(4 years, 3 months ago)
Commons ChamberWith permission, Mr Speaker, I will make a statement on coronavirus. This is the most serious public health emergency in 100 years, but through the combined efforts of the whole nation, we have got through the peak. Let us not forget what, together, has been achieved. We flattened the curve, and now the number of people in hospital with coronavirus is half what it was at the peak. We protected the NHS, and the number of patients in critical care is down by two thirds. Mercifully, the number of deaths across all settings is falling.
This Mental Health Awareness Week is an important reminder that we need to look after ourselves, as well as each other. If someone needs support with their mental health, the NHS is there for them. This is particularly important for frontline staff, and we have supported all NHS trusts to develop 24/7 mental health helplines.
Our plan throughout this crisis has been to slow the spread and protect the NHS. Thanks to the resolve of the British people, the plan is working, and we are now in the second phase of this fight. I will update the House on the next steps that we are taking as part of that plan. First, we are protecting the nation’s care homes, with a further £600 million available directly to care homes in England. We have prioritised testing for care homes throughout, we made sure that every care home has a named NHS clinical lead and we are requiring local authorities to conduct daily reviews of the situation on the ground, so that every care home gets the support it needs each and every day. All this amounts to an unprecedented level of scrutiny and support for the social care system, and a level of integration with the NHS that is long overdue.
Secondly, the four UK chief medical officers have today updated the case definition to include a new symptom. Throughout this pandemic, we have said that someone who develops a new continuous cough or fever should immediately self-isolate. From today, we are including anosmia—losing one’s sense of smell, or experiencing a change in the normal sense of smell or taste—which can be a symptom of coronavirus, even where the other symptoms are not present. So from today, anyone who develops a continuous cough or fever or anosmia should immediately self-isolate for at least seven days, in line with the guidelines. Members of their household should self-isolate for 14 days. By updating the case definition in line with the latest science, we can more easily recognise the presence of the virus and more effectively fight it.
Thirdly, we are expanding eligibility for testing further than ever before. Over the past six weeks, this country has taken a small, specialised diagnostics industry and scaled it at breathtaking pace into a global champion. Yesterday, we conducted 100,678 tests. Every day, we create more capacity, which means that more people can be tested and the virus has fewer places to hide.
Today, I can announce to 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 by visiting nhs.uk/coronavirus. Anyone who is eligible for a test but does not have internet access can call 119 in England and Wales or, in Scotland and Northern Ireland, 0300 303 2713. We will continue to prioritise access to tests for NHS and social care, patients, residents and staff, and as testing ramps up towards our new goal of a total capacity of 200,000 tests a day, ever more people will have the confidence and certainty that comes with an accurate test result.
Fourthly, I want to update the House on building our army of contact tracers. I can confirm that we have recruited more than 21,000 contact tracers in England. That includes 7,500 healthcare professionals who will provide our call handlers with expert clinical advice. They will help to manually trace the contacts of anyone who has had a positive test, and advise them on whether they need to isolate. They have rigorous training, with detailed procedures designed by our experts at Public Health England. They have stepped up to serve their country in its hour of need and I thank them in advance for the life-saving work that they are about to do.
The work of those 21,000 people will be supported by the NHS covid-19 app, which we are piloting on the Isle of Wight at the moment and will then roll out across the rest of the country. Taken together, that means that we now have the elements that we need to roll out our national test and trace service: the testing capacity, the tracing capability and the technology.
Building that system is incredibly important, but so too are the basics. We need everyone to self-isolate if they or someone in their household has symptoms. We need everyone to keep washing their hands and following the social distancing rules. We need everyone to stay alert, because this is a national effort and everyone has a part to play. The goal is to protect life and allow us, carefully and cautiously, to get back to doing more of the things that make life worth living. That is our goal and we are making progress towards it. I commend this statement to the House.
I call the shadow Secretary of State for Health, Jonathan Ashworth, who has four minutes.
I will keep it concise, Mr Speaker—your instruction.
The hon. Gentleman is right to ask detailed questions about care homes, because making sure that we have that ring of protection around care homes is important. Of course, the majority of care homes have not had an outbreak at all. We should thank those running care homes for the incredible hard work and infection control they put in place, meaning that in 62% of all care homes there has not been an outbreak. Where there has been an outbreak, there has been rigorous infection control and a huge amount of work has gone into that. We have, as he said, now got testing for all. That started with testing throughout for people who had the first symptoms in a care home. Now, it is for all staff and all residents, whether symptomatic or not.
There was no large-scale removal of people from hospital into care homes towards the start of the crisis, as has been implied by some. In fact, the number of people moving from hospital into care homes has fallen throughout the crisis and those movements have been done with care. But I agree with the hon. Gentleman that the crisis has shown that there are many lessons for reform in the social care sector, not least the much closer integrated working with the NHS that we have seen in these crisis days.
The hon. Gentleman asked about the roll out of contact tracing. We now have the people in place. The app is successfully being piloted, and we are ready and preparing for rolling out that system.
The hon. Gentleman asked for the median time for a test to get back. The median time is, as far as I understand it, under 48 hours. He made a rather uncharacteristic dig at private sector businesses which are helping us to deliver that. None of the testing capability—not a single test—would be possible without the private sector. His attempt to divide people between private and public sector is entirely wrong. I think he should remember that that bit of the Labour party left the shadow Cabinet a couple of months ago. I thought good sense had returned.
The hon. Gentleman asked about local public health services. It is incredibly important that local public health services are involved. We have brought in Tom Riordan, chief executive of Leeds City Council and a brilliant public servant, to lead the work on engagement with local public health services, which the hon. Gentleman rightly—I totally agree with him—says are an incredibly important part of getting this right.
We of course keep R under review. We keep watching it and we keep surveying to find out what it is. We have said that, if it rises above one and we see an outbreak in an area, we will be perfectly prepared to take action in that area. Indeed, if it goes dangerously high nationally, we would be prepared, as we were before, to take the necessary action.
Finally, the hon. Gentleman talked about the importance of mental health services across the board. The support is there in the NHS for all NHS staff—in fact, it is there across the board. One of the interesting things in this crisis is that paediatric mental health services have discovered that many services are better received, especially by children, via computer than face to face. In some cases, therefore, the service is better provided at a distance, over a screen, than face to face, but he is absolutely right to highlight the importance of mental health services in this crisis and beyond.
We now go across to the Chair of the Select Committee on Health, who I understand is audio only.
Thank you, Mr Speaker. I would like to ask the Secretary of State for three pieces of data, all of which are essential for this strategy. First, what level of new daily infections do we need to be down to before contact tracing happens for all new infections? Secondly, how many daily tests will the test and trace system need? Thirdly, if we are going to introduce weekly testing for all NHS and care-home frontline staff, when will our testing capacity be sufficient to deliver that on top of test and trace?
With 21,000 contact tracers now employed, we think that that is capacity for the current level of new cases that have been demonstrated by the Office for National Statistics surveys, but I am perfectly prepared to hire more to make sure that we have spare capacity within contact tracing.
On the number of tests needed daily to service test and trace, it depends on exactly how many new cases there are. It depends on the relationship between the symptoms and the number of positive cases. There are many more people with symptoms than there are positive coronavirus cases, but the number is falling because we are moving away—well away now—from the flu season, and at this time of year the number of positive symptoms, including coughs and fever, tends to fall, because other non-coronavirus communicable diseases such as flu are falling. There is not a specific answer to that question, because it changes over time. On weekly tests, we are looking to put together a plan to ensure that we cut in-hospital transmission, which will include appropriate, regular testing of the right staff in the NHS. I shall write to my right hon. Friend with more details as and when that policy is fully announceable.
We have a technical problem with Dr Philippa Whitford, whom we will return to shortly. We will go to Sir Desmond Swayne.
The regional dental hubs offer little more than extractions —but I want to keep my teeth. When will dentists be able to treat their own patients?
My right hon. Friend rightly points out that we have urgent dental hubs, so anyone who needs urgent dentistry can get a dentist’s appointment through their GP. Many people have asked how, in an emergency, they can see a dentist. Dentistry is there and available—it is an important message for all our constituents. However, we are also working on the restart of dentistry more broadly. I understand the challenges, especially for those who want to see their own dentist and for dental practices. With NHS contracts, we continue to keep the funds flowing, but of course many dentists rely on their private income as well, and we support the mixed market in dentistry. What we need to do is get dentistry up and running when we can, but it has to be safe.
I am pleased to say that we have reconnected with the SNP spokesperson, Dr Philippa Whitford, who has 90 seconds.
I welcome that eligibility for testing is being widened to all symptomatic cases as the first step towards a test, trace and isolate approach, but does the Secretary of State agree that the system should have been in place before lockdown was eased? Without it, how can he know that the crowded public transport systems that we saw last week are not already leading to a rise in infections? The Secretary of State prides himself on having ramped up testing, but we know that many thousands of those are just in the post, so will he clarify whether those tests are counted again when they are actually carried out?
The Royal College of GPs has highlighted the difficulty in getting test results back from the Deloitte regional test centres. As it is contact tracing and isolation that stop the spread of the virus, how will the Secretary of State speed up results and ensure that they are fed back to GPs and public health teams, who are critical to detecting and controlling local outbreaks? The UK still has more than six times the number of new cases per day than when the lockdown was brought in. Does he not think that that is still too high to be sending people back to work and school?
We have been working very closely with the SNP Scottish Government on testing, so I am slightly surprised at some of the questions from the SNP spokeswoman. Of course the tests are not double-counted. There has been a ramp up in testing capacity. I am very glad to see in Scotland that testing capacity is now starting to rise—in the latest figures, it was up to around 5,000. I work very closely with my SNP opposite number on making sure that everybody has the very best capacity. The contact tracing system was also stopped in Scotland. The reason was that the number of cases right across the UK became very high. We needed social distancing to bring that number down. Now that that number is coming down right across the UK, contact tracing is once again effective. That is the reason we are bringing it in now, and I am pleased that we have hired 21,000 contact tracers in England to ensure that we can get it going. Therefore we are on track for the current proposed 1 June changes. That date is dependent on making sure that everything is right, and that it is safe to make the changes then.
The Minister has just confirmed that there will be thousands of contact tracers who are not medically trained, but who will be handling highly sensitive patient information and issuing clinical advice given to them. Will he bring forward primary legislation to govern the collection and any potential misuse of data, whether that is via an app, by qualified health professionals or by the non-medical call handlers, so that members of the public can have confidence that all strands of his data collection plans are effective and safe?
I have looked at this proposal and it is clear that primary legislation is not needed, because the Data Protection Act will do the job.
I thank the Secretary of State for his unstinting dedication to protecting the health of our nation during this crisis. First, will he update the House on when the roll-out for antibody tests will be revealed, so that we can start to get back to normality? Secondly, in last Friday’s statement, he spoke about the reform of health and social care. When will the Government bring forward a lasting care funding solution to stop people in constituencies such as Romford from being forced to sell their family homes to fund long-term care?
I think the whole country celebrated when there was the announcement last week that antibody testing that fits the bill and does the job had been approved by our Porton Down labs. We are in the closing stages of commercial negotiations to ensure that those tests are widely available, and I will let my hon. Friend know just as soon as I can when that roll-out will be, but I do not want to prejudice the commercial negotiations, which I am sure he will understand.
On the second point, I strongly agree with my hon. Friend that this crisis has demonstrated just how important social care reform is, just how important social care is and how we must maintain the benefits and improvements in delivery and working practice that happened because of the crisis and happened through the heat of the crisis. We must maintain and strengthen that close working relationship. The financial changes that we put through have proved very effective at bringing the two systems closer together, but there is much, much more to do.
A recent survey by Unison North West found that eight out of 10 care workers would not receive full pay if they were ill, self-isolating or shielding because of covid-19, receiving at most £95 per week statutory sick pay, with workers putting their lives on the line to look after us. Will the Government provide increased funding and direction to ensure that all care workers receive full pay when absent due to covid-19?
In addition, given the current failings of our fractured—
That is an incredibly important question, and one of the purposes of the £600 million extra that we are putting into the social care system and that will go direct to the frontline—local authorities are not allowed to use it for other purposes—is to ensure that when social care staff need to be away from work for infection control purposes, they are not penalised for doing so.
I join my hon. Friend the Member for Romford (Andrew Rosindell) and my right hon. Friend in welcoming approval of an antibody test for use in the UK. I understand my right hon. Friend cannot elaborate on the timetable for its introduction, but can he tell us whether he is preparing for individuals to be able to input the results of an antibody test into the NHS covid app to help demonstrate their immunity and improve our understanding of the prevalence of this wretched virus?
It is not through the covid app, but we have a process for people inputting whether they think they have had the virus. As and when we manage to land an agreement on antibody testing the proposition my right hon. Friend makes is a very good one. After all, at the moment the science is not clear as to the level of immunity and the risk that we pose of transmitting to others if we have antibodies, as many of us who have had the virus hope that we have, but as the science becomes clearer, so we will also be able to be clearer with our guidance to people who have a degree of immunity on what they can do.
Two weeks ago, 1.8 million people in this country who are currently shielding were told that they would have to shield for an extra two weeks until 30 June. Can the Secretary of State confirm what protection there will be for them and their families, so that they do not face the threat of redundancy or sanction for not going to work or not going to school in order to follow that medical advice?
We have put in place extensive protections for people who are shielded, and those protections will of course continue to apply until 30 June. Shielding is not something that we do lightly, because we understand the very significant impact it has on those concerned and their families, but it is necessary in a pandemic like this.
Lincolnshire is fortunate to have good supplies of PPE, a relatively low infection rate and excellent capacity in our hospitals at this time. Will the Secretary of State join me in thanking our NHS staff across Lincolnshire, who have been intensely dedicated to treating covid-19 patients, but who are also increasingly aware of the needs of non-covid patients?
Yes, I will. The NHS restart is incredibly important in Lincolnshire and across the country. I know Lincolnshire well, and it is very important that we restart other services that have had to be paused for understandable reasons. Not only is Lincolnshire the home to many dedicated health and social care staff—I pay tribute to all those who work in the NHS in Lincolnshire—but my grandmother was a nurse at the Pilgrim Hospital in Boston and our great deputy chief medical officer, Professor Jonathan Van-Tam, is himself a resident of Lincolnshire. Lincolnshire has many great things to offer in the sphere of health, and we must ensure that that is about not just covid but health services across the board.
The Office for National Statistics has reported that covid-19 mortality rates in the most deprived areas of England are twice those in the least deprived. Once again, this virus has reminded us of the extreme health and social inequalities in our society; although it can affect anyone, from any background, those from the poorest communities have the highest risk of severe illness and death. Here in the north-east, we have some of the highest levels of deprivation in the country, as well as the highest rates of infection. What do the Government intend to do to reduce health inequalities, both during the covid-19 lockdown and as part of our recovery from the impact of the virus?
The hon. Lady is absolutely right; this is an incredibly important subject, both, as she says, during the crisis and thereafter. We have a study under way, which Public Health England is conducting, on the impact of all sorts of different conditions on the likelihood that covid-19 will hit someone hard. It is true that there is a link to levels of deprivation, in the same way as one of the strongest factors, other than age, is obesity—that needs to be investigated. We have also seen a bigger impact on people from minority ethnic backgrounds. All these things need to be studied. Levelling up and closing that health inequality gap is an incredibly important part of the Government’s agenda for recovering from this terrible disease.
As my right hon. Friend has said, due to the hard work of the entire health and social care system we can now look beyond this crisis. As we do that, may I ask him to say more today, and in the coming days, about how we intend to balance the need to address a substantial backlog of more routine and elective work, which, as he says, has been understandably pushed aside by covid-19, with the need to make sure that NHS staff, who have been through an extremely stressful period, have the time to recover?
That is one of the many balances we will have to strike in the months and years to come as we recover from covid-19. There are, immediately, three things we are doing on that. The first is that we have brought in more staff, especially retired staff, and we want to keep them. They have been absolutely brilliant and a huge help to the NHS during the crisis. The second is providing more support to staff. I mentioned the mental health support, but this involves all sorts of other, wider support to staff right across health and social care. The third thing is making sure that we rebuild the NHS, gaining from the improvements that have been made in the eye of this storm, because there have been improvements to ways of working. Huge strides forward have been taken on the use of technology, and we have found areas where that has made a very big positive impact. Although there are, of course, parts of this crisis response that we want to roll back, there are other parts we want to pick up and take forward.
My constituent Rebecca’s mother tragically died from coronavirus while working as a nurse in a Rotherham care home. The care home did not have access to the personal protective equipment she needed to keep safe. Rebecca wants to know: how will the PPE available to health and care professionals who have died in service be recorded and considered? Will accepting the £60,000 death-in-service payment prevent her family from making a negligence claim? And who signed off on the Government’s strategy of sending untested patients to care homes?
As I have said, in care homes we put in place infection control procedures as much as was possible at the start of this crisis, and there was not an increase in the number of people going back to care homes. But my heart goes out to the family of the hon. Lady’s constituent, who died working in social care, joining, I am afraid to say, many others who gave service during this crisis and died as a result of it. I am very happy to look specifically into her constituent’s case. We do look into the death of any health or social care worker and make sure we get to the bottom of all the lessons that can be learned, and I am very happy personally to do that in the case of the constituent that the hon. Lady has rightly raised.
Care homes in Ashfield such as Wren Hall, with an outstanding rating, and Sutton Manor, which is in the top 20 care homes in the east midlands, face a difficult future. With empty beds due to covid-19 comes a dramatic loss of income, which has a significant impact on their business. Could my right hon. Friend advise me what safeguards are in place to ensure that our care homes are supported to keep their doors open and continue to provide this exceptional level of care?
I want to congratulate Wren Hall, because getting an outstanding rating is not easy, and it has done that. I congratulate every single member of staff, and I thank my hon. Friend for being a champion for them and bringing to my attention Wren Hall’s outstanding rating when it was received. The funding, of course, is a critical part of this. We put in £600 million extra on Friday, and as I said, that will all go direct to care homes—it is not to go into local authority budgets for onward consideration of passing to care homes; it is to get to the care homes. That will help with infection control, but we also have to ensure that funding is sustainable for the future.
Yesterday, the British Government announced in their daily briefing that they hope to have 30 million vaccines ready for use by September, yet on the same day, the Prime Minister wrote in The Mail on Sunday that there may never be a vaccine. Considering the way that Wales has been undermined by the British Government over the distribution of PPE and testing, what confidence can the people of Wales have that we will have our fair share of vaccines if one is developed?
It is not quite fair to say that Wales has not been served on PPE or testing. I have worked very closely with the Welsh Labour Government, and although the number of tests declared per day in Wales is low—it is only just over 1,000—there is access to UK-wide testing capabilities, such as home testing and the drive-through centres.
On the hon. Gentleman’s substantive point about the vaccine, I am delighted that we have been able to come to an agreement with AstraZeneca. If the science behind the Oxford vaccine works, it is likely to be one of the first available in the world, and we then have an agreement to ensure that 100 million doses are available for the UK, the first 30 million of which will be right at the start for the most vulnerable. That is a UK-wide policy—we will deliver it right across these islands. We should pay tribute to the work and the ingenuity of our scientists in Oxford and to the industrial might of AstraZeneca, who together, should they manage to pull off the science, will be able to deliver this vaccine to our population as we need it. Vaccine science is an uncertain business. That is why we cannot ever be 100% sure that there will be a safe and effective vaccine, but we are putting everything we can into making sure that we give them the best possible chance for every citizen of the whole United Kingdom.
Can my right hon. Friend confirm that, thanks to the actions that this Government have taken and the brilliant response of the British people, we have prevented the NHS from being overwhelmed at any point during the current crisis, which has meant that ordinary people have been able to receive a fantastic standard of care when they needed it?
Yes, that is absolutely right. Two months ago, the people of Blackpool were told that it would be difficult to get through this without the NHS being overwhelmed across the country. Through the hard work of people who have done their bit by staying at home and staying alert, and through the NHS expansion, we have managed to ensure that every single person with coronavirus could get access to NHS treatment. I think the whole country should be proud of that.
As a co-chair of the all-party parliamentary group on adult social care, I have been speaking with social care providers across the country every single week since the start of this crisis. Not a single one would recognise the Secretary of State’s description last week of a “protective ring” having been thrown around them. They had no access to PPE, no access to testing and, in some cases, were told that ambulances would not take their residents to hospital. Now the sector is clear that they need access to testing on a weekly basis for all staff and residents, with prompt access to results, so that they can act to maintain infection control. Can the Secretary of State say when that essential measure will be in place?
We absolutely did a throw a protective ring around social care, not least with the £3.2 billion-worth of funding we put in right at the start, topped up with £600 million-worth of funding on Friday. Further to that, the hon. Lady does know, I think, that testing has been carried out in care homes throughout. Of course there is always more that we should and will do, but we have been working very hard and closely with the adult social care sector. Towards the start of this crisis, I was meeting the leaders of adult social care in Downing Street with the Prime Minister. We have been working very hard to tie together our response in what is a very diverse sector.
Will my right hon. Friend join me in praising the work of local initiatives such as Makers 4 the NHS in Beaconsfield, who have volunteered their time and money to help to contribute and deliver PPE to the NHS and care homes? Following the announcement of the new guidelines surrounding PPE production, will my right hon. Friend ensure that local groups like Makers 4 the NHS are not excluded from delivery of PPE, and will he meet me to discuss how we can support local businesses who are already supporting the NHS and local covid-19 responses?
Yes, I would be very happy to meet my hon. Friend, possibly via Zoom—other videoconferencing services are available—to discuss what Makers 4 the NHS and other voluntary organisations and groups of volunteers have come together to deliver with regard to PPE: it is absolutely fantastic. I pay tribute, too, to the Daily Mail’s PPE campaign, which has raised an enormous amount to bring in PPE from China. But those who are making it here in Britain I salute and I thank.
Does the Secretary of State remember that about a month ago I upset him by telling him that his Government’s policy during this crisis was a shambles? I thought they were actually getting a grip on this crisis until last Sunday’s disastrous performance by his Prime Minister. Now we have relaxed the advice to the country at a time when Yorkshire and the north-east is doubling its R rate. What is he going to do about that? Can he not get a grip? Can he not stand up to the Prime Minister?
The R rate has not doubled in Yorkshire or indeed anywhere else in the country. By contrast, as I said at the start of my statement, the good news is that things are progressing: the number of people in hospital is significantly down, and the number of people in critical care is down by two thirds. I think we should be thanking and supporting our NHS staff and others, and working together to get to the best possible outcome.
I acknowledge that no Health Secretary has faced the scale of challenges that my right hon. Friend has. Will he join me in thanking all the staff at Southend University Hospital, and those who provide associated healthcare, for their heroic efforts during this time of national crisis, and will he reassure them all that we do have plans to deliver this vaccine?
Yes, absolutely. To deliver the vaccine, if the science comes off—and we hope as much as we possibly can that it will—we will have the plans in place to ensure that it can safely be delivered to those who will benefit from it. We have the agreement with AstraZeneca for the production of 100 million doses—30 million right at the start of the programme. I join my hon. Friend in thanking the staff of Southend University Hospital, who have done so much in such difficult times to make sure that all the community can get access to the support they need if they have got coronavirus, and who I know are working now on the restoration of other services so that people with any health need can get the support they need.
When it comes to “test, trace, isolate”, the Scottish Government are expanding the resilience of the public health system. The UK Government are expanding outsourcing. While the private sector is part of an overall solution, surely the Secretary of State should be doing more to limit the profits of the likes of Serco and Deloitte.
On the contrary, one of things that we have learned in this crisis, as a nation, is that things are best delivered with people working together in the public and private sectors. I think this crisis has ended for good the idea that the public sector alone should deliver certain services. Actually, teamwork is the best option.
We are rightly tackling the global pandemic, covid-19, but there is a danger that the totally preventable diseases of measles, mumps and rubella will re-emerge if vaccinations are missed. Will my right hon. Friend reassure me and the parents in Broxtowe that it is safe and vital that scheduled vaccinations continue?
Yes, it is very important that the scheduled vaccination programme continues wherever possible, and we have protected it as much as possible. We must remember that, with the hope of a vaccine for coronavirus, so, too, will we have to redouble efforts to vaccinate children for MMR and for flu this autumn. Everybody will need to get a flu jab if they possibly can, and we will have more to say on that soon. It is really important that people vaccinate and that anybody who hears messages from anti-vaxxers stands up to them and says that what they say is wrong and harmful.
There are reports that covid-19 test results are coming in some 96 hours after testing. In that time, health workers and their families are at risk of catching the virus. Will the Health Secretary confirm whether there are enough reagents, specifically in acute settings, to perform all covid-19 tests within 24 hours?
Obviously, being able to perform all tests within 24 hours would be a great success. We are trying, as much as possible, to shorten the amount of time it takes. The average time is much, much shorter than 96 hours, and I will write to the hon. Lady with an exact figure of the time that it takes in acute settings. It is much shorter than the time that she mentions. All test results under 24 hours would be great. Sometimes it is just a matter of minutes or hours depending on how busy the test centre is.
May I return to the question asked by my hon. Friend the Member for Ashfield (Lee Anderson) and ask my right hon. Friend whether it is possible to give any specific support to care homes facing financial difficulties due to unusually high vacancy rates?
The answer that I tried to give at the end of my answer—perhaps too long an answer—to my hon. Friend the Member for Ashfield (Lee Anderson) is that, yes, that is something on which I am working. It is not something that I am able to announce today, but I do recognise the concerns and the challenges that the social care sector faces.
The number of daily new cases of coronavirus remains above 3,000 and the daily death rate higher than that of other countries, including Italy and Spain. We were slow to go into lockdown, but we now seem to be in a rush to come out, with restrictions relaxed before the test, track and trace system is fully in place, which may well be putting those numbers back on the rise. Does the Secretary of State understand why the public are anxious about the relaxation and the plans to reopen schools given the lack of systems in place now to minimise the risk of adding to the already devastating death toll?
We have set out the five tests that need to be met before relaxation. We will only do that cautiously and carefully. I would sign up to it only if it were safe to do so. The hon. Lady raises the issue of schools. It is very clear that the number of children who are badly affected by this disease is very, very, very small. It is a tiny proportion of the overall total. This disease reserves its power and its risk mostly for the elderly. The proposals that we have made for schools are safe and they are sensible. There clearly needs to be collaborative work to ensure that they can happen, because there are also risks to children, especially some of the most vulnerable children, of not going to school.
I thank my right hon. Friend for his incredible hard work and determination to get us through this crisis and for helping to save many lives in my constituency. Will he join me in thanking some of the amazing groups and organisations in my constituency of Stourbridge, such as staff at Russells Hall hospital, Mary Stevens hospice and our care homes, community pharmacists, volunteers, and all those unsung heroes who continue to work day in, day out, saving lives and supporting the most vulnerable?
I would be very happy and honoured to join my hon. Friend in thanking the staff at Russells Hall hospital and at Mary Stevens hospice, at the care homes and the community pharmacists, and indeed the volunteers of Stourbridge, who have come together. There have been many terrible things about this disease, but there have also been some heartwarming things. The dedication of staff and volunteers alike to coming to the aid of others is one of the things that the whole nation has been proud to see.
The Secretary of State will know the concerns across northern England about the Government’s approach to easing lockdown, specifically those raised by the Greater Manchester Mayor and the combined authority about the risk of a second wave of coronavirus owing to different R values across our city region. What measures is he putting in place to ensure that, as lockdown is lifted across England, those areas behind London in the curve do not see all their hard work undone?
Of course we take the decision after looking at the information for the whole country, and we take into account the R rate and the level of new cases and all other data from right across the land when deciding what is the appropriate step to recommend and to take. We do this cautiously and carefully, and we make sure that everyone is taken into consideration. The safety of the whole population is right at the front of our mind.
Wolverhampton has united throughout the coronavirus crisis and we have been testing for the virus at a rapid pace. Supplies of the reagent chemicals and swabs we have been using have reduced in the last week, which affects testing in care homes. Will my right hon. Friend address that as a matter of urgency, so that we can continue to test at the pace we need to?
Yes. This weekend, I was looking at how to make sure that there is enough testing capacity specifically in Wolverhampton. We are acting to ensure that everybody, right across Wolverhampton and the whole country, can benefit from the hugely expanding testing capability.
In south Wales and industrial towns, former miners with severe breathing issues are extremely vulnerable to covid-19. Those miners deserve recompense for years of dangerous work, but this is only possible after death if industrial disease is also noted on the death certificate. Will the Secretary of State please ask his officials to work with the mineworkers union to ensure that industrial diseases as well as covid-19 are considered as causes of death, so that grieving families can access the support they need?
Yes. I am from mining stock myself—in Nottinghamshire rather than south Wales—so I entirely understand the impact mining has on breathing and respiratory disease, and of course I understand the impact in turn of respiratory disease on the likelihood of having a bad response to coronavirus. I am happy to take up the point the hon. Gentleman makes, to contact those in the Department for Business, Energy and Industrial Strategy who I believe are specifically responsible for redress for miners, and to write to him.
In April, 16 residents of a care home in Fylde died. They represent about half of those in the home. Six of the remaining residents are displaying symptoms, but they are being told that they will have to wait until mid-June for further tests, following errors made by Randox a few weeks ago. Can the Secretary of State please investigate and work with me to resolve this important issue?
Yes, of course I can. I will take that up immediately and we will try to get a resolution. Thankfully, we have the testing capacity to be able to resolve such problems.
One of my constituents has written to me as a worried grandmother and the mother of a teacher. When scientists are divided over the coronavirus risk for children and how they might spread the virus, is this grandmother not right to ask me why Parliament is virtually empty due to social distancing measures, but her grandchild, who is least able to socially distance, is expected to return to school?
We have taken a cautious, balanced and safety-first approach to restarting schools. That is why we have we taken the approach of just three years being proposed for return in the first instance, to ensure that there can be more social distancing at schools. Of course, as the father of three small children I get that that is more challenging than among adults, but it is necessary. The approach that we propose is safe and is signed off by medical advisers as safe. Of course, because there is hardly any impact on children of this disease—a very small number of children are badly affected—that means that parents can be confident that if they send their child to school, it is a safe environment for them.
During Mental Health Awareness Week, will the Secretary of State agree with me that local volunteer-led mental health groups meeting regularly on Zoom here in Warrington South, such as Offload Rugby League Cares and Man Talk, are providing an absolutely vital service for men during these unprecedented times, and that they really should continue to receive the Government’s full backing?
I pay tribute to Man Talk, to Offload Rugby League Cares and to all those who are working to support the mental health of others during this difficult crisis.
Many teachers and school staff are anxious about a return to class, especially those who have medical conditions or who are living with someone who is shielding. I understand that it will not be a requirement, but can the Secretary of State clarify whether if, for reassurance, staff at times want to wear face coverings and/or visors, they are perfectly free to do so?
They are not advised to do so. What staff do within a school is a matter for their head.
May I please ask the Secretary of State whether the NHS is taking full advantage of the military logistics expertise currently available, and is there greater value to be had?
And some! The military have been unbelievably helpful in this crisis, right across the extraordinary things that my teams and the whole NHS have had to do in terms of logistics and delivery on the ground—literally boots on the ground. The military, just like the private sector that we were discussing earlier, have made the testing capability possible. They have supported care homes and they have done an amazing thing. They have really risen to the challenge.
Most countries have imposed some form of public health measures on international travellers in order to limit imported cases of the virus. The United Kingdom has been out of step on that since the middle of March, and today we heard that details of a quarantine scheme will not be published until next month. As Health Secretary, will he publish the detailed scientific advice on which the United Kingdom’s approach has been based in this matter since the middle of March?
We are working on a four nations approach, and trying to make sure that the approach that we have to international travel is aligned across all four nations, including with the Assembly Government in Edinburgh. We have, of course, based those decisions on scientific advice, and we will make sure that, as and when that advice is updated as we move through this pandemic, so the decisions continue to be based on that advice.
Fortunately, coronavirus presents an extremely low risk to children, and I am delighted that schools are able to plan to reopen from 1 June. We will need to monitor closely the effects of that on numbers of covid-19 infections. Can my right hon. Friend reassure parents and teachers that every effort is being made to ensure test, track and trace will be available in time for schools reopening?
That is right, and my hon. Friend makes an incredibly important point. The number of children who have died is sadly more than none, but very, very low compared to adults, and it is absolutely right that getting test and trace up and running is important. I am delighted that today we have recruited 21,000 contact tracers, ahead of the goal I set that by today we would recruit 18,000—7,500 of them medical professionals—to make sure that we can deliver safely on the opening of schools, which is so important to so many.
On the subject of those 21,000 contact tracers, what is being done to support, supervise and train them in what will be an incredibly sensitive job, dealing with not only the individuals affected but their data and other privileged information?
I have a big BAME community in my constituency of Kensington; will the Secretary of State assure me that Public Health England will look into the effect of ethnicity on outcomes?
Yes. Kevin Fenton, who is the London lead for public health in Public Health England, is undertaking exactly the review for which my hon. Friend asks. We propose to publish it in the coming weeks.
The Government have promised to carry out routine testing in care homes, yet my local authority tells me that there is a shortage of the home-test kits needed to do that and fears that such kits will be diverted to fulfil another of the Government’s pledges on tracking and tracing as more become available. Yet again, the Government have made a claim that is not borne out by the situation in our care homes. By what date will we have enough home-test kits to carry out routine testing in care homes?
I am happy to ensure that my team contacts the hon. Gentleman’s local authority, not least to explain that home testing is only one of the avenues available. In fact, much more testing in care homes is done through the mobile testing units, with the mobile unit going to the care home, or by the satellite units, from which a whole batch is taken to the care home, than through the home-testing channel, which is designed for sending an individual test or a small number of tests to an individual house.
An unheralded aspect of the comfort that has been brought to patients in the coronavirus crisis has come from hospital radio stations, such as the one at Stoke Mandeville. Will my right hon. Friend join me in thanking the volunteers who have provided the only company available to covid patients when they have not been allowed to have visitors? Will he do all he can to support hospital radio stations in the months and years ahead?
My hon. Friend should be proud to represent Stoke Mandeville hospital and Stoke Mandeville hospital radio. He is right: hospital radio is always important, but at times like this, when visitors have not been able to go into hospitals, it is even more important. I am pleased that he raised it.
The Secretary of State has mentioned that both the R rate and the level of new cases are important factors in determining the Government’s decision making, but will he clarify whether the way in which those factors differ throughout the UK will be considered in future planning, including in respect of financial-assistance programmes?
It is widely believed that the impact of covid-19 in the UK has been greater because of high levels of obesity. Does my right hon. Friend agree that we must do more to tackle the causes of obesity in our society?
Yes. It is true that the early evidence shows that obesity is a major factor in covid-19’s impact on an individual. One early study by Dr Ben Goldacre implied that serious obesity is one of the greatest factors, after age. We must make sure that we tackle obesity across the nation, and I very much look forward to working with the Prime Minister to bring forward plans to tackle obesity.
If I may, cheekily, Mr Speaker, I wish to thank all community first responders for the work that they are doing, because I know that my hon. Friend the Member for Brigg and Goole (Andrew Percy) wanted to ask about them.
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Commons ChamberWe are providing up to £200 million to hospices over the next three months to support their work alongside the NHS as part of the national response—by, for instance, providing spare bed capacity in community care to take pressure off hospitals, supporting vulnerable patients, and, of course, supporting those in need of palliative care. I am sure that my hon. Friend will be pleased to know that Sue Ryder, which runs one of his local hospices, received £5.9 million in April.
I thank my right hon. Friend for that answer. It is indeed great news that the Government are providing £200 million for those nearing the end of their lives. When does he expects hospices such as Thorpe Hall to receive that funding? In recognition of just how vital palliative care is, might we look to reform the way in which we commission palliative care when this crisis is over?
There are lots of things that we will need to learn when this crisis is over. The hospice system has always had a mixed model of funding—a very strong history of philanthropic support, as well as support and financial funding for the services it provides that the NHS commissions. The funding has started to flow. If there is a specific problem locally, I would like to know about it, and then we can get to the bottom of it.
We expanded testing to all symptomatic essential workers and members of their households last month. As capacity continues to increase, we have been able to go further still, with all those who have symptoms and who have to leave home to go to work—and members of their households—now able to access a test. This is all part of the overall testing strategy, with the 100,000 tests that are now available.
Testing of staff and residents at care homes in my constituency is being delivered by referrals either through the Care Quality Commission or through the pilot partnership that has been set up between our hospitals trust and our clinical commissioning group. In relation to the CQC, will my right hon. Friend examine why test results are taking five to seven days to come back, rather than the estimated 72 hours? In relation to the pilot scheme, where tests are being delivered efficiently, why are care home managers given the names of residents who test positive but, for data protection reasons, not the names of staff who test positive? That is creating obvious uncertainty.
I am glad to see the roll-out of testing to care homes, and we are able to go further for both residents and staff. It is an incredibly important part of the response and one of the reasons why testing is so important. My hon. Friend raises two important issues of detail in the roll-out, and I will ensure that they are looked into.
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?
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.
The development of a coronavirus vaccine is in its early stages but progressing rapidly. The Government have backed two promising vaccine candidates from the University of Oxford and Imperial College, and we are making over £45 million available to those teams—alongside the hundreds of millions that we are making available to the global vaccine search.
I am grateful for the Secretary of State’s response. The World Health Organisation has undoubtedly made mistakes over covid-19 and needs deep reforms, but this global pandemic requires a global response. How is the UK liaising with the WHO so that we work together globally to beat this virus?
We do work globally, and we do work together. As the Prime Minister made clear yesterday, we have committed £744 million to the global response to coronavirus. We are significant funders of the WHO, and I am grateful for its work. We are also a significant funder of the Coalition for Epidemic Preparedness Innovations, which is leading the global search for a vaccine. In fact, we are making the largest contribution of any country in the world to the global search for a vaccine, and three of the top 10 vaccine candidates are being developed here in the UK.
We are developing a new test, track and trace programme to help to control the spread of covid-19, and to be able to trace the virus better as it passes from person to person. This will bring together technology through an app, an extensive web of phone-based contract tracing and, of course, the testing needed to underpin all that. The roll-out has already started on the Isle of Wight, and I pay tribute to and thank the Islanders for the enthusiasm with which they have taken up the pilot. I hope that we learn a lot from the roll-out, so that we can take those learnings and roll the programme out across the whole country.
I thank the Secretary of State for his answer. I welcome the plans to introduce the contact-tracing app, but for it to be effective it will need to be rolled out to a large proportion of the population. What plans does the Secretary of State have to achieve that, and how will he alleviate privacy concerns?
I am grateful to my hon. Friend for that question. She is right to say that the more people who download the app, the more people will protect themselves, their families and their communities. The cross-party support for this test, track and trace programme is important, and right across this country people need to know that the app has privacy in its design. The data it holds is held on people’s phones and it does not go to the Government, until of course someone needs to get a test, in which case of course they have to get in contact with the NHS. So privacy is there by design, there is cross-party support and, according to a very early poll, 80% of people on the Isle of Wight want to download it. These are good early signs and we will have a big communications campaign to explain to people the benefits of the test, track and trace programme as we roll it out across the country.
In welcoming Dr Rosena Allin-Khan, may I say thank you for what you and all the staff do in the NHS, saving lives? It is appreciated.
Thank you very much, Mr Speaker. If I may, I would like to start by saying a huge thank you, on behalf of us all in the Chamber today and all those watching, to our NHS and care staff, who are working so hard on the frontline.
Frontline workers like me have had to watch families break into pieces as we deliver the very worst of news to them: that those they love most in this world have died. The testing strategy has been non-existent. Community testing was scrapped, mass testing was slow to roll out and testing figures are now being manipulated. Does the Secretary of State commit to a minimum of 100,000 tests each day going forward? Does he acknowledge that many frontline workers feel that the Government’s lack of testing has cost lives and is responsible for many families being unnecessarily torn apart in grief?
No, I do not. I welcome the hon. Lady to her post as part of the shadow Health team, and I think she might do well to take a leaf out of the shadow Secretary of State’s book on tone. I am afraid that what she said is not true; there has been a rapid acceleration in testing in the past few months in this country, including getting to 100,000 tests a day. We have been entirely transparent on the way that has been measured throughout, and I have confidence that the rate will continue to rise. Currently, capacity is 108,000 a day, and we are working to build that higher.
Of course, we have been working very hard to make the testing capacity grow as fast as possible, and as more tests are available, so we are able to make them available to more people and test people right across the NHS. I pay tribute, too, to the work of NHS and social care staff on the frontline; nothing should take away from the team spirit with which we approach this.
Test, track and trace is possible only with a mass testing programme, so I offer many congratulations to the Health Secretary on achieving such a challenging expansion in our testing capacity. He has always said that he follows the science in the decisions he takes, but does he appreciate that, Zoom or no Zoom, it is very difficult for us as MPs to scrutinise such decisions if he does not also publish the advice of the Scientific Advisory Group for Emergencies that he receives at the same time as he makes those decisions?
We are making public the membership of SAGE and a lot of the science. I know that my right hon. Friend is also able to scrutinise the scientists before the Select Committee on Health and Social Care, as he and his team did again this morning. The overall approach of transparency, which has been a lodestar of the Government’s response to this crisis, is important. Of course, different scientists have different views, and they make those plain, but, as he said, we are guided by the science in the decisions that we take, and that has been an important part of the response.
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Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
(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.
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.
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.
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.
I welcome the comments from the Secretary of State. We now go over to Sir Peter Bottomley.
I ask if we can all recognise the loving care by social services staff and NHS staff, especially those who have to go on hot or cold visits to people’s homes—not only the community nurses, dementia nurses and those who go to people with special needs, but the GPs and paramedics. Will the Secretary of State consider safer ways for those home visits, possibly using some of the offers of London black cabs, which can have a division between the driver and the clinician and also are much easier to clean down when necessary?
Yes, I am happy to look into all different ways of having safe working practices within the NHS and more broadly. Within the NHS, infection control is a critical piece of work. My hon. Friend is right to raise the point that this is a matter not just for acute hospitals—where, of course, it is mission critical—but for all parts of the NHS, including pharmacies, which increasingly have screens to make sure that there is a lower impact of transmission from customers to staff.
At least 140 health and care staff in the UK have lost their lives to covid-19, and we should pay tribute to them, but analysis of more than 100 of those tragic deaths has highlighted that there were not any among staff in critical care units, which are the most dangerous setting. Does the Secretary of State recognise that that shows the effectiveness of full PPE? He claims to always follow scientific advice, but NERVTAG, the new and emerging respiratory virus threats advisory group, advised him last June to add gowns to the stockpile, so why did he not do that? Why did Public Health England produce PPE guidelines for the whole UK that did not recommend gowns for staff looking after covid patients?
We are absolutely guided by the science. It is a very important principle of our overall response, and hence we upgraded the PPE guidelines a few weeks ago to include the use of gowns. The guidance is always looked into as we learn more and more about the virus. The plans that we had were not plans for a particular virus, but for the threat of a pandemic. We have learned more and more about this virus, which is novel and only came into being December last year, hence, as the science changes, so the scientific advice to Ministers is updated, and Ministers update decisions.
At the start of this pandemic, with no effective drug treatment, the only way to save the lives of coronavirus patients has been to ensure that hospital treatment is available for all who need it, so I thank my right hon. Friend for overseeing such a massive increase in critical care bed capacity. We saw yesterday that the NHS Nightingale in London is not due to take any more patients. While some have oddly criticised that announcement, does my right hon. Friend agree that that should be viewed as nothing other than a success that shows how effective we have been in protecting our NHS?
Yes, I am incredibly proud of the work that was done to put in place the Nightingale hospitals across the country. Most of them were put in place in under two weeks. The London Nightingale, which was open first, is the prime example of the whole team—the NHS, the private sector and the armed forces—all pulling together. It was a great accomplishment, but a greater accomplishment still is that it was never full and that this country has managed to flatten the curve. Now we are able to put it on standby, meaning that it will be physically there in case there is a second spike, but as an insurance policy, rather than as an active hospital. That is a very, very positive step that should be welcomed by all. I tend not to take much notice of some of the noises off, which sometimes criticise me for not having full enough hospitals and sometimes criticise me for not having enough people wanting test capacity. Frankly, we will get the capacity up and then hope we do not use it. That is the attitude we should take to the extra hospitals, and I pay tribute to everybody involved in the project.
[Inaudible.]
We all know the importance of PPE during the outbreak, how difficult it is to get and the great lengths to which the Secretary of State is going to procure it. On weekly calls with New Cross Hospital and the City of Wolverhampton Council, the same point is at the fore- front of our discussions: the consistency of the PPE deliveries. Will my right hon. Friend set out what plans are in place to ensure that what is promised arrives?
My hon. Friend is right to ask that important question. Getting the distribution of PPE to the frontline is critical. It has been a huge operation; the head of the Army has called it the largest logistical operation that this country has seen in 40 years. It is challenging because there is a global shortage of supply. We are working to get that supply as effective as possible. It is undoubtedly improving, but there is an awful lot of work still to do.
Having the national shortage call centre—the phone line that anybody can call if a shortage is coming up—is an important part of the response. So, too, are the automated online deliveries for the smaller settings. But we continue day and night to try to do everything we can to improve the flow of PPE to the frontline.
Disabled people are worried about who is expected to provide PPE for personal carers. Many are finding it difficult to procure appropriate equipment—and when they can, they are finding that prices are inflated. What are the Government doing to ensure that disabled people are not left without adequate equipment, or out of pocket, when attempting to protect themselves and their carers?
The hon. Lady is right that making sure that our whole social care system gets access to PPE is important. There is often a focus on PPE in hospitals and care homes, but on home visits, as she rightly raises, access to PPE is also vital.
There has been a global increase in the prices of PPE. The prices that the Government pay for PPE have increased a number of times over the course of this crisis. That is a feature of the global shortage of supply as the demand for PPE across the world has shot up. We are seeing that the world over. What I hope to do is bring on stream more and more domestic manufacturers of PPE, both to ensure that we get the quantity and to see whether we can stop the price rises happening.
Elderly constituents of mine in Wantage and Didcot have been concerned by media reports suggesting that they will be forced to stay in their homes for an extended period. Can my right hon. Friend confirm that that is in fact not the case and that, through all his work on testing and the tracking and tracing app, he is working to make sure that we can all return to a normal life as soon as possible?
I am grateful to my hon. Friend for his question. I would like to take this opportunity to set out the exact policy, which a few media outlets have got wrong in the past few days. We set out from the start, and clearly on the nhs.uk website, that broadly there are three groups of people when it comes to the strictures of the social distancing guidelines. There are people of working age who do not have underlying health conditions, who must follow the social distancing rules. There are those in groups that are, according to the science, more susceptible to this disease, including the over-70s and some with underlying health conditions, who we say are clinically vulnerable and must pay particular attention to the social distancing rules.
Then there is the group who are shielded. These are people with specific underlying health conditions who will have received a letter from the NHS. It is only to this last group that we have said, right from the start of social distancing, that they will need to stay away from people as much as is practically possible for 12 weeks. We know that that is a very significant impact and burden, hence we have written individually to those people; in many cases, they will have specific requirements because of their condition.
It is really important that people understand those three separate groups. I hope that that clears up for the House some of the confusion seen on the front pages of some of the newspapers.
The Sunday Times this week had an extremely moving piece by photographer Stuart Franklin, featuring NHS workers and patients fighting the coronavirus at West Middlesex hospital, which is based in my constituency. The article demonstrated very clearly the emotional impact of the virus on frontline health and care staff as well as patients and their families, and we all know that post-traumatic stress syndrome will be a growing issue for many throughout and after this, so will the Government invest in both immediate and long-term mental health treatment for all those affected, and will they take into account that many, particularly health and care workers, are often reluctant to seek help?
Yes. The hon. Lady makes an incredibly important point, and I agree with every word of the question. We are already investing in more support for the mental health of frontline workers, making sure that resources are available to all. Of course, at the moment there are other challenges to delivering that because of social distancing, but I commit to continuing and strengthening that over the long term. It is something that I have thought important throughout my time as Health Secretary; I pushed this agenda even before coronavirus, and now it is even more important, and I look forward to working with the hon. Lady on it.
Across Watford, as a volunteer, I have seen first-hand the many inspirational frontline workers, ranging from pharmacists to hospital volunteers to GP receptionists to cleaners. Can the Secretary of State confirm that everyone—everyone—on the frontline will have the full support of the Government, so that nobody who works on the frontline is missed out as we continue our incredibly important fight against coronavirus?
Yes, it is a big team effort and all play their part. People have different roles, of course, and people on the frontline have been incredibly flexible in the roles that they play, but all play a critical part and all deserve our support.
In order to test, trace and isolate, to keep people safe and save lives, testing must work properly and be widely and locally available, so I was astonished to hear that yesterday people in my constituency were being sent as far afield as Brighton when we have a testing site right here at the Rugby Football Union in Twickenham. Other key workers tested last week at Twickenham have had their tests lost and no one in the NHS can find them, and we are also hearing reports that people sent home testing kits have no return address to send their completed tests to, yet those tests are being counted. Will the Secretary of State please confirm how people are being prioritised for testing at their local sites, how many tests have been lost—both at drive-through sites and among those sent to people’s homes—and when he thinks we will be doing enough testing to actually move to test, trace and isolate to keep people safe, as so many other countries have been successfully doing for several weeks now?
We now have one of the largest testing capabilities in the world; we are testing more people per day than Germany, and the whole country should be reassured by that fact. Of course there are individual examples of where the logistics go wrong; that is natural in any very large system. I would be very interested if the hon. Lady could send me the details of those specifics, and then we will look into them. But what I would say is that the availability of testing across the board is now huge. It is big enough to start the test, trace and track programme. We are piloting that, as the hon. Lady knows, in the Isle of Wight from today and then we will roll it out across the country.
In an earlier answer, the Secretary of State kindly went through the definitions of all the different vulnerable groups. Definitions are really important, especially as we start to consider releasing the lockdown. When that point comes, will he be crystal clear about exactly who is entitled to do what and when and ensure that everyone in the public knows that?
Can the Secretary of State confirm that directors of public health and environmental health officers will not just be consulted but will be leading the delivery of community tracking and tracing efforts, given that that is what they have been trained to do? Can he reassure us that the Government will not repeat the mistakes they have made with drive-through testing centres and PPE supplies by outsourcing those critical tasks to private companies such as Serco, Sodexo and Deloitte, which, frankly, have proved that they are not up to the job?
I agree with the hon. Lady on the first part of her question, but she is completely wrong on the second part. In the first part, she asked whether local public health officers and environmental health officers will be a critical part of test, track and trace, and the answer is yes, they will be vital. On the second part, she is completely wrong. There is no way that we could have delivered the testing programme without the unbelievable support, help and effort of private partners in the diagnostics industry and in delivery—companies such as Deloitte and Boots, which delivered that amazing expansion of the drive-through centres in such a short period. I pay tribute, hand on heart, to the work of every single person in that programme, whether they work in the private sector or the public sector—whether they work in the NHS, in the Department, for Boots or for Deloitte. Frankly, to try to divide people in that way suggests that she has missed the tone of where the country is right now.
In order to get London back to work, we need safer public transport. Does my right hon. Friend agree that the Mayor of London needs to provide more tube trains, to provide a safer service for Londoners?
Yes, I do, because the more people are spaced out on public transport in terms of the distance between them, the safer that public transport will be. I hope that the Mayor of London is working extremely hard to have as full a service as possible, so that as few people as possible can be on each individual service.
Widespread testing and contact tracing will be essential to contain future outbreaks, and such a system will need to be operational before we move from full lockdown. In addition to the Isle of Wight trial, will the Secretary of State consider the work being undertaken by Ceredigion County Council, in collaboration with Hywel Dda University Health Board and Aberystwyth University, on a community testing and contact tracing system that could offer local solutions and expertise to complement any UK-wide infrastructure?
I am happy to look at any examples that are effective in reducing the spread of the virus. Of course, parts of this are devolved, and parts of it are the UK Government’s responsibility. We have made available all the tools that we are developing at a UK level for devolved Governments to pick up. For instance, we have published the underlying source code behind the apps, so that people can have a look at it and suggest improvements or take it and use it in their own way.
Many of my constituents with cancer understood when their treatment was deferred. They are now keen to resume it but nervous about going to hospital, in case they catch coronavirus. Can my right hon. Friend assure them that their treatments will resume and that it is safe for them to go to hospital?
Yes. I want cancer treatments to resume as soon as is safely possible. In some cases, it is clinically not advised to resume treatment because there is a spread of the virus in the community—for instance, treatments that reduce immunity to very low levels. There are other areas—for instance, some surgery—where we are able to restart. This is a very important part of the restart of the NHS. The message I would give to my hon. Friend’s constituents is: if you are advised by your doctor to go to hospital, you should go to hospital, because they will have taken into account all the different risks and decided that that is the best advice to give. So if you are asked to go to hospital by your clinician, please do go.
The Government chief scientific adviser said that if we could keep deaths below 20,000, we would have done well in this epidemic, yet the death toll now stands at a devastating 32,313. It is not about whether we can use international comparisons; this is the Government’s own measure, so many are wondering how the Government can claim that their approach so far is a success. Is that not an insult to every family member who has lost a loved one, and does it not undermine public confidence that the Government are learning from their mistakes?
We are absolutely learning from everything that has happened, and constantly looking again, trying to make sure from the time we get up in the morning to the time we go to bed at night that we have the best possible response. That includes, for example, working across parties where cross-party work can help, as we have on the test, track and trace pilot on the Isle of Wight. That is the approach that we constantly take. Of course we look at all the information and the data, but in that spirit the hon. Lady should acknowledge, I think, that the approach is a success: the curve is flattened and is now coming down, and—critically—the NHS was at no point overwhelmed. That was one of our priority goals right at the start, and it has been achieved at every point so far in this crisis. Of course there are always things we can improve, but I think we should also, rightly, study the things that have gone well.
Will my right hon. Friend confirm that, thanks to the magnificent response of the British people, including those in Stoke-on-Trent, we have prevented our NHS from being overwhelmed at any point during this crisis, so that it has been able to offer world-leading care to every single person who has needed it since the very first case?
Yes. This comes off the back of the previous question. Not more than a few weeks ago, many people were saying that we would not be able to get through this crisis without the NHS being overtopped and not having enough capacity to deal with the number of cases. Through a combination of the expansion of the NHS that we have overseen and the public doing their bit by following the social distancing rules, we have managed to avoid that outcome. Instead, at every point in the crisis, the NHS has been there to provide the care that is needed as much as it possibly can, as well as it possibly can, and it has not been overwhelmed. That is something that this country can always look back on.
My inbox has been packed for days with questions from over-70-year-olds saying that they simply do not understand what the Government advice is. Is it that none of them should ever, whatever their medical circumstances and however healthy they are, leave the house for 12 weeks? When did the 12 weeks begin and when will the 12 weeks end, or is there going to be another 12 weeks? Further to that, I asked the Secretary of State on 3 February whether face masks worked, and at that time he was very sceptical about them. In the future, will he be advising people that we should all be wearing face masks on public transport, and if so, where are we going to get them?
I reiterate the point I made in response to earlier questions. I hope that in his response to all his constituents, the hon. Gentleman will send a link to the NHS website, where the answer to his question was set out extremely clearly right from the start. It is very clear that there are three groups of people. Those who have received a letter from the NHS saying that they must shield for 12 weeks are in that category; those who have not are not. I know that some media reports have stated otherwise, but I implore people to follow the guidance clearly set out on the NHS website, which the hon. Gentleman and any other Member who has questions about that should send to their constituents to inform them. It is a matter of our public duty. It is not a matter of political debate.
What provision has my right hon. Friend made for the visually impaired during covid-19?
Getting new Government guidance to the visually impaired is of course a challenge. It is something we have been working hard on. In the first instance, the first port of call should be primary care—somebody’s GP or 111—if there are any queries. That is where I would point people in the first instance. It has been a challenge, because we have been making policy at speed, and writing and updating guidance at speed, but I would point those who are visually impaired to 111 and their GP if they have any questions.
The Trace Together app in Singapore has been down- loaded by 17% of its population since it was introduced in March. What estimate has the Secretary of State made of the numbers that will be required to download NHS app, and have there been discussions about making it compulsory if not enough people do so?
The more people who download the app the better it will be and the more effective it will be in keeping people safe. However, even small numbers downloading it will help us to spot hotspots and so will bring some value. I was really delighted yesterday afternoon to hear from Isle of Wight Radio, which stated that 80% of people on the Isle of Wight in an early survey said that they wanted to download the app. That would be a terrific result. I pay tribute to the work of Isle of Wight Radio and the local press on the Isle of Wight, who have taken to Isle of Wight’s important role in piloting this roll-out with enthusiasm. There is no numerical answer to the hon. Gentleman’s question. The answer is that as many as possible will make us as safe as possible.
I welcome the launch of the test, track and trace app, but one of the apparent challenges is that those who could benefit from it the most, namely the elderly, may be those who are least likely to be able to access it because they do not have a smart phone. What assessment has my right hon. Friend made of the probable lower take-up by that honourable cohort?
We have looked into this very important question. Of course, test, track and trace is a system. The app is one part of it, but the human contact traces are an important part of the system, as is the advice we give to people to contact their own significant contacts themselves. The whole system has been designed knowing that a proportion of the population does not have a smart phone. There are many older people who do have smart phones. I am sure, for instance, that the shadow Secretary of State is probably sending a message to his parents right now on the smart phone he is using instead of listening to my hon. Friend’s question. There is a serious point, which is that of course we have had to take that into account. It is another reason why the Isle of Wight is such a good place to trial it, because there are elderly residents on the Isle of Wight. We will work out and learn a lot from how effective that trial is.
It has become apparent that people from black, Asian and minority ethnic backgrounds are being disproportionately affected by covid-19. People in Erith and Thamesmead have also raised concerns about the disproportionate effects of covid-19 on disabled people, people from low social economic backgrounds, women and children. Does the Secretary of State have plans to publish a report on the effects of covid-19 on people who fall under one or more protected characteristics?
Yes, we have today launched a piece of work by Public Health England to look into the disparities in the impact of covid-19. However, I will just pick the hon. Lady up on a couple of points from her question. The evidence shows quite clearly that the impact of covid-19 is lesser on children and lesser on women than it is on men. There is also growing evidence that obesity has a big impact. We have to look into all those considerations. We will listen to the scientists and the medics, and learn whatever lessons we can.
I thank my right hon. Friend for his answers and congratulate him and all the hardworking staff in the NHS and carers on looking after us. Will he support my campaign to have a memorial placed at the National Arboretum at the heart of the country as a fitting way to commemorate the sad loss of essential workers to covid-19?
Yes, I would be very happy to discuss that suggestion with my hon. Friend. It is important that, as a nation, we remember and commemorate the sacrifice of those who have lost their lives while serving on the frontline of this war; it is a war in which we are all on the same side, and we should commemorate those who have given their lives in it.
The seven-day average number of new cases in the UK has now levelled out at 4,500, but it is not yet decreasing significantly. Can the Health Secretary tell us what the number of new daily cases must fall to before he believes that test, track and trace can prevent another peak if restrictions are eased?
One of the five tests that we have set out before the restrictions are eased is that the number of deaths should be falling consistently. Indeed, the Scottish Government’s document includes a similar proposal, and we are working to ensure that the UK is as aligned as possible.
Does the Secretary of State agree with you, Mr Speaker, that changes to lockdown should be announced to Parliament first? He said earlier that transparency is the lodestar of Government policy. If that is correct, will he now release the findings of Exercise Cygnus and prove that that was not just a gesture, but is actually the real policy of the Government?
Exercise Cygnus was undertaken under my predecessor, and there are specific rules in Government around decisions over papers that were produced before one’s time. I will take away that point.
There is some evidence that under-10s are at much lower risk of getting and transmitting the virus. If true, this would be a huge comfort, both to teachers and working parents. What evidence has the Secretary of State seen to that effect, and what work is being done to further explore this?
There is strong evidence that the under-10s are less likely to have symptoms of coronavirus, but unfortunately the evidence on the under-10s’ transmission of coronavirus is mixed and there is not a conclusive scientific base on that yet.
Is the Secretary of State content that the advice and guidance given to pregnant women working on the front- line of health and social care, on both safety and income, are sufficiently clear and consistent?
I congratulate my right hon. Friend on the fruits of his tireless work, along with officials and others in the Government, including delivering mobile testing in Wycombe, but could he please tell us a little bit more about what he is doing to restore the full range and scale of elective surgery in the NHS, so that people with non-covid conditions can get their treatment back on track?
That is a really important point. It is critical, because the overall impact of coronavirus is not just the direct morbidity—the number of people who sadly die from coronavirus itself; there is also the wider impact, including those whose treatment has been delayed owing to the necessity of ensuring that the NHS was ready to cope with coronavirus, or because, for clinical reasons, it was important to delay the treatment because there is such a virulent virus at large. We are working very hard to restore treatments for non-covid reasons. That work has started. I was able to announce last week, for instance, that fertility treatment has restarted and cancer treatment is restarting, and other elective surgeries will restart as soon as it is safe to do so.
I am in Orkney, where I have been receiving reports from category 2 key workers who have self-referred for a covid test through the gov.uk website and been directed to testing centres in Thurso, Elgin or even Peterhead, all of which would require a journey by ferry or plane. There is local provision and the option of postal testing, so will we get the website sorted, to allow people to get the information they need, rather than be left thinking that in order to get a test they first need to get a plane or a ferry?
I am glad that we sorted the broad- band to Orkney, so that we could take the question. It is an important question and I will look into the specifics of it to make sure that our island communities get the appropriate response on the website. The right hon. Gentleman will appreciate that we put the testing website together at remarkable pace and so in the first iteration we were not able to address this sort of important nuance for Orkney and other island communities, but I will take that away and look at it. He mentioned the answer in substance—to get the home testing kits working for Orkney—and I am sure that there is a way through.
The Royal Surrey County Hospital in Guildford, under excellent leadership and in partnership with our community, has proved to be resourceful and innovative, ensuring best practice on patient care, safety for staff and the ability to continue treatment for patients presenting with non-covid-19 needs—feedback from those patients has been very positive. Will my right hon. Friend join me in paying tribute to our NHS leaders and once again encourage those who need hospital appointments and urgent care to attend? Finally, will he give assurances that hospitals such as my local one, which are world-leading in cancer treatment, will be given the investment they need to ramp up diagnostics going forward?
Yes, absolutely. I think we have all learned the importance of diagnostics during this crisis, if we did not know it already. I pay tribute to the Royal Surrey County Hospital, its leadership and the staff there, who have done such a magnificent job, including treating friends of mine for coronavirus. If anybody in Surrey gets a message from their doctor saying that they need to go to hospital, they must go. That is important right across the country—in Guildford and beyond.
We still need to increase significantly the number of people being tested so that we can tackle the crisis. Companies such as Curative are supplying tens of thousands of saliva-only tests to the US military, but have faced road blocks in trying to supply in the UK. What is the Secretary of State going to do differently to improve the procurement of tests, so that companies that want to help can do so?
We are working with many, many companies on the expansion of testing, including new technologies. We have to be confident that the technologies are effective and work, because a test that gives a wrong result, and has too high a proportion of wrong results, can be worse than not having a test at all. I am not saying that that is the case in the specific individual example the hon. Gentleman gives—we are working with many companies on how the next generation of tests can be brought to bear—but it is important that we get this right as we ramp up testing. There is clearly a pressure to increase testing. Lyndon Johnson once said, “Politics is about ‘What have you done for me recently?’” It was only last Thursday that we hit the 100,000 target. I do not mind being urged to do yet more, but we have to do it using the right tests, in the right way.
What prospect is there of moving to robust, multi-use personal protection equipment that can stand being decontaminated many times?
My right hon. Friend, who probably has the most spectacular backdrop to any questioner in this session, is right to raise that issue. It is happening: the right personal protection equipment that can safely be decontaminated and reused is being decontaminated and reused. That is an important part of the solution to the challenge of getting the right PPE to the right people, right across the board. It does not work in all instances and first and foremost it has to be safe, but it is a part of the solution and my right hon. Friend is right to raise it.
The British Medical Association, the Faculty of Public Health and the Royal College of Physicians have all advised the Government to suspend the fees for migrants accessing the NHS during the coronavirus pandemic, to ensure universal access to healthcare. We know that the charging regulations disproportionately affect black and minority ethnic people; given the impact of covid-19 on the wider BME community, will the Secretary of State now suspend the charging regulations?
The regulations are important because it is important that people make a fair contribution. The question has been raised in relation to staff in the NHS, and in many cases in that respect the NHS trusts themselves pay the extra, which is a contribution towards the running of the NHS. That is the approach we are taking.
The Secretary of State is aware of my concerns about the discharge from hospital into care homes of patients with covid symptoms. Can he reassure the House that there will not be such discharges—that covid-positive patients will not be discharged into covid-free care homes because of the risks that they might spread the infection to other residents?
My right hon. Friend and I have been in discussions about this important issue. We have strengthened the rules on discharges to ensure that anybody being discharged from hospital into a care home gets tested and is then isolated ahead of the result of that test. If the test is negative, they can of course go into the home in the normal way; if the test is positive, that isolation must continue until they are through the virus and safe to go into the care home without taking coronavirus into the care home. I am glad to see in the latest numbers that the number of those who are dying from coronavirus in care homes is just starting to fall, but there is an awful lot more that we still need to do.
The Secretary of State said earlier that the tracing app would have privacy by design. It will be critical that there is a high degree of public confidence in the app if it is to work as he intends as part of efforts to trace the virus. What data protection will be put into place to ensure that the public are confident that this tool will be secure and that data cannot be misused?
The public can have confidence, not least because the data will be held on people’s own phone until they need to contact the NHS when, naturally, they will of course need to tell the NHS their identity in order to be tested. In that sense, privacy is there by design.
The wider point is that the app and the test, track and trace system will help to keep people safe. As I said yesterday when I launched the pilot in the Isle of Wight, people should download the app to protect the NHS and save lives. It is the civic duty of people on the Isle of Wight to do so, and it will be the civic duty of people throughout the country to do so. It has been designed with privacy at its heart. We are putting the source code on the internet so that people can see exactly what the app does. That reassurance, along with the motivation that they are helping to protect themselves and their community, will, I hope, lead to an awful lot of people downloading the app. I certainly will.
Mr Speaker, further to your opening remarks at the beginning of this urgent question about new policy being announced by Government in the House and not to the media first, the Secretary of State side-stepped the question when it was put to him by my hon. Friend the Member for Christchurch (Sir Christopher Chope), so I will try again. Does my right hon. Friend agree with Mr Speaker that statements of new Government policy should be made in this House first, and will he advise the Government to put off making the statement on Sunday until Monday and make a statement in the House?
The exact scheduling of any announcement is, of course, a matter that has to be considered across Government, but I will take away my hon. Friend’s concerns and ensure that they are looked into.
In better times, tens of thousands of people cross the land border in Ireland every day and, more generally, the UK and Ireland are committed to the common travel area. With regard to contact tracing apps, does the Secretary of State recognise the difficulties that will arise if the UK, including Northern Ireland, and Ireland use different systems, and will he undertake to work with the Irish Government to address any such operational issues?
We have considered all the different potential apps being used by different countries around the world. I am confident that any such concerns about international travel can easily be addressed, not least by the potential of someone having two different apps on their phone if they need to travel internationally.
My right hon. Friend has proved himself to be a brilliant multi-tasker, so will he kindly turn some of his attention to a firm in my constituency that has access to a network of manufacturers in southern China that believes it can supply a million items of gowns, visors, masks and other PPE equipment per week if only someone from Government would get in touch? I am very happy to text him the details directly, but I have been trying for three weeks and still Government have not got in touch with this firm.
Yes, of course; if I get the details, I am very happy to do that. I would also be very happy to know where my right hon. Friend had his hair cut, because it is extraordinary. No one else has such smart hair. Everyone is looking increasingly bushy.
Dozens of dentists have got in touch with me, saying that the measures put in place are not protecting them and their practices. They take on a combination of private and NHS patients. Many are fearing bankruptcy and, ultimately, closure. This will leave NHS dentistry in an existential crisis. What steps is the Secretary of State taking to ensure that NHS dentistry survives the current crisis?
This is an incredibly important question. My hon. Friend the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), who is responsible for dentistry, is working very hard with the British Dental Association and others to make sure that dentists get the support that they need.
Further to that question on dentistry, I have spoken to local dentists in my area and a number feel that they have the correct PPE and working conditions to be able to provide the sort of emergency dental care that many of their patients need. Can my right hon. Friend outline how we can move forward with dental practices in the same way as he has worked so hard in moving forward with the work that hospitals are able to do now, for which I would like to reiterate my thanks?
This is a really important point. I will write to my right hon. Friend with the proposed plans for reopening dentistry. Obviously, that has to be done in a safe way, and PPE is one important consideration. Dentistry by its nature requires close contact, and it can be an aerosol-generating procedure in certain circumstances, which makes it a higher risk to the dental practitioner—the dentist or nurse—and, in turn, to future patients, so we have to get this right. Emergency dentistry is available in dentistry hubs, which have been set up during the crisis. It is important to get this right, but it is also important to get dentistry back on its feet.
Thank you, Mr Speaker, and well done getting so far through the call list.
Progress notwithstanding, we are very much not out of the woods yet. Worryingly, the head of the European Centre for Disease Prevention and Control has confirmed that the UK is among five European countries not making substantial progress on cutting the overall rate of infections. Is the Secretary of State concerned by that analysis? Can he reassure the House that we will take account of the European centre’s data in any calculation about resuming normal activities and easing lockdown?
I have not seen the particular report that the hon. Gentleman refers to, but we take into account all data and considerations in making the decisions that we do.
I have a local care home that, thankfully, is free from covid-19 at the moment. The manager there is trying to get all his staff tested, just to check that they are free from covid-19 too. Not all those staff have a car, so they are not able to travel the miles to the local mobile testing facility. Can the Secretary of State tell me the best way for that manager to get his staff tested so that they can continue to look after all their vulnerable residents in a safe way?
Yes, we are rolling out testing to all care home residents and staff, symptomatic or asymptomatic, for elderly care homes. I announced that at the start of this urgent question. It is an important expansion of our testing now that we have built up the 100,000 tests a day capability. We will do that in part through mobile testing units, which are delivered by the armed forces; the testing unit goes to the care home, and staff and residents alike can be tested at the care home rather than having to travel. Clearly, whether people have a car of their own or not, when we test a whole care home, taking the testing to the care home rather than having to take everybody from the care home to a drive-through centre is a much better way of doing it.
I am very grateful to the armed forces for the part they have played in making this capability available. Our armed forces have done an amazing job in this whole crisis. Right across the board, the armed forces have stepped up where we have needed them. They have played a critical part in testing capability; we would not have got to 100,000 tests a day without them. The example that my hon. Friend rightly raises is just one of the ways our armed forces are playing their part and doing their duty in this crisis.
I am grateful, Mr Speaker. The Health Secretary told me that he would make public the evidence behind the Government’s repeatedly confirmed decision, in contrast with other countries, not to ask people arriving at our ports and airports to self-isolate. However, that evidence was not included in the Scientific Advisory Group for Emergencies papers published today, even though the papers say we were affected by many cases arriving or coming back from Italy and Spain. Surely, we need to see the evidence and scrutinise it in order to get border policy right. Why has it been withheld?
(4 years, 3 months ago)
Written StatementsYesterday we launched the NHS covid-19 app (“the app”) for initial roll-out on the Isle of Wight over the next two weeks.
This is the first phase in the development and roll-out of a national “test and trace” programme which will bring together the app, expanded web and phone-based contact tracing, and swab testing for those with potential covid-19 symptoms. This is a vital part of our plans as we move towards the second phase in our battle against covid-19.
The app has been built by a team including world-leading doctors, scientists and tech experts. If someone installs the app, it will start logging the distance between their phone and other phones nearby that also have the app installed. If a person becomes unwell with symptoms of covid-19, they can report this through the app, which will then anonymously alert other app users that they have come into significant contact with over the previous few days and provide appropriate advice. The app, which takes full consideration of privacy and security, has already been tested in closed conditions at an RAF base.
This initial roll-out will provide valuable insights into how the public respond to and use the app and how we can improve it further. There will be no changes to social distancing measures during this initial roll-out phase.
Using the app is voluntary but the more residents who download the app, the more informed our national response will be. The Isle of Wight is leading the way for the UK, for which we thank them.
The more rapidly we can identify people at risk of infection and provide them with advice on what action they should take, the more effectively we can reduce the spread of the virus. The test and trace programme will play an increasingly important part in our wider strategy to save lives and protect the health and care system.
Further details of the national roll-out will be available soon.
[HCWS222]
(4 years, 4 months ago)
Written StatementsOn 26 March 2020, the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 came into force, detailing regulations on social distancing and business and venues closures. These regulations set out that a review of these regulations must take place every 21 days to ensure they are both necessary and proportionate. The Government completed the first review as required on 16 April 2020.
In this review it was agreed that no change would be made to the existing restrictions and that they would remain in place for at least three more weeks. Recognising the potential for harm to public health and the economy if measures were relaxed too soon, it was agreed that five conditions would need to be met before the measures are eased. These conditions are:
1) Evidence that NHS critical care capacity across the UK will not be breached;
2) there is a sustained and consistent fall in the daily death rate;
3) infection rates decrease to an acceptable level;
4) supplies of PPE and testing meets future demand;
5) clear evidence that changes won’t risk a second peak in the virus.
However, a small number of minor amendments are required to clarify the regulations and ease the operation of the regulations. They relate to enforcement of the measures, and businesses and venues affected.
Publicly available Government guidance on: www.gov.uk is being updated to ensure it fully corresponds with the amended regulations. These are strict measures, but they are measures that we must take in order to protect our NHS and to save lives.
[HCWS206]
(4 years, 4 months ago)
Commons ChamberWith permission, Mr Speaker, I would like to make a statement on coronavirus.
First, may I say how pleased I am that the House is sitting once again? At this important time, it is critical that we have the scrutiny and debate that the House provides. I thank everybody who was involved in setting up the new arrangements, which demonstrate that no virus or threat will thwart our democracy.
Coronavirus continues to spread throughout the world. The latest figures show that 17,337 people have sadly died here. Our hearts—the hearts of the whole House—go out to their loved ones. I know that across the House we are united in our determination to fight this virus with everything we’ve got; today I want to update the House on each part of our battle plan.
First, on the resilience of the NHS, I can tell the House that for the first time we now have over 3,000 spare critical care beds in the NHS. That is more than three times more than we had at the start of this crisis. It is thanks to the incredible work of an awful lot of people that we now have this extra spare capacity, even before we include the new Nightingale hospitals. Over the past two weeks, I have been lucky enough to attend, either in person or virtually, the opening of four of these new Nightingales—in London, Manchester, Birmingham and Harrogate—and there are several more to come, all across the UK, including in Belfast, Glasgow, Cardiff, Exeter and Sunderland. These incredible efforts from dedicated staff, supported by our armed forces, mean that our NHS has not at any point been overwhelmed by coronavirus. Some said this would be impossible.
Today I want to reinforce the message that non-covid NHS services are open for patients: the NHS is there for you if you need advice and treatment. I want to address that message very clearly to those who might be vulnerable to heart attacks or stroke, to parents of young children, to pregnant women and to people with concerns that they may have cancer. I want to emphasise that people with non-coronavirus symptoms must still contact their GP. If you think you need medical help, please contact your GP, either online or by phone, to be assessed. If you need urgent medical advice, use NHS 111 online; if you cannot get online, call 111. And, of course, if something is serious or life-threatening, call 999. If you are told to go to hospital, the place you need to be is in hospital. The NHS is there for you and can provide the very best care if you need it.
The second part of our battle plan is on supply and working to boost supplies of core equipment. The full weight of the Government is behind this effort. Again, we have brought in the armed forces to help us to meet this demand. This includes ventilators—both purchasing extra stock and increasing the production of new ones. We now have record numbers of ventilators, with 10,700 available for use for patients. This also includes medicines, so that we can make sure everyone has access to the supplies and treatments they need, and of course it includes personal protective equipment, too. In normal times, the NHS PPE supply chain supplies 233 hospital trusts. Currently, 58,000 separate health and social care settings are being supplied with PPE, so we are creating a whole new logistics network from scratch, and we have some of the best minds in the country working on this.
I am grateful to colleagues from the NHS, Public Health England, the Crown Commercial Service, the Cabinet Office, the Ministry of Housing, Communities and Local Government, the Ministry of Defence, the armed forces—again—the devolved Administrations, territorial offices, the Department for Business, Energy and Industrial Strategy, the Treasury, the Foreign Office and the Department for International Trade, because they are all playing their part. Last week, I appointed Lord Deighton, who delivered the Olympics, to a new role in driving forward PPE manufacturing here.
Since the start of this crisis, we have delivered over 1 billion items of PPE. We are constantly working to improve the delivery system and buying PPE from around the world. We are also working to make more at home, and I would like to thank the UK businesses that have generously come forward with offers to turn their production lines to this national effort. I also thank Members from across the House who have put us in contact with businesses in their constituencies. We are actively engaged with over 1,000 companies who buy from abroad and are working with 159 potential UK manufacturers. We have a rigorous system of verifying the offers that we receive, because not all offers have been credible and it is important to focus on the biggest, most credible offers first. This work is crucial so we can get our NHS and care staff the kit they need so that they can do their job safely and with confidence.
The third part is to scale up testing. I have set the goal of 100,000 tests a day by the end of this month, and I am delighted to say that the expansion of capacity is ahead of plans, even though demand has thus far been lower than expected. We are therefore ramping up the availability of this testing, expanding who is eligible for testing and making it easier to access the tests. The tests are conducted in NHS hospitals, and through our drive-through centres, mobile units and home deliveries. These tests are then sent to laboratories. We have completed the construction of three Lighthouse Labs in Milton Keynes, Glasgow and Cheshire. Each site took just three weeks to complete and begin testing.
As we have reached the peak and as we bring the number of new cases down, we will introduce contact tracing at large scale. The introduction of the new NHS app for contact tracing is also in development. As we do this, we are working closely with some of the best digital and technological brains, and renowned experts in clinical safety and digital ethics, so that we can get all this right. The more people who sign up for the new app when it goes live, the better informed our response will be and the better we can therefore protect the NHS.
Fourthly, we need to make sure that we make the best possible use of science and research to pursue the vaccines and treatments that are essential to defeat the virus once and for all. Here, the UK is at the forefront of the global effort. We have put more money into the global efforts to search for a vaccine than any other country, and yesterday I announced over £40 million of funding for the two most promising UK projects—at Imperial and Oxford. The vaccine from the Oxford project will be trialled in people from tomorrow, and I am sure that the whole House agrees that that is a very promising development. I repeat what I said yesterday: in normal times, reaching this stage would take years. The innovative groups of people at both the Jenner Institute in Oxford and the regulator, the Medicines and Healthcare Products Regulatory Agency, deserve our special praise. They are ensuring that the process is safe, yet conducted probably more rapidly than ever before. They deserve the support of the whole House in that work. At the same time, we will invest in manufacturing capability. If either of those vaccines works, we must be able to make them available for the British people as soon as humanly possible.
The fifth measure that I will talk about in the time available is the one in which everyone can play their part: social distancing. I want to thank everyone across the country for their steadfast commitment in following the rules, including in this House. It is making a difference. We are at the peak. But before we relax or make changes to any social distancing rules, we have set out five tests that need to be met: first, that the NHS can continue to cope; secondly, that the operational challenges have been met; thirdly, that the daily death rate falls sustainably and consistently; fourthly, that the rate of infection is decreasing; and fifthly, and most importantly, that there is no risk of a second peak.
Finally, we are working to protect the most vulnerable through shielding—this is the sixth part of our battle plan. There has been a huge effort across Government to contact and support those at risk. We have been boosted by the support and help of the heroic NHS volunteer responders, who signed up in droves within two days of our call to action. An unbelievable 750,000 people put themselves forward for this initiative. With those volunteers, and with the support of the Ministry of Housing, Communities and Local Government, the NHS and local councils, which have done amazing work on this, we are shielding the most vulnerable.
These are unprecedented times for us all. We have all seen the extraordinary impact of coronavirus in our constituencies and across the country. And even though today we are physically separated, the House is at its best when we are united in our purpose and our resolve. I will keep working with Members from right across the House in the fight against this invisible killer. This may be akin to a war, but it is one where the whole of humanity is on the same side. I commend this statement to the House.
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.
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.
I hope we can speed up the answers a little. I think that answer was twice as long as the question. I know you want to make sure you are thorough, Secretary of State, but we have quite a few questions to get through.
I now call the Chair of the Health and Social Care Committee, Jeremy Hunt.
The World Health Organisation says that one of the six essential criteria for lifting a lockdown is that we should be able to track and trace every single new covid case in the community. Will that be place in the next two weeks, so that when the Cabinet come to consider whether they can lift the lockdown, they will be able to do so in a way that is compliant with what the WHO is recommending? Will the Secretary of State appoint a big hitter from outside frontline politics to make sure that happens within a short period, as he has very sensibly done with Lord Deighton on PPE?
We are ramping up our testing capacity and our capacity for contact tracing in a matter of weeks. We will have it ready to ensure that we can use that capacity as and when the incidence of transmission comes down. It is not tied to the specific decision that we are required by law to take in just over two weeks’ time. The effectiveness of test, track and trace to keep the reproductive rate of the virus down is determined by the incidence in the community, and our goal is to get to a point where we can test, track and trace everybody who needs it.
Like all MPs, I pay tribute to health and care staff across the UK. Particularly in view of the key role of care workers and in recognition of their contribution, will the Secretary of State undertake to ensure that they are paid at least the real living wage, as has been the case for some years in Scotland?
Like everyone, I welcome the stabilisation of covid cases, but does the Secretary of State accept that the testing and contact tracing must be in place before any easing of the lockdown, to avoid resurgence and a second peak? Will he achieve 100,000 tests a day by next week? If not, when? How accurate are the tests? A 25% false negative rate has been reported.
I know the Secretary of State is a fan of phone apps, so I am glad to hear him recognise the need to increase public health staff both to conduct and co-ordinate contact tracing. Will he reverse the 20% cut in public health funding in England since 2015, to ensure that those staff can be recruited now?
Finally, when I raised the issue of asymptomatic spread on 11 March, the Secretary of State claimed that it was rare, but actually it accounts for about 50%. How is he taking that into account in his covid strategy?
The hon. Lady asks a number of questions. First, on the living wage, all health and social care staff in the UK are paid the living wage, because that is the law. I am very proud that we introduced the living wage, which has led to a significant rise in pay, especially for people in social care who were on the minimum wage previously. She asks about asymptomatic transmission. The scientific evidence shows that asymptomatic transmissions occurs, which is one of the very significant challenges that this virus presents. She also asked about test, track and trace. I absolutely agree that that is a critical part of keeping the spread of this virus low. The lower the number of new cases is, the more effective test, track and trace is. We are therefore building now the capacity for the very large-scale contract tracing necessary to go alongside the large-scale testing—the 100,000 tests at the end of this month that I mentioned in my statement—and the technology that can help us to do that.
It is important that decisions should be informed by good advice, so has SAGE advised on whether the 100,000 tests a day target is the right one?
The target was set at 100,000 because that is what we estimated was needed—scientific advice was provided into that target—and it is what is practically achievable. As I said, we are ahead of our trajectory on capacity, but we need to make sure that demand increases. Increasing demand is about widening access to this testing. We did take scientific advice. I am not sure whether that came directly through the SAGE route or directly from Public Health England, but of course these decisions are based on the science.
First, I want to pay tribute briefly to all those health workers, care workers, delivery workers, street cleaners and cleaners, and so many other groups all over the country, who are doing such an incredible job, together with all the volunteers, to deal with this crisis. It is an amazing moment in this country’s history. However, Parliament’s job is to hold the Government to account, so I have a simple question. The World Health Organisation indicated that there was a danger of an epidemic from coronavirus in January—it later declared this to be a pandemic. The WHO’s director general said, in terms, that the way to deal with it is by “test, test , test”, in order to ascertain the levels of infection across our society, but we did not do that. The Secretary of State came to the House in January to say that he was going to increase the amount of testing. This issue was raised with the Prime Minister on 24 February and again in a meeting we had in March, at which the Secretary of State was present. He told us then that the level of testing would increase, but it is still nowhere near the level that is necessary. Can he assure us that there is going to be a really rapid increase in the level and availability of testing, in order to get on top of this dreadful virus?
The development of testing has been at pace throughout this crisis, entirely contrary to the story told by the right hon. Gentleman. We were one of the first countries in the world to develop a test. We rapidly increased the number of tests, from 2,000 at the start of March to 10,000 during March—a fivefold increase—and it is now going up further. This is an area where we had our foot on the gas all the way through, because it is incredibly important.
I am grateful to the Secretary of State for his statement. Would he kindly update the House on the provision of a new covid testing site in north Wales and on the UK Government’s role in delivering it, in the context of devolution?
Testing is an area with UK and devolved responsibilities. The drive-through testing sites are being provided right across the UK under a programme being driven by the UK Government with the support of the devolved authorities. It is incredibly important that we make testing available in north Wales, as it is right across the country, so that people can access those tests, as my hon. Friend said. I should also mention the home testing, which will be available through the post. Especially in more rural areas, such as his constituency, that might be one of the most effective ways of people accessing testing.
It seems increasingly likely that part of what will be required to tackle this virus in the future will be the wearing of masks by members of the public in certain situations. If the Government concludes, based on the scientific advice, that that should be recommended, will it be their policy to provide masks to the public, and if so what is the Secretary of State’s plan to source them, bearing in mind the difficulties with PPE supply? Or will members of the public be expected to source their own?
We will follow the advice and listen to what SAGE says on masks, and then we will implement that. I cannot promise that we will give everybody free masks. That would be an extraordinary undertaking. We have to make sure we have the supplies available, especially for health and care staff, where the scientific advice throughout has been that the wearing of masks is necessary. We have to ensure the provision for them.
I start by paying tribute to the excellent staff at Epsom Hospital for all the work they are doing tackling this dreadful disease. I absolutely agree with the Secretary of State that it should be business as close to usual as possible across the NHS, but of course there are many people working in our healthcare arena—dentists, physiotherapists, and others—for whom it is very much not business as usual. Will he do everything he can, together with other Ministers, to support those people, particularly to get them back working as soon as possible?
Yes, absolutely. It is incredibly important that we support NHS staff to get back to work as much as possible if they are in an area where demand has fallen because people have not been coming forward in the numbers that normally do—for instance, for emergency admission—or in a specialism where work cannot be undertaken because of the prevalence of the virus. My right hon. Friend makes an incredibly important point, and I can give him that assurance.
At present, only patients actually admitted to hospital with symptoms are being swabbed, leaving many with presumed covid being discharged into the community. At the same time, only healthcare workers currently with symptoms are being offered tests. Should not the main priority now be to test all patients and all health and social care workers, whether symptomatic or not, given that after a month of lockdown, hospitals and care homes are likely to be the major transmission hotspots?
We are testing all those who leave hospital for a care home setting, to make sure we control the spread of the disease and stop it moving from that group as much as possible. On the broader points about expansion, absolutely we are looking at these things. The hon. Lady makes some good points.
The Secretary of State is rightly making sure that all patients being discharged from hospital to care homes are being tested, but there remains concern in the care home sector about normal procedures and assessments to make sure that patients or new residents coming to them are appropriate for the care setting, given the emergency admissions that always take place. Before Easter, he kindly agreed to look at whether care homes could be indemnified or have some waiver of liability in these circumstances. I wonder whether he has reached a conclusion.
We are looking into that question and I will write to my hon. Friend as soon as we have an answer.
On contact tracing, I welcome the fact that the Secretary of State is working with experts in digital ethics because if it is not run transparently by a public company with code open to public oversight and data anonymised, people will not trust the system and it risks failing. Does he agree that only a community-led process of human contact tracing can provide the fine-grained and reliable data that such an app would depend on? Will he learn the lesson from the over-centralised organisation of the testing approach and instead adopt a more decentralised approach for contact tracing, using local environmental health officers and PHE’s regional outbreak management teams?
I agree with the first two points, including the importance of people for contact tracing as well as technology—in fact, the two working hand in hand will be the most effective approach. I also agree with the need for ethicists on this. We are all giving up a huge amount of our liberty because of social distancing, so measures to reduce social distancing through the use of data need to be considered in that context. We are making sure that that is done in a way that can provide assurance to people with concerns in that area.
On the final point, we have to make the appropriate use of both national and local resources. In testing, for instance, organising drive-through centres across the country and home testing is inevitably an issue that needs to be done centrally, and then other testing laboratories are organised locally. It is about getting the best of both worlds.
The Secretary of State has talked today about the test, track and trace strategy, and he has indicated that the effectiveness is determined by the incidence in the community. Can he give us guidance on what the incidence level is and when, based on current modelling, we might achieve it?
The current level of incidence is unknown until we expand testing yet further, but it is far higher than where it needs to be. Although, as I have said, we have high confidence that we are at a peak in this disease, obviously we need to see that come down. The reason I am not giving a numerical answer is because it is a question of degree. The fewer new cases, the more effective test, track and trace are as a way of keeping the disease down, and therefore the more social distancing measures can be lifted. This is all a question of degree, and we do not have an answer to the question of when that will all be doable, because we have not yet seen the curve start to come down and we do not know the pace at which the curve will come down under the current social distancing rules.
I have known the Secretary of State ever since he came into Parliament. I know he has been unwell, but he would expect me to be robust in my question. As the Member of Parliament for Huddersfield and from the Yorkshire point of view, I think the management and leadership of the present crisis has been shambolic. We should never have been in a position where we lag so far behind Germany, a similar country to ours, and behind many of the other European nations. We are predicted to be the worst. Eight hundred and twenty-three people died—that is like two jumbo jets crashing. It is a large number. Every time the Secretary of State speaks, he thinks what he is doing is a triumph, but it is a shambles of leadership and management, and we are letting down NHS staff. They have been let down, and I am particularly angry about the fact that—as I understand—the early whistleblowers were leaned on and threatened with disciplinary action to stop brave young doctors and nurses standing up and telling us what it was like on the frontline. Is that the fact? Can he get his act together, because many of us do not believe that he is telling the truth to the people of this country—
The hon. Gentleman has completely missed the tone and the point of what we are trying to do, as a nation, to pull together in this time of grave difficulty. It is absolutely the case that our prime goals at the start of this crisis—our two objectives to flatten the curve and to make sure that the NHS always has the capacity to treat everybody who needs it—have thus far been met. Of course there are challenges. There are enormous challenges—distributing 1 billion pieces of PPE is not straightforward.
On the hon. Gentleman’s point about whistleblowers, he is completely wrong to say that it is not possible to raise an issue in the NHS; by contrast, thousands of people do it in public and private every single day. It saddens me that a Member of this House might get the tone wrong so badly. There are reasonable questions to be asked and we try to answer them in a reasonable way. That is the best way for the House to proceed.
May I put on record my personal thanks to the Secretary of State for his remarkable personal efforts over the past few weeks? He is doing a terrific job in unprecedented circumstances. I welcome what he said earlier about non-covid-19 treatment. Will he set out, as soon as possible, a clear plan to enable elective surgery to take place again in hospitals that have capacity, so that we do not build up a nasty backlog of unmet health need?
Yes; that is an incredibly important issue. We want to get non-covid-19 treatment back up and running as quickly as is safely possible. We are of course putting in place the arrangements to make sure that when people do go into hospital without covid-19, they are not infected by people who are in hospital with covid-19—that segregation is a very important part of our considerations. The answer to my hon. Friend’s question is that yes, within very short order we will start to restart the NHS. He asked about elective operations, which are an important part of the matter, but so too is people presenting themselves. It is important to give people the confidence to call their GP if they have a problem or, if it is urgent, call 111, because with cancer, for instance, we know that early diagnosis is critical, and I want people who think they have a risk to come forward for treatment.
In the statement today, and before the Health and Social Care Committee last week, the Secretary of State has implored cancer patients to come forward and assured them of treatment, yet since that Committee meeting I have been inundated with messages from all over the country from desperate patients whose treatment has been stopped, interrupted or not even started because of covid-19. What is the Secretary of State doing to ensure that there is no gap between his welcome words and what is actually happening? Can he guarantee that treatment will go ahead and give patients confidence that we have covid-free hospitals through the frequent and widespread testing of staff? Finally, will he ensure that death in service benefits will be paid for all healthcare workers who have died of covid-19, both now and retrospectively?
I would like to be absolutely clear—as I was at the Health and Social Care Committee meeting, which was a very good discussion—on the point about cancer treatment. There is some cancer treatment that it is clinically inadvisable to undertake during an epidemic like this, because if somebody’s immune system is taken down to very low levels, that puts them at significant risk, so I cannot give the guarantee that all cancer treatment would go ahead. Even though we now have capacity in the NHS and confidence that that capacity will not be over-capped by the virus, the virus is still at large in the community, so there are some cancer treatments, especially in relation to immunotherapy, that it is clinically inadvisable to undertake now.
Having said all that, yes, we do want people to come forward, and we want as much cancer treatment as possible to go ahead, where it is safe to do so considering the impact of the virus. That is why I want people to come forward if they have a risk, and we will treat them as best as we possibly can within the constraints of the fact that we have a very serious virus stalking the land.
Frontline workers such as those in ITU and care homes are used to death—that is part of the job—but not on this scale and not in these circumstances. What are the Secretary of State and his Department doing to support the mental health of frontline workers now and in the future, when the pandemic passes?
That is an incredibly important question. We have put in place a helpline for all frontline workers in the NHS to ensure that they have the support they need. Working with my hon. Friend and others, I will make sure that that support stays in place long after this crisis is over.
Will the Secretary of State join me in welcoming the extraordinary effort by all those involved in getting NHS Louisa Jordan in Glasgow ready to receive patients, if needed? Will he outline what discussions he has had with his Scottish Government counterpart about the different operating model of NHS Louisa Jordan from NHS Nightingale in London? Will he outline what steps he is taking to address the long-term nursing shortages in England, especially given the flight of nurses from the European Union that reports suggest is impacting on the operation of NHS Nightingale?
I am terribly sorry, I do not recognise those reports at all. There is no impact at all from Brexit on our coronavirus response. The good news is that thousands of nurses and other clinicians have come back into service since the crisis started.
Daniel Falush, a professor of infectious diseases based in Shanghai, points to the fact that part of China’s successful efforts to control the virus was immediate quarantining: people go to a clinic, they are tested immediately, they wait for the results—it is a 15-minute test—and, if the test is positive, they are quarantined there and then. Will the Health Secretary consider that as we open up our economy, because it has the potential for significant mitigation of the chances of a second wave of the virus?
Well, of course we look at all options. Under the test, track and trace strand, the policy advice on how people should isolate if they test positive is an important part of that. That advice is in place, but of course test, track and trace also relies on self-isolation to ensure that it is implemented properly. Test, track and trace is about finding out who needs to take action—they then need to take the action set out.
Thank you, Mr Speaker. On 11 March, I asked the Secretary of State whether it was right to allow more than 3,000 Atlético Madrid fans to travel to Anfield to watch a Champions League game when they could not have watched their team in Madrid, as attending football matches there was banned because it was a covid hotspot. The Liverpool city region now has a higher than average incidence of covid-19 than the UK and English average. The mayor of Madrid and the director of public health for the city of Liverpool have both said that it was a mistake to let the match go ahead. The Government’s deputy chief scientific adviser has said that the idea that there is a link is an “interesting hypothesis”. Does the Secretary of State now admit that the Government were behind the curve in not banning such a gathering, and will he undertake to investigate any possible link between that match and the higher incidence of covid in Liverpool?
This is, of course, a question for the scientists. What matters now is making sure that people—including in Liverpool and across the north-west—get the treatment that they need and that we get the curve under control.
(4 years, 5 months ago)
Commons ChamberWith permission, Mr Speaker, I would like to make a statement on covid-19. The spread of coronavirus is rapidly accelerating across the world and in the UK. The actions that we took yesterday are not actions that any UK Government would ever want to take, but they were absolutely necessary. The goal is clear: to slow the rate of transmission in order to protect the NHS and save lives. Our instruction is simple: stay at home.
People should only leave their home for one of four reasons: first, to shop for basic necessities, such as food, as infrequently as possible; secondly, to exercise once a day, for example a run, walk or cycle, alone or with members of the same household; thirdly, for any medical need, or to provide care or help to a vulnerable person; and fourthly, to travel to and from work, but only where it cannot be done from home, and employers should be taking every possible step to ensure that staff can work remotely. Those four reasons are exceptions to the rule. Further guidance is available on the gov.uk website.
I want to be clear that where people absolutely cannot work from home, they can still go to work. Indeed, it is important that they do so in order to keep the country running. Key workers, for example in the NHS and social care, pharmacists and those in the medicines supply chain, should go to work, unless they are self-isolating because they or someone else in their household has symptoms. We will be publishing guidance later today to explain the steps that employers must take to ensure that employees are safe, including making sure that there is a 2-metre gap between workers wherever possible.
In addition, all non-essential shops and community centres are closed as of today, and gatherings of more than two people in public must stop. These measures are not advice; they are rules. They will be enforced, including by the police, with fines for non-compliance starting at £30 but up to unlimited fines.
I want to update the House on the shielding that was introduced yesterday. We are writing to up to 1.5 million of the most vulnerable people in the UK to advise them that they will need to shield themselves from the virus in the coming months. We will provide targeted support for all those who need it so that they have the food supplies and medical care they need to make it through. Guided by the experts, we will look at the evidence and continually review the effects of the measures.
We are engaged in a great national effort to beat the virus. Everybody now has it in their power to save lives and protect the NHS. Home is now the frontline. In this national effort, working together, we can defeat this disease. Everyone has a part to play. I commend this statement to the House.
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.
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.
I thank the Health Secretary for the superhuman efforts he has taken to resolve the issues around PPE in the last week. The evidence is that we are in a much better situation now than we were a week ago. He will not mind if I follow up what the shadow Health Secretary said about testing. The concern is that we appear to be testing on a daily basis virtually no more people than we were over a week ago, when the commitment was to increase the daily number of tests from 5,000 to 25,000. Given that this is a vital part of the success of the suppression strategies in South Korea, Taiwan, Singapore and Hong Kong, can he give us an estimated date when we will get back to routine covid-19 testing in the community of all suspected cases? Even if that is three or four weeks away, a date means that there is a plan, and without a date, people will not be confident that this really is the plan.
Although I was not in the Chamber, I heard the comments that my right hon. Friend the Chair of the Health and Social Care Committee made about this yesterday, and he is right to push on this issue. I am not going to give him a date today, because we are in the middle of buying the tests that are needed, especially the new tests that have just come on stream. I have been able to give him the update that we have now purchased millions of these tests, which will arrive in the next days and weeks. I will be in a position to give him a more concrete timetable, and I will make sure he gets that as soon as we can make it public.
I extend our continued thanks and gratitude to all who are working around the clock to help keep us all safe, and to look after us and the most vulnerable in our communities. I also extend our thanks to the millions of people who have already acted on the Government’s advice to stay at home. The importance of that cannot be stressed nearly enough, because that is what we all need to do to protect our friends and families and the vulnerable people in our communities. It is deeply unfortunate that some employers, such as Sports Direct, seem to be acting in an entirely irresponsible manner, and I welcome the Secretary of State’s comments about that.
In looking to see what more we can do, will the Secretary of State outline when he expects all frontline NHS staff to have the PPE that they need? We need to do everything we can to support them, given the extent of the risks that they are facing. How many additional ventilators have we managed to procure since the Prime Minister put out the call to manufacturers? Are the Government planning to accept the EU’s offer to share in central procurement of ventilators, testing kits and PPE?
Scotland has a number of qualified doctors and nurses who arrived in the country during the refugee crisis. Will the Secretary of State commit to talking to the Home Secretary about what possible actions could be taken to relax the existing rules, to allow those qualified medical professionals to support the country that they have adopted as their home?
In the light of the outcome of the Keeling study, which was published by the Government on 20 March, is the Secretary of State ensuring that we have rapid and effective contact tracing? The review showed that such action could reduce the number of people infected by each case from 3.11 to 0.21, and that would be a significant step towards greater containment of the current outbreak.
Finally, I stress to the Secretary of State the need to impress on other Cabinet members the urgency of finding support for the self-employed, who are still waiting to find out what position they will find themselves in. We know that people with no financial backing come under pressures that may have an impact on their health, which would put further pressure on the system.
On the last point, there was an urgent question about exactly that issue. It really is a matter for the Treasury. The hon. Gentleman is right that contact tracing is incredibly important, and the amount of contact tracing that we have done is one of the reasons why we have managed to be behind other European countries in the curve. At this stage in the epidemic, it is not possible to have contact tracing for everybody, as we can when there is a very small number. We are looking at how we can do that better and enable individuals to contact trace, including by using technology.
The hon. Gentleman asked about refugees. I do not know whether he was in the Chamber yesterday, but that subject was brought up and I said that I would look into it. I will get back on that as soon as I can.
The hon. Gentleman asked about the number of ventilators. We started with around 5,000 and we now have more than 12,000, which we have bought. We have also made the call to arms for manufacturing capability to be turned over to ventilators, and that has been very successful.
I strongly endorse and support the backing of the Scottish Government and the SNP in the UK-wide approach to getting the message out to everybody that the most important thing anybody can do is stay at home.
I commend the Secretary of State for his heroic efforts in our defence so far. Given that the proscription on travel is now legal and not simply a recommendation, will he give us some clarification on what is meant by the care exemption, and confirm that it does not apply just to professional carers? At the moment, and since special schools have been closed in the last week, a great deal of support has been given from one family to another, for example in providing respite care for special needs children. That is very important and the people doing it are often being very responsible about self-isolation, which they are already applying to their families. Will that continue to be possible, and will my right hon. Friend enable it in future?
I will say three things in response to my right hon. Friend’s questions. On special schools, one of the carve-outs in the closure of schools was keeping open schools for those who are vulnerable, including those with special educational needs. The Bill includes a power to enable us to move from that position, but we do not propose to exercise it unless absolutely necessary. The position therefore is that if someone wishes to send their child to a special school, that is fine. It was one of the specific carve-outs. In the same way, if a key worker needs to send their child to school and cannot look after them at home, schools are available.
My right hon. Friend asked about care. I want to make it clear that for people who are volunteering in response to covid-19 and those who are caring, even if their responsibilities are unpaid or informal, they are okay to do that and should do that. They should stay more than 2 metres away from others wherever possible, but that has to be a practical instruction, because of course we need to care for people. As I said in the statement, travel allows for caring, and I want to make it clear that volunteering in the response to covid-19 is a legitimate reason to travel. For example, the increasing numbers of volunteers in the NHS are important. Although it is not paid work, it is work in the national effort to respond to covid-19.
My third point is that the Patient Safety, Suicide Prevention and Mental Health Minister is sitting next to me and close to me, because she has recovered and all the evidence shows that people cannot catch covid-19 twice, at least not in quick succession. I welcome her back to her place.
Following on the volunteering theme, I know that the Government have already made arrangements for schools and given advice that volunteers may still go in for certain purposes. Will the Secretary of State expand that to cover organisations such as Samaritans, which uses volunteers to travel to call rooms? Will he make it clear that it is acceptable for volunteers to do that?
Yes, it is acceptable. It is right that volunteers in that sort of work, for example Samaritans, should travel to do it.
The Secretary of State will know that, following the Prime Minister’s statement yesterday, all tourism and leisure providers have closed. I commend those in my constituency that closed before the advice was given, in order to protect people. However, those who take lots of deposits are obviously being pressed by our constituents to return that money, and that may put them in financial distress, but equally our constituents need the money back given their financial circumstances. I accept that the Secretary of State may not have an answer for me now, but will he at least commit to take the issue away and see whether an answer is forthcoming, perhaps with the support of the Treasury?
Yes, I will get my right hon. Friend an answer from the Department for Business, Energy and Industrial Strategy.
The Independent Food Aid Network oversees the work of many food banks, and I listened carefully to the Secretary of State’s comments about volunteering. That organisation is worried about the closure of community centres and churches. Will he reassure it that its valuable work and volunteers will be covered by the guidance?
Like my honourable colleagues, I commend the Secretary of State’s superhuman efforts. On the subject of procurement, may I say two things? First, he will know that the Public Health England change of guidelines has caused some concern. Will he ensure that they are clear to people? Secondly, a senior A&E consultant reminded me that they need more blood gas machines as well as more ventilators.
It is good to see the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), back in her place—I am not sure whether the Secretary of State still needs to have 2 metres distance.
May I press the Secretary of State on personal protective equipment? I hear what he says, and it is good that the military are being involved in the distribution, but is there enough PPE available for all healthcare workers and social care workers? If not, what is happening with manufacturing and the procurement from around the world, because we are told there is some available from around the world?
Yes, we have a huge quantity that we hold ready for an eventuality such as this. That was, in fact, enhanced in our no-deal preparations, but of course we are also using that up, so we are buying to make sure that those stocks are replenished.
I am very reassured to hear that by the end of the week, care settings will all get PPE, which is not what the leader of my council was being told recently. I accept the Secretary of State’s reassurance: it is really good news. Can he further reassure me that the PPE, when it arrives, will be to the right specification, in particular FFP3 respirator masks and not simply paper masks, which are next to useless?
If there are specific concerns about the non-delivery of PPE to council settings, I want to know about them through the hotline that we have set up precisely to short-circuit such problems having to be brought to my attention on the Floor of the House. Let us fix them directly. On the second point, it has got to be the right stuff according to the clinical guidelines.
We have been told that by the time covid-19 peaks, 44,000 women will need access to early medical abortions. Women should not have to leave their homes during lockdown to access basic healthcare, so will the Secretary of State commit not to oppose moves in the other place to enable individual healthcare practitioners to certify abortions and to reinstate the regulations that were put up for a short while on the Government website last night, so that we can have use of abortion medication and one practitioner being able to prescribe on the phone?
Care homes are being asked by local authorities to contract for block bookings of beds, but at the moment they would bear the liability if something were to go wrong—if residents were to come to them with the infection. May I urge my right hon. Friend to look urgently at the question of whether an indemnity can be provided?
I will get back to my hon. Friend on that very, very important point. I am grateful that he raised it with me privately earlier, and I am sorry that I have not been able to get a reply in time.
I thank the Secretary of State for his statement. Will he join me in commending Pact House, a charity in my constituency in Stanley, which is delivering meals and food to the elderly with some 90 volunteers? It contacted me this morning because it is concerned that the building it operates from may need some type of certificate to keep operating, following the announcement yesterday.
Can he clarify the position? Will it just be allowed to open, or will it have to apply for some sort of letter to say that it can operate?
As long as it is operating within the guidelines that the Prime Minister outlined in his address to the nation last night, which are set out in detail on the gov.uk website, it is doing the right thing and does not need any further certification.
One of the glimmers of light in these troubling times are the amazing community volunteer projects that have sprung up in all our constituencies. The Secretary of State will be pleased to learn that on Sunday, we set up a “shopital” outside Worthing hospital, and I spent several hours selling rice, spuds and, crucially, loo paper to more than 100 ambulancemen, nurses and doctors. Should not that sort of arrangement be happening anyway with the supermarkets and with the new scheme delivering food packets, to make sure that NHS workers for whom going shopping at eight o’clock in the morning during the “golden hour” is not appropriate can get on with their job much more easily?
I did not know that my hon. Friend was engaged in that sort of activity on a Sunday morning, but I am delighted that he was. Making sure that we get hot meals to NHS staff who are working often many more shifts than gives them time to make a good meal is incredibly important. It is something that we are working hard on, but I am really glad when it happens spontaneously, as well as when we try to sort it from the Department.
I thank the Secretary of State for his statement. I am being inundated, as I am sure many other Members are, in relation to small firms that are still insisting on their staff going in and undertaking roles, including fitting windows and doors, and those that are saying, “Well, the business is coming in; we’re going to stay open and carry on making new work,” despite having to travel house to house to offer what is fundamentally a non-essential service. Will the Secretary of State raise this issue with the Department for Business, Energy and Industrial Strategy and other Ministers to ensure that those small firms, which arguably do not need to be working, are keeping their staff at home?
I will raise that question and make sure that the appropriate guidance is put on gov.uk.
The Secretary of State is doing an excellent job and is being incredibly responsive, despite what I appreciate must be the huge volume of correspondence coming into his inbox. He is damned if he does and damned if he doesn’t. However, there is confusion about whether people should be going to work or not. From both a health and an economic perspective, as a business owner, I would much rather have a short, sharp shock, with everything closed down for 30 days to get this disease under control and allow the Secretary of State to get his testing and tracking in place and defeat it.
I agree with what my hon. Friend has said—and not just the first bit—but I repeat what I said in my statement. I want to be clear that, where people absolutely cannot work from home, they can still go to work. Indeed, it is important that they do so to keep the country running.
That is the nub of the confusion, because I am hearing reports from constituents and from elsewhere in the city that, for example, workers in call centres for outbound sales calls—which will undoubtedly be disruptive to those self-isolating at home who receive them—are being asked to come in and work in cramped conditions, which we know exist in such places. Should those employers not be taking advantage of the Government’s furlough scheme, so that their employees do not have to come into work? Is it not the case that no employee should be punished for doing the right thing and following the Government advice to stay at home?
That sort of activity can technically be done from home and, where work cannot be done from home, employers should be following the guidelines to keep people more than 2 metres apart.
There are many essential jobs and repairs that need to be done in people’s homes by workmen. So long as those homes are not specifically shielded or self-isolating because of suspected disease, and so long as the proper social separation is maintained, surely those ought to proceed, ought they not?
If they are essential, yes, but the aim here is to try to absolutely push down the speed of transmission of this disease over the next few weeks, to get a grip on its spread. That means that, while we have set out four reasons where it is reasonable to leave one’s home, people should stay at home if they do not have a good reason.
I will not read the text message that I have received from my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) because it contains unparliamentary language. However, further to the reply given to my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury), I think the Secretary of State needs to give the House a clear explanation as to why it was yesterday that clear guidance was provided by the Government on access to abortion early in the day, only for it to be removed from the Government website later in the day. Why is that? Why are the Government not listening to the royal colleges, and why are they making it more difficult for women to get access to an essential procedure during this time of crisis?
All I can do is repeat the clarity that there are no proposals to change abortion law.
Will my right hon Friend confirm what the advice is on visiting loved ones in hospital? Will he also confirm that Rutland is not a “hospital desert”—as reported by Sky News, which has concerned my constituents, who have access to Leicester and Peterborough—and urge the media to be cautious about deeply unhelpful and sensationalist reporting?
Does the Secretary of State not agree that the attempt to alter the abortion regime through the Coronavirus Bill is not the right use of those measures? Any change to abortion legislation, which is almost the last protection for our unborn children, deserves adequate scrutiny and appropriate debate, which is not possible right now. Will he, for the record, assure me that no changes to that legislation, which regulates life and death, will be made in this way through stealth and opportunism?
I repeat an answer that I have given before: there are no proposals to change the law around abortion.
Sorry to return to the “going to work” point, but last night the Government were saying, “The only reason you may leave home is to go to work (if you’re a key worker)”, but then the part in brackets changed to “but work from home if possible”. I think that is where there is confusion. People are not sure what they can and cannot do. That is a pattern that we have, sadly, seen repeated, and which has led to “lockdown/not lockdown”. Could the Secretary of State say what the advice is again? I am not wishing to cause trouble; I am just looking for clarity.
The Prime Minister was clear in his address to the nation; I have been clear in my statement today; and the guidance on gov.uk is absolutely clear on this point.
Many hon. Members are not here because they are being responsible and allowing some of us to represent them, so that we can observe proper social distancing. My hon. Friend the Member for Sheffield, Heeley (Louise Haigh) has asked me to raise the issue of irresponsible employers. She tells me that the Home Office in Sheffield is requiring workers to come in to do word processing and administrative work that could be done at home. Will the Secretary of State undertake to communicate my hon. Friend’s concerns to the Home Secretary, and if what my hon. Friend describes is the case, ask the Home Secretary to put a stop to it straightaway and set a good example?
Will the Secretary of State join me in paying tribute to the army of volunteers in Bournemouth and across the country—the individuals, businesspeople, charity groups and local organisations—who want to be part of the solution, and to help the elderly and vulnerable, allowing us to adapt to this new way of life? Yesterday, a 30-day lockdown was spoken of; this will require some form of enforcement. Can he say what role the armed forces might play in that?
The armed forces are doing an absolutely fantastic job of supporting civilian efforts, for instance in the NHS on the logistics of delivery of protective equipment and much more; but the armed forces will not be involved in the enforcement of the law. That is for the police, who will levy fines, starting at £30 and escalating if people continue to flout the rules.
One of my constituents is a home carer who has been unable to get PPE. She stopped working because her daughter has asthma, and obviously she is concerned about the potential for passing on the virus. I am pleased about what the Health Secretary said about the availability of PPE, but people such as my constituent, and their employers, need to know how to get hold of it. He said that that information would be on the gov.uk website, but not everybody knows about the website. Could he improve awareness of how to find out this information, and make sure that we have access to the website and the phone number?
I will make sure that the hon. Gentleman gets the phone number, so that he can pass it on to his constituent, and so that others in the same circumstances know how to make that happen.
NHS workers are on the frontline of this battle, at huge personal risk. Many have returned to the NHS especially to fight coronavirus. Does my right hon. Friend agree that when this is over, we need to find an appropriate way to recognise and honour their bravery?
Yes. My hon. Friend makes an incredibly important point, which is that we as a nation owe a debt of gratitude to those who work in the NHS, and we need to constantly search for ways to show it, so that they all know how much we value the work that they do.
I echo the points made by the hon. Member for Thirsk and Malton (Kevin Hollinrake) about an absolute shutdown, and absolute clarity for the public. Does the Secretary of State agree that we urgently need to get more FFP3 masks out there? That is what the frontline health workers are demanding, because they are terrified by the prospect of this crisis. The masks provided to the construction industry would be suitable for healthcare workers, I understand.
I will look into that point. The masks need to be clinically right; it is not for me to make that decision, but I will take this up with the chief medical officer.
May I personally thank my right hon. Friend and the Department for the rapid response he has given to every inquiry that I have made on behalf of my constituents? I also praise the NHS in Dorset and, of course, throughout the country for all the fantastic work that everyone is doing in the face of this appalling virus.
First, we are still having problems getting PPE; I heard the Secretary of State say that the phone line, to which he kindly referred me, is still the best way to try to follow up on that. Secondly, supermarkets are impossible to get hold of so that food banks can go online to request regular deliveries. Is there some way that we can get a message to all supermarkets to help out in that regard?
I am grateful to my hon. Friend for his first point. He is right that the hotline is the best way to sort out the PPE supply issues. I am told that it has already responded to more than 2,000 inquiries, is moving through inquiries fast and has a lot of people on the other end of the line to make sure that people can get hold of somebody. I shall take up the latter point with my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs.
I commend my right hon. Friend for the sterling work he is doing. Will he provide some clarification on the definition of essential retail? The general store that purchases a freezer and says that it is a food store quite clearly is not, but the garden centre that incorporates a farm shop that may serve a local community might well be.
These things will inevitably end up being a judgment at the boundary, but if there are two types of shop in one organisation, we will sometimes require some parts of it to close. If there is a café in a shop that sells essential supplies, the café must close but the essential-supplies part can stay open.
I, too, praise the Secretary of State and his wonderful team for their heroic efforts in fighting this killer virus. Will he confirm that volunteers such as those in the Holme Valley Covid Mutual Aid group, who are providing shopping services, delivering food parcels, picking up prescriptions, posting mail and dog walking, should continue to supply those services for their community, in a safe way?
Yes, they should. They should stay 2 metres away from other people, wherever possible, but we are actively encouraging the voluntary effort in support of covid-19 and we actively support it.
I thank the Secretary of State for all he is doing and I thank the thousands of retired nurses who have answered his call to come back to the NHS, but may I just raise a wrinkle in my constituency of Newcastle-under-Lyme? A nurse wrote to me who is 58 and retired at 55. She has returned to work for 16 hours and is happy to work full time, but she is concerned about the possible effect on her pension. Will the Secretary of State and the Chancellor of Exchequer work together to look at the situation and make sure that there are no financial barriers to heroes such as her coming back to work for our NHS?
Yes. We solved several of the problems in the pension system at the Budget, and there are further solutions in the Bill. I have not come across any further problems in respect of pensions, but if my hon. Friend writes to me with the individual case, I will check that that is the case in that instance, too.
On Saturday, I met the chief executive and the incident management team at the Queen Elizabeth Hospital in King’s Lynn in my constituency, where sadly two patients who tested positive for covid-19 died last week. I pay tribute to the dedication of all the staff who are, as the Secretary of State knows, working in buildings that need more investment. Will he make sure that those on the frontline continue to get the PPE that they need and have more access to ventilators?
Yes, absolutely—on all counts. I just want to add my thanks to all those working on the frontline, and throughout the NHS and social care, to my hon. Friend’s thanks to those in King’s Lynn. I also put on the record my thanks to my extraordinary civil service political and Public Health England team, who have done amazing work and continue to work incredibly hard in response to this crisis.
Will my right hon. Friend join me in paying tribute to our fantastic NHS staff at Blackpool Victoria Hospital? Some private firms in my constituency have offered free or discounted parking to NHS staff, to help them out in these difficult times. Will he commend those firms and encourage others to do the same to make sure that it is as easy as possible for staff to get to work?
Yes, I will. I pay tribute to all the staff at Blackpool hospital. I met some of them during the election campaign and I know that they are working incredibly hard in preparation for what is to come. I absolutely commend all those who are giving free parking to NHS staff and we are looking at what we can do to make that happy occurrence spread more broadly across the NHS.
Bill Presented
Contingencies Fund Bill
Presentation and First Reading (Standing Order No. 57)
Mr Chancellor of the Exchequer, supported by the Prime Minister, Steve Barclay, Jesse Norman, John Glen and Kemi Badenoch, presented a Bill to make provision increasing the maximum capital of the Contingencies Fund for a temporary period.
Bill read the First time; to be read a Second time now, and to be printed (Bill 123) with explanatory notes (Bill 123-EN).
(4 years, 5 months ago)
Commons ChamberI beg to move, That the Bill be now read a Second time.
Coronavirus is the most serious public health emergency that has faced the world in a century. We are all targets, but the disease reserves its full cruelty for the weakest and the most vulnerable. To defeat it, we are proposing extraordinary measures of a kind never seen before in peacetime. Our goal is to protect life and to protect every part of the NHS. This Bill, jointly agreed with all four UK Governments, gives us the power to fight the virus with everything that we have.
Like many hon. Members, I have had a huge number of issues raised with me by NHS workers regarding the availability of personal protective equipment to frontline staff and testing. I know the Secretary of State wants to protect NHS staff through the Bill, so will he take the opportunity of Second Reading to update us, perhaps with any information he has from across the UK, about progress on these matters?
Yes. If it is okay with you, Mr Speaker, I will answer that intervention and then get on with the point in the Bill. These issues are outwith the Bill, but they are incredibly important and very much part of the topic.
In terms of making sure that NHS staff, social care staff and those who need it clinically get the protective equipment they need—especially but not only the masks— we are undertaking enormous efforts to get that equipment out. The equipment is there; we have it. It is a distribution effort. I was not satisfied with the stories I heard of people running short, so we have brought in the military to help with the logistical effort. I want to hear from every single member of staff in the NHS or in social care who needs that equipment but does not have it, so we have also introduced a hotline and an email address, which is manned. I have had an update on that, and it has had a number of calls, which are all being responded to. In that way, we will find out where the gaps are, so that we can get this distribution out. It is a mammoth effort; we have been working on it for several weeks, but the increase in the use of the protective equipment in the last week has been very sharp, as I am sure the hon. Gentleman and the House will understand. The logistical effort is very significant.
We are expanding the amount of testing. We are buying tests, both ones made abroad and ones made here in the UK, because testing is absolutely vital to getting out of this situation. I want to get to a point where anybody who wants to get tested can get tested. At the moment, we are having to reserve the tests we have for patients, especially in intensive care, so that they can be properly treated according to whether or not they have coronavirus. Very soon, we are getting the tests out to frontline staff so that they can get back to work, where somebody in their household might have the symptoms and they are household-isolating. I understand absolutely the importance of testing. We are working on it incredibly hard. We were working on it all weekend, and we are making some progress.
On the point about testing, will the Secretary of State be absolutely clear? Does the current test that is available show whether somebody has got covid-19 or has perhaps previously had it? Does it do both, or does it do just one? If it does just do one, when are we likely to have a test that does both?
Tests for both have recently been developed. The test for whether someone has coronavirus, which we call the case test, was first developed here by Public Health England, and that is being expanded. The antibody test, which tests whether someone has the antibodies that make them immune to coronavirus, has now been developed, and we are buying it in large quantities.
Nobody denies that the Bill is necessary, but given that it gives the state, for the first time in our history, unprecedented powers to enforce isolation on people who have committed no crime, will the Secretary of State reassure the House that it will be fully involved in renewing this once this crisis is over, and that there will be no drift in this matter?
Yes. I will turn to this point shortly, but let me just correct my right hon. Friend. The measures we are taking to be able to hold people in quarantine build on those in the Public Health (Control of Disease) Act 1984, which we have been using hitherto. In that element, the Bill is not unprecedented. The Bill makes these powers UK-wide and strengthens the basis on which they can be exercised, but the powers are not unprecedented. Nevertheless, the point he makes about the House’s ability to scrutinise these measures and to ensure that we are, as a House, content with their continuation is important.
Let me make a little more progress in answering my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), and then of course I will give way.
The Bill is jointly agreed between the four UK Governments. Of course, there are measures that are significant departures from the way we normally do things, but they are strictly temporary. I think that they are proportionate to the threat we face, and they will be activated only on the basis of the best possible scientific evidence. Crucially, to my right hon. Friend’s point, the legislation is time-limited for two years and the measures can each be switched on and off individually as necessary by the relevant authority, whether that is the UK Government or the devolved Government, depending on who exercises the powers. As an additional safeguard, we today tabled an amendment to give the House the opportunity to confirm that the powers are still required every six months.
I am grateful to my right hon. Friend for giving way. Everyone admires the steps he is taking. He knows that I have been questioning and corresponding with him on testing for some time. Given that, as he pointed out, the test was developed in this country, can he explain why it seems to be so much less available in this country than in other countries around the world?
We have done more testing than most countries. There are some countries that are ahead of us, and we are racing to catch up. We have tested far more than, say, France or America, but not as much as Italy. It is something that we are putting a huge amount of effort into. I understand the pressure my right hon. Friend rightly puts on me to expand testing capability. We are increasingly using private companies to do the testing—to expand their production and execution of the tests—rather than just doing it in the brilliant public health labs we have at Porton Down and around the NHS.
I commend what the Secretary of State said about working with the devolved Administrations to get the measures in the Bill right. It is crucial that many of these measures are UK-wide; I realise that these are unusual times. There is a specific power in schedule 21 to limit entry to premises and, if necessary, to close them down, which applies to all four Administrations. Can he be clear about whether that will apply to care homes? I have heard a lot of concern from constituents who are worried that some care homes still are not restricting entry to individuals and are therefore putting elderly residents at risk. There is real demand for this to be unified across the country to protect elderly residents.
We have other ways to enforce that with care homes, not least contractually through local authorities. I understand the hon. Gentleman’s concern; people in care homes need to be protected, and many of them shielded, from the virus, because many of the most vulnerable people are in care homes. I will take away the point and look at whether more needs to be done, but we do have other powers available to deliver on what he and I—I think—agree is needed.
I commend the Secretary of State for accepting the six-month review that he has just announced, but in the event that the House decides that one element of the Bill is working badly, will we be able to amend or strike out that element, or will we have to take the whole thing or reject it at that six-month point?
As discussed with the Opposition, we are proposing a six-month debate and vote on the continuation of the Bill, and before that debate we will provide evidence and advice from the chief medical officer to inform the debate. There is also a reporting mechanism for a report every eight weeks on the use of the powers in the Bill.
I thank my right hon. Friend for the time he has taken in explaining at every stage how he has used the powers of his office to this House and, indeed, to the people through the media. I am hugely grateful and I know many others are. Could I just, however, state that over the last three weeks the world has changed in a rather more radical sense than many of us appreciate? The powers in the Bill, even over six months, are likely to change and to be exercised in different ways. Can he assure me that he and all other Ministers will exercise their powers reasonably, in keeping with only the coronavirus issue, and making sure that they are limited to the purpose for which they were intended, because these powers could—in different circumstances—be used in a particularly malicious fashion?
I can confirm that the Bill is to deal with the current coronavirus emergency, and that is an important point. But I would also say that although the world has changed in the past three weeks in ways that many could not have imagined, every measure that has been taken by the Government has been part of the action plan that we published three weeks ago. Of course, the Bill has been drafted over a long period, because it started on the basis of the pandemic flu plan that was standard before coronavirus existed and has been worked on over the past three months at incredible pace by a brilliant team of officials right across Government. The Bill is consistent with the action plan, so while some people might have been surprised by each of the measures we have taken, they have all been part of the plan that we set out right at the start. I can confirm that it is only for coronavirus.
I also want to give further detail to my previous answer to the hon. Member for Cardiff South and Penarth (Stephen Doughty), which is that section 21 does not specify what it defines as a gathering or an event. It is deliberately broad, so it could include a care home, should we need it to, and that would be defined in secondary legislation should that be necessary.
I am sure the whole House will want to support my right hon. Friend and the provisions in the Bill. I just want to reinforce two points. The first is that I was very concerned to see the two-year provision, which is why I put my name to new clauses 1 and 6, and I am very pleased to hear what the Government have said about the six-month review. Notwithstanding what he just said about the period of time in which this has been produced, it is a heroic effort— 321 pages of legislation which may well be subject to changes in the next few weeks and months as this crisis develops. I hope, therefore, that he will see the six-month review not just as a rubber-stamping effort, but as a chance to improve the legislation, should it require that improvement.
We could consider that. The proposal is to have a debate and vote as opposed to a whole new piece of legislation and, of course, only to renew it if the measures in the Bill are still necessary. Then, of course, they will fall after two years. I understand the concern of my right hon. Friend and his wisdom. I know that as Secretary of State he dealt with some of these issues, albeit not here but around the world, and he knows the sorts of measures that are needed, which are contained in the Bill.
Will the Secretary of State provide clarity on the six-month period? Obviously, six months is quite a long time for people who are chronically ill or have a serious disability. Some of the proposals have implications for social care for the devolved regions or local government. What will happen if there are negative effects on people who receive social care within that six-month period? What recourse will Members have to bring that to the House?
There will be recourse, and I will come on to that in a moment. The purpose of the social care measures in the Bill, which are very important, is to allow for the prioritisation of social care, should that be necessary. However, there are a number of restrictions on that, because local authorities will still be expected to do what they can to meet everyone’s needs during that period. While local authorities will be able to prioritise to ensure that they meet the most urgent and serious care needs, there are restrictions to require them to meet everyone’s needs and, indeed, to fulfil their human rights obligations to those in receipt of care.
I thank the Secretary of State for the excellent work he has done to ensure that individuals get the care they need in these difficult and challenging times.
On the human rights perspective, I thank the Secretary of State and the Government for listening to faith organisations. Initially there were concerns that under part 2 loved ones would have to be cremated. As somebody from a Muslim background and the Prime Minister’s special envoy for freedom of religion or belief, it was completely unacceptable to consider that if taking account of the views of the Muslim and Jewish communities. I therefore thank the Government for ensuring that the wishes of the deceased will be taken into account in relation to their final rites.
I pay tribute to my hon. Friend, who has worked hard to ensure that we come to a solution in the Bill, through the amendments we have tabled today, that ensures we can not only have dignity in the case of a large proportion of the workforce not being available, but accede to the wishes of families from the many different faith communities who had concerns about the way it was originally drafted. I pay tribute to my right hon. Friend the Paymaster General, who found a way through that I think everybody can be content with.
Essentially, the Bill gives all four UK Governments a legislative and regulatory toolkit to respond in the right way at the right time by working through the action plan. While I hope that some of the powers never have to be used, we will not hesitate to act if that is what the situation requires.
To follow on from the hon. Member for Gillingham and Rainham (Rehman Chishti), I am grateful for the work the Government have done in this area, because many of my constituents—both those from a Muslim background and those of the Jewish faith—were naturally concerned. It is one of the major tenets of faith that everybody has the right to dignity in death, so I am grateful to the Government for listening. Will the Secretary of State join me, at this difficult time for all our communities, in thanking our faith communities for the role they are playing, the difficult decisions they are taking and the support they are giving?
I entirely agree. This exchange is an example of the cross-party approach we are all taking. I am very grateful to the hon. Member for the work he has done, together with the Paymaster General, to bring this point to light.
I am also grateful for the work the hon. Member and many others have done with faith groups of all religions who want to gather. Understandably, it is upsetting not to be able to do that, but it is right that they cease large gatherings—or, indeed, any gatherings—where there is social contact that can spread the disease. It is happening around the world. It is a difficult thing for some, and I pay tribute to the faith organisations and faith leaders across all faiths who have made the right decision. I urge all faith leaders to see what has been done by those who have taken the right steps and to follow them.
I wish to thank the hon. Member for Leicester South (Jonathan Ashworth) for his constructive approach to the passage of this legislation and his constructive tone in respect of this whole crisis. I reassure him that I listen to what he says very carefully. Even when he does not agree, he has done so in a calm, sensible and evidence-based way. I think the House can see from the Bill that we have taken on many of his suggestions, and they will go into law. Along with the Labour Administration in Wales, the SNP Government in Scotland and the multi-party Administration in Northern Ireland, we have taken on ideas from all parties.
The measures in the Bill fall into five categories: because we rely on the NHS and social care staff now more than ever, the first set of measures will help us to increase the available health and social care workforce; secondly, there are measures to ease the burden on frontline staff, both in the NHS and beyond; thirdly, there are measures to contain and slow the spread of the virus so that we can enforce social distancing; fourthly, there are measures on managing those whom the disease has taken from us with dignity and respect; and fifthly, there are measures on supporting people to get through this crisis. I shall briefly take each of them turn.
The first part of the Bill is about boosting our healthcare workforce at a time when it comes under maximum pressure, both through increased demand and because of household isolation and the fact that large parts of the workforce may fall sick. The Bill allows for the emergency registration of health and social care professionals, including nurses, midwives, paramedics and social workers. I can update the House with numbers: 7,563 clinicians, including Members of this House, have so far answered our call to return to work, and I pay tribute to every single one of them. These are difficult times and they have risen to the call of the nation’s needs. We know that many more will join them.
Our thanks also go to the social workers who play such a vital role in protecting the most vulnerable in this country. The Bill protects the income and the employment status of those who volunteer in the health and social care system. Volunteers will play a critical role in relieving the pressure on frontline clinicians and social care staff. Again, I offer our thanks.
Is the Secretary of State aware that many people in the refugee community in the UK are qualified healthcare professionals? I have spoken to the refugee charity RefuAid, which says it has 514 qualified healthcare professionals on its books. These are people who are willing to work and fully qualified in their own country, but there are bureaucratic barriers to their coming forward. Will he please look into this matter with great urgency so that such people can help us out?
Yes. If the right hon. Gentleman emails me with the details, we will get right on to it. He refers to bureaucratic barriers; we of course have to make sure that people are able to do the work that is necessary, but we have already shown in the Bill that we are willing not only to bring people back into service but to put into service those who are towards the end of their training, to make sure that we get as many people as possible in full service. I absolutely want to pick up on the right hon. Gentleman’s proposal and take it up with the General Medical Council or the relevant regulator to see whether we can find a way through for the period of this crisis.
I wonder whether the Secretary of State may not need an additional power in relation to the Home Office being able to waive fees for tier 2 and tier 5 visas for foreign nationals who are already working in the NHS and are about to have to renew their status in this country, or for those who have been studying as students.
It is already within NHS trusts’ power to pay those visa fees if it is necessary.
Will the Secretary of State look at the immigration surcharge for doctors and nurses who are working in intensive care units? Will he also look personally at the issues relating to research trials for potential new drugs or treatments, or existing drugs or treatments that are being used? Concerns have been raised with me that those processes are all being delayed by the traditional randomised controlled trial processes, which may not be appropriate given the emergency we face.
Absolutely. The chief medical officer is personally looking into that issue to make sure that when there is a treatment, we can bring it to bear as soon as is safely possible. There is a challenge with a disease that has, thankfully, a mortality rate as a proportion of the overall population as low as this one, which is that we do not want to do more harm than good. Many of these drugs are safe, because they are licensed for another purpose. It is a question of repurposing them—this is for treatment, rather than vaccine—and that is something we are actively working on. If the right hon. Lady has examples of particular barriers that we need to crunch through I would like to know about them. If she could email me I will take that up with the Medicines and Healthcare Products Regulatory Agency.
I want to bring to the attention of the House to the professional indemnity clauses. Where there is no existing professional indemnity agreement in place the Bill provides legal protection for the additional clinical responsibilities that healthcare staff may be required to take on as part of the coronavirus response. I do not want any clinician not to do anything that they can do because that they worry about indemnity and what might happen if it goes wrong. I want everybody in the NHS to do their very best to the top of their qualification, looking after people and keeping them safe.
I commend the Health Secretary on everything that he and his team are doing. To ensure that returning healthcare professionals can do so at the right time, when the disease peaks around Easter, we have to move at pace to put the indemnity that he has cited in place, to ensure that people are physically and mentally fit to do this work and, crucially, to ensure that they are skilled or reskilled to do what we are asking of them. Can he assure the House that those three things are being put in place?
Absolutely—all of that is in hand. My right hon. Friend is quite right to raise it.
I thank the Secretary of State for everything that he is doing. We are all rooting for him to be successful. I am genuinely worried about what is happening in London hospitals, and what it says about the prospects for the rest of the NHS. He is right to try and get staff to return, but we have to be able to keep them when they arrive. I have seen disturbing reports over the weekend of agency staff walking out mid-shift because they do not have the right protective gear, the right sanitising hand gel, and the things that they expect to keep themselves and patients safe. Can he look urgently at this issue, because London is the story that will follow for the rest of the country if we do not get this right?
Yes, this is what I have been spending the weekend on—absolutely; it is incredibly important.
Turning to the second part of the Bill, which is about easing the burden on the frontline and follows from that intervention, that refers not only to the NHS frontline but to the dedicated public servants who guard our streets, who care for our children, and look after communities, in local government—in short, all those who keep the UK running safely and securely. By cutting the amount of paperwork that they have to do, by allowing more remote working, by delaying some activities until the emergency has ended, we can keep essential services going while we get through the pandemic.
Some of the measures are difficult, and not what we would choose to do in normal times. For instance, the Bill will modify temporarily mental health legislation, reducing from two to one the number of doctors’ opinions needed to detain someone under the Mental Health Act 1983 because they pose a risk to themselves or others. In circumstances in which staff numbers are severely affected, the Bill allows for the extension or removal of legal time limits governing the short-term detention of mental health patients. The Bill also allows for an expansion of NHS critical care by allowing for rapid discharge from hospital where a patient is medically fit. NHS trusts will be permitted to delay continuing healthcare assessments, a process that can take weeks, until after the emergency has ended. The people who need this support will still receive NHS funding in the interim.
The Bill contains powers allowing local authorities to prioritise the services they offer, as we discussed earlier in relation to social care, and that prioritisation, while challenging, is vital. The measures would only be activated in circumstances where staff numbers were severely depleted. They do not remove the duty of care to an individual at risk of serious harm or neglect. We do not take any of these measures lightly. I hope that many will not have to be used, but we will do whatever it takes to beat this virus.
I am grateful to the Secretary of State for giving way. He is being very generous. On frontline care, particularly those working in intensive care units around the country, may I press him again? When will those staff be tested? There are many staff who want to go to work, but are afraid that they may be carrying the virus. For those who are at work, if they are tested and they have the virus, they want to isolate so that they can return as quickly as possible to the frontline. When are they going to be tested?
The answer is as soon as the tests we are buying are available. Expanding testing is absolutely critical to everything we are doing.
This part of the Bill also covers other mission-critical parts of public services, not just the NHS, including schools, borders, justice and national security. The Bill empowers schools, for instance, to respond pragmatically to this situation, including the ability to change teacher ratios, to adapt school meal standards and temporarily to relax provisions for those with special educational needs. The Bill also gives the Home Secretary the power to close and suspend operations at UK ports and airports, powers that will deployed in circumstances only where staff shortages at the Border Force pose a real and significant threat to the UK’s border security. It expands on the availability of video and audio links in court proceedings, so that justice can continue to function without the need for participants to attend in person. To ensure that the Treasury can transact business at all times, the Bill makes it possible for a single Minister or Treasury commissioner to sign instruments or act on behalf of other commissioners.
At a time of unprecedented social disruption, it is also essential to maintain our national security capabilities. The Bill allows temporary judicial commissioners to be appointed at the request of the Investigatory Powers Commissioner and for an increase in the maximum time allowed for an urgent warrant to be reviewed from three to 12 days. That means that vital investigation warrants can continue to be issued, and our security services and police can continue to protect the public.
On the key points of people with mental health problems being signed off by one doctor and a loosening of the regulations relating to children with special needs, what measures can be put in place, by local authorities or others, so that there is a review mechanism on those two very crucial points for vulnerable people?
Clearly, these are issues of the highest sensitivity. It is important that we take those measures in case they are needed in the circumstances where staff numbers available are low, to make sure we can get the support needed as appropriate and make the interventions that are sometimes difficult to make. For instance, it can be, in some circumstances, far worse not to detain somebody under the Mental Health Act where they are a danger to themselves or others. If there is not the availability of a second doctor, because of staff shortages due to the virus, then I think that is appropriate, but the safeguards are an important part of getting this right and an important part of why this is time limited.
I thank the Secretary of State for giving way. He is being incredibly generous. Clause 23 talks about food supply chains, which are absolutely crucial. He will have seen that many supermarkets are taking on additional workers to meet demand. Can he provide an answer on this point or get one from the Treasury? I have heard from many people who are thinking of applying for those jobs, perhaps to make up loss of income. If they are covered by the 80% wage subsidy, are they able to take on extra work or will they lose the 80% wage subsidy from their existing job? May we have urgent clarity on that point, because it could be deterring people from taking up those important jobs in our supermarkets and supply chains?
That really is a question for the Treasury. My understanding is that the 80% wage subsidy is for those who are furloughed, as the Chancellor put it, as opposed to those who have moved into other jobs, but the hon. Gentleman will have to ask the Treasury for a more detailed answer.
I thank the Secretary of State for giving way and for all the work he is doing—indeed, I thank the House for all the work it is doing—on this essential legislation. With regard to university settings, there seems to be some confusion. I have looked at the Universities UK advice, but some universities do not seem to be following it and are requiring students, notwithstanding the advice the country at large is being given, to attend.
I am surprised to hear that, because we have been very, very clear about universities, alongside schools. It is, of course, a matter for my right hon. Friend the Education Secretary in the first instance, but on public health grounds we made it absolutely clear that we were taking steps to close schools, nurseries, universities and colleges, except for the children of key workers where they absolutely need to be at school, for example where neither parent can look after them. However, all those at university can stay at home on their own and do not need a parent, so I do not think there is any excuse whatever.
Our local authority, the new unitary Buckinghamshire Council, has made the point that workers in leisure centres who are furloughed may need to be redeployed into other areas of council work where they would not normally be employed. That raises a problem. The council really needs to use the furlough scheme to take those workers out of leisure centres and put them into social care—quite a different industry. Will my right hon. Friend undertake to make sure that that is possible?
I do not think a legal change is needed to do that, because to second someone from one job to another is perfectly possible under existing employment law. In fact, the Bill brings in a statutory volunteering scheme, which is essentially a new form of employment through volunteering. That is one way that that could be done, but I would not expect it to be the main way used. If someone is moving to do a different type of job because we need more people doing some things and fewer doing others during this crisis, that sort of secondment can be done entirely normally—unless I have misunderstood my hon. Friend.
My right hon. Friend has slightly misunderstood, and I hope he does not mind me saying so. The point really is that all councils will be haemorrhaging money at this time and they will need that 80% support for those workers whom they would otherwise furlough, so that they can then use them as volunteers. The point is to constrain cost.
While we understand that the circumstances are exceptional, there is understandably grave concern about lowering social care standards. We are talking about some of the most vulnerable in our society—the elderly and disabled of all ages. Having the convention on human rights as a back-up could lead to care standards being lowered to a dangerous level, putting those people at risk. Will the Secretary of State outline the thresholds for turning the powers on, and indeed off to ensure that they do not become the new norm?
The threshold is to do with staff shortages. I say gently to the hon. Lady that I understand her concerns, but in fact the purpose of these measures is precisely the opposite: it is to make sure that when there is a shortage of social care workers, those who need social care to live their everyday life get it and can be prioritised ahead of those who have a current legal right to social care under the Care Act 2014 but for whom it is not a matter of life and death. This is absolutely about prioritising the vulnerable. That is the purpose of the legislation, but I understand her concern, and that is why we put the safeguards in place to ensure that the prioritisation works as intended.
I have a general question about the supply of medicine. Paul Howard, a consultant in palliative medicine at our excellent hospice on the Island, says that under patient group direction—that is, group prescriptions—nurses can give out morphine, but due to a quirk in the rules they cannot give similar powerful opiate painkillers. Will the Bill enable nurses to give controlled drugs as part of patient group direction? I ask not only in case medical supplies run short, but specifically because we on the Island rely on ferries, and such a provision would give us slightly more diversity in patient treatment.
I will look into those specific points. There are parts of the Bill that would help to tackle the problem my hon. Friend describes if it is appropriate to do so, but I think it is better if I get some medical advice and then get back to him.
The third part of the Bill contains measures to slow the spread of the virus. As the disease accelerates, our goal is to protect life, to protect the vulnerable and to protect the NHS by flattening the curve and minimising unnecessary social contact. This is a national effort, and everyone has their part to play—self-isolating if someone or anyone in their house has symptoms, working from home wherever possible, avoiding social gatherings and, of course, regularly washing your hands.
The Bill provides for us to go further: it gives us stronger powers to restrict or prohibit events and public gatherings and, where necessary, to shut down premises; and it gives the police and Border Force the power to isolate a person who is or may be infectious. This part of the Bill also allows us to close educational settings or childcare providers, and to postpone for one year elections that were due to take place in England in May. These are not measures anyone would want to take, but they are absolutely necessary in this crisis.
The Secretary of State will be aware that over the weekend thousands of people made their way to holiday areas and rural areas such as mine. Do the powers in schedule 21 allow Ministers to require people, in circumstances where local health boards are under increased pressure, to remain in their primary residences?
The hon. Gentleman makes an important point, because we have advised against all unnecessary travel and I do not regard going to a holiday home in Wales as a necessary journey. There is a risk of putting extra pressure on the NHS in rural areas from large numbers of people going to second homes, so I entirely understand the concern he has raised. The powers do allow for a constable to take somebody to a place in order to prevent the spread of the infection and make sure that we can police the public health guidance that we have given. We have been absolutely clear in the past few days that if people do not follow this advice, we will not hesitate to act. We acted last week on pubs, clubs and restaurants. We said that people should not go to them, but it was clear that some were still open and so we took the decision to close them down, with enforcement powers for the police and trading standards. This Bill provides those powers more broadly.
I am pleased with what the Secretary of State has said, as this is a significant problem. I received more than 1,000 emails over the weekend from constituents who are petrified about what is going on. The highland area makes up more than 10% of the UK landmass, but we have one acute hospital, in Inverness, and some of these tourist destinations are more than three hours from Inverness. We have been inundated with people who showed no concern for the local population. People are saying that they are now being denied the right to travel to the islands by ferry because we have stopped it and they are going to come to Skye. This is a dangerous situation, where they are imperilling the lives of our constituents. They must go home and they must stay at home, as I am sure the Secretary of State would agree.
Well, what can I say? I am concerned that people are not following the public health advice.
Some holiday companies have been responsible. For example, Sykes Cottages has cancelled a raft of bookings for weeks ahead. However, my hon. Friend the Member for West Ham (Ms Brown), by phone, has raised the fact that lots of Airbnb bookings are still available in holiday resorts. Surely that is irresponsible. If the companies will not do the responsible thing by limiting access to holiday properties, does the Bill give the Government the power to act? If so, will they act to stop this kind of behaviour?
If it is deemed a risk to public health, the Bill does give the potential power, through secondary legislation, to take action if that is needed.
I mean this in a constructive way, but it does feel as though we are constantly behind the curve; we are always waiting for people not to do what we have asked them to do before we then step in and introduce more strict communications. So I beg him: will he underpin this legislation and everything else the Government are doing with a much bigger, wider, louder and more comprehensive public education campaign, because right now the message clearly is not getting through? Anyone who was looking at the coverage over the weekend of people gathering in Richmond park and elsewhere will know that it is not being heard. We need to be doing an awful lot more to be able to catch up and get ahead of this.
There is the most comprehensive public communications campaign probably in the history of Government peacetime communications—maybe I will send the hon. Lady a poster.
The issue of Brits seeking to isolate in remoter parts of the country is a big issue in Rutland. Over the weekend, I went around the constituency, and I saw pile after pile of cars. I saw caravan parks open and hotels advertising self-isolation holidays and breaks in my constituency. Can the Secretary of State confirm, for the benefit of all in the House, that the current guidance is that people should stay in their own homes and not travel for self-isolation holidays or anything of the sort?
I am grateful to the Secretary of State for giving way; he is being very generous, but these are important issues. On the issue of social distancing, is there something that he feels might happen tomorrow that is not happening today, as far as people’s behaviour is concerned? People are gathering in their thousands on the beautiful landmark of the Wrekin in my constituency. It is right that people should have exercise for their physical and mental health and wellbeing, but social distancing is not being followed by many, whether it be in the Wrekin or Holland Park, Hyde Park, St James’s Park or counties around the country. What behavioural changes does he expect? Is it not the case that we will have lockdown, and would it not be better to have it today rather than next week?
My hon. Friend makes an important point. We are absolutely clear that we are prepared to take the action that is necessary.
The fourth part of the Bill contains measures for managing the deceased in circumstances where many of those involved in the registration and management of death will themselves be self-isolating. We want to ensure that those taken from us by the virus are treated with the utmost dignity, while protecting public health and respecting the wishes of bereaved families. Among other measures, the Bill will expand the list of people who can register a death to include funeral directors. It will mean that coroners only have to be notified where there is not a medical professional available to sign a death certificate. It will allow death certificates to be emailed instead of physically presented. It will remove the need for a second confirmatory medical certificate in order for a cremation to take place, and it gives local authorities the power to take control of elements of the process if needed. Those powers would only be used if absolutely necessary and on clinical advice, but we plan for the worst, even while we work for the best.
The Secretary of State will know that a new medical examiner system has been introduced in many areas, including Durham. Their role is to look into deaths in hospitals, so they will be inundated if there is a large number of deaths. Is there any provision in the Bill that loosens up their role? Otherwise, they will be overwhelmed by the number of examinations that they will have to do.
I very much hope that they will not be. The medical examiners regime is very successful, and as the right hon. Gentleman says, we are expanding it across the country. We do not deem that necessary, not least because we think that we can expand it if necessary. We do not think that there is a need for statutory change in an area that is improving.
There may be instances where it is impossible to allow for a normal funeral in the way that one is used to. There might have to be mass funerals or, for that matter, instances where just one person is allowed to attend, apart from the celebrant. I wonder whether it might be possible to ensure that in all local authorities, and in particular crematoria, it is possible to film such moments, so that loved ones at least have an opportunity to feel that they are engaged online, if not in person.
I know that the hon. Gentleman speaks from experience of having presided over these events. That is available—increasingly so—and I entirely understand why many people would want that.
The fifth and final part of the Bill includes measures to protect and support people through this crisis. This is not an exhaustive list of everything we plan to do, but the principle is that no one should be punished for doing the right thing and self-isolating if they or someone in their household has symptoms. To make that happen, the Bill will ensure that statutory sick pay is paid from day one, and this will be applied retrospectively from 13 March. Small businesses with fewer than 250 employees will get a full refund for sick pay relating to coronavirus during the course of the emergency. Finally, the Bill will require industry to provide information about food supplies. That all comes alongside our plan for people’s jobs and incomes announced by the Chancellor on Friday.
The Bill allows the four UK Governments to activate these powers when they are needed and to deactivate them when they are no longer needed. We ask for these powers as a whole to protect life. We will relinquish them as soon as the threat to life from coronavirus has passed. This Bill means that we can do the right thing at the right time, guided by the best possible science. That science gets better every day. This disease can isolate us, but it cannot separate us from the ties that bind us together. With patience and resolve, with the painstaking use of data and evidence, and with the whole nation working together as one United Kingdom, we will get through this. I commend the Bill to the House.
(4 years, 5 months ago)
Commons ChamberThank you for allowing me to make a statement at this time, Mr Speaker. The coronavirus pandemic is the most serious public health emergency that our nation has faced for a generation. Our goal is to protect life. Our actions have meant that the spread of the virus has been slowed in the UK. I pay tribute to the officials of Public Health England and the NHS for their exemplary approach to contact tracing and their work so far. However, the disease is now accelerating, and 53 people have sadly now died. Our hearts, across the whole House, go out to their families.
Our policy is to fight this virus with everything we have. Last week, my right hon. Friend the Chancellor confirmed a £30 billion package of financial firepower, including a £5 billion contingency fund to ensure that the NHS and social care system have the resources they need. We will give the NHS whatever it needs, and we will do whatever it takes. We will get through this by working through our action plan to contain, delay, research and mitigate the virus. That plan has two overriding aims: to protect the NHS by building it up and flattening the curve, and to protect life by safeguarding those who are most vulnerable. We will do the right thing at the right time, based on the best scientific advice.
Earlier, I attended a Cobra meeting chaired by the Prime Minister to decide on the next steps in our plan. I can report to the House that we have agreed a very significant step in the actions that we are taking from within that plan to control the spread of the disease. Those actions will change the ordinary lives of everyone in this country. We appreciate that they are very significant, and I understand that people will be concerned, but we have come to the view that they are necessary to save lives and to stop this disease.
First, based on the updated scientific advice, we are today advising that if you or anyone in your home has a high temperature or a new and continuous cough, you should stay at home for 14 days. If at all possible, you should not go out even to buy food and essentials. Instead, you should ask others for assistance with your daily necessities. The exception to that is for exercise, but even then you should keep at a safe distance from others. If it is not possible to receive deliveries at home, you should do what you can to limit your social contact when you leave the house to get supplies.
Even if you or anyone in your household do not have symptoms, there is more that we have to ask of you. Today, we are advising people against all unnecessary social contact with others and all unnecessary travel. We need people to start working from home if they possibly can. We should steer clear of pubs, clubs, cinemas and restaurants. We should use the NHS only when we really need to. This advice is directed at everyone, but it is especially important for the over-70s, for pregnant women and for those with some health conditions. It is especially true of London, which the evidence suggests is several weeks ahead of the rest of the country.
These measures will be disruptive, but they will save lives. In a few days’ time, by this coming weekend, we will need to go even further to ensure that those with the most serious health conditions are largely shielded from social contact for around 12 weeks. We want to ensure that the period of maximum shielding coincides with the peak of maximum transmission. While the risks of transmission at mass gatherings, such as sporting events, are relatively low, from tomorrow, we will be withdrawing our support for mass gatherings. That will free up the critical workers we need to deal with the emergency and ensure a consistent approach to social contact.
Secondly, we are increasing our testing capabilities yet further. The UK has tested more people than almost any other major economy outside of China, South Korea and Italy. We have already increased the number of tests to 5,000 a day, and that is now on its way to 10,000, then radically further.
Thirdly, we are boosting the NHS. Ventilation is mission critical to treating the disease. We have been buying up ventilation equipment since the start of the crisis, but we need more. Today, the Prime Minister hosted a call with the nation’s advanced manufacturers asking them to join a national effort to produce the ventilators we need. We have set up a dedicated team to do that, and we are hugely encouraged by the scale of the response so far. Later today, the NHS will set out the very significant steps it is taking to prepare.
Fourthly, on Thursday, we will introduce to the House the coronavirus emergency Bill, which will give us the powers to keep essential services running at a time when large parts of the workforce may be off sick. Some of those measures will be very significant and a departure from the way that we do things in peacetime. They are strictly temporary and proportionate to the threat we face, and I hope that many will not have to be used at all. They will be activated only on the basis of scientific advice and will be in place only for as long as clinically necessary. Finally, of course, we are ramping up our communications efforts, so that people know what steps they need to take to protect themselves, others and the NHS.
Tackling coronavirus is a national effort and everyone has their part to play. The more people follow the public health advice, the less need to bring in draconian actions that I am keen to avoid. Of course, we must not forget the simple things that we can all do—washing our hands, following the public health advice if we have symptoms, and looking out for the most vulnerable in the community.
The measures that I have outlined are unprecedented in peacetime. We will fight this virus with everything we have. We are in a war against an invisible killer and we have to do everything we can to stop it. I commend this statement to the House.
I commend the shadow Secretary of State for the tone he has taken throughout this crisis. He rightly asks questions; I will seek to address each and every one of them, but before I do, I repeat something that I have said to the House a few times. We welcome questioning of the approach, because we are constantly looking for the very best solution for this nation, and the very best way through this, in order to protect life. I would rather have questions from all around the House, asked in the tone in which he has asked them, so that we can ensure that we are constantly doing the best we possibly can. That goes for publishing the science and the modelling, which we absolutely will do, because the very best science is done in the open.
The hon. Gentleman asked about the NHS being prepared. I am thankful that we have the NHS all the time, but in a crisis like this, I am doubly thankful, because we are reliant on those who work in the NHS. Thanks to the NHS, we are as well prepared as any nation can be. We are, by some measures, the best prepared for this stage of the spread of the virus, but what matters is giving the NHS all the support that it needs, and especially having regard to the capacity of the NHS, so that it can address the symptoms and consequences of this particular virus. The issues are around ventilation and oxygen supply, as he says. We are increasing the number of ventilators. We have been buying ventilators for several weeks now, but we also need to manufacture more. As we have discussed in the House, there is no limit to our appetite to buy ventilators, and there should be no limit to the appetite of industry to make them, because around the world, everybody is trying to increase their ventilator capacity.
As the hon. Gentleman knows, we have ensured that we can use all hospital capability in this country, public or private, and bring it to the task. We are expanding the use and production of personal protective equipment. Making sure we get PPE to every single part of the NHS is absolutely vital. We will be cancelling or postponing non-time-sensitive elective surgery; the NHS will make a statement about that later today. We are increasing ICU bed capacity, but I want to make sure that the House understands that we do not need a generic type of intensive care capacity. Of course we need intensive care capacity, but we need very specific intensive care capacity with the ventilation that is needed in many of these cases.
I turn to the other questions asked by the hon. Gentleman. He asked, “What if you can’t work from home?”. The answer is that if you are healthy, and if you are not being asked to isolate because a member of your household or you have symptoms of the virus, then of course you should still go to work. It is important that this country keeps moving as much as we possibly can, within the limits of the advice that we have given.
The hon. Gentleman asked about shielding, and about the elderly. The policy of shielding is specifically about reducing contact for the most vulnerable. For those who have significant health conditions, the NHS will be in contact with you over the next week. We will publish a list of those conditions, and if you think you should have been contacted and you have not been by next week, get in contact with the NHS. The shielding policy starts later than the general household isolation policy and the general advice to reduce social contact, because the reduction in contact that we need to see among those whom we are shielding is much more significant, and we need to see it last for a significant period of about 12 weeks.
The hon. Gentleman asked about those who refuse to follow advice. I do not think that many people will refuse to follow advice. Of course we have powers, and powers are proposed in the Bill, should we need to take further action, but I hope and expect that that will not be necessary.
The hon. Gentleman asked about schools. The scientific advice is not only that closing schools has a significant impact on people’s ability to work in, for instance, key areas such as the health service, but also that if we get it wrong, children may stay with elderly grandparents instead of going to school, and thus increase the risk. We keep this matter under review and we are in constant discussion about it, but we have not changed the advice on schools today.
The hon. Gentleman asked about other countries. Of course we are constantly looking to all other countries around the world—including South Korea and Singapore, which he mentioned—to see what we can learn about how we can do things better. We are taking these measures at a different time from other European countries because we are behind them in terms of the progress of the virus, which is a good thing. In fact, as the chief scientific adviser has said, we are taking these actions earlier in the curve than, for instance, France and Germany did, but behind in time, because the progress of the virus is further advanced in those countries.
The hon. Gentleman asked about testing. That is very important, because of course people want to know their covid-19 status, and we are expanding testing as fast as we possibly can. The test that the world is looking for is the test that can check whether people have the antibodies because they have had coronavirus, because then we can find that out not just by testing people while they have it but afterwards, if they have had it, and therefore have the antibodies with the immunity that comes from that. That test does not yet exist, but we are putting an enormous amount of effort into creating it. We also need testing that can be done at the bedside rather than in the lab, and a huge amount of work is under way to bring that about. The same goes for vaccines and antivirals, on which the hon. Gentleman asked for a written ministerial statement, and I will of course ensure that the House is provided with one.
Finally, the hon. Gentleman asked about a package of financial support. We established a significant package in the Budget last week, and I had a meeting with the hon. Gentleman earlier today to discuss what further amounts might be needed.
There are many young people in my constituency, but when I was first elected it had the highest proportion of people above retirement age in the country. Most of those people are economically active, and many of those who are not are volunteers. I pay tribute to those over 70 who are helping people even older than themselves.
I welcome all the points that the Secretary of State has made so far, but may I put three quick points to him? He does not need to answer them in detail now. First, senior general practitioners are worried that some medicines—controlled drugs, which are safe—are being destroyed because the patient for whom they were first ordered may have died. If a shortage of morphine and the like happens, it will lead to distress and agony for people unnecessarily. Will the Secretary of State look into that, and see whether, whatever the requirements are, they might be lifted during this period?
Secondly, the advice to reduce social contact may be right and important, but if people are fit and healthy and are running a business, it is not necessarily right for that business to be closed down just because they have hit a certain age.
Thirdly, may I add to a sensible point made by the hon. Member for Leicester South (Jonathan Ashworth)? There is some help for people with mortgages, but many people who will lose their jobs are paying rent. Will the Secretary of State also ensure that no one is unnecessarily evicted or threatened during a short-term period of shortage of money?
The measures on shielding are specifically for those who have significant health conditions and will be contacted by the NHS. They are not for the generality of over-70s who are healthy, for whom the guidance is the same as that for people of working age, except that we strongly advise, as opposed to advising. That is for their own protection, because the over-70s, and especially the over-80s, are at significantly higher risk of mortality—of dying from this virus.
The other points made by my hon. Friend are welcome. He made a very important point about rent, which featured in the discussions that we had earlier today. I have been talking about it to those at the Treasury and to the Secretary of State for Work and Pensions. Many banks have already taken action on mortgages.
My hon. Friend’s point about the availability of drugs is, of course, critical. We have a very comprehensive drug supply chain system that we understand well, thanks to the planning that we have done over the last couple of years. Thus far we have not seen shortages beyond those that already existed before the virus, such as the one that we debated in the autumn in the context of HRT, but of course we keep the position under constant review.
The Secretary of State will be aware of the concern about why the UK Government’s approach was such an outlier until now, including the talk about herd immunity, when it is not clear that any immunity from this virus is long-term. The UK is now facing an exponential rise, and I therefore welcome what the UK Government have said about decreasing all non-essential contact, as I think that it is critical to slow down and limit the spread of the virus.
The briefing from the Prime Minister talked about not providing emergency services for large gatherings, but can the Secretary of State clarify whether the Government are advising against or forbidding mass gatherings? I welcome the talk about increasing testing capability, but the briefing talked about only testing those in hospital and key workers. In Scotland, surveillance testing in practices that monitor disease in the community is continuing. Will that also be the case here in England?
Following the confusion over the weekend and, indeed, the comments that he has just made about healthy people over 70, will the Secretary of State clarify what exactly is the advice for people over 70 who live in their own homes or in care homes? Are they meant to be staying at home, or are they simply meant to be decreasing contact? In particular, is the Secretary of State discussing with social care providers lengthening the time of each visit so that there is time for the careworker to take precautions? He says that the healthy should go to work, but what if they work in a club? What provision is being made for socially vulnerable people such as the homeless or those who have no recourse to public funds, such as refugees or asylum seekers? We on these Benches welcomed the measures in the Budget, but when will the devolved Governments know exactly how much funding they will have to mitigate the economic impact of this in the three devolved nations? Finally, what further changes will be carried out in the Houses of Parliament to ensure that core services continue without increasing the risk to, in particular, older Members of both Houses?
We do not support mass gatherings. We have advised against unnecessary social contact, so it goes without saying that we do not support mass gatherings.
The hon. Lady asked about surveillance testing. Across the UK, we have one of the biggest coronavirus surveillance operations in the world. Of course it happens in Scotland, but it happens throughout the UK. She also asked about Parliament. I understand, Mr Speaker, that you have been having discussions today about how Parliament will operate, but I think the whole House will be sure, in our collective decision, that although Parliament may have to operate differently, it must remain open.
May I join the Secretary of State, and the shadow Secretary of State, in commending and paying tribute to all who work in our national health service, on whom we rely from day to day, but on whom we rely all the more under these conditions?
May I press the Secretary of State on two points that have been raised by others? The advice from the World Health Organisation was very clear: test, test, test. At an earlier stage the UK changed its testing requirements, and those who have symptoms and self-isolate are no longer tested. If the full information is to be available, surely the testing has to be very significantly increased. Who exactly is going to be tested?
One of the difficulties has been the way in which information has been presented. To pick up the point made by the SNP spokesman about the over-70s that was echoed elsewhere, the headlines are that over-70s, even now, are going to have to stay at home for 12 weeks. Can the Secretary of State be absolutely precise as to what the advice is for over-70s and those with other conditions, and what those conditions are? Finally, on the question of seven or 14 days’ self-isolation, my understanding was that if someone had symptoms and were on their own they should self-isolate for seven days, but if they were in a family the whole family should self-isolate for 14 days. Perhaps my right hon. Friend could confirm.
My right hon. Friend is precisely correct on the third question. The difference between the advice for seven days and 14 is precisely as follows. If you have symptoms yourself, if you live on your own you should self-isolate for seven days, but if you live in a household with others, the whole household now needs to stay at home for 14 days. The reason is that if you live in a household with someone who has coronavirus it is highly likely that you will catch it, so it is important, to protect against onward transmission, that everybody stays at home. That is the reason for the distinction between the seven days and the 14 days, and I hope that is clear—seven days for individuals, 14 for households.
On the point about the World Health Organisation saying that we should “test, test, test”, I wholeheartedly agree. We have continued the increase in testing in this country throughout this outbreak. The point that was made last week was that as the increase in the number of cases continues, so our testing capability must increase faster, and at this stage we have to make sure that the use of the tests we have are prioritised. As we expand testing capability, we will expand the number of people who can get hold of those tests. I understand the frustrations of those who want a test, but the whole House will agree that we have to make sure that we use those tests on the people who need them most, which means saving lives in hospitals.
On the point about the over-70s, to reiterate the answer that I gave a moment ago, the advice to everybody is to avoid unnecessary social contact. For the over-70s, for their own protection, that is strongly advised. The shielding, which is essentially reducing all contact as much as possible, is for those who have underlying health conditions and will be contacted by the NHS. The precise details of all these will be published on the gov.uk website so that everybody can see not only the answers I am giving to the questions, but the precise wording of what we expect everybody to do, as I have set out in the statement.
Can I say to the Secretary of State that the House has always come together at times of national crisis as one, and that is the spirit across the House today? In that spirit, can I ask him to match the unprecedented public health measures that he has announced today with unprecedented economic measures to support all the businesses, large and small, their workers, and the self-employed, who will be affected by the measures announced today? We have seen across the world—for example, in Denmark—workers’ wages being guaranteed by a combination of Government and employers. It is no fault of the Chancellor of the Exchequer that his Budget last Wednesday is now out of date, but can I ask the Secretary of State to urge him to come back to the House with economic measures that match the gravity of the moment?
I absolutely understand the point that the right hon. Member is making, and he is right to make it. Of course, these are matters for the Chancellor of the Exchequer, rather than me. There was a G7 call today, in which the Prime Minister participated, during which economic considerations like this were considered. Finally, every single one of us in the House will have businesses in our constituencies that are already facing the brunt of this virus. We saw from the collapse of Flybe right at the start—that feels like weeks ago—the very significant economic consequences, and we have our eyes wide open to those.
I warmly welcome the measures announced today. People have debated when they were going to be introduced, but the Government have shown today that they have the courage to introduce very tough measures that will have profound economic consequences, which will reassure many people up and down the country. In the constructive spirit adopted by the shadow Health Secretary, I want to ask a couple of things about the measures that have been introduced.
First, the Secretary of State is advising people not to go to clubs, cinemas and restaurants. Will he also advise clubs, cinemas and restaurants to close their doors, so that there is absolute clarity that people should not, at this moment, engage in those activities? Secondly, if someone in a household is symptomatic, he is advising the whole household to self-isolate for 14 days. I understand the logic behind that, which was very clearly explained, but the World Health Organisation advice is to test and isolate every single suspected case of the virus, so would he explain why there is divergence?
Thirdly, to follow up the question asked by my right hon. Friend the Prime Minister—[Hon. Members: “Former”]—the former Prime Minister, is the advice to healthy over-70s who do not have an existing long-term condition that they should be part of a new shielding policy that is happening at the weekend, or is that shielding policies just for over-70s with an existing health condition?
On that last point, no—the shielding policy is only for those with existing health conditions. Those whom we are going to ask to participate in shielding, from next week, will receive a contact from the NHS, and we will publish the list of conditions that we consider necessary for shielding. On the point that my right hon. Friend makes about testing and isolating, I strongly agree with the World Health Organisation about the need for testing. I spoke at the weekend to Dr Tedros, head of the World Health Organisation, and we strongly agree on the need for testing. The question is how fast can we ramp up testing capability for the tests that we need—the blood tests to know who has had coronavirus and the bedside test or the home test, so that these tests can be expanded rapidly across the whole country? The first has yet to be invented, although we hope that it will be fairly soon, and the second has just been invented in the past few days, and we are in intense negotiations about rolling those out very rapidly.
Today I bring a message from my colleagues who are working hard on the NHS frontline. They say that they do not have the protective equipment that they need, nor do they have the capacity to manage the spread of infection in their own departments. There is clear concern among hospital staff and the wider public alike about the transparency of the plan to tackle the virus. Does the Secretary of State agree with me that our incredible staff must immediately have the protective equipment that they need to be safe; that they should be tested if they show symptoms of virus infection, as currently not all of them are being told that they can; and that more information must be transparent so that medical teams across the country can prepare their departments for the very worst?
The whole of our action plan is based on the science and on as much transparency as possible. We have exhibited unprecedented transparency in this crisis so far, and I pledge again to full transparency, publishing, for instance, the modelling that underpins the scientific advice, and also publishing the action plan two weeks ago. At the time, that felt as if we were looking at some things that were quite out of the ordinary, and I do not think that anybody then anticipated that we would have to bring them in in the way we have, and as many countries have now brought them in. I pledge once again to that transparency.
The hon. Lady is completely right about PPE, and we need to expand the amount of PPE. Again, we are buying it, as with ventilators, as fast as we possibly can, and part of our call for a national effort to manufacture includes PPE.
I want to end my answer to the hon. Lady by saying something about those who work in the NHS. The NHS will face an extraordinary period and many people will do extraordinary things, but it will be very, very difficult. I pay tribute in advance to the service that every single person who works in the NHS will give.
The hon. Lady is right to remind me. Of course we want as much staff testing, as soon as possible. We are using the testing capacity we have to save lives, and that includes saving the lives of medics.
In the past 24 hours or so, I have spoken to a great number of the headteachers in my constituency. I think it is a fair summary to say that there is support for the decision to keep schools open, and I agree with them. However, there is great concern that no matter what they or we might want, an increasing number of teaching staff becoming unwell and therefore unable to be in school might end up forcing the issue, leaving heads in an impossible position. I feel slightly guilty asking the Health Secretary these questions, but his is the statement we have today. What is the Government’s view on relaxing the student-staff ratio and getting Ofsted off schools’ back now, please. Also, if we were to run a skeleton service in schools to allow key workers to keep working, how are we to define key workers, given that we are in the middle of a national crisis?
We are looking at all those questions. The proposal to relax student-staff ratios is in the Bill. We will publish the content of the Bill tomorrow and the Bill itself on Thursday. The point about key workers is incredibly important. I am working hard with the Education Secretary to address precisely the concerns that my hon. Friend raises. Of course schools play an important part not just in educating our children but in allowing so many people to go to work, but we have to make sure that they are safe as well. One of the blessings of this virus is that it almost entirely spares children, which means that it is safe for children to go to school.
Can the Health Secretary give the public some reassurance about his plans for social care, which many vulnerable elderly and disabled people rely on? In particular, what plans does he have to ensure that the care workforce can continue to be effective? We already have more than 120,000 vacancies in the sector, and half of all home care workers are on zero-hours contracts. Is he confident that the care workforce can do what elderly and disabled people and the NHS need?
Obviously, that is an incredibly important area. Earlier today, there was a call with local authority leaders, my right hon. Friend the Communities Secretary and the Care Minister. Enormous amounts of work are being done and we will do everything we can to support social care.
I congratulate the Secretary of State and the shadow Secretary of State on the tone both have adopted. It is inevitable that most people will be infected. Most people will recover. When can the people who recover return to work, and what will the impact be?
Yes, most people recover within seven days of first showing symptoms—most people, not all. Many become very ill, but for most people this is a mild to moderate illness, and the vast majority of the evidence is that once they have recovered, the illness does not come back for some time. Of course, all the evidence is kept constantly under review.
Will the Secretary of State clarify some details of his answer to the hon. Member for Tooting (Dr Allin-Khan) regarding testing of our frontline healthcare workers and, just as important, our frontline social care workers? Our services are stretched to the max already. We cannot afford to have those who do not need to self-isolate self-isolating, potentially multiple times if they do not know whether they have had the virus.
I entirely understand that point. I want to get testing to everyone who needs it as soon as possible.
I join the Secretary of State and the shadow Secretary of State in extending sympathy to those who have died of the virus and admiration for NHS staff members and others who are coping with it. May I press my right hon. Friend on testing? First, if we are relying on scientific evidence, it is important that we are transparent about it. When will he publish the scientific evidence that he mentioned in his statement? Secondly, there has been a change in policy on testing. Up to the end of last week, people could be tested via drive-in or home visits; that is no longer the case. Is that because there is not the necessary quantity of test kits available? If so, will that type of test be restored when they are available, and when does he expect that to be?
At the start, when the number of cases was very small, we had enough tests to test everyone who had suspected symptoms. The number of cases has risen exponentially and the number of tests has been increased, but we need to make sure that the tests we have available are there for saving lives. We hope that the introduction of a home test or equipment for bedside testing, which my right hon. Friend and I have discussed previously, will enable us to increase the number of tests radically, and get ahead of the epidemiological curve as soon as possible. We are in live negotiations about bringing that in.
Many of us have thousands of constituents who are either on zero-hours contracts or are self-employed. I have raised this question before, but unless the Government can offer those people some sort of minimum income guarantee, they will quickly be facing repossession and homelessness.
Of course I understand that, and it is part of the discussions I have been having with the Welfare Secretary and the Chancellor of the Exchequer.
I thank my right hon. Friend for his statement and everyone in the House for their calm response. I have two brief questions. One has been raised several times, and although it may sound flippant, it is important. People are asking whether they can walk their pet if they are self-isolating. I ask because people want to know whether self-isolating means that they should be fully housebound, or that they can go to a park and walk their pet.
The second question—[Interruption.] I will be very quick. In Watford, we have a great volunteer network popping up. I am sure that is happening across the country. Will there be guidance for volunteers on how to ensure they do not spread the virus by doing the right thing?
The answer to the second question is yes. The answer to the first is yes, people should go outside. Walk your pets. People in household isolation should go out, but they should try to avoid other people. It is very important that we look out for others in our communities and that people get the exercise they need.
I realise that this is not in the Secretary of State’s remit, but he announced that the Government will advise people not to go to pubs, clubs, restaurants and so on. Unless the Government mandatorily close them down, they cannot claim on their business insurance. Will he please get a diktat from the Government that formally closes such businesses down?
We have set out the advice today, and I will look at the point the hon. Gentleman raises.
Will the Secretary of State make sure that in the legal powers and guidance will be provision to ensure that all our councillors who are over 70 can participate fully in council and committee meetings from their home, using technology?
Indeed, technology has a huge role to play in helping people to get through this.
Everyone wants us all to pull together and support the same strategy, and the Health Secretary will be aware of the real unease about the differences between the UK’s approach and other approaches taken internationally. Can he reassure us that the Government’s objective is the same as the WHO’s, which said today that we should be testing everyone who has symptoms, not waiting for a future test that might work in different circumstances? Is that the objective: to test everyone who has symptoms now? What is his target for how many new tests a day he wants to be able to do and by when? I have been contacted by GPs who are self-isolating because they cannot get tests.
Does the test give evidence of no infection? That goes to the point that has been made about frontline health workers. Is the Secretary of State saying today that there is an immunity that builds up? Has that been medically confirmed for people who have had this once?
On the latter point, the chief medical officer has set out today that immunity is built up by having had this virus. That evidence is constantly being kept under review, but immunity does appear to be built up. On the testing point, as I said to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), of course we want tests to be available for everyone. Our goal is to beat this virus. We want to make sure that all our frontline medical staff can have the testing and that everyone in the community can have those tests, but where only a limited number of tests are available we have to use them to save life. I am working as fast as I can to increase the number.
The Secretary of State said that this was a national effort and he is right, but it is more than that; this is a global crisis that has seen different approaches taken in different countries. Does he not accept that we need stronger, co-ordinated, global leadership, both on the health front and on the economic front, to get the best possible response to this global crisis?
I half agree with the right hon. Gentleman, and that is because I think that international co-ordination is important—I have been participating in regular G7 calls, as have the Prime Minister and the Chancellor of the Exchequer—but different countries are also in different places on the curve. For instance, we have introduced measures such as these earlier on the curve than similar countries, such as France and Germany.
May I repeat the point made by the hon. Member for Edinburgh South (Ian Murray) about pubs and restaurants? I have been contacted by a number from the Moorlands today that are particularly concerned in the run-up to Mother’s Day, which would normally be one of the busiest days of the year. Can the Government give firm advice now as to whether pubs and restaurants should close or not, so they can claim on insurance?
We are advising against all unnecessary social contact. I appreciate that this has consequences and I regret having to take these measures, but we are having to fight this virus.
When exactly did the Government start buying extra ventilators? How many more have they managed to get? How many more do they need?
We started weeks ago. I can get back to the right hon. Gentleman with the exact date of the first time I authorised the purchase of more ventilators, but I can say that it was very shortly after it became clear that ventilators are the thing needed to support people who have coronavirus. On the question of how many more we will need, I can say that we will buy however many will be produced.
This morning, I was pleased to hear Nicola Sturgeon say that she supported the UK Government’s approach, but of course the devolved health service, the police and the education service are different and different operational decisions will inevitably be made in Scotland. How can that be respected at the same time as ensuring that we have a common message across the UK?
My right hon. Friend is right about the advantages of a common message across the UK, and we have worked hard to try to achieve that. I visited the three devolved nations on Friday to meet my counterparts to try to ensure that we have as co-ordinated a message as possible, but of course there are differences in the delivery of our local NHS.
The Secretary of State made reference to the special measures announced by the Chancellor last week, yet the Northern Ireland Executive have yet to have been given a clear indication as to what the consequentials are for our funding in Northern Ireland. That inhibits our ability to respond to this crisis, and to provide leadership and direction to people in Northern Ireland on the schemes we can implement.
My hon. Friend the Economic Secretary to the Treasury tells me that undoubtedly the devolved nations will very rapidly get the information they need. After all, this is a UK-wide effort.
Will my right hon. Friend join me in thanking the thousands of local community groups that are already mobilising in order to deal with what may be a very serious situation in their communities, involving looking after vulnerable people and even nursing the sick? Will he, with the Prime Minister and others, make sure that we mobilise these people and empower them to take decisions without having to wait for instructions?
Yes, this is incredibly important. Communities have a huge role to play in this; it is truly a national effort. I want to empower people on the ground in communities and within the NHS to do the right thing by what is in front of them. We will support wherever possible, but people should not wait for the instruction—they should get on with it.
The World Health Organisation has given the advice of, “Test, test, test”. The Secretary of State has said that there is a limited capacity in terms of testing kits. When will those kits be made available? What is the timeframe? How many does he think we are going to need?
I thank my right hon. Friend for the sterling job that he, his ministerial team, his officials and everybody on the frontline of this crisis is doing. Does he share my concern about reports I have had in my constituency in the past few days of local pharmacies hiking up prices of products such as sanitiser and masks, given that we should all be working together and, rather than profiteering, acting responsibly?
Everybody has a responsibility: citizens have a responsibility to follow the public health advice; all of us have a responsibility to make sure we buy only that which we need; and of course businesses have a responsibility to look after the communities they serve.
Will the Secretary of State confirm that it is now the Government’s wish, subject to capacity being available, to test all those with symptoms who are at home? If so, as the capacity ramps up, how does he intend to prioritise tests of people living at home, potentially with the disease?
The right hon. Gentleman asks the question very precisely and correctly. The answer is: yes, that is our intention, and Public Health England will advise on the order of priority for the use of these tests.
People want accurate information during this crisis. Are the Government considering creating an offence of the malicious spreading of disinformation about the coronavirus with the intent of harming public health? Are they considering requiring social media platforms to act against known sources of such disinformation, should it occur?
My hon. Friend is an expert in this area. So far, the social media companies have acted with great responsibility in this area and have responded to all the asks we have had of them.
The Government are trying to regulate behaviour, so to avoid some of the scenes we have seen at the weekend would he encourage supermarkets to allow the elderly to have one hour a day when only they can shop to get their essentials?
I have seen this call and how the Australians have done this, and I discussed it with the Environment Secretary today.
May I ask my right hon. Friend about specific very vulnerable groups? A mother in my constituency is keeping her four children off school because her husband is a diabetic and she does not want to put him at unnecessary risk. Is she doing the right thing? More generally, what should pregnant teachers be doing? Should they be going into work now, or is that too risky?
Both cases are covered by the formal public health advice that will be published on the gov.uk website. For all specific questions such as that, which of course our constituents will have, I refer them to that advice, to make sure that we get the answers completely accurate.
We are now rightly asking people, including the self-employed, to self-isolate for seven or 14 days if they show symptoms of coronavirus. The self-employed do not qualify for statutory sick pay and there is no one else to pay them, so will the Government revisit statutory sick pay for the self-employed, and pay it at a rate that enables them to put food on the table and pay their bills? Unless we do that, we are asking people to make impossible decisions.
I discussed this issue with the hon. Member for Leicester South (Jonathan Ashworth). The delivery of support to make sure that nobody is penalised for doing the right thing is incredibly important but, as the hon. Lady says, there is no employer for those who are self-employed, so it has to be delivered through the benefits system.
With flight restrictions around the world, many of us have constituents who are stuck abroad. Will my right hon. Friend provide reassurance that consular assistance is available and that he is working closely with the Foreign and Commonwealth Office so that stranded constituents in countries that have imposed flight bans can get home?
Yes. That is an incredibly important point that I discuss regularly with the Foreign Secretary.
Food banks will be under unprecedented pressure in this period, so what measures will be put in place to provide volunteers with protective equipment? Will the Secretary of State consider requiring supermarkets to put aside stocks and provide donations to food banks in this crisis?
As we expand the amount of protective equipment available, we should look to and work with food banks, which have an incredibly important role to play. I certainly urge supermarkets to do what the hon. Lady asks.
In welcoming this package of measures, I very much urge my right hon. Friend to encourage businesses to be as flexible as possible so that employees can work from home, and to step up testing for emergency and public sector workers. Will he particularly focus on the elderly and the vulnerable who are living alone? There is a risk that in this sort of scenario they become inadvertently ignored by the system. What more can the Government do to reach out to these people—whether by looking at the voting register or whatever—to ensure that they are catered for? They are particularly vulnerable if they live alone.
My hon. Friend makes an incredibly important point. One reason why we have held off from taking measures like this for as long as we have is because they have significant downsides, many of which have been discussed in the Chamber today. I of course urge people to follow the advice that my hon. Friend gave, and I urge communities to come together as much as possible to help each other through.
We need a plan for scaling back schools. Teachers are saying to me that they are part of a mass collection of people every day and are concerned not only about being infected but about relatives who may have secondary illnesses and about colleagues who are pregnant. Schools are losing pupils and losing staff. They will close of their own volition unless we have a plan to scale them back and provide essential childcare for those workers who will still need to work and the children who will still need to go to school.
I understand why some parents are concerned, but the evidence is that children are not badly affected by this virus and it is important to take that into account. The hon. Gentleman makes the point about people who need to go to work not being able to because of childcare responsibilities, and that is very serious in terms of the impact that it could have and is therefore very important to take into account.
In the past two hours, the Prime Minister has said that school closures will be kept “under review”. In the event of a school needing to close, who takes the final decision—is it the Government, the local education authority or the headteacher?
It is the headteacher, and there are discussions with regional schools commissioners in such cases in England. We are looking to address that issue in the Bill.
I join other Members in placing on record my condolences to the families of those who have lost loved ones. I pay tribute to the workers in the NHS who are working around the clock and to those working in social care.
After a decade of austerity, our NHS and public health were already at breaking point, even before the coronavirus hit our communities. Public sector workers have borne the brunt of austerity over the past 10 years, and they are the very workers who are expected to continue to provide services to the most vulnerable people in our society.
Today, I have been contacted by Paul, a critical care nurse in my constituency who has had to self-isolate after developing a cough. He has been told that he will not be tested. His skills, along with those of his colleagues, are vital to care for patients. Frontline staff need to be—
Can I just say this, Mr Speaker? When will local government be provided with the additional ring-fenced funding for public health? When will public health officials be provided with their allocations for the new financial year?
I have addressed the question on testing repeatedly. I am delighted that we go into this situation with a record number of people in our NHS, and I pay tribute to each and every one of them.
Covid-19 may put particular pressure on the dozen or so unavoidably small hospitals that serve isolated and island communities. We have one respiratory consultant on the Island, and we are ferry-dependent. I know that the Secretary of State is very busy, but will he assure me that isolated communities will not be forgotten about when it comes to mutual aid, clear advice and the supply of medicine and equipment?
Last week, I asked the Secretary of State why public advice about covid-19 had not been translated into any language other than English. Coronavirus has been present in the UK for more than a month, and it is five days since I raised the issue with the Government, yet there are still no translations available on the NHS England website. Will the Secretary of State provide an update on when exactly translations will be made available? Will he clarify which languages the Department is currently working on?
We are going to do that as soon as possible, but I am sure the hon. Member will understand that we have just published new guidance that we have been working on and it is a very rapidly evolving situation. We will translate it as soon as we possibly can.
I endorse the point made by the hon. Member for Glasgow South West (Chris Stephens) about having an hour in supermarkets—I believe Iceland is already doing this—when older people can purchase food before it is stockpiled and so on. Can mothers of very small children be included in that? I am afraid I have heard today of some scarcity in baby products, which is of course of great concern for us all.
Yes, that is a very good suggestion. It is one for the Secretary of State for Environment, Food and Rural Affairs and the supermarkets, of course, but is an example of people pulling together to help the most vulnerable.
In answer to the question from my hon. Friend the Member for Leeds West (Rachel Reeves), the Secretary of State stated that people had to take it through the benefits system, unlike maternity allowance, just as an example. I wish to speak for a moment about the benefits system. My own brother, who is a universal credit claimant and an agency worker, has likely lost his job because he had to self-isolate for a period and it will not be kept open for him. Given the lag of universal credit, he will not get anything until early May. The Secretary of State needs to tell us now when he will come before us with a package of financial benefits for business and people, because it is getting too late.
We changed the law on Friday to take into account the need to make sure that payments are made from day one, in some of the benefits. It is absolutely the case that statutory sick pay is paid by employers. For the self-employed, there is no employer. We cannot put in place, in the time that is necessary, a whole new system. We need to make sure that people use the benefits system that exists.
Will the Government consider giving the much needed funds to support businesses directly to regional mayors and combined authorities, so that businesses in Redcar and elsewhere that are affected by the coronavirus can get the help that they need without delay?
I am discussing with the Chancellor of the Exchequer a further package of support, because it is absolutely clear that the measures that we are having to take will have a very significant impact on business.
Professor Costello of University College London says that the virus is particularly contagious at the early stages before symptoms present. Given the prevalence of this virus in London in particular, is the current Government’s strategy based too heavily on responding to observable symptoms and is there not a case now for going further faster, particularly in London?
The point behind household isolation is precisely to address the concerns that the hon. Gentleman has raised. Furthermore, by reducing all unnecessary social contact, we will help to reduce the sorts of transmissions that he talks about.
Will the Secretary of State explain how he and his team have been working to learn from the experience of other countries that are ahead of the curve, so that we can see the things that they have done well, and the things that they have not done so well?
Yes, we are constantly looking at what is happening around the world, what people are doing and the research in order to try to make sure that we calibrate the very best possible response.
Many of my constituents live in severely overcrowded accommodation or in single hostel rooms. There is a looming public health crisis in the short term and a looming long-term mental health crisis because of the conditions in which they will have to self-isolate. What will the Secretary of State do about those people and what advice will he give?
Yes, of course, we are incredibly concerned about that, and it is reflected in the guidance that we have specifically put out. It is one of the many reasons why we encourage people to get outside, even if they are in household isolation, so long as they do not come into contact with others. Of course, I understand the consequences of the advice that we have given for the hon. Lady’s constituents.
Many of those whom the Secretary of State will want to shield at the weekend and who are self-isolating are in receipt of at-home social care. Can he be clear about the guidance that he is going to give about whether they should continue to be visited, or what else he will put in place to protect those individuals?
Yes, of course, the further advice will go out for social care. We put updated advice out at the end of last week knowing that that was a likely step, and there will be further advice precisely to help people to address exactly that question.
Given the anxiety in schools, colleges and universities about exams, will the Minister reassure students and staff alike that there is provision in place for exams to take place within the cycle of this academic year? Will he also reassure the House that, in the event of school closures, there is provision in place to feed those children who are currently in receipt of free school meals?
Those are both very important points. Children who receive free school meals often receive their best or, in some cases, their only meal at lunch time at school, and it is an issue that I discussed with the Education Secretary over the weekend.
My hon. Friend the Member for Folkestone and Hythe (Damian Collins) talked about the importance of information consistency, but some constituents are seeing competing messages which look like they come from credible sources and are then passed on in good faith. In the worst cases, not only do they mislead, they can even be dangerous. May I encourage my right hon. Friend to continue his work with the platforms not only to ensure the primacy of the official information, but to actively work against that which disinforms.
The Spanish Government recently announced sweeping measures to take over private healthcare and to requisition products such as ventilators, testers and, indeed, facemasks. We have heard that, in the UK, the Prime Minister has ordered the NHS to acquire resources from the private health system to the tune of something like £2.4 million today. Will the Secretary of State outline measures that the Government will take to ensure that we put public health and public safety before private profit?
I am absolutely delighted at the response of the private hospitals which are rising to that challenge, and we are working very closely with them.
Will my right hon. Friend outline what discussions he has had with the First Minister of Wales to ensure that the plan is consistent and that constituents do not get mixed messages? Furthermore, will he appeal to certain sections of the media to realise the power of their platform and encourage them not to undermine the official advice?
Yes, that is very important. I was in Cardiff on Friday to discuss that with my opposite number who attended the Cobra meeting today. We are working very closely with the Welsh authorities, which, of course, run the NHS in Wales.
What consideration have the Government made of the possibility that some people, especially those living in London, may, in light of today’s announcement, decide to move from more urban areas to rural areas? Will the Secretary of State reassure us that additional resources will be made available to local health authorities should there prove to be a significant shift in population?
Last Friday, the heads of all the NHS services in Gloucestershire held a conference call with the six MPs in the county, and very helpful it was indeed in answering all our questions and giving us information to share with our constituents. Does my right hon. Friend think that this is something that could be done in every NHS cluster around the country?
Yes, and I have asked Simon Stevens, the head of the NHS, to ensure that local trusts and clinical commissioning groups keep their local MPs informed of what is happening locally, what is having to happen and how they are responding. Of course, the NHS is incredibly busy at this time preparing for events to come, but that would be a good idea.
What extra support will be available for pharmacists, and when will local authorities know what their public health funding allocation will be?
The public health budget is going up and pharmacists are an incredibly important part of the NHS family.
The people most seriously at risk are those with underlying conditions. Will the public health agenda being published promote how people can minimise those conditions—for example, by giving up smoking and leading a healthier life—so that we can minimise the number of serious cases that are seen by the NHS?
That is absolutely right. It is abundantly clear from the research into previous coronaviruses that smoking makes the impact of a coronavirus worse.
Every time the Prime Minister makes a statement on coronavirus and the advice changes, the 111 hotlines go mad. Our 111 call handlers are asking that the script changes in real time, because they are required to keep to the scripts, and on Thursday there was a three-hour delay before the scripts were updated. Please will the Secretary of State look into this and change it for next time?
Yes. First, let me pay tribute to the 111 call handlers and the clinicians who have done an amazing job over these past few weeks. I do not know what we would have done without them. Secondly, the three-hour turnaround of the script changes was an unbelievable task for those who implemented it. They did a magnificent job to turn it round so quickly, and I, of course, applaud them for doing so, and would wish them to be able to turn it round even quicker, but they did an amazing job doing it as fast as they did.
The Secretary of State’s announcement today will mean that large numbers of elderly and vulnerable people will be required to self-isolate. Will the Government therefore co-ordinate all the volunteering organisations because large numbers of people will be required to deliver necessities to those vulnerable groups?
Just as we have introduced a national effort for ventilators, so we are introducing a national effort for volunteers, and my right hon Friend the Secretary of State for Digital, Culture, Media and Sport is leading that drive.
In answering my right hon. Friend the Member for Leeds Central (Hilary Benn) earlier, the Secretary of State made it clear that he wanted everybody to be tested at home if they had the symptoms. What is the difference between the number of new cases currently and the number of tests that are currently available per day?
Our estimate of the total number of new cases is significantly higher than the available number of tests right now, which is why we need to increase testing capacity so quickly.
Something that will unite us across this House is our utter admiration for the great British public. All parts of our society have responded to this crisis—our public health officials, families, communities and, today, businesses that have heeded the call for ventilator production. Can the Secretary of State confirm that, as well as the hotline, there is now also an email address for businesses to send their response to if they want to contribute to the national ventilator effort?
Yes, there is. We have been absolutely overwhelmed with the positive response to the national effort for building ventilators. That email address is up and running, and we are trying to engage with everybody who contacts us.
Can the Secretary of State assure the House that if schools are closed because of the coronavirus, money will be made available so that lunches and hot food are provided to the children who are the most in need? Also, he said that he took advice from other countries—Ireland has closed its schools.
We are looking at the impact of all the decisions that different countries have taken. There will be lots of consequences should we take the decision to close schools, but we have not taken that decision today.
May I pay tribute to my right hon. Friend, and to all the staff and officials at the Department of Health who are working around the clock in incredible situations to deal with coronavirus? Indeed, I also pay tribute to the Secretary of State’s counterpart in the Scottish Government and to all her staff, who are working to do exactly the same north of the border; I know that my constituents in West Aberdeenshire and Kincardine appreciate it. Does the Secretary of State know whether the Transport Secretary will be coming to the House at some point soon to update us on any discussions he is having with the airline industry? The maintenance of routes is very important to the economy of the north-east of Scotland, and the survival of those airlines is vital.
It is of course a matter that I discuss with the Transport Secretary, who I am sure will be coming to the House sooner rather than later.
May I encourage people across the country to have complete confidence in the Government’s medical and scientific advice, and that is essential for the safety of the country? I also encourage the Secretary of State to ensure that the population as a whole have confidence in their own economic futures. We spent £500 billion bailing out the banks in 2008. We need to be prepared to go even further than that to ensure that people—for example, the 60,000 people working in tourism and hospitality in Cumbria—know that their economic future is not about to be burnt.
I understand the concerns raised by the hon. Gentleman, and it is important that they are addressed. Coming from a small business background myself, I understand the impact that a change like this can make, especially to the tourism industry, which is so important in the hon. Gentleman’s constituency. We regret having to take the measures that we are taking today. As I said earlier to the former leader of the Labour party, the right hon. Member for Doncaster North (Edward Miliband), this is something on which we are working at pace.
The Secretary of State should be congratulated for the calm and responsible leadership that he has shown during this crisis, but may I draw his attention to the subject of a hugely vulnerable group—that is, children with immunosuppression with underlying health concerns? The advice to those children is still to go to school, but he will know that any virus can be devastating to them given their low immune systems. Will he issue specific guidance to parents with such children who have these concerns?
I have talked to my local trust this afternoon, and it is doing everything it can to prepare for the potential surge in covid-19, but it told me that the big problem it has is knowing what to do if schools close, and what that will mean for the workforce and their ability to turn up to work. Can we please have an assurance that there will be a national childcare policy, particularly for key workers in the NHS?
This, allied with the fact that children are safe at school because they do not have significant symptoms from covid-19, is the reason that we are keeping schools open for now.
Charities and third sector organisations are also going to be deeply affected. Will the Secretary of State inform the House what support will be available to them, especially when they are trying so hard to help in our communities?
My hon. Friend is absolutely right to raise such an important point. We need communities and people to come together to help out those who are badly affected by the virus. Of course, that means supporting charities to ensure that they can keep providing the sort of support that we were going to need in the weeks and months to come.
If schools are to close—I appreciate that that is not the Government’s position currently—headteachers in my constituency have asked me to convey to the Government that a particular priority must be given to child safeguarding, and that this should also become the priority for Ofsted. Will the Secretary of State discuss that with the Schools Minister?
British businesses—large and small, including those in West Sussex—stand shoulder to shoulder with the Secretary of State on the excellent work that he is doing. May I commend the advanced manufacturing initiative for ventilators, but encourage him to go much further into other hard-pressed categories across our health and social care system?
Yes, the response to this crisis has been extraordinary. Things are happening in this country that nobody would have wished, and things are happening faster than so many people anticipated, but people’s ability to respond—even to changes that nobody would have wanted to see—has so far been, in many cases, remarkable. Of course we talk about the NHS and social care, but so many businesses that are also under intense pressure and stress are looking to see what they can do to help.
The Secretary of State has made it very clear that it is no longer business as usual, but for families and businesses up and down this kingdom, it is bills as usual. What measures can the Government take to introduce rates relief for families and businesses and a VAT delay for the coming year, and, importantly, for Her Majesty’s Revenue and Customs to ensure that it gives people time to pay the most critical bills for their businesses?
The hon. Gentleman is right to raise all those issues, and we will address them all.
We are all looking for clarity in these uncertain times. I have just been contacted by the owners of a café and a hairdressing business in my constituency, who have heard the strong advice for people not to frequent their businesses, putting them at great risk of not being viable. A lot has happened since the Budget last Wednesday. Does the Health Secretary agree that it would now be useful for the Chancellor to return to the House this week, and clearly to lay out the latest raft of measures available to support large and small businesses, employees, the self-employed and freelancers?
I will absolutely take that concern directly back to my right hon. Friend the Chancellor of the Exchequer.
The Government have talked of drafting in volunteers to provide care, but people with disabilities often have some of the most complex needs and it is highly unlikely that volunteers would be able to provide the care that is needed. How will the Government ensure that people with disabilities continue to receive the support to stay in their own homes?
Of course, volunteers have a huge role to play in doing jobs that work for their skillset, but an incredibly high set of skills are needed to support some people—for instance, the people with disabilities that the hon. Member mentions. Supporting those people to get the social care they need is a critical part of our response to this virus.
What steps are the Government taking to increase the availability of high-quality masks and other protective equipment for NHS workers?
We are distributing personal protective equipment across the NHS from the stockpiles and supplies that we have in place for this purpose, but we are also seeking to enhance the production of these items because it is clear that we are going to need a lot.
Many pharmacies across the country refuse to take prescription requests over the phone. Will the Health Secretary explain what he is doing, with the other Health Ministers across the UK, to ensure that people can access prescriptions over the phone or electronically that are then transmitted directly to pharmacies, and to relax restrictions on the supply of medicines—for example, so that people can get a three-month prescription, rather than a month?
The hon. Member is quite right to raise this point. In England, where I am responsible for these matters, we are addressing all these points. I am sure that the devolved nations are looking at them too.
Given that the new advice today is that people should remain at home for up to 14 days if they have a high temperature or a continuous cough, I wonder if my right hon. Friend can clarify for constituents what actually constitutes a continuous cough—is it half an hour or half a day?
It is a cough that does not go away. It is not an irregular cough. I cannot give any more detail on the specific advice than that. It is a continuous cough; that is the best way to describe it.
If pubs are unsafe, why is it being left to customers to decide whether they should go to them or not?
Because our advice to everybody is to reduce unnecessary social contact to protect themselves.
I commend the personal resilience of the Health Secretary during this crisis, and all the staff at Kettering General Hospital. Do we have any lessons to learn from the German experience, given that Germany has had five times as many confirmed cases, but only a quarter of the number of deaths?
I have discussed that point with my German counterpart, and I am afraid that I wish there was something we could learn because it is important. We think that the reason for the difference in ratio is that the early cases in Germany were largely people who had been skiing in northern Italy and therefore were more healthy, whereas the mortality of this disease is very strongly correlated with age.
I live with my 80-year-old mother, my wife who has a heart condition, my daughter and sons, who attend educational settings, and my three-year-old grandson. What advice can the Secretary of State give to multi-generational households such as mine, where self-isolation is not a viable option and alternatives are far from obvious?
That point is incredibly important and is directly addressed in the advice that will be on the gov.uk website.
I have been approached by many who are 70-plus years old who are still in full-time employment. They want to know, if they are still healthy and willing to go to work, that the Government are supportive of them doing so.
The shielding measures, where we insist on the lowest possible social contact, are for people who have existing conditions and will be contacted by the NHS. For those over 70 who are healthy and, for instance, in work, as my hon. Friend says, we strongly advise them to minimise their social contact.
To prevent people from stockpiling and panic buying infant formula, will the Secretary of State speak to supermarkets and perhaps insist that they limit sales to two per family? In the event that breastfeeding support groups are unable to meet, will he direct people to the national breastfeeding helpline, which runs from 9.30 am to 9.30 pm every day?
I will look into the second point. On the first point, those conversations are happening.
I congratulate my right hon. Friend for his openness and for the quality of the information he is giving us. Will he please offer some guidance to the large number of religious communities—churches, mosques, gurdwaras—on what actually constitutes a large gathering of people?
We address that in the advice, and this is a very important point. We have taken advice on how to respond to the crisis, including from our ethics committee, which includes representatives of the major religious faiths. It is true that we include religious groups in our advice about social contact. We have seen from elsewhere in the world how sometimes it is through religious gatherings that the virus can spread so, with the deepest regret and the heaviest of heart, we include faith groups and gatherings of faith within the advice.
Will the Secretary of State and the Chancellor at the very least write to all Members this week to set out the measures that they understand will be taken to support the self-employed and small businesses in our constituencies? That information is vital. May I also ask him about local authorities? They will be on the frontline of supporting families facing hardship, as well as ensuring that services reach those in need. It will be a mammoth effort, undertaken at the same time as employees will have to be encouraged to work at home. What financial support, including hardship funds, are the Government providing to cash-strapped local authorities and how, alongside the enormous effort provided by community organisations, will the Secretary of State ensure the safeguarding of older people?
These are all important considerations. The financial ones are of course a question for the Treasury, which is looking at how to address all these things.
Hundreds of thousands of students are currently revising for their public examinations. Does the Secretary of State have a contingency plan for GCSEs and A-levels to be sat on time?
Seventy per cent. of people over the age of 70 are living with hearing loss, so it is welcome that most public health messaging on TV is subtitled. However, for those whose first language is British Sign Language, reading written English can be really difficult, and much of the public health messaging is inaccessible. Given the seriousness of this fast-moving situation, will the Secretary of State ensure that all press conferences featuring a Minister, the chief medical officer or the chief scientific adviser have a BSL interpreter present? Also, how is he ensuring that the communication needs of those with hearing problems are being met when they require health treatment?
That is an incredibly important point. Many of the statements on coronavirus from the Dispatch Box have been signed, and I understand that the press conference that the Prime Minister gave today with the chief scientific adviser and the chief medical officer was also signed on the BBC.
May I put on record my thanks to our NHS and careworkers for their fantastic work and pay tribute to the immense public support out there from community organisations? Although we are no longer performing community testing, with consideration given to testing of NHS staff as a priority, will my right hon. Friend advise whether that will be extended to social care staff, the police and teachers, to ensure that our frontline services continue to operate?
That is an incredibly important point. Public Health England is addressing the order of prioritisation, and we are also trying to drive up the number of tests available, as we have discussed many times earlier.
Schools are closing. London Oratory School in Fulham, which had 1,300 pupils, closed today. One effect of that is that other schools in the vicinity then come under pressure to do likewise from the school community. That is no criticism of anyone, but can the Secretary of State review and clarify the policy on schools and what happens if they have to downsize or if the policy changes?
We are of course reviewing all those points, and there are some measures in the Bill tomorrow to enable them to be addressed directly.
The week before last it was “shortly”, last week it was “imminently”. Does the Secretary of State know when the public health budgets will be announced, and if he does, can he shed some light on that?
It is as soon as possible. There are so many things that we need to get on with, and this is one of them.
My hon. Friend the Member for Leicester East (Claudia Webbe) referred earlier to reports that the private health industry is planning to charge the NHS £2.4 million a day for the rental of 8,000 beds. Does the Secretary of State really feel that that is the right way to go, given that this is a national effort and that we are all in this together? What steps will he be taking to ensure that private health providers are doing their bit?
I do think it is the right way to go, to make sure that private sector capacity is urgently available to address this crisis. It is a matter of all working together to deliver.
My constituent cannot get mortgage payment support because she does not have a sick note to go with self-isolating. When will electronic online sick notes be available through the NHS 111 service?
We are fixing that, but we are also changing the law to ensure that people who are self-isolating are clearly deemed to be sick for these sorts of purposes.
Among those who cannot work from home and who feel vulnerable are GPs. Will the Secretary of State heed the advice of the locum who came to see me, and sort out the inconsistencies whereby 111 has been diverting people to surgeries? Can he also do away with the box-ticking target culture that makes GPs terrified to perform a number of consultations in a certain length of time, and also get rid of the quality and outcomes framework appraisals, which are just unnecessary, and let doctors be doctors?
My message to everybody in the NHS is that they should do what they need to do to keep people safe in front of them. We are reducing a whole load of the bureaucracy that gets in the way —for instance, with measures from the Care Quality Commission—to ensure that people just do what is right in front of them. As the hon. Lady says, GPs cannot work from home. Some GP appointments do need to be face to face, but increasingly they can be over the phone or over Skype, and so they should be.
Several Members have raised concerns about care staff. As we all know, many of them are on zero-hour contracts and work for multiple providers. That means that they struggle to prove that they are eligible for statutory sick pay, forcing them to choose between protecting their clients and paying their bills. What action will the Secretary of State take to help healthcare staff who are not eligible for statutory sick pay and cannot prove their eligibility?
This is an issue that I discussed with the hon. Member for Leicester South, the shadow Health Secretary, earlier today. The package of measures in the Budget addresses it as much as is possible, and we are prepared to go further if that is what is needed.
I have been contacted by constituents concerned by the lack of health and safety and testing at our borders. Do the Government have plans to implement stricter measures at our airports, ports and rail terminals?
Now that there is onward transmission in the UK, those sorts of measures are less efficacious. Of course, we have been doing that all along and strengthening it, but there are also those who said, “Go further and stop all the flights.” Of course, the Italians were the ones whose who initially stopped flights from China and ended up as the European epicentre of this anyway.
The Secretary of State has indicated a willingness to revisit the statutory sick pay issue if, as many of us think, the current arrangements do not go far enough. When will he make that assessment?
Coronavirus has already claimed the life of one of my constituents, and my thoughts are with his family. What action will the Secretary of State take to prevent the closure of the Mildmay Hospital in my constituency, which is much needed to relieve some of the pressure on the Royal London Hospital? Will the Secretary of State explain what action the Government will take to put restrictions on the increasing price hikes on the supply side of goods and on panic buying? Panic buying is understandable, given that the guidance is changing, but we need to get a grip on it to protect vulnerable and poor people in our constituencies.
We are looking at all those points. With respect to the last one, that is a matter that the Environment Secretary, who is responsible for the food supply, is looking at very closely. We are confident in the food supply of this country, even in the grip of this crisis, but we have to make sure that people behave responsibly in buying only what they need.
If the advice to customers is that it is safer not to go to bars, restaurants and theatres, presumably the same advice applies to members of staff in the hospitality sector. Why therefore are the Government not saying to all businesses in those sectors that they must close, which would then put them in a much better position to claim on their insurance?
We have taken a decision on health grounds to make the changes to the advice that are deemed necessary, according to the scientific advice and the medical advice, to keep people safe. I understand that there are huge consequences from that for businesses right across the country, and my right hon. Friend the Chancellor is leading the work to support those businesses.
In Shetland we have 15 of the 171 confirmed cases in Scotland. That is almost 9%, from an island community of 22,000. In normal circumstances, anyone requiring intensive care in Shetland is taken by air ambulance to mainland Scotland. Because of the nature of coronavirus, we cannot do that. I understand that military assets will be engaged for that transportation, but clinicians tell me that there is no understanding of the protocols and there has not yet even been a dress rehearsal. Will the Secretary of State speak to his right hon. Friend the Secretary of State for Defence to ensure that all necessary communication happens to ensure that when the service is needed, it will work?
Yes, I will. We will make sure that we support people on all parts of these islands, including all islands that are part of these islands.
I have been contacted by a constituent of mine in Erith and Thamesmead. His elderly grandparents are stranded on the Fred Olsen liner. Will the Secretary of State please tell me what action he will be taking to provide support to those stranded with coronavirus?
That is an important point. My right hon. Friend the Foreign Secretary is leading on that response. We have already provided medical capability to try to support people who are on board. It is a difficult situation, as I am sure the hon. Lady will understand. We are doing the very best we can.
In recent days, I have been speaking to health workers across the sector and also to the local council about our schools. I understand that there is a strong under-supply of hand sanitiser. Warwickshire County Council tried to order £19,000-worth and could only get half that for its schools. Will the Secretary of State update us on what he is doing in terms of generating production for that?
Yes. We are keen to see further production of hand sanitiser. There are not many hand sanitiser production plants in the UK, and I would add that soap is better than hand sanitiser. Nevertheless, it is something we are working on.
Will the Secretary of State for Health and Social Care please speak to his right hon. Friend the Environment Secretary about what more can be done to guarantee essential food supplies to those who are symptomatic and self-isolating? In the absence of the Health Secretary’s national volunteering scheme, which is not yet in operation—at least, not in my part of south-east London—people were phoning me over the weekend to say that they cannot get essential home deliveries. They have been cancelled and they cannot get them for three weeks. They have no friends or family around and they are too sick to go out.
I talk to the Environment Secretary almost daily about this issue. It is obviously incredibly important, and it is important that within communities people help each other to be able to get essential supplies.
This morning I visited Turney School in my constituency. It is a special educational needs school with an outstanding track record with the education it provides for its students. As well as education, the school also provides vital emotional and social support and respite for families, and the staff are very worried about what will happen, in the event that the school has to close, to the provision of social care for families who often live in overcrowded accommodation. Some 90% of them are eligible for free school meals. Will the Secretary of State say what measures he is taking to ensure that social care capacity for such families will be expanded in the event that schools are forced to close?
The hon. Lady makes an important point, which is that the consequences of closing schools are very complicated. It is something that my right hon. Friend the Education Secretary is addressing directly.
Lots of my constituents in Bradford West in the Muslim and Jewish communities have concerns about burials because they want to bury as soon as somebody dies. Given that we might sadly lose people to the virus, what conversations has the Secretary of State had with religious institutions across the country in that regard?
The Communities Secretary leads on that question, because ultimately local authorities have an incredibly important role to play in making sure that such things happen smoothly. There are further powers in the Bill. The detail of those will be published tomorrow to try to make sure we have what we need to address that difficult situation.
Over the past month, we have heard an awful lot about the Government’s science-based strategy to deal with the crisis. Will the Secretary of State provide me and my constituents with an idea of the modelling he is using so that we can understand just how many fatalities we could see in this country under the herd immunity strategy that the Government seem to have been pursuing? Are they still pursuing that strategy, or have they instead changed strategy and gone in the direction of actually saving lives?
No. We are very clear that herd immunity is not part of our plan. It is a scientific concept; it is not a goal or a strategy. On the first part of the hon. Gentleman’s question, yes, we will be publishing that modelling.
In the interests of transparency and public confidence, will the Secretary of State clarify whether he will be publishing the advice that explains the rationale for how testing will be expanded, so that people understand what groups are going to be tested next and how those cohorts are to be prioritised?
People without a home of their own have particular challenges when seeking to self-isolate, which puts their health at risk, as well as that of the wider public. Can the Secretary of State assure me of two things? First, will everybody who is street homeless be guaranteed the opportunity to self-isolate if they start showing symptoms? People are being turned away from shelters at the moment. Secondly, given that tens of thousands of people are evicted every year, will he take action now to ensure that more people are not added to the homelessness total?
That is a very important point that is being addressed by my right hon Friend the Communities Secretary, along with the mayors and local authorities, who lead in many cases on the provision of those sorts of services.
Many local services in my constituency are supported by the third sector, including charities such as Luton Foodbank. They will be hit by a double whammy of many of the volunteers being 70 or over or living with people who may have long-term conditions, and equally having to cancel large fundraising events because they are large gatherings. What support can be provided for those organisations?
In answer to a previous question about charities, I made the point that we have a charitable sector that has a huge role to play, including with the increase in volunteering in response to this unprecedented crisis. We will support them in whatever way we can.
Thank you for your generosity in letting this statement run, Mr Speaker, and I thank the Health Secretary for dealing with all the questions. What advice does the Secretary of State have for my constituent Mr Emerson, who is in London today to collect a private script for medicinal cannabis for his daughter, who, at three years old, relies upon it? He can only cash the private script in London, and he has to travel to London every month. He has asked for three months’ supply in case he cannot travel from Belfast to London in the months to come. Can the Health Secretary give any advice or guidance to him or to the chief pharmaceutical officer?
We are trying to address the precise point of the supply of medicinal cannabis products through a change to the Home Office regulations anyway. The advice is against unnecessary travel, and the sort of travel that the hon. Gentleman describes sounds very necessary to me.
Later, at the height of the crisis, the Secretary of State will be judged on the answers he gives today. At the beginning of the crisis, there were estimated to be only 5,000 ventilators in the NHS. Can he tell us exactly how many ventilators he has purchased, what the modelling says about how many ventilators will be needed at the height of the crisis, and whether we will be able to get everybody on a ventilator at that point?
As the hon. Gentleman knows from my previous answers, that is not the way we are addressing this question. The way we are addressing it is that we will buy as many ventilators as are made. It is not a question of putting a target on it. We are just going after as many as we possibly can.
Gaps in NHS capacity, particularly in mental health services, have been filled in recent years by excellent local charities in my constituency such as Home-Start, which supports isolated, disabled and terminally ill parents in their own home. However, it has now almost completely run out of money. How does the Secretary of State suggest that I support such charities to continue, now that we need their services more than ever?
To the extent that the charity, to which I pay tribute, can support the local effort, the hon. Lady’s local CCG will be best placed to make that judgment.
Following the Secretary of State’s statement, the Independent Parliamentary Standards Authority has announced that its office will be closed, with staff who are able to do so working from home. Its phone lines will be closed, and all inquiries will be answered by email. Will that be the approach of other Government Departments in response to this crisis?
I have many heavy responsibilities, and I hope I have answered questions about the activities of almost every Department of Government, but I am not responsible for IPSA. It is not a Department of Government—it is independent, as we well know. I am sure that Mr Speaker has heard the concern raised, and I am passing this one to you, Sir.
Will the Secretary of State ensure that former medical staff who are brought back in to deal with the virus are put on the correct registers and have the most up-to-date qualifications and training needed to deal with it?
Thank you, Mr Speaker. I have the strongest legs in the Chamber.
What discussions has the Secretary of State had with banks and lenders regarding mortgage payments? In answering for every Department today, can he tell us whether there will be a three-month freeze on mortgage payments, which would be extremely helpful? After all, banks and building societies have a role to play.
My right hon. Friend the Chancellor of the Exchequer is in constant dialogue with the Governor of the Bank of England and the banks themselves. There were active discussions over the weekend about what further measures can be brought forward. The hon. Gentleman is right to ask that question of a different Government Department of me. We are working incredibly hard right across Government to address that concern and, indeed, every concern that Members across the House have rightly raised this evening.
Mr Speaker, I am grateful to you for allowing me to make this statement at an unusual time, and I will commit to come before the House whenever necessary to answer each and every concern.
On a point of order, Mr Speaker. We all appreciate the work and the efforts of the Secretary of State for Health and his attempts to answer our questions this evening, but there were questions that he was not able to answer for several other Departments, such as the Treasury, the Department for Business, Energy and Industrial Strategy, the Department for Work and Pensions, the Department for Education, the Ministry of Housing, Communities and Local Government, the Department for Digital, Culture, Media and Sport and the Department for Transport. When will we get statements from other Secretaries of State, so that we can quiz them properly on the arrangements the Government are making on the very important issues we are raising on behalf of our constituents?
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Commons ChamberThis afternoon, the World Health Organisation declared coronavirus a global pandemic. I have spoken to the Leader of the House, and we have had discussions, Mr Speaker, and we have resolved that we will keep Parliament open. Of course, in some ways this House may have to function differently, but the ability to hold the Government to account and to legislate are as vital in a time of emergency as in normal times. Our democracy is the foundation of our way of life.
Turning to the advice that is being provided to Parliament, may I start by welcoming the way in which you are working with the Government, Mr Speaker? I know how seriously you take the wellbeing of all Members and staff in Parliament, and the Government will continue to work closely with you, the Lords Speaker and the authorities in both Houses in the coming days and weeks. As the Leader of the House said in business questions last week:
“The public will expect Parliament to sit, and to get on with its job...
Our approach will be guided by the best scientific evidence and medical advice, and we will take all necessary measures to deal with this outbreak.”—[Official Report, 5 March 2020; Vol. 672, c. 984.]
Mr Speaker, I know that you are committed to providing as much information to Members and staff as possible and to taking any action that is required. A cross-parliamentary group of senior managers meets daily to plan the response to covid-19 and ensure business continuity, with close input from the Government. It is essential that the parliamentary authorities continue to work closely with the Government and in line with medical advice, and I commit us to that endeavour. Both Houses are conscious of our national role at this time, and by basing decisions on the very best public health advice, we can be confident that we are doing the best we can to respond to this virus.
Around the world, the number infected is rising. As of today, here at home, 456 people have tested positive and eight people are, sadly, confirmed to have died. The positive cases of course include the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries). She has done exactly the right thing in following the official advice to self-isolate, and I know the whole House will wish her well as she recovers. Public Health England has world-class expertise in contact tracing, which it initiated as soon as her case was confirmed. PHE will contact anyone whom it thinks may need testing. This will only include those who had close contact. The advice of the chief medical officer is that close contact is defined as being within two metres of someone who has active symptoms for more than 15 minutes. Those who have not been in close contact with my hon. Friend since Thursday have no cause for concern in this case, and anyone who has concerns should seek guidance from PHE. I also know my hon. Friend wants me to pass on her thanks to officials at PHE and to the NHS, who have been brilliant throughout.
Of course, a Member of this House and Health Minister testing positive has brought this issue home to us all, and I know that the public will be concerned that coronavirus has now been deemed a global pandemic. The official advice is clear: people should go to NHS 111 online or call NHS 111 if they think they have symptoms of coronavirus, notably a cough and fever. Of course, the best way to minimise the risk to themselves and others is regularly to wash their hands.
Earlier today I chaired a meeting of Cobra. Our response will be built on the bedrock of the science. It is clear that we will need legislation to ensure the best possible response, and I can tell the House that I have invited the Official Opposition to meet with me first thing tomorrow to discuss the proposed emergency Bill that we will set out before the House next week. In addition to the measures that my right hon. Friend the Chancellor set out in the Budget earlier, the Bill will include measures to help in the national effort to keep vital public services running, to support business and to help everyone play their part.
Adult social care will be at the frontline of our response, with social care providers looking after many of the most vulnerable in society. We are working closely with the sector to make sure that it is ready. Tomorrow, the Prime Minister will chair a further meeting of Cobra to decide what further measures may be necessary.
We will do the right thing at the right time. I know how worrying this is. I know that people have deep concerns. I know that everyone will play their part in this national effort to defeat the virus. The best way to beat it is for us to work together. We will do whatever it takes. We will give the NHS whatever it needs and we will do all that we can to keep people safe and get through this together, as a Parliament and a nation. I commend this statement to the House.
I am grateful to the shadow Secretary of State for the tone that he has adopted and for his full support for keeping Parliament open. He raised the issue of statutory sick pay. Statutory sick pay and the measures that we are taking in the Bill are an example of why accountability helps to get the response right, especially when there is a constructive tone, as there is. He was the first person to raise the issue of statutory sick pay across these Dispatch Boxes, and it will now be in the Bill because the point that he raised was the correct one, and we therefore took action. Likewise, the Bill has been drafted alongside the Labour Welsh Government, the SNP Scottish Government and the multi-party Administration in Northern Ireland, and they have added contents to it. It is a true cross-party effort.
The hon. Gentleman asked about advice for those who are ill but cannot recall whether they came into close contact with my hon. Friend the Member for Mid Bedfordshire. The answer is to call 111 and ask the questions, and then get the clinical advice and follow that advice. The advice may be different for people in different circumstances. When people are recommended to follow certain advice by 111, they should follow that advice, because it takes into account a clinical judgment based on the information that is provided to a clinician.
We will, of course, as I have repeated many times, be guided by science. The hon. Gentleman mentioned that some voices are asking whether the appropriate moment for further action is now. Of course, we keep action under review all the time and, as I said, the Prime Minister is chairing a Cobra meeting tomorrow. There are some voices that are saying that we should not base our response entirely on the science, but I think that they are wrong. He asked about our differences with other countries and mentioned Spain in particular, but there are others. The truth is that different countries are at different stages of the virus. The point is that we will do the right thing at the right time. There are some countries that are not fully following the science. I am not going to criticise them, because I think that in responding to a pandemic such as this, everybody is doing their level best.
The hon. Gentleman asked about money. There was a very significant increase in funding—£6 billion for the whole NHS and social care system. It is important to stress that this is for social care, too. We want to make sure that the social care system has everything that it needs to respond to this crisis, because we entirely understand both the strains on the social care system should a large proportion of the population fall ill, but also the importance of the social care system, because that is where so many vulnerable people either reside, if they are in a care home, or are supported. He asked whether we will have to wait for the spending review for any top-up. The Chancellor made it quite clear in the Budget that we will not.
The hon. Gentleman asked about the CQC. The CQC has already published a statement today, saying that it is relaxing some of its requirements and taking into consideration the impact of coronavirus, and I welcome that. It is, of course, independent. He asked about the public health grant budgets. As I made clear yesterday, those budgets are going up in real terms in every single local authority area, and the precise details will be set out very shortly.
I thank both Front Benchers for the highly responsible way in which they are approaching this crisis, which shows Parliament at its best. I also thank the Health Secretary for his role in getting those very generous words for the NHS into the Chancellor’s speech this afternoon; they have been widely welcomed across the NHS and were much needed.
The chief medical officer says that we would have to be “pretty optimistic” to think we could contain the virus in this country. The deputy chief medical officer says that she thinks we may hit the peak in the next fortnight. We now have more reported cases in this country than there were in Wuhan when it went into lockdown. We know that the Secretary of State will rightly follow the science, but could I ask him to give his judgment to the House as to whether he thinks we still can contain the virus in this country and, if not, whether he expects to move to the delay phase very soon so that families up and down the country can start to prepare their loved ones for any precautions they might want to take?
I want to make two comments in response to my right hon. Friend. First, I want slightly to correct the point about the deputy chief medical officer, who said that in the next couple of weeks we may see the numbers starting to rise fast to their peak. We do not expect numbers to peak in the next fortnight. We expect them to continue to rise after that. The peak would be in a matter of a couple of months, rather than a couple of weeks. This is a marathon, not a sprint. Secondly, the World Health Organisation declaring this afternoon that the virus is globally now regarded as a pandemic indicates that the WHO thinks it will spread right across the world, and that will have a significant impact on the way in which countries around the world will now take forward their plans. Of course, the expectation that this may well happen was all within the plan that we set out. We will be discussing that at the Cobra meeting tomorrow.
I echo the good wishes to the hon. Member for Mid Bedfordshire (Ms Dorries).
I welcome the declaration to keep Parliament open, but surely we should be looking at core functions, at who comes into the House and at what we do in the House. I have to say that I was a bit disappointed to have several hundred of us jammed into the voting Lobbies on Tuesday. That is just not a good idea. There are ways of working that would still allow Parliament to stay open.
With cases having increased by 13 times outside China in just two weeks, the virus has of course been declared a pandemic by the WHO, which describes its concerned at “levels of inaction”. It calls for quicker and wider testing so that milder cases are diagnosed quickly, isolated and the spread reduced. We have seen the speed of change in northern Italy over a matter of a couple of weeks, so should we not be thinking about the delay phase? Containment and delay are a continuum; it is not a switch between one and the other.
We see large leisure events still continuing. They are not critical, so should we not be decreasing them? Do we know yet whether children are spreaders? We know they do not catch the virus, but do they spread it? That would be central to any decision about closing schools, and obviously closing schools would have an impact on NHS and social care staff.
I welcome the announcement in the Budget of funding to support people on sick pay, but will the Secretary of State clarify whether this will be provided to people who do not have sick pay in their contract? That is exactly who we were concerned about when we raised this point.
How quickly will all three devolved Governments hear about the extra funding that they are going to get, since it is urgent for them to take action as well? There has been talk about bringing doctors back from retirement. Is there a discussion with the General Medical Council about relicensing doctors, and about providing Crown indemnity for doctors who may have retired within the last year or two? The UK is already outside the European Centre for Disease Prevention and Control, so will the Government now at least rethink leaving the pandemic early warning and response system?
The hon. Lady asked some important questions about how Parliament will function. Matters of how we work are of course for Parliament—for the Leader of the House, the Speaker and the Commission, all guided by the science. They are in constant contact with Public Health England to get the very best advice. As for when we are voting, this disease passes in very, very large part from people who have symptoms, and we may not have symptoms. What really matters is making sure that as soon as people have symptoms potentially of coronavirus, they get in contact with 111 or Public Health England.
The hon. Lady asked for more testing. We are absolutely ramping up the testing capabilities. We have been commended on the approach we are taking by international bodies; she mentioned the WHO. She asked about children. One of the good pieces of news about the virus is that it does appear to have a much, much less significant impact on children. On the GMC and indemnity, absolutely —both those issues will be addressed in the Bill, and we are working very closely with the GMC.
The hon. Lady asked about collaboration and work with the European Union. We still remain within the European Union data transfer capabilities. Most of this data is being transferred—frankly, it is being published. We are being as transparent as possible. This week, we brought out a new website in order to be as transparent as possible about all the cases in the UK. Most European nations are taking exactly that approach.
I would like to take the Secretary of State back to his point about a real national effort. Last week, he talked about the supermarkets helping to get supplies to elderly and vulnerable constituents, many of whom cannot get out—and right now we do not want them to do so. Will he join me in paying tribute to the army of volunteers across the country in community shops such as the Hursley community shop in my constituency? The shop told me today of the service that it is running for elderly parishioners in getting essential supplies to them and picking up prescriptions for them. That is a brilliant example of the big society—remember that?—doing its bit to help this country to get over this terrible time.
Gosh, that is a blast from the past—that phrase was invented almost exactly 10 years ago. My hon. Friend is quite right, though. This is a national effort, and community shops can play a huge role in helping people to get the groceries and other supplies that they need. There has been much discussion of supermarkets. I am glad to say that the vast majority of supermarkets are playing an absolutely incredible part in this national effort; we are working very closely with them and have been for some time. Our community shops will be really embedded in their communities; they often know which people are going to need the most support, and have those personal relationships. As long as they are following the public health advice to ensure that the people they are helping are also kept healthy, then they have an important role to play in our national effort.
Can I press the right hon. Gentleman on the issue of the 3,000 or so Atlético Madrid fans who have travelled to Liverpool and are, at the moment, in a crowd of 54,000 at Anfield? Schools and colleges are closed in Madrid, and public gatherings of over 1,000 people are banned, because there is a cluster of 782 coronavirus cases and there have been 35 deaths. Now that we have a pandemic, is it really sensible for this to be allowed to continue? Both the Government and UEFA told the Liverpool Echo today that it is not up to them to take action—so who is it up to? Is it really sensible for fans who could not watch their team at home to be able to travel to Liverpool and watch their team play with 51,000 locals?
It is for Public Health England to make advice available and to give guidance. We will always follow the scientific advice on what makes the biggest impact. It is interesting, listening to the scientists, that sometimes the things that we, as lay people, may feel intuitively will have the biggest impact do not in fact have the biggest impact. The measures that we are taking and proposing to take include, for instance, looking at asking people who have symptoms, however mild, to stay at home. We are aiming to do the things that have the biggest impact. There are some things that feel right but do not have an impact at all. That is why it is so important to follow the science and what Public Health England says.
Primary care clinicians are expected to collect quality and outcomes framework data, which can be-time consuming and take them away from their clinical work. Will the Secretary of State consider suspending QOF data?
We are looking to reduce bureaucratic burdens on primary care and GPs—we were looking at it anyway, but we have accelerated that work because of this outbreak. We have moved to a principle of “digital first” in primary care and with out-patients: unless there are clinical or practical reasons, all consultations should be done by telemedicine.
I am grateful to the Secretary of State for his statement and for all the work being done to keep the public safe. In conversations with colleagues in South Yorkshire today, specific concerns were raised about the guidance for GPs on personal protective equipment and the resilience of the social care sector. May I gently push him on the public health grant allocation? I very much welcome the fact that there will be an increase, but I am sure he will acknowledge that it is in everybody’s interest for directors of public health to know precisely what their budgets will be sooner rather than later.
I would like to associate myself with the Secretary of State’s remarks. I wish my hon. Friend the Member for Mid Bedfordshire the very best and hope that her family recover as quickly as possible if they succumb to the virus.
My constituents have developed a test for the virus. They are selling it all round the world, but we are not using it in this country. It costs £5. It is working, and it gives a result within 10 minutes—it is a quick, cheap way to do it. May I urge the Secretary of State to ask the Department to investigate that and ensure that we are using the most effective test possible?
Yes, absolutely. My hon. Friend has brought that to my attention before. We have done research into it, and we are working with over two dozen commercial companies that have tests of this kind. In fact, I had a meeting on this today.
I welcome the Secretary of State’s focus on social care. Will he clarify how much of the additional spending in today’s Budget will go into social care? Will PHE issue protective equipment to careworkers? His statement referred to adult social care. There are many sick children in this country who are reliant on care. Will he ensure that children’s needs are not overlooked? I wrote to him about that earlier this week, and I would welcome clarification.
As the hon. Lady knows, guidance is coming out this week. She is right about the importance of protective equipment, and of course, we are taking that into account. The Chancellor set out that more money will be available in social care if it is needed—and I expect that it will be—and announced a total of up to £5 billion for the NHS and social care, while saying that his door is open should more be needed. These are all very important considerations, and the guidance will be out shortly.
I welcome my right hon. Friend’s determination to base his actions on what he calls the “bedrock” of the science. He will be aware that the World Health Organisation-China joint mission report drew particular attention to the importance of the rapid expansion of detection and diagnosis as a way to prevent illness and death. The daily number of tests in this country has been relatively stable over the last few days. In fact, it fell between 7 March and 10 March, while the number of cases increased. Can he assure the House that the right number of people are being tested? When will the expansion of testing that he announced yesterday translate from capacity into the actual number of people being tested?
That is a very important consideration. As I said, the number of labs doing testing has already gone from one to 12, and we are working with more than two dozen companies on further testing capability. We are rolling out a big expansion of testing. The critical thing is to ensure that it is not just about the testing. Getting the whole pathway right—from somebody feeling sick to calling 111, being tested and then getting the test result back—as the number of tests goes up is the critical thing we have to do.
Will the Secretary of State update us on the thinking about what will happen, if this does continue as is projected, for schools? If schools close, what in particular will happen to children on free school meals, whose parents massively rely on them to keep their children well fed?
The hon. Member sets out one of the many reasons why there are downsides to closing schools. There are significant downsides, especially because of the knock-on consequences it has on the number of staff available for critical public services, including the NHS and social care. There are many considerations we have to take into account if we close schools, and that is why we have no plans for a mass closure of schools. Of course, individual schools will sometimes be advised to be closed, but because one of the saving graces of this virus is that it does not have a big impact on children, there are fewer benefits to closing schools, and she sets out one of the downsides.
Will the Secretary of State elaborate on social distancing? What would it entail, particularly for more vulnerable groups such as older people?
There are different types of social distancing. There is what is essentially case isolation, which is where somebody has symptoms and we are asking them to self-isolate. At the moment, if somebody has moderate or heavy symptoms, they should self-isolate, and we have talked about going, at the right time, to self-isolation—staying at home—for people with mild symptoms. There is also, of course, the need to ensure that older people and vulnerable people, for whom this virus has a bigger impact, can get the right advice on self-isolating, and that is something we are working on.
Here the timing really is critical, because the evidence of past epidemics and past crises of this nature shows that people do tire of these sorts of social distancing measures, so if we start them too early, they lose their effect and actually it is worse. The social science and the behavioural science are a very important part of the scientific advice that we rely on.
One of the questions in the public’s mind is the degree of resistance acquired by those who have contracted the virus and then recovered. I appreciate that this is more a question for his medical and scientific advisers than directly for him, but could the Secretary of State give us any information on the degree of resistance acquired by those who have been through the virus and come out the other side?
I asked the chief medical officer this precise question this morning, so I can report to the right hon. Member what the chief medical officer says is the answer to this question. The degree of resistance is deemed to be very high, especially in the first year or more afterwards, for similar coronaviruses, and is therefore likely to be very high for this one. It is good news that it is highly likely that once people have got it and recovered, they are going to be okay. That is obviously good news for people who have had it, including our hon. Friend the Member for Mid Bedfordshire.
I have received a large number of representations to pass on to the Secretary of State, but am I right in thinking that the one thing he is not short of at the moment is advice?
This is supposed to be an easy question, but actually my right hon. Friend is completely wrong. I would rather have the advice. I would rather go through 100 ideas, 99 of which we have already looked into, to find the one that we had not thought of than not be bombarded, so I ask him to send them on.
Earlier this week, the Secretary of State told the House that the NHS requires more ventilators. He will be aware that two weeks ago today Italy had the same number of confirmed cases as we have, and he will also be aware of the great pressure that intensive care units and hospitals in Italy are under. Can he tell us whether the additional ventilators that he is seeking will arrive with the NHS in time to cope with any rapid increase in the number of critically ill patients who require breathing support?
I am afraid that is not how we are thinking about it, as that implies a perfect world in which things are available and not in demand around the world. Our approach to ventilators, and to staffing-up—obviously, we need trained staff to operate ventilators, or else they are dangerous—is to get our hands on as many as possible, and to train up as many people as possible. We think that we will need as many ventilators as we can get our hands on. There is no calculus of demand and availability; we are trying to buy as many as we can get hold of.
I pay tribute to the way that the Minister and his team, Public Health England, and the whole NHS are dealing with what is frankly an unprecedented situation. I am hugely grateful to them all. Is the Secretary of State working with our right hon. Friend the Foreign Secretary on keeping our diplomats and envoys safe abroad, and giving them the advice they require? What is he doing to work with the World Health Organisation to ensure that we limit spread as much as we possibly can around the world, so that we are not infected again afterwards?
My hon. Friend is right, and along with the International Development Secretary, my right hon. Friend the Foreign Secretary is working hard to ensure that through funds from the Department for International Development, and the judicious use of other British assets around the world, we can try to slow the spread elsewhere. Consular support for UK citizens and Government employees overseas is critical.
Today I was deeply concerned to learn that public health information is not being shared in any language other than English. Given that we live in a wonderfully multi-lingual society, in which 4 million people—including me and other hon. Members—are non-native English speakers, will the Secretary of State explain why information is not being provided in any other language? Does he agree that it is in all our interests for every person, no matter their language skills, to understand what they need to do to protect themselves, and others, from this virus?
Of course we will provide guidance in languages other than English. We are developing this guidance at speed, and I commit to making that available as soon as we practically can.
May I commend my right hon. Friend for the sure-footed way he has approached this, and the hon. Member for Leicester South (Jonathan Ashworth) for his balanced and measured response? The Health Secretary knows well that the problem with intensive treatment units and intensivism is not so much the kit, as the people. What is he doing to ensure that clinicians within the service who are in non-acute specialties are given the skills they need to deal with what may be coming?
As my right hon. Friend knows, we are inviting and encouraging recent retirees and health care leavers back in, and we will provide for some of that in the Bill. We are also ensuring that as we make what is effectively a big change to the NHS case mix, and do fewer elective operations and focus more on respiratory diseases and coronavirus, there will be a retraining exercise for people to go on.
I completely agree with the Secretary of State about keeping Parliament open, and I am grateful for the work that he, you, Mr Speaker, and the Leader of the House, have done to ensure that is the case. May I ask about something that I did not fully understand from what the Chancellor said this afternoon? As I understand it, if Wales wants and need extra money for the health service to deal with coronavirus, it will get it, whatever amount is needed. I presume that also applies to social care budgets in Wales, which my local authority is already worried about. Why does it not apply to all the other measures that are meant to support the economy through this difficult period? Why does it not apply to council tax and business rates?
The hon. Gentleman presses me on a question that is not in my departmental area. I apologise, but I would rather get him the right answer than give him the wrong answer now. I will make sure that we get back to him.
My hon. Friend the Member for Mid Bedfordshire (Ms Dorries) has been playing a pivotal role in supporting our east Kent hospitals, and I would like to add my good wishes to her, her family and her staff.
Areas like mine in Dover and Deal are on the border with another country. With a global pandemic now announced, will my right hon. Friend update the House on any additional steps being taken internationally to manage transmission risk between countries, such as between our country and France?
Yes, we are increasing the support available at all ports, including airports and seaports such as Dover, and making sure that better information is available, including in multiple languages, to those who are arriving. Specifically and importantly, no matter who is here, we want to make sure that they know that if they are ill they should call 111, because this virus travels from human to human, not from people of one nationality to another. It does not see that distinction.
Does the Secretary of State accept that keeping Parliament functioning as normal, with the public visiting, is simply irresponsible? As others are encouraged to cancel large meetings, events and unnecessary travel, we instigate large meetings, host events and receptions, and travel from all across the country—vectors, I heard an hon. Member call us last week. Festivals, concerts and football games have been postponed, but it is business as usual here. We are even holding our surgeries. As we continue to meet hundreds of people weekly, I am concerned that we are potentially spreading the virus. My biomedical training tells me that a number of Members in this House probably already have the virus. I am genuinely concerned about older Members, older constituents and those with underlying health conditions. Will he implement testing for all Members and staff of this House, not for reasons of special treatment but because of all the people we meet and have met in the past few weeks? Will he agree to having electronic voting or automatic pairing for any Member who may wish to self-isolate?
As I said in my statement, I am delighted that Parliament is staying open. There are, of course, considerations around procedures and how the House operates. It is rightly a matter for the Leader, Mr Speaker, the House of Commons Commission and every single Member to express their view, and the hon. Lady rightly puts her view firmly on the record. As long as the public health advice is taken into account, and it is based on that advice, then, as far as I am concerned, I am sure the decisions will be got right, led by you, Mr Speaker.
The one point I will respond to is that calling for testing for everyone is not going to help, because the test is not reliable for people who are not symptomatic. That is why testing at the airport, for instance, which several people have called for, is not effective. Some of the countries that started it, stopped it. Temperature testing leads to a load of false positives, because you might be ill with something else, and that complicates the system—or it leads to lots of false negatives, with the test returning a negative even though somebody is ill, because they do not yet have enough virus in their system to be symptomatic and for the test to pick it up. Testing people who do not have symptoms is not reliable and is counterproductive, so we will not be doing it.
My right hon. Friend rightly talks about chronology: feeling ill, dialling 111 and then going to take the test itself. However, may I echo the concerns about the self-test capability? He points out the difficulties with accuracy. I am concerned that about one fifth of the UK workforce might be off ill, many of whom may not develop the full symptoms. Will he look at our ability to advance a capability to self-test in the near future? That would eliminate many of the workforce going off unnecessarily.
Absolutely—in fact, there was a very big conference in London today on precisely this issue. We are working with dozens of companies on it. We will work with anybody and scour the world for a solution, as my right hon. Friend describes. I just add one thing: he talked about how I had described what people should do if they feel ill—they should call 111—but also, going to the 111 website is really, really important, because that takes pressure off the call centres and many people can get the answers they need without talking to someone.
I bring the Secretary of State back to his discussions and liaison with supermarkets. I am aware of at least one supermarket chain that has already said to local food banks that they are cutting their orders and limiting what they provide to food banks. Will he raise this with supermarket chains to make sure that those who need food aid provision in the country—the most vulnerable and needy—get what they need?
The Department for Environment, Food and Rural Affairs is leading the work with the supermarkets now, so I will ensure that it gets that message and takes that up.
The vast majority of people who contract the disease will be able to self- isolate and recover at home. A small number of cases will need hospitalisation, and as the number of people who are infected increases, so could serious cases. Would my right hon. Friend say that people who have to be hospitalised will have to be isolated, and what plans are there then to increase the number of beds that will be available in hospitals on isolation units?
We are increasing the number of beds, and, by moving away from some of the elective activity, making more beds available. However, I want to pick my hon. Friend up on one thing: as and when this virus becomes widespread, isolation becomes less important than ventilation. The normal flu procedures are that keeping several people who all have the same flu in one room—in one ward—is absolutely fine, because they cannot infect one another because they all have the same disease. Isolation is vital in the contain phase. It is still important in delay, but as we get through to mitigating the impact, the need for isolation facilities is less important.
The Chancellor’s announcements earlier today were very welcome, but will the Secretary of State help to cast a bit more light on the announcement about employment and support allowance? There are millions of people, as he knows, who do not qualify for statutory sick pay. The effectiveness of self-isolation and doing the right thing relies absolutely on many people who do not have standard employment contracts being able to be confident that if they self-isolate, they will not lose out, yet the ESA system works in retrospect, with delays, and is quite bureaucratic. Will he say a bit to us tonight about how that is going to be mitigated so that those who are not on standard employment contracts will know that they can do the right thing and not suffer?
Yes, we will publish more on this in very short order. Some of the changes in this area will be in the Bill, but some will be in secondary legislation, so that they can go at a faster pace, potentially, than the Bill. The ESA (C), as it is known, comes in only after seven days and bringing that down is an important part of the reassurance that the hon. Member seeks.
I thank the Secretary of State and all his team for the way that they have handled this so far and for the statement this evening. I also thank him and others for the way in which they have continued to communicate in a clear and very accessible way. As the spread of the virus affects people’s lives in more and more ways, it is really critical that that continues to happen and that fake news cannot be given breathing space. Will he assure us that there is a clear plan about how to communicate so that the whole public know exactly where to go for information when they need it?
Absolutely. This is right at the top of the agenda; tackling fake news is incredibly important. The major social media platforms and search engines have already risen to this task and I pay tribute to them—in the past, I have been known not to pay tribute to them, and sometimes quite the reverse. They have absolutely risen to this task and we will keep on it, but, of course, the information that we provide to the public will have to evolve both as we learn more about the disease and as we move through the plan. For the moment, the absolute core message is that people should wash their hands.
Are we reaching the stage where people, if they have any form of cold, should be self-isolating? We all know people who have had colds, some of them more severe than others, but they have been able to be confident that it has not been coronavirus. Now it is becoming prevalent, how can they be sure? It is going to create a lot of confusion. Are we reaching the stage where, as the Prime Minister alluded to the other day, people may have to self-isolate if they have any symptoms?
We are not there yet, but we are moving towards it. That is what the chief medical officer set out in the press conference on Monday, in part for exactly the reasons the hon. Member sets out.
I hugely welcome the fact that we are following the science, including the behavioural science, and the cross-party approach we are taking. Does the Secretary of State share my concern, therefore, that celebrities, including some politicians on social media, are advocating a different approach? They are completely at liberty to do that, but does it risk undermining the national cohesion we need to rise to this challenge?
I have heard some of the noises off. I merely encourage everybody to base their decisions and judgments on science, rather than politics.
I thank the Health Secretary for his continued updates to the House. The partner of a constituent of mine suffers from cystic fibrosis and other related illnesses and requires daily treatment that includes cleansing—alcohol wipes, gels and so on—but because of the panic buying in some shops they have been unable to purchase these items, which could result in serious health issues for them. Are there any other measures the Government can put in place, working with supermarkets, to manage this?
Yes, absolutely; this is really important. We have some supplies of these sorts of things, in the supply chains and, in some cases, within the shops themselves, and we are working with the shops to ensure availability of things that can be critical to people’s care. We are working on that with DEFRA, the NHS and within the Department, particularly in relation to pharmacies, to make sure we get the right kit to the people who need it.
I commend the Health Secretary on doing a difficult job in trying circumstances extremely well. Likewise, I commend all the staff at Kettering General Hospital, who are working their socks off to ensure that the hospital is fully prepared. The only easily understandable benchmark our constituents have to judge the scale of this thing is seasonal flu, so can he tell the House, on average each year, how many people catch seasonal flu and how many people die from it?
That is a great question to which I do not have the answer in my head, but it is a matter of hundreds of thousands in the first instance and thousands in the second.
We know that social care workers play a key role in supporting people to recovery and in alleviating pressure on clinical staff, yet today’s Budget offers no clarity on new money, and care providers are still awaiting a draft social care strategy. If the Secretary of State rightly seeks cross-party agreement, what steps have the Government taken to introduce a draft social care strategy for discussion, and what discussions is he having with the Welsh Government regarding social care capacity?
The delivery of social care is a devolved matter. We will publish guidance, and we will work with the devolved authorities to make that as consistent as possible, but social care policy is different in the four nations, so obviously we will have to take those differences into account.
On Sunday, Birmingham will host one of the largest St Patrick’s Day parades in the world. Can the Health Secretary assure me and the people of Birmingham that he will do everything he can to issue the right guidance as quickly and effectively as possible so that people can make sensible decisions when it comes to their use of public transport and attending mass gatherings?
Yes, absolutely. I can assure my hon. Friend of that. For now, the guidance is to wash your hands and, if you sneeze or cough, to catch it in a tissue and throw the tissue away.
I thank the Secretary of State for keeping the House informed throughout this crisis. He is doing his job well, and it is good that the response is cross-party and has the support of people right across the United Kingdom.
Lecturers and schoolteachers in my constituency have contacted me to ask what discussions the Secretary of State is having with the Department for Education, exam boards and the devolved Administrations about what will happen as we approach the examination season. The point was made to me, particularly by further education lecturers, that it is not just children who face exams in the coming months.
This is an important consideration. I discuss it regularly with the Education Secretary and the Minister for School Standards. We are keeping the matter under review. Obviously, in the best possible world, we would want all exams to go ahead as always, but we also must keep people safe.
I pay tribute to the amazing work of NHS staff, who are working to support patients who have contracted covid-19, and to prevent others from catching it. What can be done to minimise the risk to those amazing NHS workers?
This is a really important part of our work. We are rolling out personal protective equipment to all primary care settings and GPs by the end of this week—we are on track to do that—and making sure that everybody in community settings in the NHS gets support. This will be a tough time for people who work in the NHS. The demands on them will be significant. Nurses, doctors and all the staff in the NHS do an extraordinary job all the time, but they will be called to be the frontline of our response in a way that many have not seen before. I thank them in advance—I think the whole House would want to do so—for the service that they will give.
I note what the Secretary of State said about different approaches in different countries, but I was recently approached by the professor of visual neuroscience at Cardiff University, Professor Jonathan Erichsen. He says that there is a great deal that we can learn from South Korea in particular. Will the Secretary of State give a commitment that he will keep an open mind on how we approach this problem, in the light of lessons from other countries?
Absolutely. We are looking daily at how every country in the world is responding, to try to find the very best response. That is part of the science. The Scientific Advisory Group for Emergencies, the body that meets to bring that science together, is constantly reviewing that, simply because we want the very best response possible, and that is what we base judgments on.
I welcome the measures taken in the Budget to fight this virus, and I pay tribute to the work of the Secretary of State and his team to tackle it; he is doing a fantastic job, and it is not going unnoticed. Sadly, a local resident who had coronavirus passed away at St Helier Hospital in my constituency on Monday. I am sure that my right hon. Friend will want to join me in giving our condolences to the friends and family. He will understand that a certain level of fear has arisen in my community as a result of that death. I hope that he will join me in urging calm among the local population, and assuring people that this is not time to panic-buy or listen to social media rumours; instead, they should take the advice of the chief medical officer and call NHS 111 if they need to.
Absolutely. I want to pass on my condolences to the family and loved ones of all those who have died, including my hon. Friend’s constituent. I know that the hospital, with which he works closely, is absolutely safe, and did exactly the right thing in this case. I reassure his constituents, and everybody else’s, that the best thing to do is follow the advice from the chief medical officer, who is doing a remarkable job, and either call 111 or go on NHS 111 online if they have a query.
The Secretary of State said in his statement, “We are working closely” with the social care sector “to make sure that it is ready.” Could he say a little more about some of the stories circulating about the use of volunteers, and particularly students, to provide social care?
There will of course be a big voluntary effort should there be staff shortfalls right across public service. People who volunteer need to be asked to do tasks that fit their skillset. If people have medical qualifications and volunteer, that is fantastic—they can go and do that and potentially do clinical work, if that is right. Some volunteers will not have that sort of skillset, but there are still things that they can do, especially to make sure that people can get what they need if they are asked to self-isolate and not leave their homes. It is a matter of finding the right match for the skillset of the people who are going to help. In a scenario in which 20% of the public are off sick, volunteers will be able to help to alleviate some of the inevitable pressure that that brings.
Following today’s Budget, I have been contacted by a local authority in my constituency of Erith and Thamesmead that is seeking clarification on the urgent need for further funding for one of the local hospitals to deal with the immediate coronavirus crisis, and specifically for the social care sector. Will the Secretary of State explain and elaborate further on what he has said so far?
Yes, of course. The funding needs for social care, as for the NHS, over the weeks and months to come are not yet clear, so the Chancellor set out an envelope of up to £5 billion to make sure that we can now plan according to what we need to do, with the resources constrained by what the nation has, especially in terms of people and trained people, as opposed to being limited by the funding. He also said that if we need even more than that, his door is open. I do not have a specific answer as to where all the money is going to be spent—as would be normal in a Government announcement of this kind—because we are in unprecedented circumstances. We will of course be transparent and clear about how the money has been spent. No doubt afterwards there will be a huge amount of looking into what happened to try to learn lessons, and the financial part will be one strand of that work.
As more people become seriously unwell and need treatment in hospital, it will become very important that those who recover are discharged quickly back into the community. Will the Secretary of State say what work is being done to ensure smooth discharge pathways so that we do not get delayed discharges, which compound the problems for the NHS?
This is a really important point that I met the NHS to discuss specifically today. It is critical that we ensure that discharges are as fast as possible. That is important in normal times, but when large proportions of those in hospital could, with the right support, leave hospital and be in a setting that works for them in social care, we have to make sure that that happens. The extra funding will help with that, but it is not all about funding; a lot of it is about co-ordination, and people are working at their level best to try to make that happen.
Some parents are unsure whether to send their children to school when somebody in the family household is self-quarantined. Will the Secretary of State confirm what guidance has been given to schools to deal with what would normally be classed as unauthorised absences? Perhaps he will be able to alleviate some of the concerns from headteachers and indicate that Ofsted will take a lenient view of absence figures in later inspections.
Yes, Ofsted absolutely will take a lenient view of the impact of coronavirus on what happens in schools. When it comes to the broader point about what households should do when one person tests positive, that is of course something we are considering very closely. At the moment, the number of cases is at a level such that we can give individual advice to each household. It is likely that that will not be possible throughout this situation, so we will make sure that there is formal public guidance for everybody, so that everybody knows what to do.
Will the Secretary of State clarify a point that was made by the Secretary of State for Work and Pensions on Monday? She said that social security claimants who were due to take a work capability or work-related activity assessment would not have their social security support stopped, but those claimants were omitted from the group that the Chancellor talked about in the Budget statement, so will the Secretary of State clarify who is right? Will he also make sure that information is available for the deaf and the visually impaired? There is a gap in the information in that respect.
On the latter point, I entirely agree, and it goes with the earlier point about communications in foreign languages. On the first point, I will ensure that the Work and Pensions Secretary writes to the hon. Lady with the answer.
Local government will have an important role to play, beyond social care, in working with the Secretary of State’s Department to deal with this issue. When will local councils get an indication of the extra funds they may receive?
The Secretary of State said that the peak in cases may come in two months’ time. That is exactly the time of the local government elections. Will the Government now give some consideration to the desirability of postponing those elections, as happened in 2001 with foot and mouth epidemic?
We are not proposing to delay the local government elections and the other elections—for instance, for police and crime commissioners—that are happening in early May. That is not part of the proposal, and local authorities should plan as normal for those elections. If people think they may need a postal vote—they may want to have a postal vote just in case—I would always advise them to get a postal vote. I am very happy for that message to go out loud and clear.
I also commend the Secretary of State’s measured approach. Are there any plans to offer specific guidance for dealing with rough sleepers and unaccompanied children—two quite vulnerable groups who, for different reasons, will pose a challenge to the authorities?
Yes. I entirely agree with the hon. Gentleman, and he is very wise to raise that point. That strand of work is being led by the Communities Secretary.
I thank the Minister for his dedication and for the vital role he has played in this House. History has taught us many lessons. In the pandemic of 1919, secondary schools stayed open, as did churches—it was normal life, with precautions in place for all. Is that the message the Health Minister is sending out to people tonight?
I hope that the decision to keep Parliament open makes it clear that the institutions that are fundamental to our way of life in this country will continue through this virus. We will get through it as a nation, and then we will take this nation forward. This is going to be a difficult and challenging time for many, many people. It will be a national effort, but that national effort will prevail, and we will get through.
I was pleased to hear what the Secretary of State had to say about the involvement of the devolved Administrations, including the Welsh Government, in the legislation that has been drawn up. It would be useful to have the clarification on funding that my hon. Friend the Member for Rhondda (Chris Bryant) asked about. However, can I ask about mutual aid between the four NHSs of the UK? For example, the Secretary of State talked about procuring ventilators. Is that being done on a UK-wide basis with the four NHSs, or are they competing against each other? What will be done in terms of cross-border needs—for example, Welsh patients travelling to English hospitals or vice versa—where the need is greatest?
The four NHSs are also working together. I discussed this with Simon Stevens, the chief executive of NHS England, today. That cross-border work is, of course, important, and it is something that my opposite number in the Welsh Government has raised. As a Chester boy, I get the point, and I will make sure that we keep that level of co-ordination, as well as the co-ordination at the point of the chief medical officer.
May I answer an earlier question better than I did before, Mr Deputy Speaker? My hon. Friend the Member for Dudley South (Mike Wood) asked whether GPs were getting their protective equipment. We have rolled out protective equipment to almost 100% of GP surgeries now.
Earlier, the Government, through the Treasury, announced a package of support for local authorities to protect the vulnerable during the coronavirus outbreak. Does the Secretary of State agree that a proportion of this hardship fund should be allocated to local welfare provision so that support can be given to those who are most vulnerable and facing financial hardship?
Yes. That is a really important point, and that will be part of the provision.
I congratulate my right hon. Friend—[Interruption.]
Thank you, Mr Deputy Speaker.
I congratulate my right hon. Friend the Secretary of State on this campaign, which has kept the level of conversation stable and consistent throughout. This week, sadly, we also had a constituent pass away at Watford General Hospital, and I pay tribute to the family and to the staff who work so hard.
My question is on the broader responsibility of this place, councils, local government and anybody in a public position. Does my right hon. Friend agree that the main message we need to get out is for people to remember that, on the frontline, the most important thing they can do is regularly wash their hands for 20 seconds? That is not much to ask of the general public, but it is the most frontline thing they can do to stop the spread.
That is incredibly important, and we have to keep reiterating it, even though we may have heard it a thousand times—I may have said it even more than that. Although there is a huge debate about coronavirus and what we can do as a country, there are some really simple things that are really effective.
I have two questions for the Secretary of State. I thank him for his commitment to keeping this place open, which I agree is very important.
What guidance will the Secretary of State give to prepare us for what may be necessary, such as the possibility of having to cancel events, constituency surgeries and so on? I have staff, as I am sure most Members do, who are already concerned about how they should be protecting us and, most importantly, themselves and their family and friends.
Secondly, what is the Secretary of State doing, or talking to colleagues about doing, for those on very low incomes who have to self-isolate and are unable to order food through the internet because they have either no credit card or no internet?
First, the Leader of the House, Mr Speaker and the House of Commons Commission, advised by Public Health England, are best placed to come forward with guidance on the details of how this place can run should a significant number of colleagues and, potentially, staff be unwell or self-isolating.
Secondly, it is very hard, from central Government, to make sure we reach all the people who will need the sort of support the hon. Lady describes. This is best done through local authorities, which is why we have introduced a £0.5 billion fund for local authorities essentially to do whatever they think is necessary in these circumstances.
I also thank my right hon. Friend for his conduct and his handling of this situation.
It is true that Wales has seen very few registered cases of coronavirus relative to other parts of the UK. Indeed, I believe we have no registered cases of coronavirus in north Wales. None the less, I welcome the installation of temporary testing sites by the Betsi Cadwaladr University Health Board. Will my right hon. Friend confirm that the Welsh Government have access to the same advice as he does, and that they are being fully included in the preparations he is making here in the UK?
Yes, absolutely. This is a four-nations approach, and the Welsh CMO is in daily contact with the English CMO, the Scottish CMO and the Northern Irish CMO. Indeed, they are also working with the chief medical officer of the Republic of Ireland. The basis of the scientific advice is the same across the four nations. Although, as my hon. Friend reports, there are no cases in north Wales, I am afraid this virus will continue to spread and we should expect there will be a case in north Wales before too long.
I certainly welcome the Government’s determination to keep Parliament open. What a U-turn from the situation not that long ago, when we had to take them to court to keep it open.
Does the Secretary of State accept that it does not have to be all or nothing? A lot of things happen in this place that are not essential to the functioning of our democracy and that, either in fact or certainly in perception, create a high risk of infection. For example, why do we still have functions at which food is left out on uncovered plates on a table at the end of the room without enough sets of tongs, meaning people have little choice but to help themselves using their hands? Why is it that, on the few occasions that we have to divide the House, we cannot use a deferred Division system so that people go through the Lobbies in dribs and drabs over a two or three-hour period, instead of being crammed in, 300 at a time, within a maximum time limit of eight minutes?
Will the Secretary of State and his colleagues in government look at some of the practices in this place, partly to minimise the chances of our carrying this infection back to our constituencies but also to send a message to the rest of the population that we have identified where our own practices fall short of the best standards of hygiene and that we are taking steps to correct it?
I understand where the hon. Gentleman is coming from. The issues he raises are matters for the House authorities, and I am sure they will have noted his comments.
Newcastle upon Tyne Hospitals NHS Foundation Trust welcomed the UK’s first coronavirus victims, six weeks ago. In the intervening time, the role of Newcastle City Council’s public health team has become increasingly important, as local cases are identified and local concerns raised, yet it does not know what its budget will from April. How can it plan an effective public health campaign? Will the Secretary of State at least confirm when it will be told what its budget is and that the increase—there will be one—will increase with the duration of the crisis?
Yes, of course, because I expect this crisis to last for less than a year. I have been absolutely clear that the allocations will increase in real terms, so everyone can plan on that basis, and we will get the details out as soon as we can.
I thank the Secretary of State for his actions to date. What further consideration has been given to UK citizens overseas who find themselves, perhaps in greater numbers, being required to self-isolate for an extended period and thus find themselves in financial hardship? What consideration has been given to citizens of other countries who are visitors to our country and are required to self-isolate, but do not have the means for that extended stay?
This is really important and quite difficult. Our general approach is that people who become ill should stay where they are and be treated in the country in which they find themselves. This comes back to the previous question, because the first two victims of coronavirus in the UK were not British citizens, but they were treated brilliantly by the hospital in Newcastle. The treatment they received was fantastic, and rightly so. Of course there are cases and examples where we have to support people to come back to the UK. For instance, this afternoon a flight from California landed, bringing people from the cruise ship that had been off California. But the general principle should be that people are supported and treated where they are.
Will the Secretary of State review the criteria for testing? A constituent of mine has returned from the United States with symptoms of the virus but has been refused testing because she has not come into contact with a known case. Will he also say what the policy is on NHS staff wearing masks when on duty, primarily to avoid to the risk of the virus being spread by undiagnosed medical staff?
I am grateful for the constructive tone in which the hon. Gentleman asked the questions. This is an example of the House working well, because he and I have sometimes had cross words across this Chamber, but he has asked these two questions quite rightly. The advice given on 111 has to be dependent on the circumstances presented to the clinician giving that advice on the other end of the phone. It is really important that I do not fetter their discretion, but if he comes to me with details of the individual case and wants me to double-check that his constituent got the right advice, I am happy to do so.
On the second point, the deputy chief medical officer had a discussion with the Prime Minister today that was videoed and put on Facebook, and in that she was clear on this question about masks. There is not an advantage in wearing a mask if you are healthy—that is the advice from the medics here—but there is an advantage in respect of keeping others safe if someone who is ill wears a mask. There are also examples of when medical staff will need to wear the right type of mask to keep them safe. But the general advice is: don’t wear a mask unless you are advised to by PHE; or if you are ill, it is perfectly reasonable to wear a mask to stop infecting others—that is an act of generosity.
First, I thank Mr Speaker, his team and the House authorities for ensuring that this statement is signed. A concern has been raised by Action on Hearing Loss and others about the lack of information in British sign language.
This afternoon, my office was contacted by a constituent whose mother is in a care home that has been closed to visitors for what is described as “the foreseeable future”. Will guidance be issued to residential care homes to ensure that the proper arrangements are made for access to residents?
Absolutely. I agree very much with the hon. Lady about the importance of sign language and the signing of this session. I thank the House authorities for arranging it.
Yes, new guidance on care homes will be put out this week. If the hon. Lady passes on the details of her individual case to the Minister for Care, I am sure that my hon. Friend will be happy to look at it.
Earlier today, I was contacted by a constituent who flew back from northern Italy yesterday evening. He told me that, on landing, there was a complete lack of information and no staff were on hand to offer any guidance. He proceeded to watch most people from that flight spill on to public transport.
I fully agree with the Secretary of State’s advice that we should follow the medical science, but, whether they have symptoms or not, people arriving back on flights from category 1 countries should not be met with that situation.
Today we have upgraded the response to flights coming back from Italy. I understand some of the concerns raised earlier in the week. We have put an awful lot of effort in with the Department for Transport, the Border Force and the airports authorities themselves— I pay tribute to them all—to address exactly the concerns that the hon. Gentleman raises.
I thank the Secretary of State for his statement today and I wish him and his wonderful NHS team well in their endeavours during this pandemic.