gentleman rightly asked about the powers that will underpin the decisions that I have taken. They will be brought forward with a statutory instrument very shortly, and I commit to keeping the House updated on the two-week review of whether we can lift some of the measures.

The hon. Gentleman is quite right to talk about the proud diversity of the city of Leicester. It is very important that that diversity is taken into account in communicating these decisions and undertaking the public health measures in Leicester. That includes, for instance, the financial support that we put in place for the translation of the messages.

The hon. Gentleman asked whether the testing units can be there for the long term. They will absolutely be there for as long as they are needed. He asked for the provision of home testing kits. I will take that away, but I commit to him that we will increase the number of home testing kits that are available for Leicester. He asked about accommodation for those who are required to self-isolate but whose accommodation does not allow for that in practice. We are working with the city council to put in place availability, on a discretionary and exceptional basis, for accommodation for those who are required to self-isolate by public health officials.

The hon. Gentleman asked about childcare. I appreciate that these decisions—especially the closure of schools—will have an impact on working parents. Childcare is, of course, a reason for essential travel, and I hope that, as during the broader lockdown across the country, people will be able to make arrangements for it.

Finally, the hon. Gentleman asked about other areas that have high intensity. We are of course looking across the country at the cities where cases of this virus remain higher than elsewhere. However, the number of cases in Leicester is three times higher than the next highest city. That is not due to the fact that there is now more testing in Leicester. If it were, the proportion of people who test positive would be falling. Actually, that proportion has remained static, which is one of the reasons why we are specifically concerned about Leicester. It is not just that there is increased testing; it is that there is a higher prevalence in Leicester. That is why we have taken the actions that we have.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 23rd June 2020 Commons Chamber

[Matt Hancock]

That is a very important question on supporting children’s mental health. We absolutely reiterate the long-term plan ambitions for service transformation and expansion. Indeed, one of the things we have learned during coronavirus is that when it comes to paediatric mental health, telemedicine can actually have a better and more effective impact than face to face. That is a good thing to have learned and will help the roll-out further.

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

On the app, the Secretary of State told us it was crucial and would be ready by mid-May. Experts warned him it would not work. He spent three months, wasted £12 million and has got nothing to show for it. It is a good job he is a tech-savvy expert on apps; otherwise, this would be a right shambles now, wouldn’t it?

[Matt Hancock]

On the contrary, ensuring that we use technology to its best possible effects is incredibly important. I would have thought that the shadow Secretary of State would want to side with and support the efforts of all those, including in the NHS, who are doing the work to ensure that we can get this up and running as quickly as possible.

[Jonathan Ashworth]

In the past few days, I have been listening to the Secretary of State’s excuses. He is like the Eric Morecambe of the Commons: he has been playing all the right notes, just not necessarily in the right order. On test and trace, local areas such as Leicester, which has had a spike, still do not have local data; GPs still cannot refer people for testing; and NHS staff are still not tested regularly. He has spent £100 million on a Serco and Sitel call centre where the tracers are saying they have nothing to do. This is not a “world-beating” system; it is more like a wing and a prayer. When are we going to get a functional test, trace and isolate strategy?

[Matt Hancock]

The shadow Secretary of State is far better when he supports the Government than when he pretends to oppose them. We have all seen him explaining why the steps that the Government are taking are the sensible ones, why it is important to move from a national lockdown as much as is safely possible to local outbreak control, and why test and trace is important. When he gets on to saying that the money we have spent to protect the NHS and put in place the actions needed to get us out of the lockdown is wasted, I think that that is opposition for opposition’s sake.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 17th June 2020 Commons Chamber

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

(Urgent Question) To ask the Secretary of State for Health and Social Care if he will make a statement on coronavirus.

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

I am grateful for the chance to update the House on the urgent matter of coronavirus.

Yesterday’s treatment breakthrough shows that British science is among the best in the world. As a nation, we can be incredibly proud of our scientists. The UK is home to the best clinical trials, the most advanced immunology research, and the most promising vaccine development work of any country. We have backed the science from the start, and I am sure the whole House welcomes the life-saving breakthrough that was announced yesterday. Today, I will briefly update the House on all three aspects of that national scientific effort.

First, on clinical trials, our recovery programme, which looks at the effects of existing treatments in real-world hospital settings, is the largest of its kind. As of yesterday, 11,547 NHS patients had been recruited to the programme, which is operating across 176 sites in all four nations. In Oxford University’s dexamethasone trial, over 2,000 NHS covid patients were given a course of the drug—a commonly used steroid—over 10 days. For patients who were ill enough to require oxygen, the risk of dying fell by a fifth, and for the most seriously ill patients on mechanical ventilators, the risk of dying fell by over a third.

This is an important moment in the fight against this virus, and the first time that anyone in the world has clinically proven that a drug can improve the survival chances for the most seriously ill coronavirus patients. In February we began the trial, supported by £25 million of Government funding, and in March we began recruiting patients, and started the process of building a stockpile in case the trial was successful. As of today, we have 240,000 doses in stock, and on order. That means that treatment is immediately available, and already in use on the NHS. I am incredibly proud that this discovery has happened right here in Britain, through a collaboration between the Government, the NHS, and some of our top scientists. It is not by any means a cure, but it is the best news we have had.

Throughout this crisis, our actions have been guided by the science, and that is what good science looks like: randomised control trials; rigorous and painstaking research; moving at pace, yet getting it right. The result is that we now have objective proof—not anecdotes, but proof—that this drug saves lives, and that knowledge will benefit many thousands of people all around the world.

Seven other drugs are currently being trialled as part of the recovery process, and a further nine drugs are in live clinical trials as part of the ACCORD programme, which is looking at early-stage treatments. We look forward to seeing the results of those trials. I thank everyone involved in that process, and put on the record my thanks to our deputy chief medical officer, Professor Jonathan Van-Tam, who led the work in Government, as well as to NHS clinicians, the scientific teams, and the participants in the trial who took the drug before they knew that it worked.

Our immunology research, again, is world leading. Last month I announced a new antibody testing programme to help us understand the immunological response to the disease, and whether someone acquires resistance to coronavirus once they have had it and recovered. I am part of that programme, and as of yesterday, 592,204 people have had an NHS antibody test. The nature of immunity research means that it takes time, and we must wait to see whether someone with antibodies gets reinfected. However, with every test, we improve our picture of where the virus has been, and we grow the evidence to discover whether people who have had the disease and have antibodies are at lower risk of getting or transmitting the virus again.

Crucially, that work will help to inform how we deploy a vaccine, and it is moving at pace. Earlier this week Imperial College began its first phase of human clinical trials, and 300 participants will receive doses of the vaccine. Should they develop a promising response, Imperial will move to a large phase-3 trial later this year. Yesterday, AstraZeneca signed a deal for the manufacture of the Oxford vaccine, AZD-1222, which is the world’s most advanced vaccine under development. Its progress, while never certain, is promising.

None of that happened by accident. It happened because the British Government, scientists, and the NHS put in place a large-scale, programmatic, comprehensive, well-funded, systematic, rigorous, science-led system of research and innovation. We have been working on it since the moment we first heard of coronavirus. There is more to do in this national effort, but that is how we will win the battle. We will leave no stone unturned as we search for the tools to hunt down, control, and ultimately defeat this dreadful disease.

[Mr Speaker]

May I just say to the Secretary of State that he has gone way over the allocated time? It would have been easier for him to make a statement rather than having to have an urgent question. In future, perhaps he could come forward with a statement if he needs the extra time, and I will certainly grant that and support him in doing so. Some extra time for Jonathan Ashworth as well, and for Philippa Whitford.

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

I am grateful, Mr Speaker. I welcome the news from the Secretary of State about Dexamethasone. As he said, this is an important moment and good news, and I congratulate all those involved. It is a reminder that we can be immensely proud of our science base in this country. I note what the Secretary of State said about vaccinations. A vaccine is crucial, and I hope he will join me—I am sure he will—in saying that when a vaccine is available, we must have no truck with those who spread poisonous anti-vax propaganda on social media. Vaccinations save lives, and ultimately that will be the exit strategy from this dreadful, horrific disease.



The good news is tempered by the high death rate. The Prime Minister likes to boast of flattening the sombrero, and it is certainly true that deaths from hospitalisations are coming down, but we still have 58,000 excess deaths across England and 13,000 in care homes; and 300 health and care staff have sadly lost their lives. All our NHS staff deserve great praise, so may I ask the Health Secretary about a specific matter that has emerged in the past couple of days? Why are student nurses who joined the frontline six months ago as part of the coronavirus effort now seeing their paid placement schemes terminated early, leaving them with no income? That is no way to treat student nursing staff.

This week, the World Health Organisation has warned that the UK remains in a “very active phase of the pandemic”.

The right hon. Gentleman will accept that if a second wave comes, especially if it coincides with flu season, that would be completely disastrous. Can he reassure the House that the decisions that he and the Prime Minister are making on easing lockdown measures, such as the mooted relaxation of the 2-metre rule and the opening of non-essential retail this week, will not precipitate a deadly second wave of the virus? Would he update us on the latest thinking on that by the Home Department? In the past, the right hon. Gentleman has said that he is prepared to institute local lockdowns, but local authorities continue to say that they do not have the resources or powers to enforce that. Can he update us on when he will give local authorities powers to enforce those lockdowns?

Yesterday, the Health Service Journal said that for people in the shielding group, shielding will come to an end at the end of July. We were promised a full update on shielding on 15 June, two days ago. Can the right hon. Gentleman update the House now on what is happening and what the future is for the shielding group with regards to getting their medicines and supplies and whether they will be able to leave their homes by the end of July?

We have always said that testing, tracing and isolating is crucial to the safe easing of the lockdown. On testing, local authorities say that they are still not getting the specific test data that they need. Indeed, the Deloitte contract, as confirmed in a written answer from the Minister for Patient Safety, Mental Health and Suicide Prevention, did not specify that it needed to report test results to GPs and local directors of public health. We need to fix that.

Why is the right hon. Gentleman still not publishing the number of people who have been tested, and can he explain something that is puzzling many of us? The tracing figures that he revealed—we are grateful for them—suggested that 8,000 people went into the contact tracing system in England, but in that week, the Government testing figures said that there were around 12,500 positive cases in the UK. Even if we can make an assumption about how many of those cases are in England, that still suggests that there are around 2,000, perhaps 3,000, cases not being traced and contacted. Can he explain why that is and what he is going to do to fix it?

Finally, we have now seen Public Health England recommendations on the impact of covid on those from black, Asian and minority ethnic communities. Those recommendations are welcome. Many of them, such as mandated ethnicity data collection and recordings on death certificates, should have been done years ago, but when will those recommendations be implemented? Black people are nearly four times as likely to die from covid as white people, and over 90% of doctors who have died during the pandemic were from black, Asian and minority ethnic communities, so surely this is a matter of urgency. We cannot wait, and we need those recommendations to be implemented straight away.

[Matt Hancock]

I 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.

Covid-19: R Rate and Lockdown Measures

Debate between Jonathan Ashworth and Matt Hancock

Monday 8th June 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care to make a statement on the R value and lockdown.

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

Thank you, Mr Speaker, for this opportunity to update the House on progress on our plans for controlling coronavirus.

Thanks to the immense national effort on social distancing, as a country we have made real progress in reducing the number of new infections. As we move out of lockdown, we look at all indicators to assess progress in tackling the virus. Last week’s Office for National Statistics infection survey estimated that the number of people who have had coronavirus in England fell from 139,000 between 3 and 16 May to 53,000 between 17 and 30 May—a drop of over half. In terms of new cases, an ONS estimate released on Friday shows that there are now around 5,600 new cases each day within the community in England: a huge drop since the peak.

The number of new fatalities each day is, thankfully, falling too. Today’s figures record 55 fatalities, the lowest number since 21 March, before lockdown began. They also show that there were no deaths recorded in London hospitals. That is a real milestone for the capital, which, of course, in the early stages of the pandemic, faced the biggest peak. Yesterday, we saw no recorded deaths in Scotland, which is very positive news for us all. Sadly, we expect more fatalities in the future, not least because the figures recorded at the weekend are typically lower. What is more, Mr Speaker, 55 deaths is still 55 too many and hundreds of people are still fighting for their lives. Each death brings just as much sadness as when the figure was much higher in the peak. I know that the thoughts of the whole House are with those families and communities who are grieving for their loved ones.

We, of course, also look at the R rate. The Scientific Advisory Group for Emergencies confirmed on Friday that its estimates, taking into account 10 different models, are that R remains between 0.7 to 0.9, and that it is below 1 in every region of the country. That means the number of new infections is expected to continue to fall. So there are encouraging trends on all critical measures. Coronavirus is in retreat across the land. Our plan is working and those downward trends mean that we can proceed with our plans, but we do so putting caution and safety first.

Even at the peak of the pandemic, we protected the NHS and ensured that it was not overwhelmed. We will not allow a second peak that overwhelms the NHS. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on infections in our hospitals, including through the new measures to tackle nosocomial infection, such as face masks for visitors, patients and staff. Finally, we are strengthening protections for our care homes, including by getting tests to all elderly care home residents and staff.

I am glad to be able to tell the House that David Pearson, the eminent social care expert who has previously led the social care body ADASS—the Association of Directors of Adult Social Services—and has decades of experience of leadership in both social care and public health, will be chairing our new social care taskforce to drive our covid action plan yet further. David has an impressive track record and I am delighted that he will be supporting us in leading this important work. Together, we are getting this virus under control and now more than ever we must not lose our resolve.

[Jonathan Ashworth]

I note what has just been said about the social care taskforce, but may I say that it probably should have been set up some months ago? The Government are easing restrictions, but even when looking at their own tests we know that PPE supplies are still not secured—dentists are warning about PPE today; that tracing is still not fully operational—the chief operating officer of test and trace has warned that it will not be fully operational until September; that testing is still not sufficient—we are still not routinely testing all NHS staff, whether asymptomatic or not, even though we know that such testing will arrest the spread of the virus in hospitals; and that the R value, according to the PHE Cambridge model, is close to 1 in many regions and is at or above 1 in the north-west and the south-west. The modellers of that model warn that that may result in the

“the decline in the national death rate being arrested by mid-June.”

The British people have shown great resilience and fortitude in observing this lockdown and helping to slow the spread of this deadly, horrific virus, but we have still had more than 40,000 deaths. As the Secretary of State said, infections are still running at more than 5,000 a day. We should proceed with caution, but many now fear that the Prime Minister is starting to throw caution to the wind. I therefore wish to put some specific requests to the Secretary of State: will he agree to start publishing, on a weekly basis, the regional R value estimate, alongside the national estimates? Does he agree that the voices of regions must be heard in future decisions about lockdown? Will he start including the various metro Mayors, such as Andy Burnham, in the covid Cobra meetings? Will the Secretary of State ensure, this week, that local authorities and general practitioners start receiving specific data about who has tested positive so that they can start putting in place area-based responses? Will he issue, this week, written guidance on defining what a “local lockdown” is, how it will be enforced and what resources and powers local authorities and agencies will be able to draw upon?

Finally, we know that the more deprived an area is, the higher the covid mortality level. There are pockets of deep deprivation in the north-west and in the south-west, such as in parts of Cornwall. What financial support will be given to those who are asked to isolate? Given that we also know that black, Asian and minority ethnic people are more at risk from covid, will he now publish the PHE report on disparities in full—all the chapters, all the analysis, all the recommendations—because action to protect BAME people, especially BAME health and care staff, must be an urgent priority?

Covid-19 Response

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 2nd June 2020 Commons Chamber

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

There have now been 56,308 excess deaths since the beginning of March, 12,500 of which are not related to covid, but we do have one of the worst excess death rates in the world—why does the Secretary of State think that is? What does he believe is the cause of the non-covid excess death rate?

With respect to the PHE’s findings, which I am pleased to see published today, we have always known that there is a social gradient in health. The poorest and most deprived have inequality in access to healthcare and inequality in health outcomes. What the Secretary of State has confirmed today is that covid thrives on inequalities. Yes, indeed, black lives matter, but it is surely a call to action that black, Asian and minority ethnic people are more likely to die from covid and more likely to be admitted to intensive care with covid. He has seen the findings. I note that the Equalities Minister is taking work forward, but what action will be taken to minimise risk for black, Asian and minority ethnic people?

There are other vulnerable groups who are highly at risk. I am sure the Secretary of State will have seen today the Care Quality Commission report which shows a 134% increase in deaths of people with learning disabilities. Surely it is now time to expand testing to those under 65 in receipt of adult social care.



On the easing of restrictions, the Secretary of State said that this was a sensitive moment—well, quite, Mr Speaker. Our constituents have concerns and are looking for reassurance, particularly those in the shielding group. They really should not have had to wake up on Sunday morning to find out that they could now leave the house once a day. They need clarity and details. And why were GPs not informed in advance?

We are still at around 50,000 infections a week, so may I press the Secretary of State a bit further on the easing of restrictions? The biosecurity level remains at 4, but his own Command Paper from 11 May said that changes to lockdown

“must be warranted by the current alert level”.

At the Sunday news conference, the Secretary of State for Housing, Communities and Local Government said that all the proposed easing of restrictions had been modelled and showed that the R value remained below 1. That is, of course, reassuring, but will he now publish that modelling so that it can be peer-reviewed?

The easing of restrictions was based on tests, so may I ask the Secretary of State a couple of questions? First, on NHS capacity, we know that the NHS has not been overwhelmed, but that has been on the back of cancelled planned surgery, delays to vital treatment, and the postponing of cancer screening. Arguably, it has been the biggest rationing exercise in the history of the NHS. Will he now publish the total number of planned operations that have been cancelled and detail them by procedure? As the lockdown is eased, is it his intention to step down some of that surge capacity so that this backlog of clinical need can start to be tackled?

On managing the virus, one of the tests is on whether we can manage the virus, but, as the Secretary of State has said, that depends on testing and tracing. There is now capacity for more than 200,000 tests, but there is still a lack of clarity about how that figure is arrived at. The UK Statistics Authority has written to him today, saying that his figures are still

“far from complete and comprehensible”,

that the testing statistics still fall well short of standards in the code, and that it is not surprising that testing data is mistrusted. That is quite damning, I have to say to him. Will he start publishing again the actual numbers of people tested? Will he stop counting tests mailed to homes as completed? Will he detail what proportion of the 200,000 tests are diagnostic PCR, what proportion are antibody, and what proportion are surveillance? Can he tell us how many care home staff and residents have been tested? When will he start weekly testing of all NHS staff, as that is crucial for getting on top of infections in hospitals? Will he tell us what percentage of the Deloitte-run testing facilities have been sent to GPs?

On test and trace, which is absolutely vital to safe easing out of the lockdown, the Prime Minister told the House before the recess that it would be “world-beating” and operational by yesterday, but it is not actually fully operational at a local level, is it? Can the Secretary of State confirm that local directors of public health have been told to prepare strategies for tracing with a deadline of the end of June, that they will not actually start receiving local individual data until next week, and that many have still not been told their allocations of the extra £300 million nor what they can spend it on? When will they get those allocations? Despite this, he said yesterday that test and trace is up and running. I am not sure how he can say that it is up and running when local directors of public health are still asking for that information. Will he publish the data and what percentage of infections have been contacted and how many contacts have been followed up? Will that data be published on a daily basis?

This is a crucial week, given the easing of restrictions, and our constituents want reassurance and clarity, but I am afraid that trust has been undermined by the Dominic Cummings scandal. Our constituents want to do the right thing for their loved ones and their neighbours. Can he give them those reassurances today?

[Matt Hancock]

I entirely agree that it is critical that people play their part in making sure that we continue the work of controlling this virus and driving down the number of new transmissions. I am glad that he recognises the work that has been done, not just by Government, but by all of us, to get this virus under control.

Let me answer the hon. Gentleman’s questions specifically. He asks about the inequalities in health outcomes. He is quite right to address that subject. It was important before we went into the coronavirus crisis, and it is even more important now. Black lives matter, as do those of the poorest areas of our country, which have the worst health outcomes. We need to ensure that all these considerations are taken into account and that action is taken to level up the health outcomes of people across this country, because there is no more important levelling up than the levelling up of a person’s life expectancy and the quality of health with which they live that life.

The hon. Gentleman asked specifically about those with learning disabilities and autism. That testing in care homes for those of working age has continued all the way through this crisis, and we are rolling it out further. He mentions the changes to those who are in the shielding category. I was very pleased that we were able to make these changes. We announced them at the weekend and they have been very well received, especially by those who are shielding, because they are now able, safely, to go outside. It is hard to overstate the impact of saying to people that the recommended medical advice was that they should not go outside for 10 weeks. I am glad we have been able to lift, just slightly, the restrictions on those in the shielding category.

The hon. Gentleman also asked about the restart of the NHS. It is vital that we get the rest of the NHS going again, and that work is under way. The expansion of cancer facilities is under way. The demand for accident and emergency and urgent care is not as high as it was, but I look forward to the full restoration of our A&E facilities across the country, including in central Lancashire.

The hon. Gentleman asks, rightly, about the NHS test and trace capability. That is up and running, and working well. He asks how I can say it is working well. It is working well because thousands of people have been contacted and their contacts are being traced. So the system is working. We absolutely will publish data on that, but, as the letter from the UK Statistics Authority this morning shows, it is very important that we get that data publication right. We will work with the UKSA to make sure it is happy with how we are publishing that data, to make sure we get the data published in a reasonable and sensible way, one that also supports the operation of NHS test and trace, which we agree is a critical part of the next stage. I commit to publishing that data and to working with the UKSA on how it is put together.

The final point to make in response is that the goal here is to have a more targeted approach to the lockdown, so that we can carefully and cautiously lift the broader lockdown. That is what we are working to achieve, and I am very grateful for the support from right across the House for our efforts to accomplish that.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 5th May 2020 Commons Chamber

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

We need to be doing all we can to protect our key workers, especially those in healthcare. I welcome and note what the Secretary of State said about testing, but has he considered the study from Imperial suggesting that weekly screening of healthcare workers—testing them every week whether symptomatic or not—reduces their contribution to transmission by around 25% to 33%? Will he look at testing all healthcare staff whether they have symptoms or not?

[Matt Hancock]

Yes. The shadow Secretary of State has asked questions in a responsible and reasonable way, and I welcome his support for the test, track and trace pilot on the Isle of Wight that we announced yesterday. His question is quite right; we have piloted the testing of asymptomatic NHS staff in 16 trusts across the country. Those pilots have been successful, and we will be rolling them out further.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 5th May 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the Government’s response to covid-19.

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

We have flattened the curve of this epidemic, ensured that the NHS is not overwhelmed and expanded testing capacity to over 100,000 tests a day. As a Government, we are working resolutely to defeat the coronavirus, and there are two important areas where I want to update the House today.

First, on the expansion of our work to test, track and trace, we have now built a national testing infrastructure of scale, and because we have this extra capacity, we will be delivering up to 30,000 tests a day to residents and staff in elderly care homes, making sure that symptomatic and asymptomatic staff and residents can all be tested. Our care system represents the best of us, supporting our loved ones with tenderness and dedication at their time of greatest need. Through this unprecedented expansion of testing, we can give them the certainty and confidence that high-quality testing can provide.

Secondly, we are working to build the resilience of the NHS. We currently have 3,387 spare critical care beds in the NHS and that does not include the capacity provided by our Nightingale hospitals, including the 460-bed Sunderland Nightingale, which opened earlier today. We should all be very proud that we built up the NHS so fast and that our collective national effort has helped to protect the NHS and flatten the curve. As a result, we are now able to start to restore some NHS services and we are in a position to be able to place the London Nightingale on stand-by. This is good news, because our NHS has not been overwhelmed by this crisis and remains open to those who need care, and that means that this nation’s shared sacrifice is having an impact.

Throughout its time, this Chamber has borne witness to so much, and it has borne witness to the nation’s resolve once more. I am delighted that the British people are well and truly rising to this incredibly difficult challenge.

[Jonathan Ashworth]

Our thoughts, as always, are with the loved ones of those who have lost someone to this awful disease. May we again pay tribute to our brave NHS and care staff? I say to the Secretary of State that clapping and campaigns for medals are appreciated, but does he agree that NHS and care workers deserve fair pay, mental health support and access to personal protective equipment? I am hearing reports that we may have problems with the stocks of sterile gowns. Could he update the House on that front or write to me if he is not able to do so today? We also rely on international staff, as he knows. Will he scrap the health surcharge that they have to pay? It seems particularly unfair at the best of times, but especially at this time.

We are tracking towards having one of the worst death rates in the world—we have seen the figures again today. I know that the Secretary of State said that we are through the peak, but can the same be said of the care sector, given the number of deaths we have seen reported today in the care sector? He knows that we support lockdown and it is right that we engage in a debate about it. The strategic aim must be to suppress this virus, not simply to flatten its spread, in order to save lives and minimise harm. Testing, tracing and isolation is crucial.

Does he agree that we should be mobilising our expertise in local authority public health services, as well as other specialists such as environmental health officers, and our expertise in primary care? Would that not be a better route than outsourcing the call centre work to firms such as Serco? We support digital tools, but he will understand that there are questions about privacy. Will he undertake to publish a data protection impact assessment?

As we heard in Question Time, deprived areas have experienced covid mortality rates that are more than double those in less deprived areas. There are disproportionate mortality rates among black, Asian and minority ethnic communities. Does that not show that covid thrives on inequalities and that we need a funded strategy to support low-paid, deprived and marginalised communities, including by enforcing protections in the workplace when we transition out of this lockdown?

Can the Secretary of State comment on the remarks that were made in a Select Committee earlier by the chief scientific adviser, who said that we imported many cases from Italy and Spain early on in March? That was when events such as Liverpool v. Atletico Madrid were still going ahead. What advice will he be taking about testing at ports of entry and quarantine when we transition out of the lockdown?

Finally, we are building up a huge a backlog of unmet non-covid clinical need in the NHS. What resources will be available to deal with that, and how will we get the waiting list down? We do not want the lockdown to result in excess mortality and morbidity among those with non-covid conditions.

[Matt Hancock]

I am grateful to the shadow Secretary of State for his questions, and he is quite right to raise them. I will go through them as fast as I can and respond to them in turn. First, gown supply is improving and we have a better distribution system for PPE, on which we have been working incredibly hard under the leadership of Lord Paul Deighton. He has come in to help on PPE and made a significant improvement already.

The shadow Secretary of State asked about the number of deaths in the care sector. It is incredibly important that we protect those who live in social care settings and those who receive social care in their own homes. I am glad that in the data released by the Office for National Statistics this morning, the number of deaths in care homes was slightly lower, but it is still far too high and there is a huge amount of work still to do.

The shadow Secretary of State rightly asks about making sure that we suppress the virus. That is the goal—not just to flatten the peak, but to get the numbers right down. In doing so, our local authority public and environmental health teams will be absolutely vital, and he is right to draw attention to them. In this Chamber, we often rightly praise the NHS and social care staff, but I think this is a good moment for us to come together to praise our public health officials and environmental health officials in local authorities.

Finally, the shadow Secretary of State asked about non-covid needs, which are incredibly important. People who need treatment should get that treatment. We are opening up and reopening the NHS, and that includes any temporary closures, for instance of A&Es that need to reopen. I can think of one example in Chorley, Mr Speaker, which we are working hard to reopen as soon as possible, as the NHS reopens. I am happy to put that on record. It sometimes seems slightly unfair that you, as Speaker, cannot ask open constituency questions, but I know that that is something you have worked incredibly hard on, along with your colleagues in Lancashire.

Finally, I want to reiterate the point about levelling up. The Government’s agenda of levelling up is unabated; in fact, it is strengthened by this crisis. There are many reasons for the disparate impacts of coronavirus on different groups. Public Health England work is urgently under way into, for instance, the impact on ethnic minority groups, the impact of obesity and deprivation, and the much greater impact of coronavirus on men than women. All those things need to be considered and looked into, and we need to level up our country once this crisis is over.

Covid-19 Response

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 22nd April 2020 Commons Chamber

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

I am grateful to you, Mr Speaker, for making the arrangements for us to be able to participate in these circumstances. I thank the Secretary of State for advance sight of his statement.

My thoughts are with all those who have lost their lives to this horrific virus. I pay tribute to the NHS staff who have lost their lives. I hope that, when this is over, we can find an appropriate way to remember the frontline NHS staff who gave their lives for all of us. May we also remember those social care staff who have also lost their lives? Will the Secretary of State tell us the actual number of social care staff who have sadly died? The First Secretary did not have those figures at his fingertips a few moments ago.

It looks like we are heading for one the worst death rates in Europe. The Government have been careful to always say that they are following scientific advice. Will the Secretary of State tell us the explanation from the Government’s scientists for why our death rate seems so poor when compared with Germany’s, for example? Will he undertake to publish the Scientific Advisory Group for Emergencies’ minutes, which have not been published? Will he also undertake to publish the evidence on why we are following a seven-day rule for isolation? That appears to contradict the World Health Organisation, which suggests a 14-day rule for isolation.

As the virus develops, we see that, while it attacks the respiratory system, it also attacks cells throughout the body with ACE2 receptors, leading to cardiovascular and renal failure. In the same way that the Secretary of State can convene SAGE and other committees, will he convene the clinical societies so that we can share understanding of the disease among clinicians regarding how best to treat the disease as research emerges?

I am sure that the Secretary of State is struck, as I am, by the high proportion of deaths among black, Asian and minority ethnic communities. We see that in the United States, too. He has launched an inquiry. Will he update the House on that and tell us when it will report?

I am sure the Secretary of State is as horrified as I am by the deaths in care homes and nursing homes. This was always a high-risk sector, which is why we have long called for a social care strategy. Will he undertake to do four things? Will he ensure that all deaths are recorded on a daily basis?

The CQC suggested today that the death rate in care homes is double what was reported by the ONS yesterday. Can he ensure that testing for staff is delivered in care homes at local NHS sites or by mobile units? It is clearly ludicrous to expect care workers to travel for miles and miles to drive-through testing centres. Can he ensure that PPE supply systems for the NHS are expanded to the social care sector as well? The Secretary of State said in the past that the NHS will get whatever it takes. Will the social care sector now get funding to cover the huge costs that it is facing, which are associated with increased staffing levels and PPE? I join him in praising the leadership of the NHS for what it has done.

The Secretary of State gave us the critical care figures. How many general and acute beds are currently empty in the NHS? If there are significant numbers of empty beds, could they be used for social care residents, or to start a return to elective surgery? We know that the lockdown is having an impact on people’s wider health. Cancer patients are going without treatment, and we know that elective waiting lists will rise. Can he tell us the latest estimates how high he thinks those lists will rise? There are also bound to be mental health problems associated with the lockdown.

Many people are understandably angry that front-line staff do not seem to be getting PPE on time, and we do not seem to have taken part in some of the European procurement projects. The Chancellor of the Duchy of Lancaster said that was because we missed an email. The Secretary of State said that we are now part of that project, but that prompts the question of why we were not part of it at the beginning. The senior civil servant at the Foreign Office said it was a political decision. Will the Secretary of State tell us exactly what went on? Will he publish the background briefing so that we can see exactly what happened?

Finally, I agree that testing and contact tracing are vital to coming out of a lockdown. The Secretary of State talked about wanting to upscale contact tracing, but that is very labour-intensive. Can we use the 750,000 volunteers who have signed up to do some of that contact tracing? The app that he mentioned is welcome. When will it be available? Is he proposing that it will be mandatory, or will it be voluntary? If it is voluntary, how will we ensure that it is taken up by the population? Will he comment on reports today that the PCR test, which has been used for some NHS staff, returned false results and that those staff had to be tested again? How many people have been affected by that? What is now in place to ensure that that does not happen again? If the Secretary of State cannot answer all those points today, I hope that he will write to me with the details at a later point.

[Matt Hancock]

I thank the shadow Secretary of State for the approach that he has taken in applying scrutiny, but in a tone that makes it clear that right across the House we are united in our efforts to tackle this virus. He asked about the number of social care staff who have sadly died: 15 social care staff have sadly lost their lives. Just as we pay tribute to and remember all those NHS staff who have died, so we do for those who serve our country and look after people in social care.

He asked about international comparisons regarding the number of deaths. Of course, that needs to be done scientifically, taking into account the size of the populations of different countries. We are constantly making an important analysis of why the death rate as a proportion of the population in Germany is lower, and I speak to my German counterparts about that. In the same way, we look at all the European countries where the death rate is higher, and we try to learn lessons and ensure that we are doing the best we possibly can. There are many explanations for what is happening in Germany. One of them, which the German Health Minister explains both in public and in private, is the nature of those who first caught the disease in Germany. There is an awful lot of analysis of why, and we are constantly looking at that question, to improve our delivery here.

The hon. Gentleman asked about the seven-day rule and the proposals through SAGE. SAGE is an advisory committee, and it advises Ministers. We are guided by the science throughout this, and the science recommends the seven-day rule for coming out of full-blown isolation—it is not returning to normal by any stretch—once somebody has had the disease and no longer have symptoms. That is the scientific advice. The basis on which that decision was taken was, precisely as he says, that we listen to the advice from SAGE and then take decisions based on it. That was one where we fully accepted the advice, as we do with most of these clinical decisions.

The hon. Gentleman asked about expanding clinical understanding. He is right that the biggest impact of this disease is on the respiratory system, but it is not the only impact, and I will seek to take up his suggestion that the key clinical figures are convened. I think that the royal colleges are doing that already, but I will check that that is happening.

The hon. Gentleman asked about the disproportionate number of people from minority ethnic backgrounds in the figures of those who have died. We are indeed investigating that, and I will ensure that he has a copy of the results of that investigation as soon as it is concluded. That is a very important piece of work. There is also a disproportionate number of men who are badly affected by this disease compared with women. We need to look at all these characteristics and ensure that we have the full analysis, so that we can learn how to treat.

The hon. Gentleman asked about care homes. All deaths in care homes are, of course, recorded. In terms of the difference between the figures produced by the CQC, the Office for National Statistics and the NHS for deaths in hospitals, those figures measure slightly different things in different timeframes. It is important to look at a rigorous analysis of the comparison of the three. Yesterday there was some debate about whether the ONS figures showed that the deaths outside hospitals were 40% higher. It turned out that that was not true—it was comparing apples and pears—and the real figure is closer to 20%. I would caution the hon. Gentleman against comparing the headline figures without a true comparison of the underlying statistics.

The hon. Gentleman asked about the testing of staff. I am really pleased that we have managed to roll out testing to staff in care homes. He is right that that can helpfully be done through mobile units and the home testing kits that are increasingly available, especially for care homes that are not close to one of the drive-through centres. We now have 27 drive-through centres, and we are increasing that number over the next few days. There are new drive-through centres coming on stream all the time.

The hon. Gentleman rightly asked about PPE supplies to care. A new service is coming on stream directly to provide the PPE that is needed for care homes and domiciliary care—care provided in people’s homes. As I say, increasing that supply has been a massive logistical undertaking, with over 1 billion items of PPE delivered so far.

The hon. Gentleman asked about the spare capacity in the NHS. There are over 10,000 beds currently free in the NHS. We want to reopen the NHS to non-coronavirus symptoms and patients with non-coronavirus conditions safely and carefully as soon as it is safe to do so. The first step we are taking is to send the message loud and clear to people who have suspected conditions that they should come forward. If you think you have a lump that might be a cancer, come forward now, and you will be safely and properly treated in the NHS. The same goes if you have a suspected heart attack or stroke. We have systems in place to make sure that if you come to the NHS, you will be looked after and protected.

We will gradually reopen the rest of the NHS—for instance, to the sort of non-life-threatening conditions and elective surgery the hon. Gentleman mentioned—as soon as it is safe to do so. As he can see, the combination of having some spare capacity in the NHS and at the same time having reached the peak of the virus means that we can now start to reopen the NHS. Part of that is encouraging people to seek NHS treatment when they need it.

Finally, the hon. Gentleman mentioned contact tracing and the app. The app is currently in beta trials, which are going well, but, clearly, although an app to tell people who test positive for coronavirus whom they have been in contact with is helpful, we also need mass contact tracing so that as we bring the rate of transmission down and the rate of testing up, we can contact all the people anyone who tests positive has been in contact with and make sure that they get access to support and know what to do. In that way, we can control the virus with fewer of the extraordinary social distancing measures that have been in place.

Covid-19 Update

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 24th March 2020 Commons Chamber

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

I thank the Secretary of State, as always, for advance sight of his statement. As he knows, yesterday we called on the Government to move to implement the enforcement of social distancing measures, so the Prime Minister was quite right last night to call for people to stay at home.

May I put to the Secretary of State a few quick questions? The virus thrives on inequalities. It is the most vulnerable, without financial security, who are especially at risk. I therefore urge him to consider abolishing prescription charges for the duration of the outbreak, especially for those with conditions such as asthma. We are very mindful of the mental health implications of asking people to stay at home, and we are also deeply concerned about the potential for domestic violence to increase. What support is available on those two fronts?

We also need clear and unambiguous advice around which workers can and cannot go out. The Opposition would call for just key workers to be able to go to work. We have seen Sports Direct, for example, insisting that its workers turn up today. We are hearing stories about warehouses insisting that agency workers turn up and about construction sites not putting in place social distancing measures. That is putting workers at risk, and it is putting the lives of us all at risk. We need clear enforcement; if we are telling people that they will be fined for leaving their house, why are we not fining employers for insisting that their employees turn up to work when they should be staying at home? My right hon. Friend the shadow Chancellor will be putting more points to the Government about income protection in the debate later today.

Let me quickly turn to personal protective equipment. I understand the efforts the Government have made, but there are still NHS staff saying that they have no access to adequate PPE. We still have hospital chief executives expressing concern that they do not have access to FFP3 masks, that they are not getting the visors and sanitisers they need on time and that, when they do get masks, they are different from the previous masks, so staff have to be retrained. I urge the Government to move heaven and earth to get the PPE our staff need to the frontline. We also need PPE in social care. We are beginning to see outbreaks of covid-19 in social care homes. What support is in place for the residents of care homes, and when will we get the PPE that we need into the social care sector?

Enforced social distancing is welcome—we called for it—but in many ways it is a blunt tool without ramping up testing and contact tracing. That is how countries such as South Korea have managed to suppress the virus. We are still testing only around 5,000 people a day. We do not have enough community testing. We are still not testing enough NHS staff. As the World Health Organisation has instructed the world, test, test, test.

Leaked emails today suggest that, on Sunday, the Government were asking to borrow research institutions’ testing kits—we have called for that, and we do not disagree with it—but the emails also said that the Prime Minister had said:

“there are no machines available to buy”.

Many of our constituents, and indeed NHS staff, will be asking why we did not procure machines and kits sooner.

On intensive care capacity, there are reports today that the ExCeL centre will be turned into a field hospital of 500 beds and that staffing ratios for intensive care are being relaxed. We understand that, given the staffing demands we face, but if we are setting up more field hospitals, will the Secretary of State tell us what oversight there will be? That change also means that more of our specialist staff will be stretched further—we understand why—but what guidance will be in place? Will the Secretary of State update the House on how many intensive care beds are now open, and how many more will be opened; how many ventilators we have, and how many more will be purchased; how many beds with oxygen we have; and what the current extracorporeal membrane oxygenation capacity is?

Will the Secretary of State quickly update the House on an issue that has emerged overnight about access to abortion care, as a result of some of the implications of the Coronavirus Bill? Will he assure the House that women who want access to abortion care will continue to be able to get it?

Our constituents are worried; our constituents are fearful. I hope the Secretary of State understands that when we put these questions to him, we are doing so because we want the national effort to defeat this virus to succeed.

[Matt Hancock]

I 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.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Monday 9th March 2020 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will update the House on the coronavirus outbreak.

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

The coronavirus outbreak continues to advance around the world. The number of cases in China and South Korea keeps rising but at a slowing rate, but the outbreak in Iran, Italy, Switzerland and now France and Germany is growing. In Italy alone, we have seen 1,492 more cases overnight and 102 more deaths. Here in the UK, as of this morning, there were 319 confirmed cases. Very sadly, this now includes four confirmed deaths. I entirely understand why people are worried and concerned, and we send our condolences to the families.

The UK response is guided by our four-point action plan: we continue to work to contain the virus, but we are also taking action to delay its impact, to fund research and to mitigate its consequences. Throughout, our approach is guided by the science; that is the bedrock on which we base all our decisions. Our plan sets out what we are prepared to do, and we will make the right choice of which action to pursue at the right moment. The scientific advice is clear that acting too early creates its own risks, so we will do what is right to keep people safe. Guided by science, we will act at the right time, and we will be clear and open about our actions and the reasons for them. These are the principles that underpin the very best response to an epidemic such as this.

On research, I can report to the House that we have made available a further £46 million to find a vaccine and develop more rapid diagnostic tests, and we will continue to support the international effort. Here at home, the NHS is well prepared, with record numbers of staff, including nurses and doctors. I thank all those involved for their work so far. The number of calls to NHS 111 has increased—we have now added an extra 700 people to support that effort—and 111 online is now dealing with more inquiries than the voice calls.

To date, Public Health England has tested nearly 25,000 people, and the time taken to test is being reduced, as we are bringing in a new system for faster results, but of course responding to coronavirus will take a national effort; everyone must play their part. Of course, that means Government, and it also means everyone washing their hands more often and following public health advice, but there is much more we can all do, through both volunteering and supporting the most vulnerable. We will shortly introduce legislative options to help people and services to tackle the outbreak. The Bill will be temporary and proportionate, with measures that will last only as long as necessary in line with clinical advice. I can also report that over the weekend, we initiated action to help 120 passengers on the Grand Princess cruise ship off the coast of California to return home.

We will stop at nothing to get our response right.

[Jonathan Ashworth]

Our thoughts are naturally with the loved ones who have sadly died of covid-19. Let me also record, again, our thanks and gratitude to our hard-working NHS and Public Health England staff.

May I press the Secretary of State a little further? He will know that we have called repeatedly for an emergency funding package for our NHS, he will know that the NHS is short of 100,000 staff, and he will know that critical care beds were at 81% capacity during the week for which the latest figures are available. The Chancellor has said that the NHS will receive whatever it needs. Does the Secretary of State agree that in this Wednesday’s Budget we need to see significantly more resources for the NHS, not just rhetoric?

Scaling up and freeing up capacity in the NHS is now urgent. What is being done to scale up intensive care beds in the NHS, what is being done to expand access to the oxygen and ventilation machines that will be needed, and what is the current capacity of extra corporeal membrane oxygenation beds? We welcome the distribution of personal protective equipment to NHS staff, but does the Secretary of State agree that GPs and social care staff also need access to that equipment?

Those in receipt of social care are some of the most vulnerable, and could be affected extremely badly by this virus. Indeed, many who work in social care are low paid, and if they have to go on sick leave there are huge implications for the delivery of social care. What advice has been given to social care providers and, indeed, local authorities to ensure that the most vulnerable are protected, and what plans are in place to protect staff and increase the number in the social care sector?

Public health directors are expected to play a leading role in local preparations. They need to make decisions about deploying staff—Public Health England, for example, has asked for staff to be seconded—yet they still do not know their public health allocations for the next financial year, which will start in three weeks’ time. We are begging the Secretary of State: please tell local directors of public health what their Budget is for this coming April.

We are still officially in the containment stage. At some point, we presume, we will need to move into the delay stage, when we understand that social distancing measures will be necessary. Many of our constituents are now asking—and I think it would benefit the House if the Secretary of State could explain to them—why we are not yet considering more home working, whether we should be asking those over 65 to isolate themselves, whether we should be cancelling larger events, and whether those returning from northern Italy, for instance, should be quarantined. I think it would help our constituents if the Secretary of State ran through the medical advice, although I understand why he has made the decisions that he has made.

Can the Secretary of State also confirm that once we move into the phase in which measures of this magnitude are proposed, he will come to the House, explain why that has happened, and allow Members to question him? He has hinted, or suggested, that we will need emergency legislation for the mitigation stage. As a responsible Opposition, we would like to sit down with him in order to understand the content of that legislation, because we want to work on a cross-party basis; but let me leave him in no doubt that we also want statutory sick pay for all from day one. Asking people to wait five weeks for universal credit is not a serious solution.

Will the Secretary of State update the House on food supplies and the conversations that he has had with supermarkets? Can he reassure us that our constituents do not need to be panic-buying, as we saw people doing on social media in some parts of the country over the weekend? Finally, does he agree that whatever happens, we must find a way for Parliament to continue to hold Ministers to account so that we can ask questions on behalf of our constituents? However, we continue to offer to work constructively with the Government, because the public health interest and the safety of our constituents must always come first.

[Matt Hancock]

Let me start by concurring with what the hon. Gentleman said about the legislation. It should be taken through on a cross-party basis. I should of course be happy to talk to him about the proposals in that legislation, and also to ensure that the clinicians are able to explain why they are necessary and proportionate. I am grateful for the tone that he has taken throughout, recognising that our responses are led and guided by the science.

The hon. Gentleman asked about the NHS and its preparedness. There are record numbers of nurses and doctors, as I said. The 8,700 increase in the number of nurses over the past year is welcome in this context. We are, as he said, scaling up intensive care beds, and making sure that we have as much availability of ventilation equipment and, crucially, the skilled and trained people to use it, because ventilation equipment, without trained people, is dangerous. On that subject, we are making sure that we have the oxygen needed to go into those ventilation kits, working with oxygen suppliers to make sure that that is available.

The hon. Gentleman also asked whether GPs would have access to the protective equipment that they need, and the answer is yes. We have stockpiles of protective equipment and, again, we will release it at the right time. I am working closely with NHS England to make sure that that happens.

The hon. Gentleman asked about social care. He is absolutely right to draw attention to the importance of making sure that the staff in social care are well enough supported, including if they are sick and, critically, because many people in residential social care are some of the most vulnerable. Those living in the community in receipt of social care are likely to be vulnerable, whether because of prior health conditions or because they are elderly, or both. That is an area of significant attention, and we will update the existing guidance this week with further information for social care providers.

The hon. Gentleman asked about public health budgets which, of course, are going up. He also asked about home working and the cancellation of large events. We are not at this stage proposing the cancellation of mass events, because we are following the scientific advice that that is not what is proposed at this stage. Home working and flexible working are things that, in many cases, are advocated anyway. People will make their own decisions as to when that is appropriate. What we are saying from the Government point of view is that people should follow the public health advice so that, for instance, if they are returning from an affected area and they have symptoms they should stay at home, and that means home working. Over the weekend we added northern Italy to the list of places to which the Foreign Office does not recommend travel except in exceptional circumstances. We recommend that people returning from northern Italy self-isolate if they are symptomatic.

The hon. Gentleman asked about the food supply. We are confident that food supply will continue, even in our reasonable worst-case scenario. We have been talking to the supermarkets for some time about this scenario. I appreciate that on Friday there was discussion about whether every single supermarket executive had been involved in those talks. If any further supermarket executive wants to be involved in those conversations they should get in contact, but those conversations have been ongoing, and it is important, especially as we ask more people to self-isolate and stay at home, that we can ensure that we get supplies that are needed to the people we are asking to stay at home.

The hon. Gentleman asked about statutory sick pay, and I can confirm that we are proposing to put changes to statutory sick pay in the legislation, and I am happy to go through the details with him in the talks that I mentioned at the beginning of my response.

Finally, on Parliament, of course, this is a matter for the whole House. I know that the Commission met this morning, and I think that parliamentary scrutiny of decisions of the magnitude that we are having to take in response to coronavirus and their novel nature is incredibly important, and I will do all that I can to ensure that Parliament remains open.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 3rd March 2020 Commons Chamber

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

May I apologise to you, Mr Speaker, and to the House for being a few minutes late? I had a problem with my printer when I was trying to print the Secretary of State’s statement. I thank him for advance sight of the statement, and, indeed, for advance sight of the action plan this morning. Let me also record my thanks for the briefing that the Leader of the Opposition and I received yesterday from departmental officials, the chief medical officer and the Government Chief Scientific Adviser. I believe that the chief medical officer will brief parliamentarians later today, and I think that that is a very welcome initiative.

The Government’s strategy to contain then delay, research and then mitigate has our endorsement, but may I ask the Secretary of State for some specific clarifications? The first relates to containment and self-isolation. The Prime Minister said today—as, indeed, the Secretary of State has said before—that workers who self-isolate are considered to be on sick leave. Can the Secretary of State confirm that those who need to self-isolate will not need to visit a GP to obtain a sick note, given that the Government’s advice is not to visit a GP? As he will know, 2 million workers on low pay or insecure contracts in the gig economy do not even qualify for statutory sick pay. He will also know that those who are receiving benefits are often asked to physically attend appointments. Can he guarantee that no financial sanction will be imposed if they are asked to self-isolate?

Does the Secretary of State accept that people should not be forced to make a choice between their health and avoiding financial hardship? We are told that he is considering emergency legislation. Will he introduce legislation to remove the barriers to self-isolation so that all workers can receive the sick pay that they deserve? That is in the interests of public health. If he introduces such legislation, we will help him to get it on to the statute book quickly. He could do it this week or he could do it next week, and we will support him. Let us give all workers the security that they deserve, so that they do not have to put their health ahead of their financial interests or vice versa.

More broadly on the NHS and social care, I want to look at the response of the NHS and the support that it will be given through the containment and mitigation phases. We know that around 80% of critical care beds were occupied last week. We know that the NHS is short of 100,000 staff, and we also know that staff working in the NHS, particularly those on the frontline such as GPs, need to be protected as well. Even if we take at face value the Government’s insistence that they have provided the NHS with the resources to deliver the commitments of the long-term plan—we obviously disagree on this, but that is a debate for another time—we can surely all accept that covid-19 is going to lead to increased demand on trusts and the wider NHS. Every trust that sends a sample for testing has to pay for it to be couriered. Trusts are likely to take on more agency staff. If retired staff are encouraged to return to practice, the wage bill will increase. By the way, on retired staff, can the Secretary of State reassure us that protections and oversight will be in place, particularly around returning staff who, as we understand it, will not need to go through a revalidation process for their licence?

The Government have recognised that, as we move into the mitigation phase, non-urgent care may be delayed. I assume that means that trusts will be looking at cancelling elective surgery, which will result in waiting lists growing. Again, this will impact on trusts’ finances. Will the Government provide an emergency funding increase for the NHS resource budget to support the NHS through this next challenging period? Directors of public health still do not know their public health allocations for the next financial year, which starts next month. This means that directors of public health could be cutting the nurse workloads they are responsible for commissioning at a time when those very nurses will be needed to deal with covid-19 cases. Will the right hon. Gentleman announce the public health allocations as a matter of urgency?

On social care, we know that many who are at risk from the virus are the elderly and those with chronic conditions. Social care is responsible for and has a duty of care to many of the people who are most vulnerable to the outbreak. What advice does the Secretary of State have for social care providers, and will extra resources be announced for social care services? On the emergency powers that he has briefed about, will he sit down with us and other Opposition parties to discuss the contents of that legislation?

On the global efforts to contain the virus, we know that disease knows no borders. We cannot build a wall or an iron curtain around these islands. Why, then, are the Government apparently walking away from the EU early warning and response system, which plays such a vital role in pandemic preparations? We have been led to believe that No. 10 has overruled the Secretary of State on this. Also, to contain the virus internationally, countries with weaker health systems need to be supported as well, otherwise, we will not contain the virus. Can the Secretary of State update us on what help he is offering to the World Health Organisation on that front?

This is a serious time. Our constituents will be concerned, and many will be frightened. We will raise our concerns responsibly, but we offer to work constructively with the Government, because the public health interest and the safety of our constituents must always come first.

[Matt Hancock]

I am grateful to the hon. Gentleman for the constructive approach he has taken from the start, and I will seek to address all the questions that he has raised. His first point was about statutory sick pay. For those who need to self-isolate for medical reasons to protect others, that counts as being off sick. They do not need to go to a GP, because there is a seven-day allowance for self-declaration. I hope that that addresses that point directly—[Interruption.] We keep all matters on this under review because, broadly, I agree with him on the principle that he has set out. On the NHS, he asked about resources. We have already increased resources to the NHS and we stand ready to do so if that is necessary.

The hon. Gentleman asked about doctors and revalidation. In legislation, we are proposing to make revalidation simpler. We will bring forward those measures, and of course we will engage with the Opposition on the potential measures as and when that is necessary.

On public health allocations, we have already been clear that the public health grant is going up in aggregate. As my right hon. Friend the Communities Secretary set out last week, we have seen a 4.4% real-terms increase in local authority budgets this year, and the social care budget is going up by £1 billion. I think that that takes into account the issues that the hon. Gentleman raised.

The hon. Gentleman also raised engagement with the World Health Organisation We have supported the WHO with extra funding. On engaging with the EU, I have regular engagement with colleagues from across Europe, and some of the reports I have seen in the newspapers are not accurate, because the questions of engagement with the EU on matters of health security are a matter for the negotiations, as set out on Thursday in the negotiations document.

Medicines and Medical Devices Bill

Debate between Jonathan Ashworth and Matt Hancock

2nd reading & 2nd reading: House of Commons & Money resolution & Money resolution: House of Commons & Programme motion & Programme motion: House of Commons & Ways and Means resolution & Ways and Means resolution: House of Commons
Monday 2nd March 2020 Commons Chamber

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

We do not intend to divide the House on the Bill this evening. We understand the need for the Bill because its purpose is for the UK Government to take the powers they need as a result of Brexit. In that respect, we broadly support the principles of the Bill, and we offer to work constructively with the Government on strengthening and improving aspects of it. I have a couple of remarks to make that are related to this, but not to the exact contents of the Bill.

May I start by saying that we all know, not least because of the coronavirus outbreak, that disease knows no borders and defeating disease cannot be done in isolation? International co-operation and research and development are vital and must be accelerated, not hindered. Will the Secretary of State—or indeed the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), in her winding-up speech—explain or comment on the press reports today suggesting that the UK is not seeking to participate in the EU pandemic preparedness measures, which may obviously help in relation to coronavirus and other future outbreaks?

I am of course talking about the early warning and response system. It was suggested in The Daily Telegraph today that No. 10 had overruled the Secretary of State. Since then, a former Minister, Baroness Blackwood, has told Sky News:

“My advice while I was in there was that I thought it was absolutely appropriate that we should stay engaged with that system… I think this is something that the EU would want to maintain and we as Britain should seek to maintain.”

I agree with her. I believe it would be foolhardy to pull out of something like this at the best of times, but to do so at the time of an outbreak such as this is surely putting narrow dogma before the public health of the country. I would be grateful if the Minister responded on that.

Secondly, we also learned at the weekend that the UK will not participate in the unified patent court, which will make developing medicines here in the UK more expensive, not cheaper and easier, and it may make doing clinical trials here less attractive. The Government have done lots of briefing on this Bill, but over the weekend they slipped it out while briefing trade magazines that the UK will not be seeking involvement in the unitary patent system. Again, that is disappointing, and I would welcome some remarks from the Minister on that front when she sums up.

However, this Bill is important, and we do not want to see anything that undermines what has been built up over many years in the United Kingdom. We do have much to be proud of in the field of medical innovation. We have long history of taking a leading role in scientific advance and novel trial design. Indeed, the recent deal to give NHS patients early access to a new cholesterol treatment demonstrates that the UK is already a world-leading destination in which to develop cutting-edge treatments. We want to build on that, not undermine it.

Members across the House will be aware that our pharmaceutical industry is the single largest private sector investor in UK R&D and provides many jobs across the country for many of our constituents. We should be proud of that sector and of the contribution that life sciences make in providing access to the most cutting-edge treatments. We should be proud that they are vital to economic growth, enhance UK productivity and ensure prosperity for the future.

Yet while the opportunities before us to develop medicines and medical devices are transformative—both saving lives and radically improving the quality of life for those with the most debilitating of conditions—we also know that things can go wrong. There must never be any compromise on patient safety. Patients put their trust in practitioners, literally trusting them with their lives, and they rightly expect medicine and medical devices to be safe, yet too often in recent years the system has failed patients.

For many years, long before I acquired the health brief in my party, I worked closely with a constituent, Emma Friedmann, who has campaigned for justice for women whose children were impacted by sodium valproate. Members from across this House have spoken with passion and eloquence on behalf of women affected by Primodos. Equally, we have heard heartbreaking stories in this House about the surgical mesh scandal. My hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), the shadow Minister, has been one the leading campaigners on this issue, along with colleagues across the House. We eagerly anticipate the Cumberlege independent medicines and medical devices review, but there have been other scandals too—breast implants, hip replacements—that are not necessarily covered. We would welcome an update from the Minister about that review and some remarks on whether the Government expect to implement its findings.

My point is that a robust regulatory framework for medical devices to protect patients and users is paramount. We will be testing this Bill to ensure that it provides the safety standards that our constituents deserve, while at the same time ensuring it is forward looking enough to be the correct framework to capture the fast pace of innovation in this field, which the Secretary of State mentioned. However, I believe that the existing regulatory framework has become complex and, arguably, unwieldy.

The House will be aware that much of the regulatory landscape derives from EU directives that have been implemented in domestic legislation. At the end of the transition period, these frameworks will be preserved as retained EU law, but as I understand the Bill, the Secretary of State is proposing to take delegated powers to allow these existing regulatory frameworks to be updated without the need for primary legislation. The Bill requires the Secretary of State, as he said, to have regard to the safety and availability of medicines and medical devices, as well as to the attractiveness of the relevant part of the UK with respect to the life sciences sector. We argue that that attractiveness clause could benefit from some definition, and it would allay concerns if the Government accepted an amendment in Committee to indicate that the Secretary of State, or some other appropriate authority, would always prioritise safety.

The overall effect of the provisions is to confer on the Secretary of State an extensive range of delegated powers to make regulations that span the manufacture of medicines, marketing and supply, falsified medicines, clinical trials, fees, information and offences, and emergencies. That extensive range of powers risks inadequate scrutiny of what will become major policy decisions, and in Committee Labour will press Ministers to support time-limiting those delegated powers.

[Matt Hancock]

I am sure that this debate will continue in Committee, but for clarity, those delegated powers existed under the European Communities Act 1972. The Bill proposes to replace existing delegated powers from the 1972 Act with new powers to make such regulations under the new Act. This is not a new set of delegated powers; it replaces one set with another—indeed, the Bill replaces those powers with clearer safeguards on those matters to which the Secretary of State must have regard.

[Jonathan Ashworth]

That is a welcome clarification, but I am sure the Secretary of State will agree that it is important that decisions made in this field are properly scrutinised through the usual procedures. We are keen to ensure that by tabling an appropriate amendment in Committee.

We are leaving the EU, but Labour Members consider it essential that we stay closely aligned with it on medicine regulation. With that in mind, the Government should clarify their attitude to new EU regulations such as the in vitro diagnostic medical devices regulation, which is due to be implemented in 2022. As I understand it, that regulation will not automatically apply to the UK. Is it the Government’s intention to align with it? The EU tissue and cells directive is being reviewed. Do the Government intend us to align with it? To ensure that the UK remains a world leader in scientific research and discovery, it is vital that we align with guidelines on clinical trials. Otherwise, patients could miss out on participating in trials and the UK could find it harder to access funding.

Effective joint working with our European partners has been vital for the NHS over recent years on everything from infectious disease control to the licensing, sale and regulation of medicines. Patients in the UK can access EU-wide trials for new treatments and the UK has the highest number of phase 1 clinical trials across the EU, as well as the highest number of trials for rare and childhood diseases. It is vital for improving health outcomes in the UK and EU that the UK continues to access those networks. Otherwise, we run the high risk of patients with rare diseases being adversely impacted.

The Bill contains provisions to extend the range of professions that can prescribe medicines, thereby allowing additional health care practitioners such as paramedics and midwives to be given restricted prescribing rights. We welcome those provisions and, assuming that their competencies have been assessed in the same way as those of other prescribers and that equal safeguards are in place, we support that sensible and timely reform. Will there also be plans for a consultation on the future prescribing rights of physician associates and surgical care practitioners?

I will not say too much about part 2 of the Bill, other than to confirm that any measures that help in the battle against anti-microbial resistance have Labour’s support. Part 3 is about medical devices. I have already commented on the use of delegated powers, and as I said at the outset, patient safety must be the priority and we will look to strengthen regulation in that area. Unlike medicines and drugs, many surgical innovations can be introduced without clinical trial data or centrally held evidence. That is a clear risk to patient safety, and it undermines public confidence. Manufacturers are often in charge of testing their own products after faults have developed and they can shop around for approval to market their products without declaring any refusals.

Two years ago, freedom of information requests to the Medicines and Healthcare Products Regulatory Agency revealed 62,000 adverse incident reports that were linked to medical devices between 2015 and 2018, and more than 1,000 had resulted in death. Most devices are cleared through a pathway that allows new products to inherit the approval status of “substantially equivalent” products already on the market. In some cases, after lengthy chains of equivalence-based approvals, the new devices scarcely resemble the original version. Indeed, a study in The BMJ in 2017 found that the family tree of 61 surgical mesh products related to two original devices that were approved in 1985 and 1996. Unless we fix that and put patient safety at the heart of the regulatory framework, patients will suffer and lack confidence.

We know the Secretary of State is a great champion of and has promoted many health-based apps. We need a robust and sophisticated mechanism to evaluate app-based healthcare for use in the NHS, and in Committee we will look to strengthen the regulation of that. We welcome what appear to be plans for a devices register, and I took note of what the Secretary of State said in his interaction with my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe). We believe, however, that such a register must provide comprehensive data on who, where, how and why devices were implanted, and by whom, so that any recall could be quickly enacted.

To achieve that, we encourage Ministers to strengthen the Bill by reflecting provisions in existing EU regulation and to ensure there are unique device identifiers, such as serial numbers on medical devices that are labelled with tracking information, as well as the power to track the use of those devices, so that the NHS can find and notify affected patients if and when problems arise. By the same token, the Government must reassure us that with such a register it is practically possible to cover all devices, including everything from implants to bone screws, software, apps, mesh, medical cannulas, pacemakers and so on. That is an extensive list of different devices, and I would be keen to hear how such a register could be implemented practically.

Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 26th February 2020 Commons Chamber

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

I thank the Secretary of State for advance notice of his announcement and for sight of his statement. Again, all our thoughts must be with those who have been diagnosed with coronavirus—covid-19—in the UK and across Europe, and again we reiterate our support and put on record our thanks to all NHS staff and public health staff, as well as to the chief medical officer for the leadership he is showing.

The World Health Organisation has warned that countries are “simply not ready” for a pandemic. There has now been significant spread of the virus across the European continent—in Italy in particular, but other cases have been identified in Austria, Croatia and Switzerland. This is clearly now very serious. Yesterday there did appear to be a little bit of a discrepancy, if I may say so, between the travel advice from the CMO and the Secretary of State. Can the Secretary of State clarify for the House what exactly the travel advice is for those travelling or seeking to travel to northern Italy? I think that would be welcome.

We welcome the Secretary of State’s plans for Heathrow. Could he explain to the House why that facility is proposed only for Heathrow, and why similar facilities will not be in place at other major airports, particularly the bigger airports such as Manchester and so on. The Secretary of State mentioned the situation in Tenerife. We are all obviously very concerned about the situation there. Could he offer a little more detail about what advice and support are being offered to British nationals at this hotel?

I note what the Secretary of State says about schools, and I entirely understand it, but we do have several schools in England and Northern Ireland shut completely at the moment for a deep clean, after students and teachers returned from skiing trips. I understand that schools should check relevant websites and get local advice, but does the Secretary of State expect advice to be sent to schools from the Department for Education? If schools have to start shutting, will the Government consider arrangements for alternative schooling provision for those affected?

Will the Secretary of State update the House on how many specialist and extracorporeal membrane oxygenation beds are available across the NHS? We know that the NHS is under intense pressure at this time of year—indeed, today the BBC is running a story about people waiting on trolleys in hospital corridors and so on. The Nuffield Trust has warned that there is “little in the tank” to cope with coronavirus, and Public Health England has announced that tests for the condition are being increased to include people displaying flu-like symptoms at 11 hospitals and 100 GP surgeries across the UK.

Will community trusts and clinical commissioning groups fund the extra work related to coronavirus from their existing baselines, and is the Secretary of State making representations to the Treasury for additional emergency NHS revenue resource in the coming weeks? Will he update the House on how much has been drawn from the capital facility for hospitals to develop specialist pods to quarantine patients, which he announced in his previous statement?

I reiterate that the Opposition want to work constructively with the Government on this issue. We are broadly supportive of the steps taken by the Secretary of State, and I hope he understands that we are trying to be constructive in our questions. We continue to thank all NHS staff for their work at this difficult time.

[Matt Hancock]

I join the hon. Gentleman in reiterating our thanks to all NHS and Public Health England staff, and others, who have been working so hard on this issue. I also express my thanks to the hon. Gentleman, and to every Member of the House with whom my Ministers and I have had dealings. In each and every case, everyone has taken a responsible and proportionate approach. This is not a political matter; this is a matter of keeping the public safe, and everybody in this House has played their part.

Plans are in place in case of the virus becoming a pandemic, but it is not yet certain that that will happen. The plan is still in the phase of “contain”: we aim to contain the virus both abroad and here at home, and prevent it from becoming a pandemic, while of course ensuring that plans are in place should that happen. On travel to Italy, our advice is that all but essential travel is not recommended to the quarantined areas of northern Italy. The advice for people returning from northern Italy is clear: those returning from the quarantined areas should self-isolate, and those returning from the rest of northern Italy should self-isolate if they have symptoms. I hope that advice is clear, and it is available on the Government website.

The hon. Gentleman asked about Heathrow, and we have expanded the availability of supported isolation facilities. Just having Arrowe Park and the facility at Milton Keynes is not appropriate for individual travellers whom we think need to be quarantined, but at the moment those numbers are low, which is why we need only one facility. We chose a facility near Heathrow because that is the point of biggest throughput, but we do not rule out rolling that out more broadly if we think it necessary.

The Department for Education has repeatedly issued advice to schools—I am glad to see the Minister for School Standards in his place—and we issued revised advice this morning. Our goal is to keep schools open wherever we can, as long as that protects the public. Our wider goal is to have minimum social and economic disruption, or disruption to the NHS, subject to keeping the public safe. The message that we do not have a policy of blanket school closures is important. Unless there is specific professional advice, or until there is a positive test, schools should stay open and follow the advice on the GOV.UK website. If they have queries they should contact their regional schools commissioner.

The hon. Gentleman asked about the availability of testing, and as far as we know, we now have testing sites at all A and E facilities across England. We are also planning to introduce home testing, some of which has started already, so that people do not have to go to the pod in front of A and E—that pod has been placed there to ensure that people do not go into A and E, where they might infect others. Home testing is the safest place to be tested because people do not have to go anywhere, and that will allow us to roll out testing to a larger number of people. The hon. Gentleman asked about the available funding. Funding is available from the Treasury. So far we have used it for capital funding, but we will obviously keep this issue under review.

Social Care

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 25th February 2020 Commons Chamber

[Matt Hancock]

As I said, life expectancy is rising, Madam Deputy Speaker.

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

The Secretary of State will have seen Sir Michael Marmot’s report, launched today. Indeed, one of his own departmental officials spoke at the launch, because he could not make it, and said that no one could disagree with the analysis. Sir Michael Marmot says that life expectancy advances are flattening and even going backwards—they are decreasing—for the poorest 10% of women. Is Sir Michael Marmot wrong? Is that what the Secretary of State is saying?

[Matt Hancock]

No. What I am saying is that life expectancy, as I have repeated, is going up, but there are areas where it is not, and we will and we must tackle that. The challenge for us as a country is not to try to pretend that things are different to the facts. The challenge here, which Opposition Members will not accept, is that there are parts of the country where life expectancy is advancing rapidly and there are parts where it is not, and we must tackle that. We cannot have a decent policy conversation if half of the debate will not accept the facts on the ground.

The Marmot report was published this morning. It is absolutely critical that we level up life expectancy. The fact that in Blackpool a healthy life expectancy for men is 53 years yet in Buckingham it is 68 years is a disgrace, and we will put that right, but you cannot put things right if you ignore the facts when you are starting.

Wuhan Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 11th February 2020 Commons Chamber

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

I thank the Secretary of State for advance sight of the statement and advance notice of the regulations and steps he was going to invoke yesterday.

Our thoughts must be with all those diagnosed with novel coronavirus and those in quarantine, and I place on record again our thanks to NHS and Public Health England staff and all other staff involved in responding to the outbreak.

On the specific issue of the quarantine arrangements, I understand the approach the Government have taken, and the Secretary of State will recall that in response to last week’s statement I asked him what would happen should an evacuee wish to leave Arrowe Park. In response he understandably reminded the House that evacuees had signed contracts that effectively offered passage back to the UK in return for compliance with the Government’s quarantine arrangements. However, given that questions were raised around how practically enforceable those contracts were, and indeed wider questions about what was allowed under human rights legislation, I understand why the Secretary of State has invoked the regulations that he is entitled to do under the Public Health Acts. He has our support.

Quarantine arrangements must be seen to be necessary, proportionate and in accordance with the law, and enforcement of those quarantine arrangements, including with powers of restraint where necessary, must be fully transparent, and the rights and freedoms of the quarantined evacuees must be fully understood so as to ensure they are treated with dignity and respect. We agree that a legislative framework for this is far preferable to the ad hoc contracts that were the original basis for the quarantines.

In order to maintain public confidence in these arrangements, that framework must be understood and scrutinised by Parliament. With that in mind, on the instrument the Secretary of State laid before the House yesterday, at what point will the House get an opportunity to consider the regulations and will that be on the Floor of the House? I appreciate that the Secretary of State is not one of the business managers—although there is going to be a Government reshuffle so who knows by the end of the week—but if he can give us some clarity at this point on that, we will appreciate it.

Turning to the UK response more generally, can the Secretary of State tell the House if he is asking clinical commissioning groups and trusts to make plans should this outbreak turn into a pandemic in the coming months? What work is he doing to ensure that the local plans are robust, and can he guarantee they will be fully resourced? What communications have directors of public health in local authorities received and how will they continue to be kept informed?

Is the Secretary of State confident that NHS 111 has sufficient capacity to deal with increased numbers of calls? Will community health trusts, which I understand will be tasked with visiting suspected patients in their homes to carry our swab tests, be given extra resources to scale up capacity, or will they be expected to fund this extra work from their existing baselines?

With respect to the capital facility the Secretary of State has announced, I understand that hospitals are being given specialist pods to quarantine patients and access to this facility. Can he tell us whether GPs have the necessary equipment and resources to cope with patients who may present with novel coronavirus? Will they be able to apply for this capital facility?

I welcome the Secretary of State’s advice on travel arrangements, not least with school holidays coming up next week. Many people will want clarification. Can he assure us that Foreign Office advice is fully aligned with Public Health England advice, and tell us what monitoring arrangements are in place at airports for flights returning not just from China but other places across the world where there has been a coronavirus outbreak?

Finally, can the Secretary of State update the House on international efforts to share research and intelligence, as well as attempts to find a vaccine, and a timescale? He will know that there is a World Health Organisation summit today, for example.

On behalf of the official Opposition, we again thank all our hardworking NHS staff, particularly those on the frontline, some of whom have been diagnosed with coronavirus. We thank the Secretary of State for coming to the House, and reiterate our hope that he will continue to keep the House updated in the weeks ahead.

[Matt Hancock]

I am grateful for the support of the Opposition for the measures we have taken. The best way to deal with an outbreak like this is on a bipartisan basis. The approach the House has taken has thus far helped to enable as efficient and capable a response as possible to what is obviously a very difficult situation. I entirely agree with the hon. Gentleman that the use of the powers we brought into force yesterday must be proportionate. Enforcement, too, needs to be reasonable. That is a very important consideration.

The hon. Gentleman is right to ask about NHS 111. We will ensure that NHS 111 services have support available. We have plans in place to expand support for those taking the calls on 111 if necessary. Thus far, we have not had to do that. Compared with the huge scale of the millions of calls to NHS 111 that are made, the number concerning those who think they may have coronavirus is still relatively small, but of course we stand ready to do that if necessary.

On timing, as far as I understand it business managers have not yet scheduled the debate on the affirmative procedure for the statutory instruments I presented yesterday. They are made affirmative—as in, they become law—the moment they are signed and thus are law now. They remain in force, with the requirement for Parliament to debate and pass them within 28 days. We will ensure that that happens. They then stay in force for two years, or until the end of the public health emergency is declared.

The hon. Gentleman asked about links with the local authority in Brighton. That is an incredibly important question. I understand that the links have been very close and that the public health officers in Brighton have been working very closely with Public Health England. I thank them, as well.

The hon. Gentleman asked about access to capital for GPs. If GP facilities or other parts of the NHS need capital upgrades, we will of course look at that. In the first instance, though, it is very important that people do not go immediately to their GP, but rather call NHS 111. If they do go to A&E, we will ensure that pods are available so that people are separated from the vast majority of those going to A&E, as we do not want them to be contaminated.

The advice remains absolutely clear: if you suspect that you may have coronavirus, call 111 and do not leave home until you have spoken to a clinician.

Wuhan Coronavirus

Debate between Jonathan Ashworth and Matt Hancock

Monday 3rd February 2020 Commons Chamber

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

I am grateful to the Secretary of State for advance sight of his statement, for the way in which he has kept the House updated, and for making arrangements for the chief medical officer, NHS England officials and Public Health England officials to keep me updated.

Our thoughts are naturally with those who have lost their lives and those who have contracted the virus, including the two cases mentioned by the Secretary of State. I thank our NHS staff, who once again show themselves to be exceptional and dedicated. I pay tribute to our world-leading expertise at Public Health England and NHS England. I also join the Secretary of State in putting on record our thanks to all those involved in returning British nationals from Wuhan. Will he tell the House whether it is the Government’s intention to return all remaining British nationals in China, and whether there will be more Foreign and Commonwealth Office chartered flights in the coming days?

I agree with the Secretary of State that we must remain vigilant and alert, and not succumb to alarmism or scaremongering. As things stand, the virus has a mortality rate of around 2%. That is certainly significant but, as he says, most people will recover. However, the virus is highly infectious. The pathogen appears to be easily transmitted. Cases have now been reported in over 20 countries. The epidemic has grown at a pace quite unprecedented in recent history, with the official case count more than tripling in the past week.

I welcome the Secretary of State’s remarks about the G7. He will be aware, of course, that we have seen cases in countries such as Cambodia, Nepal and the Philippines that have weaker health systems than ours. What work is he carrying out with the Secretary of State for International Development to support countries around the world that will need extra help at this time?

I welcome the Secretary of State’s £20 million for vaccine research, but we have to recognise that, even if a vaccine is produced, it is probably some months away. Therefore, slowing down the virus spread while that vaccine is developed is absolutely crucial. So how many people has Public Health England now contacted who have been in touch with the two people who were infected? Is he able to share those figures with the House?

I understand, and indeed endorse, the precaution of NHS England in quarantining evacuees from Wuhan at Arrowe Park Hospital on the Wirral. I must mention my hon. Friend the Member for Wirral West (Margaret Greenwood), who is the local MP and who has been in touch regularly with Ministers, her constituents and the hospital since the news broke last Thursday. I have been contacted by a patient in quarantine who has told me that evacuees are tested for the virus only if they display symptoms because risk of virus transmission is considered low. It would help to reassure the House if the Secretary of State could clarify why, if risk of transmission among non-symptomatic evacuees is low, there is no option for evacuees to self-quarantine at home. I understand that Japan and the Netherlands are allowing such quarantine. As I say, I endorse the precautions that Ministers are taking, but it would be helpful if he could offer greater clarity and those reassurances. Indeed, what would be the response of the Government and the NHS if evacuees wanted to leave Arrowe Park and self-quarantine at home? Could he update the House on that?

I welcome the public information campaign. Will the Secretary of State update us on what discussions he has had with local authority public health officials and local authorities’ social care providers and social care staff, who are obviously caring for people who are especially vulnerable to the respiratory problems associated with coronavirus?

This is a time of considerable strain on the NHS. I know the Secretary of State and I disagree on why that is, but he will accept that it is a time of huge pressure. How many specialist beds are available across the system to deal with more cases of coronavirus should we need them, and what is the capacity of trusts to flex up extra specialist beds if needed? If we do succumb to the epidemic in the UK, that will start to affect the wider NHS workforce as well. What plans are in place to ensure that NHS staff are protected over the coming months—because, as he rightly says, this is a marathon, not a sprint?

I am sure the Secretary of State would agree that we should have no truck with the racism and insensitivity shown towards Chinese and east Asian people that we have sadly seen in some quarters, with wrongly attributed videos showing wild animals being eaten and crass cartoons in the Evening Standard. Indeed, the French media are digging up old racist tropes as well. None of these attempts to dehumanise an entire ethnicity should be allowed to prevail.

I welcome the Secretary of State’s statement today and hope he will continue to keep the House updated in the coming days and weeks.

[Matt Hancock]

I will try to answer all the shadow Secretary of State’s questions, not least because I want to pay tribute to him for his balanced and reasonable approach in tackling what is ultimately a very significant public health challenge.

I entirely share with the shadow Secretary of State, and perhaps should have put in my initial statement, the rejection, which the whole House demonstrates, of any racism and insensitivity towards the Chinese community here or visitors here of Chinese origin. That will not help us to tackle this disease. We will do everything we can to tackle the disease, but racism will not help anybody, so I share his comments entirely.

We have no plans to evacuate all remaining UK nationals in China. There are an estimated 30,000 UK nationals in China, and the proportion of the population who have the virus outside Wuhan is much lower than in Wuhan. Of course, there are continued flights—not by British Airways and Virgin, which have suspended flights, but by Chinese airlines. We have appropriate measures in place at the airports, as advised by Public Health England, to ensure that those coming from the rest of China also get the appropriate advice, which includes to self-isolate if they have symptoms. We are clear that this evidence-led approach is the right way to take things forward. Of course, if the evidence and the clinical advice change, we will update policy, and I will come to the House at the first available opportunity to explain that. We are trying to take a science-led approach at all times.

The hon. Gentleman asked about the challenge of the virus getting out to other countries, and especially developing countries. I am working closely with the Department for International Development and have spoken to the Secretary of State on a number of occasions about this. Of course, the WHO represents the whole world. The Global Health Security Initiative is chaired by the UK and had a call this weekend. We are leading efforts around the world to ensure that we can help all countries, no matter the calibre of their health systems, to get a grip. I have authorised a team of British experts to go to the Philippines to support their work.

The hon. Gentleman is right that the goal is to slow down the spread of the virus, and we will take all actions that are proportionate and scientifically appropriate to do that. In the case that the epidemic here gets much more serious, we have 50 highly specialist beds, and a further 500 beds are available in order to isolate people, but of course, we are working on further plans should there need to be more.

Public Health England’s contact tracing is ongoing. We will explain how far it has gone when we are ready to, and when we have managed to get in contact with all the people we need to get in contact with. I join the hon. Gentleman in thanking his colleagues from the Wirral, several of whom I have spoken to, for their support of the rational and sensible approach that we have been trying to take.

The hon. Gentleman asked about self-quarantine at home. The truth is that it is belt and braces to have full-blown quarantine. All those who are in quarantine have signed a contract agreeing to go into quarantine in return for getting on the flight. That is a good deal, because the flight was provided by the UK Government so that they could come back from an area that we deemed did not support their health. In return for coming back, they agreed to quarantine.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 28th January 2020 Commons Chamber

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

You rather surprised me then, Mr Speaker!

The Secretary of State mentioned primary care networks. As he will know, two weeks ago GPs rejected the new service specifications in those networks. This has been described as a debacle, and as leading to more red tape and taking GPs away from patients. If the Secretary of State is going to fix these contracts, can he tell us how he is going to do it—or is he content to see more GPs walk out of primary care networks before they have even got off the ground?

[Matt Hancock]

Primary care networks have been an incredibly successful innovation, covering the whole country and allowing practices to work together. Of course, the negotiations with the BMA over the GP contract are always tough: they have been in every year in which they have taken place. The hon. Gentleman will understand why I want to get the best possible value for the money that the NHS spends, but I also want to see a successful conclusion to this negotiation, and we are working with the BMA to that end.

[Jonathan Ashworth]

The Secretary of State describes primary care networks as a great success, but a local medical committee in Buckinghamshire and Berkshire has just warned that they will cost each practice £100,000 more. Having failed to deliver the 5,000 extra doctors that the Government previously promised, having failed to recruit more GPs in the poorest areas, having now bungled the negotiations over this contract, and having failed to fix the pension tax changes for which he was partly responsible, how on earth can the Secretary of State be trusted to deliver on the Prime Minister’s promise to cut GP waiting times to less than three weeks?

[Matt Hancock]

It is a bit of a disappointment to hear the hon. Gentleman talk down primary care. We are making record investments in primary care, we have record numbers of GPs in training, we are seeing an increase in the number of appointments in Wolverhampton and across the country, we are negotiating with GPs to strengthen general practice, in the last year we have introduced primary care networks that help to make primary care more sustainable, we are improving the technology that is available in primary care, and, for the first time in a generation, the proportion of the total NHS budget going into primary and community care is rising, whereas there were cuts under Labour. I think the hon. Gentleman should be standing up and saying thank you.

NHS Funding Bill

Debate between Jonathan Ashworth and Matt Hancock

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

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

I beg to move, That the Bill be now read a Second time.

With your permission, Madam Deputy Speaker, before turning to the Bill I would like to update the House on the ongoing situation with the Wuhan coronavirus. The chief medical officer continues to advise that the risk to the UK population is low and that, while there is an increased likelihood that cases may arise in this country, we are well prepared and well equipped to deal with them. As of 2 pm, there are currently no confirmed cases in the UK. We are working night and day with the World Health Organisation and the international community and are monitoring the situation closely. Our approach has been guided by the chief medical officer, Professor Chris Whitty.

As I set out in my statement on Thursday, coronavirus presents with flu-like symptoms including fever, a cough and difficulty breathing, and the current evidence is that most cases appear to be mild. However, this is a new disease, and the global scientific community is still learning about it. I have therefore directed Public Health England to take a belt-and-braces approach, including tracing people who have been in Wuhan in the past 14 days. Coronaviruses do not usually spread if people do not have symptoms. However, we cannot be 100% certain.

From today, as concerns have been raised about limited pre-symptom transmission, we are asking anyone in the UK who has returned from Wuhan in the last 14 days to self-isolate—to stay indoors and avoid contact with other people—and to contact NHS 111. If you are in Northern Ireland, you should phone your GP. If you develop respiratory symptoms within 14 days of travel from the area and are now in the UK, call your GP or ring 111, informing them of your symptoms and your recent travel to the city. Do not leave home until you have been given advice by a clinician.

Public Health England officials continue to trace people who have arrived in the UK from Wuhan. Having eliminated those who we know have since left the country, we are seeking to locate 1,460 people. The Foreign Office is rapidly advancing measures to bring UK nationals back from Hubei province. I have asked my officials to ensure that there are appropriate measures in place upon arrival to look after them and to protect the public. If you are in Hubei province and wish to leave, please get in contact with the Foreign Office; there are details on the gov.uk website.

The UK is one of the first countries in the world to have developed an accurate test for this coronavirus, and PHE is undertaking continuous refinement of that test. PHE has this morning confirmed to me that it can scale up, so we are in a position to deal with cases in this country if necessary. I want to stress that the NHS remains well prepared. The NHS has expert teams in every ambulance service and at a number of specialist hospital units with highly trained staff and equipment, ready to receive and care for patients with any highly infectious disease, including this one. The NHS practises and prepares its response to disease outbreaks and follows tried and tested procedures, following the highest safety standards possible for the protection of NHS staff, patients and the public. Specific guidance on handling Wuhan coronavirus has been shared with NHS staff.

This is a timely reminder of why it matters to have a world-class healthcare system—to be able to plan and prepare for such situations.

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

I am grateful to the Secretary of State for updating the House and for letting me intervene at this point, before we move on to the substance of today’s debate. First, could he offer some further clarification? According to the newspapers, there are suggestions that France, the United States and Japan are airlifting their citizens out of Wuhan tomorrow. I emphasise that I am going off newspaper speculation and I appreciate that that is not his portfolio, but how advanced are the Foreign Office’s plans? Secondly, could he update the House about whether it is correct that the treatment of coronavirus would need a number of extra corporeal membrane oxygenation beds to be open? ECMO beds are in high demand in winter. Could he update the House on how many ECMO beds are currently open, and on what preparations the NHS is making on that front?

[Matt Hancock]

The Foreign Office is working with international partners both in America and other EU countries, keeping open about the procedures and what it will do for the estimated 200 UK citizens who are in the area in China in which this is currently contained. On the point about the readiness of the NHS here, four centres are stood up and ready should there be a need. The centres are in Guy’s and St Tommy’s, Liverpool, Newcastle and the Royal Free, and there is a further escalation if more beds are needed. So we are ready, but of course we keep all these things under review.

--- Later in debate ---

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

This is not a serious funding Bill; it is an underfunding Bill. It is a political gimmick of a Bill. The Secretary of State hoped that the Bill would signal the Tories’ commitment to the NHS, but it actually reveals their lack of commitment to the NHS. I remind the Secretary of State that the last Labour Government, who I did indeed work for, did not need a piece of legislation to increase NHS funding by record levels—6% extra a year. We just got on and delivered record investment in the NHS in spending review after spending review. That record investment delivered the lowest waiting times, the highest satisfaction ratings, and 44,000 more doctors and 89,000 more nurses. He is unable to match that record.

This Bill essentially caps NHS funding—[Hon. Members: “No it doesn’t.”] It certainly does because, as the Secretary of State outlined, the amounts in the Bill are in cash terms, not real terms, which is what the previous Secretary of State presented to the House in summer 2018. The amounts in the Bill are in cash terms, and when my hon. Friend the Member for Nottingham South (Lilian Greenwood) asked the Secretary of State whether the NHS will get the real-terms increases that the previous Secretary of State outlined should inflation run at unforeseen levels, he could not give that commitment.

The Secretary of State could not give my hon. Friend the cast-iron commitment needed by the NHS chief executives on the ground because this Bill outlines only the cash figures. If inflation runs at a higher level than expected, the NHS will not get the extra money that the Secretary of State boasts about from the Dispatch Box unless we have that commitment. As the hon. Member for Glasgow North (Patrick Grady) said, the money resolution has been tightly drawn to restrict hon. Members from tabling amendments to give the NHS the levels of funding it needs. This Bill is a political stunt.

The Bill attempts to enshrine revenue spending in law, but the test will be whether the uplift outlined by the Secretary of State, albeit in cash terms, is sufficient to deliver on the promise made by the Prime Minister at the Dispatch Box two weeks ago:

“We will get those waiting lists down.”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]

That means reversing the significant deterioration in care under this Government over a decade of decline.

This Bill fails the Prime Minister’s test, because the level of health expenditure that the Secretary of State is asking the House to put into law will not drive down waiting lists or drive up A&E performance to the levels our constituents deserve. The level of expenditure that the Secretary of State presents as an act of great munificence are not sufficient to enable the NHS to deliver the aspirations of its long-term plan. What he says is not what NHS Providers, the British Medical Association, the Health Foundation, the Institute for Fiscal Studies, a whole host of think-tanks and staff representatives are saying about the Bill.

[Matt Hancock]

It is what the British people say.

[Jonathan Ashworth]

That is pretty dismal by the Secretary of State’s standards. [Interruption.] I am aware that his party won the general election, but it does not mean he is correct about NHS funding.

The Secretary of State is not prepared to put it in the Bill, but let us suppose he delivered on the real-terms increases outlined by the previous Secretary of State—around a 3.3% annual uplift for NHS England revenue. The problem is that NHS activity usually increases by 3.1% a year. We have an ageing population with a wide variety of complex conditions and a wide variety of co-morbidities, and we have seen years of austerity for which the Secretary of State was responsible as George Osborne’s right-hand man. We have seen health inequalities widen, needs increase and demands on the NHS rise, which is why health experts, including the IFS, the Health Foundation, NHS Providers, the BMA and a whole range of Royal Colleges, have said that health expenditure should rise across the board—not just in NHS England but in capital, education and public health—by 3.4% just to maintain current standards of care.

If we are to start driving down waiting lists, improving performance in A&E and driving down GP waiting times, as the Prime Minister promised on the steps of Downing Street, the NHS needs at least a 4% increase across the board. As the Health Foundation has said, investing in modernising the health service, as set out in the NHS long-term plan, requires around a 4.1% uplift a year. The Government are not giving the NHS 4.1% a year.

Health and Social Care

Debate between Jonathan Ashworth and Matt Hancock

Thursday 16th January 2020 Commons Chamber

[Jonathan Ashworth]

I am afraid that on this occasion I will not, because many Members want to make maiden speeches. There is nothing worse for a Member waiting to make a maiden speech than seeing the time ticking down because Front Benchers are taking lots of interventions.

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

You know you’re talking rubbish.

[Jonathan Ashworth]

I will tell you who was talking rubbish, Mr Deputy Speaker: the Secretary of State when he said at the general election that he was delivering 50,000 extra nurses. That is why he avoided Piers Morgan during the election campaign. I do not know why the Secretary of State avoided Piers Morgan—he is a pussycat. I went on Piers Morgan’s show every week; why did the Secretary of State not go on?

I will give way once more, and then if Members will indulge me, I will not give way again, because a lot of Members want to make their maiden speeches in the debate.

--- Later in debate ---

[Matt Hancock]

My hon. Friend is dead right. Pharmacies should be doing more to keep the pressure off GPs, because they are in the community and more accessible, and within a GP surgery not everything needs to be done by the GP. We are expanding the number of GPs by 6,000 over this Parliament, and increasing by 26,000 the number of other clinicians who work in primary care, supporting GPs. When someone goes to their primary care practice, they might see the GP, a practice nurse, a pharmacist, a physio or a geriatrician. The boundary that has existed since Lloyd George between primary and secondary care, where someone either sees a GP or goes to hospital, needs to become more porous so that we can have that care where it is right for patients.

My next point is that prevention is better than cure. Expanding primary care, allowing pharmacies to do more, growing our community teams—that is about driving prevention. My third priority is technology. That is not just because we stand at the cusp of a health tech revolution that has the potential to transform healthcare for the better, but because the first task is to drag the NHS out of the 20th century and into the 21st.

The next priority is infrastructure, much of which we have already started to discuss. Buildings have to be expanded and improved, and while we do that expansion, with upgrades to the 40 new hospitals, we will also repair the damage done by those terrible private finance initiative deals that have hamstrung hospitals—deals struck by the hon. Member for Leicester South and his friends: Mr PFI himself. When we hear from him about the challenges that the NHS faces, everyone should remember with every word he says that he was at the heart of the Treasury that was driving PFI, which has caused so many problems across our national health service. Our plan is for a more integrated NHS, with a culture that gives patients more control over their healthcare, and colleagues more control over their work.

[Jonathan Ashworth]

The Secretary of State is so pleased with himself and that attack line, he really is.

[Jonathan Ashworth]

The hon. Gentleman says that he has good reason to be. I was at the Treasury as a young man in my twenties, signing off paper, when the Secretary of State was at the Bank of England, so by his logic, he would have been putting up interest rates for hardworking families. I was at the Treasury, but I was not responsible for any PFI contract. If he is going to say that I was responsible for every decision made by the Treasury when I was there in my mid-twenties, I will take responsibility for giving the NHS the biggest cash boost in its history, which meant the shortest waiting lists. That is a record I am proud of; that is a record he has not been able to match.

[Matt Hancock]

The cash boost that we are giving now is bigger. I think today is the anniversary of Prime Minister Tony Blair sitting on the couch of a TV show, talking about increasing funding for the NHS, which was opposed by Gordon Brown, who was Chancellor of the Exchequer at the time. We will not take any lectures.

I am thrilled that the public comprehensively rejected the Labour party’s baseless scaremongering, which was repeated through the election campaign and worried some of the most vulnerable people who rely on our NHS. I lost count of the number of times I had to debunk some politicised nonsense put about by the Opposition across the country because they had nothing positive to say. The hon. Member for Leicester South was at it again yesterday and in his speech. He said that the settlement in the NHS Funding Bill is a cap, although clause 1 states that it is a minimum. Clause 1(1) states:

“In making an allotment to the health service in England for each financial year…the Secretary of State must allot an amount that is at least the amount specified”.

Did the hon. Gentleman even read the Bill? Did he get to clause 1? I am not sure he bothered reading it.

Let us look specifically at the amendment. It calls for reform of social care and for the Government to bring forward a plan, and that is precisely what the Queen’s Speech provides for. It also calls for additional funding for the NHS, which is what we are legislating for. The long-term plan is fully funded by the largest cash injection in the history of the NHS, and I urge Members across the House to support it fully. We can only fund the NHS with a strong economy, and that is exactly what we will do.

The National Health Service

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 23rd October 2019 Commons Chamber

[Jonathan Ashworth]

I need to move on because I think the House is getting slightly tired of our focusing on our constituency issues and I am abusing my position. I will try to give way again shortly, but I am testing the indulgence of the House on the issue of Leicester.

In the Queen’s Speech, there are also proposals on mental health, and we look forward to the mental health White Paper and hope that Sir Simon Wessely’s review is quickly implemented. He also called for significant capital investment in the mental health estate, yet none of the hospitals the Secretary of State has announced includes mental health trusts.

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

Yes they do.

[Jonathan Ashworth]

No they don’t; none of the hospitals the right hon. Gentleman announced at the Tory party conference includes mental health trusts. He knows there are 1,000 beds in old-style dormitory-style wards in desperate need of upgrade. He knows that we have problems with anti-ligature works that desperately need doing in mental health trusts because they are putting lives at risk every day.

On social care, we were told we were going to have the big solution to social care. The Secretary of State was briefing that a previous Chancellor, the right hon. Member for Runnymede and Weybridge (Mr Hammond), was holding him back and he was going to give us a solution on social care. And what do the Government say? They say, “We have not got a social care Green Paper, we have not got social care proposals, we will get proposals on social care in due course.” The Secretary of State is kicking the can on social care down the road again.

Let me come to the Health and Social Care Act 2012. On Second Reading, it was described by the new Minister, the hon. Member for Mid Bedfordshire (Ms Dorries)—I welcome her to her elevation to the Treasury Bench; it was remiss of me not to do that earlier—as one of the most exciting Bills to be put before Parliament in the 62 years since the NHS was established. We were told that there was going to be legislation to undo the worst excesses of that Lansley Act, but all we are getting apparently is draft legislation, again, “in due course”—that is the wording in the explanatory notes to the Queen’s Speech.

--- Later in debate ---

[Matt Hancock]

I will debate the hon. Gentleman’s involvement in PFI, which hamstrung the hospitals, every day of the week. Now, however, I wish to—

[Jonathan Ashworth]

I am delighted that the Secretary of State has elevated me; I was a 25-year-old adviser in the Treasury at the time. I remember sitting in that box as a special adviser listening to Tory shadow Health Secretaries calling for more PFIs in the NHS. The right hon. Gentleman was an adviser to George Osborne, so what about this quote from 2011:

“George Osborne backs 61 PFI projects…the chancellor, is pressing ahead with private finance initiative…on a multibillion-pound scale”.

The right hon. Gentleman should be apologising for PFI.

[Matt Hancock]

In 2011, I was the MP for West Suffolk. I opposed PFI in opposition and I have opposed it ever since, and I am delighted that the Government are cancelling it. It is just such a shame that the hon. Gentleman spent so many years driving through PFI when we could have built better hospitals for less money if we had properly put them on the books of the nation’s balance sheet, as we are doing now.

--- Later in debate ---

[Matt Hancock]

I very much agree with my hon. Friend. In many trusts, things have gone very well over the past few years and there is a much more open and less hierarchical culture, with less bullying and more openness to challenge. However, that is not the case in every part of the NHS, and that needs to change. The Health Service Safety Investigations Bill addresses that directly. After the welcome given by the shadow Secretary of State, I hope that Bill will proceed on an essentially consensual basis.

[Jonathan Ashworth]

indicated assent.

[Matt Hancock]

The hon. Gentleman is saying yes, which I am grateful for. I am open-minded to changes and improvements, and to listening to the experts and those with constituency cases that they can bring to bear, to make sure that the Bill is the best it possibly can be.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 23rd July 2019 Commons Chamber

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

My I pursue the question asked by the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston)? We know that obesity is a major cause of cancer and other diseases, and we know that we have severe rates of childhood obesity, so why does the prevention Green Paper say only that the sugar tax “may” be extended to milkshakes? The evidence is clear. Is the Secretary of State not kicking this into the long grass?

[Matt Hancock]

I have asked the chief medical officer to review the evidence to ensure that our policy for tackling obesity is evidence-driven. Follow the evidence: that is what we do on this side of the House.

[Jonathan Ashworth]

A year ago the Secretary of State said, to great fanfare, that prevention was one of his priorities. Now the prevention Green Paper has been sneaked out in the night on the Cabinet Office website. Health inequalities are getting wider and wider, and life expectancy is stalling, but the Secretary of State still cannot give us any clarification on the future of the public health ring-fenced grant. Is it not the truth that he has buckled under pressure from the sugar industry, is not taking on the alcohol industry, and is not taking on the tobacco industry? That is more about trying to get in with the new Prime Minister than putting the health needs of the nation first.

[Matt Hancock]

I thought that the hon. Gentleman would welcome the prevention Green Paper, which was published yesterday. We have been working very hard to publish a huge amount of policy, including the Green Paper, which contains about 80 different policies to ensure that we prevent people from becoming ill in the first place. However, it is also part of a broader drive, which Conservative Members support, to ensure that we are the healthiest of nations, and that people can take personal responsibility for their health, as well as relying on the NHS, so that it is always there when people need it.

NHS Long-Term Plan: Implementation

Debate between Jonathan Ashworth and Matt Hancock

Monday 1st July 2019 Commons Chamber

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

I am grateful to the Secretary of State for an advance copy of his statement. I had hoped for a greater sense of urgency from him. He talks about the 100-year anniversary of the Ministry of Health, but this year is the first time in 100 years that the advances in life expectancy have begun to stall, and even go backwards in the poorest areas. Just the other week, we saw that infant mortality rates have risen now for the third year in a row. As this is the first time that they have risen since the second world war, I would have hoped for a greater focus on health inequalities in his statement today, not least because public health services—the services that, in many ways, lead the charge against health inequalities—are being cut by £700 million. Now he says that we should wait for the spending review for the future of public health services, but we do not know when the spending review is. The Chief Secretary to the Treasury has said that it will be delayed, so it could be next year.

In the past, the Secretary of State has talked about a prevention Green Paper. Will that prevention Green Paper be before the spending review or after the spending review? Will he also tell us whether it is still the intention of the Department to insist that local authorities fund their public health obligations through the business rates?

At the time of the publication of the long-term plan last year, the then Secretary of State for Health said that we cannot have one plan for the NHS without a plan for social care, yet we still have no plan for social care. We have been promised a social care Green Paper umpteen times. We are more likely to see the Secretary of State riding Shergar at Newmarket than see the social care Green Paper. Where is it?

The Secretary of State talks about the better care fund revenue increase. May I press him further on that? Is he saying that the clinical commissioning group allocations to the better care fund, which tend to be the bulk of the better care fund, will increase in line with the NHS revenue increase, or is he saying that there will be new money available for the better care fund? Adult social care has been cut by £7 billion since 2010 under this Tory Government, which is why hundreds of thousands of elderly and vulnerable people are going without the social care support that they need. Presumably, we will have to wait for the spending review for proposals on social care.

The Secretary of State talks about the workforce. We have 100,000 vacancies across the NHS. We have heard about the interim people plan, but of course we have seen the bursary cut, the pay restraint, and the continuing professional development cut. That plan is all good and fine, but when will it be backed up by actual cash?

The Secretary of State talks about IT systems and apps—we know that he is very fond of that—but again he gives us no certainty on capital investment. Hospitals are facing a £6 billion repair bill—ceilings are falling in and pipes are bursting. The repair bill designated as serious risk has doubled to £3 billion. When will we have clarity on NHS capital?

We broadly welcome what the Secretary of State said about mental health, but 100,000 children are currently denied mental health treatment each year because their problems are not designated as serious enough, and over 500 children and young people wait more than a year for specialist mental health treatment. He talks of a fundamental shift, so can he guarantee that clinical commissioning groups will no longer be allowed to raid their child and adolescent mental health services budgets in order to fill wider gaps in health expenditure? On mental health resilience and prevention, only 1.6% of public health budgets is currently spent on mental health, so will he mandate local authorities, when setting their public health budgets, to increase the money they spend on mental health?

On cancer, we broadly welcome what the Secretary of State has said, but patients are waiting longer for treatment because of vacancies and out-of-date equipment. Today we learned that consultant oncologists with shares in private hospitals are referring growing numbers of patients to those hospitals. Is that not a conflict of interest? When will we see tougher regulation of the private healthcare sector?

The Secretary of State talked about the clinical review of standards that is being piloted in 14 hospitals, yet those hospitals are not publishing the data. If he wants to abandon the four-hour A&E target, will he insist that those pilot hospitals publish all the data? He did not mention waiting lists. We have seen CCGs rationing treatment because of the finances. We have seen 3,000 elderly people refused cataract removals. We have seen CCGs refusing applications for hip and knee replacements. We have even seen a hospital that until last week was inviting patients to pay up to £18,000 for a hip or knee replacement—procedures that used to be available on the NHS. When is he going to intervene to stop that rationing of treatment, which we are seeing expand across the country because of the finances?

Finally, there are many laudable things in the long-term plan that we welcome. Alcohol care teams were a Labour idea. Perinatal mental health services were a Labour idea. Gambling addiction clinics, which the Secretary of State announced last year, were a Labour idea. Today he is talking about bringing catering back in-house, which is also a Labour idea. Why does he not just let me be Heath Secretary, and then he could carry on being the press secretary for the right hon. Member for Uxbridge and South Ruislip (Boris Johnson)?

[Matt Hancock]

Well, it is great that by the end of his questions the hon. Gentleman finally got to the future of the NHS, which is what we are here to discuss. However, what I did not hear—unless I missed it—was a welcome for the extra £33.9 billion that we are putting into the NHS. I did not hear him welcome the fact that life expectancies are rising, or our plan to drive up healthy life expectancy still further. I did not hear him say whether the Labour party supports our efforts to ensure that the NHS is properly funded and supported not only now but into the future, because that is what this Government are delivering.

I will go through some of the questions that the hon. Gentleman did raise. He asked about the prevention Green Paper. Indeed, he will know that preventing people getting ill in the first place is a central objective of mine, and it will be forthcoming shortly. He mentioned the better care fund. I was very precise in what I said about the better care fund, because its funding is rising in line with NHS revenue growth. In fact, the overall funding available to deliver social care in this country has risen by 11% over the past three years. Of course there is more to do to ensure that we have a social care system that is properly funded and structured to ensure that everybody can have the dignity of the care they need in older age, and that people of working age get the social care they need, but the Labour party ought to welcome the increase in funding, as well as the aim of ensuring that we get the best possible value for every pound.

The hon. Gentleman mentioned the clinical review of standards, which he welcomed when it was announced recently. The pilots that he mentioned started just four weeks ago, and of course we will be assessing the results and ensuring that we get the right structures in place in future. I am glad that he welcomed it, but in relation to publishing data, after just four weeks it is unsurprising that we are still in the early stages.

The hon. Gentleman asked me to ensure that the increase in funding for mental health will happen and that CCGs will be required to see that increase flowing through to make sure that patients get better service. I can confirm that NHS England is already intervening. The £2.3 billion increase that we have set out in the long-term plan will be required to flow through to the frontline. This implementation framework is part of the system that we are putting in place to make sure that that happens.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 18th June 2019 Commons Chamber

[Jonathan Ashworth]

Indeed.

I dare say that this is the Secretary of State’s final outing at Health questions, because we believe he has secured transfer to pastures new. In his time here, he has failed to deliver a social care Green Paper and failed to deliver a prevention Green Paper, while he is privatising Oxford cancer scanning services and we have hospitals charging £7,000 for knee replacements. Does he really think that is a record deserving of Cabinet promotion?

[Matt Hancock]

I am agog—and aghast. Over the last year, we have not only delivered £33.9 billion of increased funding, but we have produced the long-term plan for the future of the NHS. Starting this year, with the money already flowing, we are seeing the biggest increase in funding for community, primary care and mental health services. We have developed our work on the prevention agenda, and we have instituted a new verve and energy into the adoption of new technology in the NHS. I look forward to driving forward all these things in the future.

[Jonathan Ashworth]

Will the Secretary of State tell us about the verve and energy in his own constituency in Suffolk, where 32 health visitors are being cut because of his cuts? He is apparently now supporting a candidate who wants £10 billion-worth of tax cuts for the richest in society. Will that not mean further cuts to public health, further cuts to social care and, ultimately, cuts to the NHS as well?

[Matt Hancock]

For the majority of its 71-year history, the NHS has been run under the stewardship of a Conservative Secretary of State. At this moment, it is getting the biggest funding increase and the longest funding settlement in its history, along with the reforms to make sure that everybody can get the health care that they need.

Listeria: Contaminated Sandwiches

Debate between Jonathan Ashworth and Matt Hancock

Monday 17th June 2019 Commons Chamber

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

To ask the Secretary of State for Health and Social Care to make a statement on the listeria outbreak related to contaminated sandwiches in hospital trusts.

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

I would like to update the House on the actions the Government are taking to protect the public following cases of listeria in hospitals linked to contaminated food. The NHS has identified nine confirmed cases of listeria in seven different hospitals between 14 April and 28 May this year, all linked to contaminated sandwiches from a single supplier. All the known cases involve in-patients. Very sadly, five people have died. I would like to express my condolences to the families of those who have lost a loved one. I promise that there will be a full and thorough investigation, with severe consequences if there is any evidence of wrongdoing.

Lab testing indicated a link between two cases in Manchester Royal Infirmary and one case in Liverpool. Contaminated sandwiches were identified as the likely cause by Public Health England. The manufacturer—The Good Food Chain—and its supplier, North Country Cooked Meats, have withdrawn the sandwiches, and voluntarily ceased supply of all products on 7 June. They are both complying with the Food Standards Agency on a full product withdrawal. The other cases have been identified at these hospitals: Royal Derby, Worthing, William Harvey in Ashford, Wexham Park, Leicester Royal Infirmary, and St Richards in Chichester.

The risk to the public is very low, but any patients or members of the public with concerns should contact NHS 111 or, of course, 999 if they experience severe symptoms. Listeria infection in healthy people may cause mild illness but is rarely fatal. However, for certain groups it can be much more serious, as we have tragically seen. The NHS, Public Health England and the Food Standards Agency have acted swiftly to identify, contain and investigate the cause of this listeria outbreak. These deaths should never have happened. People rightly expect to be safe and looked after in hospitals, and we must ensure that we take the necessary steps to restore that trust that the public deserve to be able to hold.

This is not just about ensuring that the food we serve in hospitals is safe—the NHS served 140 million main meals to in-patients last year—but, importantly, is also about ensuring that food given to patients is healthy, nutritious, and aids their recovery. So I can inform the House that we are launching a root-and-branch review of all the food in our hospitals—both the food served and the food sold. The Government will work with the NHS to build on progress in three vital areas. First, there is eliminating junk food from hospitals. Since the introduction of the NHS action on sugar scheme, we have halved the sale of high-sugar soft drinks, and trusts are taking action to remove unhealthy food and drink items and replace them with healthier alternatives. After all, hospitals are places for good health. Secondly, on improving nutrition, new national standards for all healthcare food will be published this year. All patient menus will have to ensure that minimum patient nutrition standards are met. Thirdly, on healthier choices, we will work closely with the Hospital Caterers Association and others to ensure that healthier food choices are available across the NHS.

The review will identify where we need to do more, where we need to do better to improve the quality of food in our hospitals, and how we help people to make healthier choices. I know that this is an issue that many colleagues in the House feel strongly about, as do the public. We will do everything we can to ensure that the food we eat in hospitals is both safe and healthy.

[Jonathan Ashworth]

Let me say at the outset that despite our often sharp political differences across the Dispatch Box, the Secretary of State has my commiserations over his entirely noble ambition to want to be the Prime Minister of this country—but perhaps, given Brexit, he has had a lucky escape.

Moving on to the substance of what we have to discuss today, our thoughts really must be with the families of those who have lost their lives. This is, first and foremost, an issue of patient safety and standards of care. Every patient deserves the very safest possible care and absolute confidence about the quality and safety of the food that they are offered. I am pleased that there is an investigation, and I welcome what he said about serious consequences if wrongdoing is found. I am also pleased that he talked about a root-and-branch review, which we have been calling for. As I understand it, NHS Improvement was already reviewing the hospital food plan, which was delayed from April. Is this a new review or an existing review that now has new obligations? Can he explain to the House how the review he has announced interacts with the existing NHS Improvement review?

I know that the investigation will want to get to the bottom of what went wrong and why, and it will no doubt make recommendations for the future, but we would be grateful if the Secretary of State offered some clarification. The first case showing symptoms of listeria was on 25 April, and sandwiches and salads were withdrawn on 25 May. When were Ministers informed, and what action was taken?

I am grateful that the Secretary of State listed the other hospital trusts affected, which include the one in my Leicester constituency. As I understand it, the Good Food Chain was supplying sandwiches to 43 trusts. Can he tell us the status of investigations or what investigations have gone on in the other trusts that he has not listed today? Does he expect cases to emerge in more trusts, and what action is currently under way to contain the spread?

What advice has the Secretary of State received from officials that microbiological controls for listeria need to be improved with respect to pre-packaged sandwiches? Will he consider introducing mandatory testing on all batches of high-risk food? Of course, this is not the first time that there has been a listeria outbreak. There was an outbreak back in 2016, and in response, the Food Standards Agency investigated and issued a report warning Ministers of the dangers posed by pre-packed sandwiches. Can he outline what measures were taken by Ministers in response to that report in 2016?

I have been speaking to hospital catering staff in recent days, and they raised concerns that tight finances and years of capital cuts have left kitchens substandard, which has driven a move to greater outsourcing of catering, with sandwiches and soups steadily replacing hot meals. Recent data show some hospitals spending less than £3 per patient per day. Does the Secretary of State agree that the review he has announced today should be backed up by investment in hospital catering facilities and legally backed, clear minimum-quality standards for hospital food? Healthcare is not just about medicine, surgery, bandages and procedures; it is about nutrition and hydration too. Patients will need urgent reassurance. Can he provide that today?

[Matt Hancock]

The shadow Secretary of State raises important questions, and I will try to address them all. Ultimately, I strongly agree with him that this is about standards of care. People deserve to be able to trust that the food they eat and are given in hospital is safe and, indeed, nutritious and good for their health—that is an important part of this too. Clearly, the most acute aspect of what we are discussing is safety and the lack of listeria in food, but it is part of a much bigger picture, which is why we are having a root-and-branch review.

The hon. Gentleman asked about the hospital food plan, which NHS Improvement has been leading. The review will be wider than, but will encompass, some of the existing work that is ongoing. It is about not only how food is procured by hospitals, but the quality of food. Work on the national standards in hospital food is important. It has been ongoing for several years and will come to fruition very soon. More broadly, dozens of hospital trusts have brought their catering in-house and found that they get better quality food that is more likely to be locally produced and is better value for money. We will be examining that model closely, because I am very attracted to it, and it has the potential to reduce the risk of safety concerns such as this.

The hon. Gentleman asked about timings. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), was made aware of this outbreak on 4 June. I was informed on 6 June, and we published the details of the outbreak on 7 June.

Before that, Public Health England very swiftly identified that there was a link between these particular listeria outbreaks. It is only because of recent advances in genomic medicine and testing that we could work out—that Public Health England could work out—that the outbreak in Liverpool and the outbreak in Manchester were connected, and therefore identify that the source was outside those hospitals, rather than inside the hospitals, and that is what then identified that this was from the food source. The truth is that there are just over 150 listeria cases a year. It is a notifiable disease, so we are confident that we are properly notified of the various cases. Frankly, it was cutting-edge work by Public Health England that allowed us to connect these different cases and work out that a single source was causing these deaths.

The hon. Gentleman mentioned the 43 trusts that we know bought from the Good Food Chain. We have of course been in contact with all hospital trusts, whether or not they bought from this individual company, to try to make sure that we have confidence in their supplies. The Good Food Chain has confirmed that it has followed advice and has disposed of all products. That is what the Good Food Chain company has said to us, but we are of course reconfirming that with the trusts because we want to get this right.

Finally, the hon. Gentleman asked about investment in food and catering facilities. The truth is that it is important to have the best-quality food in hospitals. I am completely open to upgrading hospital equipment if that is what is necessary, and if it provides value for money. I have been struck by the number of hospital chief executives who have said that from the point of view of patient satisfaction, staff morale, and nutrition and the quality of food, bringing such food supplies in-house is the best thing they have done.

Health

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

The public health grant is of course an important part of this, but it is only one part. The overall funding of the NHS is rising by £33.9 billion, the first £6.2 billion of which came on stream last month. I understand the hon. Lady’s point. That is on the money. On the health inequalities, I entirely agree with her that they should be tackled. Doing so is at the heart of the NHS long-term plan. It is a vital task that we do not shirk. Indeed, we embrace it and are addressing it.

Let me turn to the details of the motion. While I care deeply about making sure that we have the best possible health in this nation and the strongest possible NHS—and we are prepared to put the resources in to see that happen—I also care about good governance of the nation. The way that we are run is one of the reasons this country has been strong over generations, and I believe that using the Humble Address to undermine the ability of experts, clinicians, and civil servants to give me the benefit of their frank and wise advice not only undermines me as Secretary of State, but makes it harder to make good decisions. I know the shadow Secretary of State sits on the Front Bench with revolutionaries, but I thought he was a grown-up. I do not know what his mentor, Lord Mandelson, would make of his posturing today. Of course, we will object to the motion and, if he searched the depths of his heart, he would too.

The hon. Gentleman has obviously had a missive from the Leader of the Opposition’s office—LOTO, as it is called—telling him to present the Humble Address, but it is not his style. I hope that we can get back to debating these issues on a proper motion in the future. I respect and like the hon. Gentleman: he is a really nice guy. If he had asked for the information directly—perhaps he could have sent me a message on the app—

[Jonathan Ashworth]

I’m not on it.

[Matt Hancock]

Now that is an insult! There are only two types of people in the world—the people who are on the Matt Hancock app and the people who are not on the Matt Hancock app yet. I can see that the hon. Gentleman falls into the latter category. I digress.

If the hon. Gentleman had asked for the information directly, I would have been more than happy to provide it. To show willingness, I am happy to provide the House with the information requested in the motion. We will republish the impact assessments on the public health grant. They have already been published, but I am happy to do that. We will republish the Office for National Statistics stats and the Public Health England report on life expectancy. We will publish a statement on the “Agenda for Change” decision that he mentioned. It had been released already this week, as it happens, before we saw the motion.

If the hon. Gentleman wants to know about the “Agenda for Change” pay rises, I am delighted to keep talking about them. Perhaps he should ask the 1 million NHS staff who last month received a pay rise of up to 29%, including £2,000 extra a year for new full-time nurses. That came into force at the start of last month. I will debate with him the “Agenda for Change” pay rises any day of the week. Because the Government are running a strong economy, we can afford to put the money in to make sure that under “Agenda for Change” nurses get the pay rise they deserve.

--- Later in debate ---

[Jonathan Ashworth]

I am delighted that the Secretary of State wants me to join his Make Matt Hancock Great Again WhatsApp group. Please add me to it. Perhaps in the group I can get some style tips from him, because he looked rather Alan Partridge-esque in the photos on Friday. I digress.

On Agenda for Change, it was reported in the Health Service Journal that the Government will not honour the pay rise for public health staff such as health visitors, sexual health staff and school nurses—all the sort of staff we have been talking about this afternoon—and that there was a dispute between NHS England and the sector about who will fund that £50 million pay rise. Is he telling us today that the Government will honour that pay rise for public health staff working in public health services?

[Matt Hancock]

We are honouring the pay rise proposed—of course we are. I love the HSJ, which is an absolutely terrific journal, but it was wide of the mark on that. We are putting in record funding.

Tessa Jowell Brain Cancer Mission

Debate between Jonathan Ashworth and Matt Hancock

Monday 13th May 2019 Commons Chamber

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

I thank the Secretary of State for an advance copy of his statement. We warmly welcome today’s announcement. His tribute to our much-missed friend and colleague was moving and powerful. It is an extraordinary testament to Tessa’s bravery that in the final harrowing months of her life, faced with a highly aggressive and very-difficult-to-treat cancer, and in full knowledge of the life expectancy associated with such a devastating cancer, Tessa led from the front to campaign for better brain cancer treatment for others. She spoke with extraordinary courage in the Lords, she brought the then Secretary of State and me together, and she convinced Ministers to shift policy, not by garnering sympathy, understandable though that approach would have been, but by persuasion based on facts and policy argument. It was typical Tessa.

Tessa would have been delighted by the Government’s announcement—some 2,000 brain cancer patients a year will now benefit from the “pink drink” solution—but she would be keen to go further still. Almost 11,000 people are diagnosed each year with a primary brain tumour, including 500 children and young people, which is 30 people every day, and more than 5,000 people lose their lives to a brain tumour each year. Brain tumours reduce life expectancy by around 20 years, which is the highest of any cancer, and are the largest cause of preventable blindness in children.

We live in hope of dramatic improvements, but further research is needed, given that less than 2% of the £500 million spent on cancer research is dedicated to brain tumours. I welcome the Secretary of State’s commitments on research, but does he agree that we also desperately need more involvement in clinical trials? The number of brain cancer patients taking part in clinical trials is less than half the average across all cancers. How will the Government encourage more trials and data sharing?

Finally, we know that the NHS remains under considerable strain generally. The 93% target for a two-week wait from GP urgent referral to first consultant appointment was not met once last year. Neurosurgery is no exception. In March 2019, the 18-week completion target for referral to treatment pathways stood at 81.3% for neurosurgery— 5% lower than the average for all specialties—which made neurosurgery the worst performing specialty. This is a question of both resourcing and staffing. I know the Secretary of State has his answer on revenue resourcing—we disagree, but we will leave our political arguments for another day—but on workforce there are vacancies for more than 400 specialist cancer nurses, chemotherapy nurses and palliative care nurses, and there are diagnostic workforce vacancies too.

Meanwhile, the staff who are there are reliant on outdated equipment, and we have among the lowest numbers of MRI and CT scanners in the world. Failing to diagnose early is worse for the patient and more costly for the NHS, so will the Secretary of State update us on when we can expect Dido Harding’s workforce plan? Can he reassure us that the cancer workforce will be a key part of that plan? On equipment and MRI scanners, can he guarantee that the NHS will see increased capital investment budgets in the spending review so that it can upgrade existing equipment and increase the number of MRI and CT scanners?

Overall, however, we welcome today’s announcement. It is a fitting tribute to our friend Tessa Jowell, and like Tessa herself will touch the lives of so many.

[Matt Hancock]

The cross-party tone of this discussion demonstrates what we can achieve when we work together. This is not just about Baroness Jowell, who did so much and was so brave in how she made her case—in the last few months in particular, but before that as well. It is about the many others who have worked together, including the many who were inspired by her words to work harder on brain cancer.

In truth, the amount of research money going into brain cancer—and therefore the number of clinical trials, which the hon. Member for Leicester South (Jonathan Ashworth) mentioned—was too low. There were so few clinical trials because research overall was too low. That is partly because brain cancer is a very difficult disease to treat. Just because it is difficult, however, does not mean we should not try, so we have increased the amount of research money, and I am determined to see an increase in the number of clinical trials and to make sure that the data from them is properly used and openly disseminated.

The hon. Gentleman asked about the cancer workforce. As I mentioned, of course we will need more people to treat cancer. That is partly what the £33.9 billion extra is all about.

The hon. Gentleman is also right to say that we need more early diagnosis. The truth is that, while the NHS is very good at treating cancer once it has been spotted—indeed, it is one of the best in the world—our cancer survival rates in this country need to improve through early diagnosis. That means giving more support to community services, strengthening primary care and ensuring that we have the diagnostic tools that he mentioned. We have more MRI scanners and more Linux machines for treatment purposes, but of course there is always more that we can do.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

Yes, I entirely understand my hon. Friend’s concerns. We are acting to make sure that there is better access. We have a review of access to primary care. But, more than that, the biggest increase of the £39.9 billion of extra taxpayers’ money that we are putting into the NHS is in GP access, primary care and community care to make sure that we get ahead of the curve and help people to stay healthy rather than just treat them in hospital.

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

Can the Secretary of State explain why 200,000 nurses have left the NHS since 2010 and why today we are short of 40,000 nurses?

[Matt Hancock]

The good news is that we have record numbers of nurses in the NHS. We have more staff in the NHS than at any time in its history. While of course in any very large organisation like the NHS there is always turnover, what matters is having the people we need. We are putting more money in, we are going to need more people, and we are developing a plan to make that happen.

[Jonathan Ashworth]

We have about 90 nurses a day leaving the NHS, so rather than posing for the newspapers by the stables like a character from a Jilly Cooper novel, why does the Secretary of State not show some actual leadership and reverse the cuts to development, reverse the cuts to training places and reverse the abolition of the training bursary so that we can start to recruit the nurses and midwives our NHS needs today?

[Matt Hancock]

What I will not reverse is the increase in the number of people who are helping to improve lives and save lives in our NHS. It is only because of the extra money that we in this Conservative Government have put into the NHS that we can be confident that we are securing its future to deliver better care for every single person whom we represent in this House.

Social Media and Health

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 30th April 2019 Commons Chamber

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

I am grateful to the Secretary of State for advance sight of his statement. These social media platforms must be made to take responsibility for the harm caused by the dangerous fake news they host, because they are helping to fuel a public health crisis. He talks about the actions that platforms such as Instagram have taken since February, but I have just searched on Instagram and found images and videos of graphic self-harm; there are 8 million posts with the hashtag #suicide—from a quick glance, many are distressing—226,000 posts with the hashtag #killmyself, and 249,000 posts with the hashtag #selfinjury. I found similar pro-anorexia posts and the normalisation of eating disorders. I am sorry to have to share those examples with the House, but I think that we have to understand the scale of the challenge we face. As the father of two beautiful daughters, aged seven and five, I would be devastated if they saw such posts as they grow up.

Dangerous content should be blocked and taken down. I look forward to the Samaritans’ recommendations, so can the Secretary of State update us on the timescale? He talked about the online harms White Paper, but we need action immediately, so can he tell us when the proposed legislation will come before the House? When will the new regulator and duty of care be enforced? Can he guarantee that there will be criminal sentences for executives for serious breaches? In what circumstances would the maximum fine of 4% of global turnover be applied? If, God forbid, something similar to what happened to Molly Russell—I am sure that the whole House will want to praise her father for his brave campaigning—should happen to another child, what action would be taken against the social media companies?

I have also been able to find dangerous anti-vaccination propaganda on platforms such as Facebook, at a time when measles outbreaks are on the increase across Europe and the United States and in parts of the United Kingdom. Unvaccinated children are being turned away from schools in parts of Italy and banned from public areas in parts of New York. I would hate to see that happen here. UNICEF has warned that more than half a million children have missed their measles vaccination, which means the UK now has the third-worst ranking of all high-income countries. As the Secretary of State said, take-up of the MMR vaccine has now declined for the fourth year in a row, making coverage for the vaccine the lowest it has been since 2011-12.

I know that the Secretary of State said on the radio last week that he was considering banning unvaccinated children from schools in England, but we urgently need a clear vaccination action plan from the Government. This cannot be about penalising families. Yes, we need intervention with social media platforms when the legislation is in place, but while we wait for the legislation will he consider instructing Public Health England to launch an online social media campaign, on the platforms that are currently sharing anti-vaccination propaganda, to challenge those dangerous myths?

Will the Secretary of State also accept that our falling vaccination rates are not just about online activity? Public health services have been cut by £800 million. Our health visitors have been cut by 8% in recent years, and our school nurses by 24%. General practice has faced a funding squeeze, and GP numbers are down by 1,000 since 2015. At the same time, 2018-19 marks the first year that we have seen a reversal in the percentage of children receiving vital health check-ups on time since the measurement of these figures began: 14.5% of children are not receiving a six to eight-week review on time; 24% are not receiving a 12-month review on time; and the number of mothers over 28 weeks pregnant receiving their first face-to-face antenatal contact with a health visitor has fallen for the second year in a row. Will he therefore commit today to reversing public health cuts and restoring health visitor numbers, and will he invest in general practice so that we can meet the 95% national vaccination coverage rate, as recommended by the World Health Organisation? When does he expect us to meet that 95% rate?

Children are 20% of our population but 100% of our future. We must always put their health and wellbeing first. Yes, there has been some progress, but we need further action from the Government today.

[Matt Hancock]

I pay tribute to the hon. Gentleman, who has provided leadership on this agenda from his position as shadow Secretary of State. I am glad, listening to his response, that we agree very broadly on the direction we need to take. The agreement across the House is valuable in demonstrating to social media companies the clear consensus on the need for them to act, and to every parent in the land the importance of vaccination. That cross-party support is very, very valuable.

I join the hon. Gentleman in paying tribute to Ian Russell, the father of Molly Russell, whom the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), the Minister for suicide prevention, met this morning. He has been brave and eloquent in bringing these issues to light. I pay tribute to him and thank him for how he has spoken about what needs to be done. I know he is as determined as we are to ensure that action translates into saving more lives.

We agreed, after the meeting yesterday, to reconvene in two months’ time, by which time I expect further action from the social media companies. As I said in my statement, we have already seen some progress. I am glad that some of the global algorithms and global terms and conditions have been changed as a result of action taken by the UK Government. It is very important that we keep the pace up. In two months’ time, we expect to see further action from the social media companies and progress by the Samaritans on being able to define more clearly the boundary between harmful and non-harmful content. In each area of removing harms online, the challenge is to create the right boundary in the appropriate place. It is the challenge when tackling terrorist and child abuse material online, so that social media companies do not have to define what is and is not socially acceptable, but we as society do. I am delighted that the Samaritans will formally play that role on material relating to suicide prevention and self-harm, and that Beat will do so on material relating to eating disorders.

The hon. Gentleman asked about the online harms White Paper. We are currently in the middle of a 12-week consultation. I hope he and everybody listening to this who has an interest will respond to it. We are clear that we will have a regulator, but we also genuinely want to consult widely. This is not really an issue of party politics, but of getting it right so that society decides on how we should govern the internet, rather than the big internet companies making those decisions for themselves. I have to say that the tone from the social media companies has changed in recent months and years, but they still need to do an awful lot. I look forward to working with him and others across the House to ensure we can deliver on this agenda.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

Well, it is getting scrutiny and debate now. The change that is being proposed is about making sure we can get people the drugs they need. Of course the responsibility is on the pharmacist to ensure that it is the appropriate drug and, if necessary, that the GP is involved. However, it is absolutely right that we make changes to ensure that we have an unhindered supply of medicines whenever there are shortages—whether that is to do with Brexit or not.

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

The Secretary of the State spoke with his characteristic self-confidence about the supply of insulin, but at the end of last week Diabetes UK said that

“despite reaching out directly to the Department of Health…we still have not seen the concrete detail needed to reassure us…we cannot say with confidence that people will be able to get the insulin and other medical supplies they need in the event of a no-deal Brexit.”

Why is Diabetes UK wrong and the Secretary of State right?

[Matt Hancock]

Diabetes UK is not a supplier of insulin. Of course, it plays an important role in representing those who have diabetes. We have given Diabetes UK reassurances, including, for instance, that the stockpiles we have for insulin are more than twice as long as we proposed and as required. That is an important assurance.

[Jonathan Ashworth]

I hope the Secretary of State will contact Diabetes UK to give it those reassurances directly.

On the various no-deal medicines statutory instruments that the House will debate today and on other occasions, the Government’s own impact assessments say that, in a no-deal scenario, the NHS will pay more for drugs, UK firms will face more red tape, and NHS patients will go to the back of the queue when it comes to international innovation. Given that the consequences of no deal would be so devastating for the NHS, will the Secretary of State—as, apparently, the Justice Secretary will—resign from the Government if it means blocking no deal?

[Matt Hancock]

If the hon. Gentleman really cared about stopping no deal, he would vote for the deal. There is something else that is worth saying about this shadow Secretary of State. He is a reasonable man—he is a sensible man—and I like him. My politics are probably closer to his than his are to those of the leader of his party, so why does he not have the gumption to join his friends over there on the Back Benches in the Independent Group, instead of backing a hard-left proto-communist as leader of the Labour party?

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 15th January 2019 Commons Chamber

[Matt Hancock]

No, absolutely, we have ensured that there will be aircraft available, and air freight, to make sure that we can get those isotopes that have a short shelf life and cannot be stockpiled, and that there is unhindered supply. I make the following point to the hon. Lady and her colleagues, with an open mind and in a spirit of collaboration: if she is worried about no deal, which she seems to be, she and her party should support the Government tonight.

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

The Secretary of State boasts of being the world’s biggest buyer of fridges to stockpile medicines, but if sterling drops because of the Government’s mishandling of Brexit, the parallel trade in medicines could mean that stockpiles rapidly deplete as medicines are quickly exported back into the EU. Will he impose restrictions and suspend the necessary export licences that he is responsible for? Otherwise, he risks his fridges standing empty.

[Matt Hancock]

Of course, we have the legislative tools and powers the hon. Gentleman describes at our disposal; we know that. Nevertheless, stockpiling is going according to plan—it is going well—and the pharmaceutical industry has responded very well, with great responsibility. But I say, rather like a broken record—[Hon. Members: “You are.”] Yes, and it is important that I say it again and again and again. There is one route open to the House to avoid no deal, which Opposition Members purport to be worried about. They cannot complain about no deal unless they are prepared to do something about no deal, and to do something about no deal, they need to vote with the Government tonight.

[Jonathan Ashworth]

If the Secretary of State has those powers, he should use them now. This is going to be the biggest disruption to patient safety we have ever seen. He is also proposing emergency legislation that means patients might not get access to the medicines their GPs prescribe. Can he tell us whether an insulin patient will be able to get their prescription within a day of presenting at a pharmacy? He is the Secretary of State for Health; why will he not do the responsible thing and rule out no deal, which will do so much damage to the NHS and patients?

[Matt Hancock]

Because of the votes of most of us in the House, including the hon. Gentleman, no deal of course is the law of the land unless the House passes something else. He is a reasonable man. He is a mentor of the old Blairite moderate wing of his party. He is absolutely a centrist. I do not believe that, privately, he believes in the hard-left guff that comes from other Opposition Front Benchers. He is a very sensible man and I like him an awful lot, so after this session and before 7 o’clock tonight, why does he not take a look in the mirror and ask himself, “In the national interest, is it best to vote for the deal and avoid no deal, or is it best to play politics?”

NHS Long-term Plan

Debate between Jonathan Ashworth and Matt Hancock

Monday 7th January 2019 Commons Chamber

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

I welcome the advance copy of the Secretary of State’s statement, but may I quickly say at the outset that Churchill’s Tory party voted against Labour’s NHS 22 times?

We welcome many of the ambitions outlined today by NHS England. We welcome the greater use of genomics in developing care pathways. We welcome the commitment to early cancer diagnosis; after all, it was a Labour policy announced at the general election. We welcome the commitment to new CT and MRI scanners; it is a Labour policy. We welcome the greater focus on child and maternal health, including the expansion of perinatal mental health services; again, it is a Labour policy. We welcome the roll-out of alcohol teams in hospitals, because, yes, it is another Labour policy.

The Secretary of State did not mention this, but we will study carefully the details of any new proposed legislation, because we welcome the recognition that the Health and Social Care Act 2012 has created a wasteful, fragmented mess, hindering the delivery of quality healthcare. Healthcare should never be left to market forces, which is why scrapping the competition regime and scrapping the Act’s section 75 procurement regulations, as proposed today by NHS England, are long-standing Labour policies. The Government should be apologising for the Health and Social Care Act. But why stop halfway? Why not commit to fully ending the purchaser-provider split? Why not commit to democratic accountability when planning care? Why not commit to consigning the whole Lansley Act to the dustbin of history?

What about the other holes in today’s announcement? Waiting lists are at 4.3 million, with 540,000 waiting beyond 18 weeks for treatment. A&Es are in crisis, with 618,000 trolley waits and 2.5 million waiting beyond four hours in A&E. So why is there no credible road map today to restoring the statutory standards of care that patients are entitled to, as outlined in the NHS constitution? They were routinely delivered under a Labour Government. Is it not a damning indictment of nearly nine years of desperate underfunding, cuts and failure to recruit the staff we need that those constitutional standards will not be met as part of this 10-year plan?

The Secretary of State boasts of the new budget for the NHS. Will he confirm that once inflation is taken into account, once the pay rise is factored in and once the standard NHS England assumption about activity is applied, there is actually a £1 billion shortfall in the NHS England revenue budget for this coming financial year? When he answers, will he tell the House—I will be listening carefully to what he says—whether he has seen or is aware of any internal analysis from the Department, NHS England or NHS Improvement that confirms that £1 billion shortfall figure?

Can the Secretary of State also confirm that despite his rhetoric about prevention, the public health budget is set to be cut again in the next financial year as part of a wider £1 billion of cuts to broader health spending, and that when those cuts are taken into account, spending will rise not by 3.4%, as he says, but by 2.7%? That will mean deeper cuts again to smoking cessation services, deeper cuts again to drug and alcohol addiction services and deeper cuts again to sexual health services when infections such as gonorrhoea and syphilis are on the rise. By the way, why is HIV/AIDS not even mentioned in the long-term plan? What was the Secretary of State’s answer when asked about public health cuts in his weekend interviews? Targeted Facebook advertising. Given that life expectancy is going backwards, health inequalities are widening and infant mortality is increasing, the public health cuts should have been reversed today, not endorsed.

The NHS long-term plan admits that

“the extra costs to the NHS of socioeconomic inequality have been calculated as £4.8 billion a year in greater hospitalisations alone.”

Does that not confirm that, for all the rhetoric on prevention, the reality is that the Government’s austerity and cuts are making people sicker and increasing the burden on the NHS? Nowhere have we seen greater austerity than in the deep cuts to social care, but where are the Government’s proposals today? They still do not have any.

With respect to social care, surely the Secretary of State agrees that:

“It is not possible to have a plan for one sector without having a plan for the other.”—[Official Report, 18 June 2018; Vol. 643, c. 53.]

Those are not my words, but the words of the Foreign Secretary when he stood at the Dispatch Box last June as the Secretary of State for Health and Social Care. I agree with him; it is a shame that the current Secretary of State does not.

By the way, the Foreign Secretary also promised that:

“Alongside the 10-year plan, we will also publish a long-term workforce plan”.—[Official Report, 18 June 2018; Vol. 643, c. 52.]

Where is it? The Secretary of State has not done it. We all want to know where the staff are coming from to deliver the ambitions that have been outlined today. We are short of 100,000 staff. We are short of 40,000 nurses. The Secretary of State talks of doing more for mental health services; we are down 5,000 nurses in mental health. He talks of doing more for primary and community care; GP numbers are down by 1,000 and district nursing numbers are down by 50%. Now, the Home Secretary wants to impose a £30,000 salary cap on those coming from abroad to work in our NHS, ruling out nurses, care assistants and paramedics. The Secretary of State should do his job and tell the Home Secretary to put the future sustainability of the NHS first, instead of his Tory leadership ambitions, and ditch that salary cap for the NHS.

There are certainly many welcome ambitions from NHS England today, but the reality is that those ambitions will be hindered by a Government who have no plan to recruit the staff we need, who have no plan for social care and who are pushing forward with deep cuts to public health services. Patients have been let down as the Government have run down the NHS for nearly nine years. We do not need 10 more years of the Tories. The NHS needs a Labour Government.

[Matt Hancock]

Well, I think we discovered from that that Labour has absolutely nothing to say about the future health of the nation. The hon. Gentleman did not even deign to thank the people who work in the NHS for their incredible work. Did we hear any acknowledgement of the million more people who are seen by the NHS, of the record levels of activity going on in the NHS and of the fact that we have more nurses and doctors in the NHS than we had in 2010? He had nothing to say. He talked about the workforce. Chapter 4 of the document is all about the workforce plan. He gives me the impression that, like his leader on Brexit, he has not even read the document he is talking about.

The hon. Gentleman asked about targets and legislation. On legislation, when clinicians make proposals on what legislation needs to change to improve the NHS, we listen. We do not then come forward with further ideological ideas. We listen. So we will listen to what they have said. The clinicians have come forward with legislative proposals and we will listen and study them closely.

On the money that the hon. Gentleman talked about, it was a bit like a broken record. He asked about a £1 billion shortfall in the NHS budget. I will tell him what we are doing with NHS budgets: we are putting them up by £20.5 billion. There is an error in the analysis by the Nuffield Trust, because it does not take into account an improvement in the efficiency of the NHS. Is it true that every year we can improve the way the NHS delivers value for taxpayers’ money? Absolutely. We can and we must, because we on the Government Benches care about the NHS and about getting the right amount of money into the NHS, but we also care about making sure that that money is spent wisely. The hon. Gentleman would do well to heed the views of the NHS itself, which says that yes, the NHS is probably the most efficient health service in the world, but there is always more to do.

The hon. Gentleman argued about various budgets. The budgets in the NHS are going up because we care about the future of the NHS. The Labour party called for an increase of 2.2% a year; we are delivering an increase of 3.4% a year. Labour has nothing to say on health, as it has nothing to say on any other area of domestic business. We will make sure that we are the party of the NHS for the long term.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 27th November 2018 Commons Chamber

[Matt Hancock]

Yes. General practice will be at the heart of the long-term plan. GPs are the bedrock of the NHS. We will put an extra £3.5 billion, at least, into primary and community services to help keep people healthy and prevent them from going to hospital.

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

The Secretary of State got into a muddle last week with his GP figures, so may I suggest that he download an exciting new app to his phone? It is called a calculator. He has said that there will be more for community and primary care by 2024. Can he guarantee that there will be the extra GPs and district nurses to provide the services that he is promising?

[Matt Hancock]

Yes, I can; given that we have the money coming into the NHS, we are doing everything possible to ensure that we have the people to do the work. I am delighted to say that we have a record number of GPs in training right now.

[Jonathan Ashworth]

But GP numbers have gone down by 700 in the last year, have they not? There are 107,000 vacancies across the NHS, acute trusts are closing accident and emergency departments overnight, the closure of chemotherapy departments is being considered, and Health Education England’s training budget is the lowest that it has been for five years, with more cuts to come next year. Does the Secretary of State agree that if the long-term plan that he will publish next week is to be credible, he must reverse those training cuts and deliver the staff that our NHS needs?

[Matt Hancock]

That was a bit of a surprise, because the hon. Gentleman is normally such a reasonable fellow. I thought that he would welcome the record number of GPs in training, and the record number of nurses in the NHS. Because we love the NHS, of course we want to do more, and we will.

Gosport Independent Panel

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 21st November 2018 Commons Chamber

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

I thank the Secretary of State for an advance copy of his statement. I welcome the statement and the tone of his remarks, and I thank him for repeating the unambiguous and clear apology that the previous Secretary of State, the right hon. Member for South West Surrey (Mr Hunt), offered at the Dispatch Box before the summer—it is good to see the previous Secretary of State sitting on the Treasury Bench today.

We welcome the Secretary of State’s apology today. The whole House was shocked when the previous Secretary of State reported the findings of the Gosport inquiry to the House. This Secretary of State is right to remind us that everyone who lost a life was a son or daughter, a mother or father, a sister or brother. As he said, our thoughts are with the families of the 456 patients whose lives were shortened because of what happened at Gosport, and the families of the 200 others who may have suffered—whose lives may have been shortened; because of missing medical records, we will never know for sure. That lingering doubt—never knowing whether they were victims of what happened at Gosport—must be a particularly intolerable burden for those families affected.

Like the Secretary of State, I pay tribute to the victims’ families, who, as he says, have in the face of grief shown immense courage, fortitude and commitment to demand the truth. I think the whole House will pay tribute to them today. I also reiterate our gratitude to the former Bishop of Liverpool, James Jones, for his extraordinary dedication, persistence, compassion and leadership in uncovering this injustice. Finally, I applaud those hon. Members who played a central role in establishing this inquiry, not just the previous Secretary of State, but the right hon. Member for North Norfolk (Norman Lamb) and the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), who in recent years has played an important role in her capacity as a constituency MP.

The Secretary of State is correct to say that lessons must be learned and applied across the whole system. We all understand that in the delivery of healthcare and the practice of medicine, sadly, tragically, things can and do sometimes go wrong, but we also understand, as Bishop Jones said in his report, that

“the handing over of a loved one to a hospital, to doctors and nurses is an act of trust”,

but that that trust was

“betrayed.”

I still believe that that betrayal was unforgivable. Patient safety must always be the priority, so when there are systemic failures, it is our duty to act, learn lessons and change policies.

I wish to respond to the Secretary of State’s announcements today. We welcome his commitment to legislation placing more transparency duties on trusts, and we will engage constructively with that legislation. Is it his intention to bring forward amendments to the Health Service Safety Investigations Bill, and if so when, or should we expect a new bill altogether? We look forward to his proposals on strengthening protection for whistleblowers, but he will know that the NHS has just spent £700,000 contesting the case of whistleblower Dr Chris Day, a junior doctor who raised safety concerns. He will also be aware of the British Medical Association survey showing that not even half of doctors feel they would have the confidence to raise concerns about safety. Moreover, he will be aware of how Dr Bawa-Garba’s case played out, with her personal reflections effectively used in evidence against her. Can he offer more details on how he will change the climate in the NHS so that clinicians feel they can speak out without being penalised?

I welcome the thrust of the Secretary of State’s remarks on medical examiners, and I agree they are a crucial reform, but can he offer us some more details? Is it still the Government’s intention that they will be employed directly by acute trusts? He will be aware that this has provoked questions about their independence. We would urge him to go further and base them in local authorities and extend their remit to primary care, nursing homes and mental health and community health trusts. If legislation is needed, we would work constructively with him.

We welcome the review into improving safety when prescribing and dispensing medicine. Clearly, one of the first questions that comes to mind when reading the Gosport report is: how were these prescriptions monitored? The Government’s own research indicates that more than 230 million medication errors take place a year, and it has been estimated that these errors and mix-ups could contribute to as many as 22,000 deaths a year, so this review is clearly urgent. Can the Secretary of State tell us whether it will be an independent review, who will lead it and when we can expect it to report?



Finally, patient safety is compromised when staff are overworked and overburdened with pressures. He will know that we have over 100,000 staff vacancies across the NHS. Some trusts are proposing closing A&E departments overnight because they do not have the staff, and some are even proposing closing chemotherapy wards because they believe that the lack of staffing means services are unsafe. How does the Secretary of State plan to recruit the staff our NHS desperately needs to provide the level of safe care patients deserve?

In conclusion, I offer to work constructively with the Secretary of State to improve patient safety across the NHS, and we support his statement today.

[Matt Hancock]

I appreciate the tone of the hon. Gentleman, who rightly focuses on the need to ensure that this never happens again, and I join him in thanking Bishop James Jones for his work on this and other inquiries. It was quite brilliant empathetic work. I also thank the right hon. Member for North Norfolk (Norman Lamb), for whom I have an awful lot of respect.

The core of the questions the hon. Gentleman raised, about the need to ensure that whistleblowers are listened to and that people are heard in the NHS, comes down to culture change. A whole series of policies underpins that culture change, and I will come to them, but ultimately it comes down to this: errors happen in medicine—it is a high-risk business—but what matters is behaviour, that everything is done to minimise errors and, when they are made, to learn from them, rather than try to cover them up. The culture change needs to be driven across the NHS. It has changed and improved in many areas, but there is still much more to do.

The hon. Gentleman asked whether amendments would be tabled to the Health Service Safety Investigations Bill or in separate legislation on whistleblowers. We are looking at both options. Partly it comes down to the technicalities of scope and the exact distinction and definition of the amendments, but I look forward to working with him on that legislation.

The hon. Gentleman asked why gagging clauses are still in use. I may well ask the very same question. They were deemed unacceptable by my predecessor—I join in the tributes to him—who did so much on this agenda. Gagging clauses have been unacceptable in the NHS since 2013. Trusts, which are independent, can legally use them, but I find them unacceptable, and I will do what it takes to stamp them out.

The hon. Gentleman said that too many people in the NHS feel unable to speak up. To ensure a route for this, we now have, in every single NHS trust, an individual separate from line management to whom staff can go to raise concerns. This is part of the culture change, but it is not the whole. Line management itself in every hospital should welcome challenge and concerns, because that is the way to improve practice. Challenges and concerns that are raised with managers should be deemed an opportunity to improve the service offered to patients, rather than a problem to be managed.

The hon. Gentleman also mentioned medication errors. Of course, this was not a case of medication error—it would have been far less bad had it been; it was a case of active mis-medication that led to deaths. Medication errors are an important issue, however, and we are bringing in e-prescribing across the board to allow much more accurate measurement, audit and analysis of medication.

Finally, the hon. Gentleman said that pressures often come from staff shortages. Again, that was emphatically not the concern here, and we absolutely must not muddle up the behaviour here with the issue of staff shortages. Nevertheless, I acknowledge the need for more staff in the NHS. Indeed, we are putting £20 billion into it over the next five years to make sure we have the people we need to deliver the NHS that everyone wants.

Prevention of Ill Health: Government Vision

Debate between Jonathan Ashworth and Matt Hancock

Monday 5th November 2018 Commons Chamber

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

I thank the Secretary of State for advance sight of his statement. We welcome his remarks on the use of medicinal cannabis and on the appalling, barbaric abuses of those with learning disabilities and autism, by which we have all been shocked. I understand his point about the review and about asking NHS England to carry out some work, but is it not time that these institutions were closed down and proper support provided in the community instead?

Of course we welcome the emphasis and focus on prevention, but these promises are not worth a candle if they are not backed up with real, substantive action. They come on the back of £700 million-worth of cuts to public health services, with more cuts to public health services pencilled in for next year, including £17 million-worth of cuts to sexual health services, £34 million-worth of cuts to drug and alcohol services, £3 million-worth of cuts to smoking cessation services and £1 million-worth of cuts to obesity services.

The Secretary of State did not mention childhood obesity in his remarks.

[Matt Hancock]

indicated dissent.

[Jonathan Ashworth]

I apologise if I missed it. Could the Secretary of State tell us when he plans to outlaw or ban the advertising of junk food on family television and when the consultation will end?

Immunisation rates for children have fallen for the fourth year in a row, so a big part of prevention should surely be a focus on investment in children’s and early years health services, yet Government cuts to those budgets and, indeed, the privatisation of many of those services in our communities have seen health visitor numbers fall by more than 2,000, school nurse numbers go down by 700 and 11% of babies miss out on mandated health checks. What is the Secretary of State’s plan to reverse those cuts to health visitors and school nurses?

All in all, alongside wider Department of Health and Social Care budgets, there will be £1 billion-worth of cuts to health services next year, with public health budgets taking considerable strain. Those £1 billion-worth of cuts should have been abandoned today, and it is a missed opportunity that the Secretary of State has not abandoned them. When he was asked about this in the Budget debate, he said it was a matter for the spending review. Well, today the Association of Directors of Public Health has said that the spending review should allocate an extra £3.2 billion for the public health grant next year. Does he accept that figure?

Of course prevention is about more than just public health; it is also about primary care. But GP numbers are down by 1,000 since 2015, and since 2010 district nurses have been cut by more than 3,000, so can the Secretary of State tell us what his plan is to increase the primary care workforce to support his wider ambitions on prevention? We know he wants a higher proportion of NHS spending to go to general practice, so does he agree with GPs that general practice should again receive around 11% of the overall NHS budget? If not, why not?

Of course, prevention is also about mental health services, but 30% of patients referred to IAPT—improving access to psychological therapies—services never receive treatment. What is his plan to ensure that everyone who needs IAPT services next year gets them?

Finally, on the wider social determinants of ill health, the shameful reality is that people in poorer areas die earlier and get sick quicker. Life expectancy has begun to stall, and has actually gone backwards in some of the poorest parts of the country. Rates of premature mortality are twice as high in the most deprived areas of England compared with the most affluent, and mortality rates for the very sickest of babies are increasing. As laudable as many of the aims that the Secretary of State has announced today are, this document does not even mention poverty or deprivation. It does not even recognise that some of the deepest cuts to public health grants have been in the areas of highest need and highest deprivation.

Yes, we welcome a focus on prevention—we have long called for such a focus—but a genuine commitment to prevention would go hand in hand with a genuine commitment to ending austerity. That must start with reversing the public health cuts and blocking the £1 billion of further cuts to health services to come next year. On that test, the Secretary of State has failed today.

[Matt Hancock]

Great, well I take that as a broadly positive response from the hon. Gentleman, and I will address the points he makes. He asked about money, and we are putting £20.5 billion extra into the NHS—this is the largest and longest financial commitment any Government have made to any public service ever. Of course, as well as the NHS budget, local authorities have budgets for public health; as he said, that will be addressed in the spending review. The increase in funding must ensure that we do more on prevention, which means more going into community services and into primary care, as well as making sure we get the appropriate level of spending into public health.

The hon. Gentleman asked about the consultation on advertising as part of the obesity plan. As he knows, that will be published before Christmas. He also asked about rates of immunisation. I want to see immunisation used right across the country. There is a campaign all of us can take part in to persuade people and ensure that immunisation takes place. We do not have compulsory immunisation in this country. I believe that is right, on civil liberties grounds, but by goodness it means it is incumbent on all of us to persuade everybody of the health benefits of immunisation.

The hon. Gentleman asked about GP numbers. We want 5,000 more GPs, and I am glad to report that we have got record numbers of GPs in training, thanks to action by this Government. Finally, he asked about the economic causes of ill health. The No. 1 economic cause of ill health is not having a job, and there are record numbers of jobs in this country. If he says that inequality has an impact on ill health, he should probably welcome the fall in inequality that we have seen under this Government.

Budget Resolutions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 30th October 2018 Commons Chamber

[Matt Hancock]

I pay tribute again to my right hon. Friend, who has worked tirelessly in support of that project. The Defence and National Rehabilitation Centre in Loughborough will link world-class military medical facilities with our NHS. That means lessons learned in the medical field from treating our brave troops who come back from the frontline can be brought into the NHS—for instance, surgical techniques that were learned in battle can be adapted to help civilians here. I pay tribute to her and others for the work they have done.

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

Here is a representation from a Jonathan from Leicester. Further to the question from the Chair of the Select Committee on Health and Social Care, the hon. Member for Totnes (Dr Wollaston), can the Secretary of State confirm that, in next year’s spending review, the cuts to capital budgets and the £700 million-worth of cuts to public health budgets will be reversed, and that there will be real-terms increases in funding for capital, training and public health? Can he guarantee that?

[Matt Hancock]

The spending review is next year. What I can guarantee is a £20.5 billion increase in NHS spending. That is the biggest increase in any spending commitment for any public service in the history of this country. [Interruption.] It is a pity that the Leader of the Opposition is not interested and does not want to hear about it. If he stayed, he could also hear about the reforms we are going to make. He should hear this more than anyone. We are acutely aware on the Conservative Benches that this is not Government money or NHS money but the hard-earned money of taxpayers, and we need to ensure that it is spent wisely. When he sprays his commitments around, Opposition Front Benchers would do well to remember that this is money from taxpayers.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 23rd October 2018 Commons Chamber

[Matt Hancock]

I pay tribute to the Select Committee for the report on AMR that was published yesterday. Of course, digital tools such as the one that my hon. Friend mentions are important in making sure that we make the best use of antibiotics and counter antimicrobial resistance as much as possible.

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

If we have a “technological revolution”, in the words of the Secretary of State, surely that depends on capital investment, but that has been cut by £1 billion. For example, we have the lowest numbers of CT and MRI scanners on average in the OECD, hospitals are reliant on 1,700 pieces of out-of-date equipment, and the hospital repair bill now stands at £6 billion. If austerity has ended, can he tell us when this maintenance backlog will be cleared?

[Matt Hancock]

Unlike with the failed national programme for IT, we are delivering modern technology in the national health service. That is underpinned by a record commitment of £20 billion extra for the NHS over the next five years, accompanied by a long-term plan that will show how we will support the NHS and make sure that it is guaranteed to be there for the long term.

[Jonathan Ashworth]

But I asked the Secretary of State about capital budgets, not revenue budgets.

Innovative technology can play a role in prevention, but so do public health budgets. With health inequalities widening, infant mortality rising in the most deprived parts of the population, rates of smoking in pregnancy remaining higher than the EU average and child obesity levels getting worse, will the Secretary of State commit, alongside an investment in technology, to reversing the £700 million of cuts to public health, or is the reality that his promises on prevention are entirely hollow?

[Matt Hancock]

I am afraid that the hon. Gentleman has it slightly muddled up, because technology does involve capital investment, but it also includes revenue investment to ensure that the service element of any technology can continue to be delivered. Maybe he should have another look at how technology is delivered these days. Alongside the capital budget, we have record spending on the NHS to ensure that it is there for the long term. Of course public health is an important element of that, and there has been £16 billion for public health over this spending review period because it really matters.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Tuesday 24th July 2018 Commons Chamber

[Matt Hancock]

I would be absolutely thrilled to. I have previously participated in mindfulness training. In fact, the former chairman of my local Conservative association became a mindfulness instructor, which shows how much we take it seriously locally. I pay tribute to my hon. Friend’s work on this issue. He will have seen that, even in my first two weeks in this role I have already spoken out in favour of moves towards social prescribing and the broader prescribing of less intervention and less medicinal methods, where possible, because medicines do of course have their place. The work that he has done on this issue over many years is to be applauded.

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

I welcome the Secretary of State to his post. May I take a moment to thank all the NHS and social care staff who are caring for vulnerable patients in this intense summer heat?

The new Secretary of State inherits waiting lists at 4.3 million, with more than 3,000 patients waiting more than a year for an operation. He inherits a situation in which 1,700 patient requests for hip and knee operations have been refused, and in which patients in Sussex are now expected to endure “Uncontrolled, intense, persistent pain” for six months before they receive hip or knee treatment. Does he consider such increased rationing to be fair?

[Matt Hancock]

I am grateful to the hon. Gentleman for his welcome. Like him, I pay tribute to the work of NHS and social care staff in this summer heat. There are of course pressures on the NHS—I fully acknowledge that—and he raises a couple that I have already raised with NHS England. What he did not mention was that since 2010 there are 6,000 more operations every day and 1,800 more emergency admissions every day.

[Jonathan Ashworth]

Since 2010, the NHS has suffered the biggest financial squeeze in its history, and the rationing that I referred to is a consequence of that squeeze.

Let me ask the Secretary of State about general practice, which he will know is facing a severe workforce crisis, with GP numbers down by 1,000 and many GPs worried about the patient safety implications of the Babylon app, which we have already discussed this morning, and its funding implications for their model of practice. When Babylon itself admits that it is still testing it out, when Hammersmith and Fulham CCG says that

“there is evidence of concern regarding the risk to patient safety”

of expanding the service, and when Birmingham and Solihull CCG questions whether Babylon can operate in an effective and safe manner, why does the Secretary of State dismiss concerns about patient safety and say that the rules simply need to be updated? Will he tell us what specific rules will be updated to allay concerns about patient safety?

[Matt Hancock]

It is almost as if it was not just my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami) who popped out, but the shadow Secretary of State, who obviously was not here for the earlier discussion. Getting more resources and increased resources into primary care and to GPs in particular is absolutely mission critical to the long-term sustainability of the NHS. I am delighted that there is record GP recruitment at the moment and that the work that has been done to increase GP training is bearing fruit. On the question of new technology, as we discussed over a series of questions earlier, yes, it is important to make sure that it works well and that the rules are right but, if we turn our backs on new technology, we are turning our backs on better care.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 15th June 2016 Commons Chamber

[Matthew Hancock]

We have made huge progress in ensuring that we have registers of beneficial ownership in the overseas territories. We are also publishing the beneficial ownership register for the UK. The progress that has been made in the overseas territories is the greatest under any Government in history, which perhaps is one reason Transparency International said that the summit had been a good day for anti-corruption.

[Jonathan Ashworth (Leicester South) (Lab)]

The Panama papers have shown how illicit finance robs the very poorest countries of the world. Malawi, for example, loses about $130 million a year through such finance. Will the Minister explain why the Malawian company Press Trust Overseas Ltd cannot have its tax affairs scrutinised because it is in the British Virgin Islands? Should not the summit have come to an agreement to force such overseas jurisdictions to publish central beneficial registers?

[Matthew Hancock]

If the hon. Gentleman cares so much about the matter, he might have congratulated us on the progress that we made at the summit. He will be delighted to know that the British Virgin Islands has signed up to have a beneficial ownership register and to share that information with the UK Government. We are making progress in tackling the scourge of corruption, about which previous Governments, including the one he supported, did too little.

Oral Answers to Questions

Debate between Jonathan Ashworth and Matt Hancock

Wednesday 1st July 2015 Commons Chamber

[Matthew Hancock]

My hon. Friend raises an important point. This is true not just about ethnicity in the senior civil service but about gender and people with disabilities. We need to ensure that the senior civil service represents the country that it serves. Steps are under way to ensure that that happens and I look forward to working with my hon. Friend to reach that conclusion.

[Jonathan Ashworth (Leicester South) (Lab)]

We welcome the Minister to his place and the Opposition support genuine efforts to increase the diversity of the civil service. He will be aware that 58% of permanent secretaries were privately educated, as were 53% of senior diplomats and 45% of public body chairs. Would he therefore support targets to increase the numbers from state education at the top of our civil service?

[Matthew Hancock]

I certainly strongly agree that it is important that as well as considering gender, ethnicity and other characteristics we ensure that people from all backgrounds—whichever school they went to and whichever part of the country they come from—can get to senior levels in the civil service. We have a programme under way to ensure that that happens.