(3 years, 10 months ago)
Commons ChamberWell, it is very good to hear of the set-up in York that the hon. Member describes, and what I can do is take away from here and follow up to ensure that there is joint working, which we know is a really effective way to bring together national resources with the local resources, expertise and knowledge that are so important in tackling this virus.
With covid, speed is of the essence, but people are struggling to get a test due to limited capacity at the Lighthouse labs. New labs were due to open in Newport in August and in Loughborough last month, but both are delayed. As NHS labs are having to take on more testing, can the Minister say what additional funding will be provided specifically to increase NHS lab capacity?
The context is the huge increase in the testing capacity of our system that we have already seen, going from in the order of 2,000 tests a day back in March to well over 200,000 tests a day now and building up to 500,000 tests by the end of this month. I recognise also that there is both the Lighthouse labs—what is known as pillar 2 testing system—and the important part that NHS testing facilities play in the pandemic. And of course the hon. Member will know that a huge amount of money has been and is going into the NHS to support its response to covid.
Scotland’s public health-based tracing service has reached over 95% of contacts, yet four months on, the Serco system in England has still only reached 61%. As finding contacts and getting them to isolate is critical to reducing covid spread, should not tracing in England now be based more on local public health teams?
It may be helpful to say that, since the NHS Test and Trace system started, it has contacted 78.5% of those who have tested positive, and then 77% of their contacts have been reached. There is an important part of the system where the national contact tracers are handing over to local authority contact tracers who are able to access the same system and are supported in contact tracing but, critically, are also using their local knowledge of the local area to increase the success rate. It is really important that people are reached wherever possible and advised to self-isolate.
May I also say how much I appreciate and thank all those who are doing the right thing by self-isolating, both those with symptoms and those who have been contacted by contact tracers?
(3 years, 10 months ago)
Commons ChamberThe expansion of the NHS testing is, of course, critical as well. The system in question, where the problem was over this weekend, brings together the data both from the NHS systems and from the so-called pillar 2 systems. The challenge was in a system that integrates the two, rather than just on one side or the other, but my right hon. Friend makes a broader point, which is that as we expand the NHS’s capacity as part of the overall expansion of testing, we have to ensure that we use that capacity to best effect. In many parts of the NHS, increasingly, it is NHS testing capacity that is used for NHS staff testing. That system works well, because the test is local and convenient, and we are looking to expand in exactly the sort of direction that he outlines. I urge colleagues away from trying to bifurcate between the two systems. Essentially, we have a whole series of different ways to access a test, and we need to make sure that people get the tests that are easiest to access for them as much as possible.
The delay in entering almost 16,000 covid cases into Government databases has resulted in last week’s case numbers being totally inaccurate. The Secretary of State says that the updated statistics would not have led to additional measures, but are there any new areas of heightened concern? PHE has blamed the problem on test result files being too big to load on to its central system. Was that, as has been suggested, due to the transfer of data between formats? If the underlying issue was due to the rapidly rising number of positive cases, why was that not anticipated or identified sooner? Can he be sure that something like this cannot happen again?
Just as importantly, this means that none of those cases was registered with the tracing system. While, as the Secretary of State says, people with a positive test got their result and, we hope, self-isolated, they did not get direct advice and they did not give the details of their contacts. From the Government’s data, people with covid report an average of three to four contacts each, so that would represent 50,000 to 60,000 contacts who were not identified and asked to isolate and therefore will have continued to spread the virus. While up to 10 days have lapsed and the opportunity to prevent onward spread may have been missed, the Secretary of State mentions that 51% of cases have been contacted, but on what timescale does he hope to reach all the contacts of those cases? Given that only about 60% of community contacts in England are currently reached, will he involve local authority public health teams in what is now a massive contact-tracing operation?
(3 years, 11 months ago)
Commons ChamberThank you, Mr Speaker. As the chief medical officer and chief scientific advisers said this morning, the UK is in danger of losing control, as we have seen happen in many countries in Europe. As the Secretary of State has said, we could be facing 50,000 new cases a day by mid-October, leading to about 200 deaths a day by mid-November. No one should be in any doubt that it is a mistake to think that the virus has changed and that it will not kill people if we get back to where we were in April.
I agree utterly with the Secretary of State that we need to take action now, and that action is personal; every single person has the responsibility to stick to the rules—to wear a face covering, wash their hands and keep their distance. I remind Members in this House, because I have been watching it from outside, that that is not always what is on show in this Chamber, and we all have a responsibility to set an example. That responsibility extends to self-isolating, whether we have symptoms, we are proven, we are a contact or we have returned from a high-risk country. If we are meant to be isolating, we need to do it. I really welcome the fact that the Government are finally putting in place financial support for people on low incomes, who might be tempted not to isolate because they simply do not have any other opportunities to feed their family.
However, it is crucial that we have a fast and responsive test and trace system, so I have a couple of questions for the Secretary of State. In recent weeks, he has talked about aiming to have 500,000 tests a day by the end of October. Given the surge we are facing, does he envisage being able to accelerate that and bring it forward? Secondly, on 8 and 15 September he committed to me that he would be increasing funding to expand NHS testing, but, as we heard from the shadow Secretary of State, NHS trusts in England have been told that funding is capped and they are not to expand covid testing. Surely this is resource that we want to use and make available.
I wholeheartedly agree with the hon. Lady’s comments about the need for action across the UK. We have seen in Scotland, as in England, Wales and Northern Ireland, that the number of cases has, sadly, risen sharply. I welcome her physically back to the Chamber, in demonstrating this unity of purpose across the four nations of the UK. If we can bring forward the goal of 500,000 tests per day from the end of October, of course we will do so; we are pushing that as hard as we can and are on track to meet that commitment. As she says, that is for across the UK, so it includes the tests done by the Scottish NHS. I know that conversations have taken place between the NHS in Scotland and the NHS in England to work on making that happen. We are expanding NHS testing, including the funding. In the funding letter that went out to the NHS for the second half of the financial year—for the cover in winter—we set out that that includes the commitment to support financially the testing done in the NHS in England.
(3 years, 11 months ago)
Commons ChamberI wholeheartedly support the points that my right hon. Friend has made. I pay tribute to him for his work in establishing World Patient Safety Day and thank him for his ongoing work in the international arena, both representing our country and driving forward this agenda globally. I entirely agree with his comments about 111 First. It is absolutely critical that both the online and phone systems act to ensure that sepsis is recognised, wherever that is feasible, to ensure that people get the best and safest route to care. I will ensure that that point is registered. We have put in the extra funding, which I have just announced, for 111 to ensure more clinical support for people accessing the service through NHS 111 First. Indeed, I pay tribute to him for introducing 111 in the first place. There is an awful lot of work to do here, but it will undoubtedly help patients to get a better service and help the NHS to deal with the multitude of cases that come its way.
While personal behaviour and local measures are critical, so is a functioning test, trace and isolate system. Last week the Prime Minister claimed that there was capacity for 350,000 covid tests a day, but I am sure the Secretary of State is well aware that a third of that capacity is antibody testing, which becomes positive only after the infection and is therefore of little use in diagnosing cases or managing outbreaks. Why have the Government not published the daily diagnostic testing capacity since last Thursday? The Secretary of State has promised that there will be 500,000 diagnostic tests a day by the end of next month. Can he confirm that that definitely refers to diagnostic antigen testing, and is he confident that it will be delivered on time?
The current problem appears to be a shortage of laboratory capacity, with the Government now cutting test appointments in many parts of the UK. Does the Secretary of State accept that that causes a danger of new outbreaks not being detected at an early enough stage? With the rationing of test slots, there are multiple reports of people being advised to enter an Aberdeen postcode to obtain authorisation for a test, even though the test will be carried out in the south of England. Does he accept that that will undermine Scotland’s contact tracing system and that incorrect data could give the false impression of a local outbreak in Scotland that does not exist? How does he plan to stop that practice?
Finally, the Secretary of State has previously talked about his moonshot testing project, based on millions of people testing themselves for covid every morning. Can he clarify whether he is planning for such tests to be provided on the NHS, or would individuals be paying for them? If they are on the NHS, given the enormous price tag and the fact that the technology does not even exist yet, should he not focus funding and efforts on getting the current diagnostic testing system working in the here and now?
Taking those points in reverse order, of course investing in the next generation of technologies is important here and now, because if we do not push forward those technologies that allow us to expand testing, we will always be stuck with the current one. The idea that there is a dichotomy between the two is completely wrong.
On the hon. Lady’s point about an Aberdeen postcode, we already have in place a system to ensure that if someone puts in one postcode but then turns up at the wrong drive-through centre, that will be indicated to the people there, so that problem has been resolved—indeed, it had been resolved before it was first raised in the House.
I hope that, like the Scottish Government, the hon. Lady will reiterate the point that people should come forward for a test when they have symptoms or have been told to do so by a public health professional, and they should not come forward if they do not have symptoms. Working together across the UK is undoubtedly the only way to solve this crisis, to the benefit of all our constituents.
That brings me to the point about testing in Scotland. More tests are being done in Scotland—through drive-through centres, local testing sites and mobile testing centres—than across the rest of the UK per head of population. We over-index the number of tests through those routes that we put into Scotland. Indeed, in the Scottish NHS there is spare capacity that needs to be used. I am working closely with the Scottish Government to ensure that that spare capacity is used, given the enormous demand for tests right across this country. I think that tone of working together is what we need to hear.
(3 years, 11 months ago)
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I think that we will be able to solve this problem in a matter of weeks. In his constituency yesterday, 194 people got their tests. We are managing to deliver record capacity, but as he well knows, demand is also high, and the response to that is to make sure we have prioritisation, so that the people who most need them can get the tests that they need.
With covid cases doubling every week, it is clear that laboratory capacity for diagnostic testing is not keeping pace with demand, leading to testing slots being cut. For example, only 70 new covid cases were reported in Scotland yesterday, yet 267 were reported today, many from tests carried out over the weekend. With a reported backlog of 185,000 tests, is the Secretary of State not concerned that results will not be received quickly enough to allow timely contact tracing, and that the delay in data means that new outbreaks will not be identified until they are out of control? Last week, the Secretary of State appeared to accept that additional NHS funding could allow hospital laboratories across the UK to rapidly increase their testing capacity, so can he confirm whether he plans such an approach, and on what timescale?
Yes, I think it is important that we expand the NHS labs, and that we work across the whole of the UK to get the testing capacity needed. For instance, in Scotland, when there was a surge in demand for tests last month, we diverted more of the UK’s capacity to support people in Scotland, and we currently deliver more tests per head of population in Scotland than in the UK as a whole. In the tone of the hon. Lady’s question, it is absolutely necessary to work together, across party lines, between the Scottish devolved Government and the UK Government, to make sure that we get the support to the people of Scotland as to every other part of this country.
(3 years, 11 months ago)
Commons ChamberI agree that it is indeed critical that everyone recognises the importance of our own personal actions in controlling covid, but we also need an efficient test, trace and isolate system, the first step of which is for people to get access to a test. With UK cases having trebled over the past fortnight, demand has increased and there have been many reports of people being sent hundreds of miles to get a covid test. One of the most extreme examples was somebody in Plymouth being sent by the booking system to the test centre in Inverness.
I understand that demand varies depending on local incidence, but surely it is dangerous to have possibly infectious people travelling long distances when they are unwell and may need to use motor-services facilities on the way. Would it not make more sense to allow covid tests still to be taken locally, and just shift the samples around the UK to the labs with the greatest capacity?
While the commercial pillar 2 testing has increased dramatically since April, the
laboratories are very centralised, whereas NHS hospital laboratories are far more numerous and based within easier reach of communities. To meet the high demand that is likely this coming winter, will the Secretary of State consider additional funding to the NHS to allow the expansion of its PCR facilities and to maximise pillar 1 testing capacity?
The answer to that last question is, absolutely, yes. The hon. Lady is quite right that expanding the NHS capacity, as well as expanding the so-called pillar 2 capacity, is right. The SNP spokesperson and I sometimes have robust exchanges but on this, she is completely right. It is an “and/and together” strategy of having the pillar 2 mass testing across the board and the expansion of NHS capacity. I am working as closely as I possibly can with Jeane Freeman, my opposite number in the SNP Government in Edinburgh, to deliver that as effectively as possible right across the UK.
(3 years, 11 months ago)
Commons ChamberAbsolutely. I am glad to hear what the hon. Lady says about the constantly improving integration between the national and local systems. We have worked hard to make that happen, and I am glad to hear that it is happening in Croydon, as it is in other parts of the country. The budgets in that respect are of course important, and we have been clear that financial provision will be made. I cannot make any more definitive statement than that at this stage, but it is of course an important consideration.
Since June, the Scottish public health-based tracing system has managed to trace 99.7% of positive cases and almost 99% of their contacts, yet in England the commercial Serco call centres have traced less than 60% of contacts. Will the Secretary of State clarify whether any targets are included in the £10 billion contact with Serco? If so, are they being met?
If I may correct the hon. Lady, there is no £10 billion contract with any private company. The private companies have been critical in the work to make sure that the whole testing system could be built at the scale that it has been. As I said, the improvements are continuing. We are seeing local engagement, which is critical, and we are seeing testing rolled out right across the UK. For instance, when there was a local outbreak in Aberdeen over the summer, we were able to use UK resources to get huge amounts of testing into Aberdeen, thanks to the collaborative work between the UK Government, who provided the UK testing, and the Scottish Government, who were responsible for the lockdown.
That does not address the fact that the call-centre system run by Serco has managed to contact only 60% of people’s contacts. Regional Public Health England teams have been working flat out for the past seven months and are tracing more than 95% of the cases with which they deal. Does the Secretary of State really think that the middle of a pandemic is a good time to be threatening the job security of those teams with a huge reorganisation?
(3 years, 11 months ago)
Commons ChamberIt is my intention to deploy as much testing as possible using the new testing innovations coming on stream and to do so as widely as possible following clinical advice. We have set out the process we propose to use for the current generation of testing capability, but if a new, easier type of test gets over the line, of course we will always keep that under clinical review, being guided always by clinicians.
Is the Secretary of State aware that some people are being refused home-testing kits because the credit-checking company TransUnion has not found their names on the public version of the electoral register? Can he explain why he contracted this American company to verify people’s identities and what he will do to resolve the issue? He still has not addressed the poor performance of Serco, which has failed to trace 40% of contacts and apparently did not even have contact details for over 2,500. This compares poorly with the public health-based systems of the devolved nations, which are managing to trace 90% or more. Instead of breaking up PHE, will he not provide it with the necessary resources to develop a public health-based tracing system for England, too?
Finally, Chris Whitty says it is not possible to open up everything and keep the virus under control. While it is really good to see the number of deaths from covid falling, the number of new cases in the UK is currently higher than when we had to go into lockdown in March. If getting children back to school is his Government’s priority, why are they pushing people back into offices at the same time?
I have addressed several of those points already in questions. The idea that, instead of the large-scale national system working together with local contact tracers, we should disparage one part and praise the other—this divisive approach proposed by the SNP spokesperson—is wholly wrong and would lead to things getting worse, not better. Instead, we need to work together to improve the system, in the same way the Scottish Government and the UK Government worked together to provide testing capability right across Scotland.
On the arrangements for the future of PHE, we look around the world for the best way to ensure we have systems at a national level that can respond to the virus, in the same way we put in place the Joint Biosecurity Centre, when we worked closely with the Scottish Government, the Welsh Government and the Northern Ireland Administration to ensure the best possible system—for instance, when cases move over a border. Some of the best systems in the world, such as the German system, have an institute dedicated to infectious disease control. I am convinced that the enormous amounts of extra money we are putting into health protection, along with the extra support going in and the clarity and dedication of the new National Institute for Health Protection, will be a step forward. I pay tribute to all those who have worked in PHE and right across the board to keep people safe during this crisis.
(4 years, 1 month ago)
Commons ChamberYes. That is a really important point, and we monitor those data all the time. I am glad to say that the latest data are a little bit better than my right hon. Friend suggested, but the point is still important. The main cause of the gap is people who are asymptomatic and therefore do not know they have the virus and do not come forward for testing. We are going to ramp up our communications to make clear that, if in doubt and if people think they might have the symptoms, they should come forward and get a test. We are also going to ramp up our asymptomatic testing of high-risk groups, which he and I have had exchanges about before. I am grateful for what he said about the 100,000 testing target. Of course, he will recognise that I am as delighted as he will be that the Prime Minister set me a new target on Friday to hit half a million by the end of October, so there is my summer sorted.
I, too, welcome the progress being made regarding vaccine development by research centres and companies across the UK, including Valneva in Scotland, but a widely available vaccine is still some way off. In the meantime, avoiding the social and economic impact of repeated local lockdowns depends on driving down community transmission. Professor Dominic Harrison, public health director of Blackburn with Darwen Council, has highlighted that only half of contacts are being traced by the central system and called to be given information in individual covid cases so that their contacts can be traced and isolated in the short window before they, too, become infectious.
In the covid statement last Thursday, I again raised the issue of delays in providing individual test results to local public health teams. The Health Secretary said he could not answer so many questions from me, so he chose not to answer any. To make it simple, I will ask only one. Postcode information was utterly insufficient, so by what date can he guarantee that every single director of public health in England will receive the identifiable details of all new positive cases on a daily basis?
(4 years, 1 month ago)
Commons ChamberI would be very happy to meet my right hon. Friend and Professor Tim Briggs, who does an incredible job. He is a brilliant public servant, who has done great work on the Getting It Right First Time programme. As my right hon. Friend knows better than almost anybody, the unjustified variation in performance between different hospitals within the NHS is a huge issue across the board, because if the standards in every hospital were the same as the standards in the best hospital, the performance of the whole would be so much higher. That is exactly what the Getting It Right First Time programme was designed to deliver. It was instigated by him, and I would be very happy to listen to what both he and Professor Briggs have to say.
Directors of public health in England are still complaining they are not getting the information they need. They only started to get area data from late June, when it became clear that Leicester had had 900 cases in less than a month. Within a week, Leicester was back under lockdown. The Prime Minister has described this as his “whack-a-mole” approach to controlling covid, but does the Secretary of State recognise that for the people of Leicester it has felt just as bad as the national lockdown?
I have raised many times the issue of test results from the UK Government labs not being sent to general practitioners or local public health teams. Is it true that that was not even specified in the contract? Even after Leicester, and despite covid being a notifiable disease since 6 March, local authorities and health protection teams in England are still being sent only anonymised area data, which is of little use to identify clusters, and only on a weekly basis, which is far too slow. Does the Secretary of State not accept that public health teams need daily data, with work and home postcode details, so they can spot an outbreak, and that they need individual test results, so they can isolate all those involved to break the chains of infection and prevent the further spread of the virus?
The Secretary of State rarely mentions isolation, but surely he knows that that is what actually breaks the chains of infection. That should be isolation of affected individuals, however, not our whole society or a whole city. The test and protect system in Scotland has been up and running since the end of May and disrupted a cluster of just 12 cases in the south of Scotland. That is the level of detail required to drive an elimination strategy.
The Secretary of State says that local lockdowns will be the cornerstone of his ongoing strategy, but how does he plan to deal with the social and economic impacts? Will he not join the devolved and Irish Governments in following an elimination strategy to avoid repeated local lockdowns? When does he envisage having a fully functioning test, trace and isolate system in place across England?
I am terribly sorry that I am not going to be able to answer all the points that were made. All I can say to the hon. Lady is that I will send her an update on the data that, in England, local directors of public health get, because there has been a huge amount of progress since many of the situations that she described.
I bow to no one in my desire to use data to make policy and to get the best data out. We have been getting better and better data out to local areas. We have been publishing more and more data. Many of the hon. Lady’s comments were out of date.