(2 years, 11 months ago)
Written StatementsI wish to inform the House of the action the Government are taking to consider how to further improve uptake of covid-19 and flu vaccinations by those who work in our health and social care services.
Following a public consultation on making covid-19 vaccination a condition of deployment for those working in adult care homes, the Government informed the House on 17 June 2021 that covid-19 vaccination would be required of people entering a CQC registered adult care home, unless exempt, to protect vulnerable residents.
While residents in care homes are some of the most at risk from covid-19, the responses to this initial consultation made a clear case for extending this policy beyond care homes to other settings where vulnerable people receive care and treatment.
It is right that the Government strain every sinew to maximise the benefits of the vaccine and protect the most vulnerable as we return our freedoms and get back to a normal way of life.
The Government are therefore now undertaking a further public consultation on whether or not to make covid-19 vaccination and flu vaccination a condition of deployment for frontline health and care workers, to help safeguard the vulnerable.
While many of those working in health and social care sectors have taken up the offer of vaccination, it is crucial that this is consistent across services to safeguard vulnerable people, and that this high level is maintained as new people join the workforce.
Recent research has shown people infected with both flu and covid-19 are more than twice as likely to die as someone with covid-19 alone and nearly six times more likely than those with neither flu nor covid-19, so it is right that both are considered within the consultation.
These are complex and important issues and the consultation seeks to gather a wide range of perspectives from the public and across the health and care sectors about whether vaccination requirements should be introduced and how they could be implemented.
I will provide an update to the House, following the completion of the consultation.
[HCWS273]
(3 years, 1 month ago)
Written StatementsI am responding on behalf of my right hon. Friend the Prime Minister to both the 34th report of the NHS pay review body (NHSPRB) and to the 49th report of the review body on doctors’ and dentists’ renumeration (DDRB). I am grateful to both Chairs and the members of both review bodies for their reports.
At the 2020 spending review, my right hon. Friend the Chancellor of the Exchequer, announced that pay uplifts in the public sector would be paused this year due to the challenging fiscal and economic context, but, given the unique impact of covid-19 on the health service, and despite the challenging economic context, the Chancellor committed to continue to provide for pay rises for over 1 million NHS workers.
It is within this context and after careful consideration of both reports that we have chosen to accept the recommendations of both PRBs for 2021-22. In doing so, we have committed to uplifting the salaries of staff within the remit groups by 3% on a consolidated basis. This is expected to be a real-terms increase and nurses will receive an average increase of around £1,000. Overall, the awards amount to a cost to the NHS of £1.9 billion for the “Agenda for Change” workforce and £0.3 billion for consultants.
This is not without its challenges given the economic and fiscal context.
This is an annual process and as is always the case, decisions about future awards will be considered in light of the fiscal context and ensuring awards are affordable and fair.
Investing in the NHS to ensure patients get the care they need as quickly as possible is also a key priority for this Government. We are delivering on our historic long-term settlement for the NHS, which will see NHS funding increase by £33.9 billion by 2023-24. To recognise the unprecedented pressure facing the NHS, the Government are providing £3 billion of additional funding to the NHS in 2021-22 to support its recovery from the impacts of covid.
The DDRB were asked not to make a pay recommendation for contractor general medical practitioners (GMPs), doctors and dentists in training or specialty and associate specialist doctors moving onto new contracts as those groups are within multi-year deals. For doctors and dentists in training the multi-year deal will mean all junior doctor pay scales will have increased by 8.2% by the end of the deal, and in addition circa £90 million is being invested to reform the contract, including to create a new, higher pay point to recognise the most experienced doctors in training.
The Government are also committed to delivering 50,000 more nurses in the NHS by the end of this Parliament and this pay award will help us to ensure we can continue to recruit and retain the nurses we need to reach this target. The number of NHS nurses currently employed in CCGs and NHS Trusts is at the highest recorded level in England, and the latest published NHS Digital provisional data for April 2021 shows 303,800 FTE nurses in NHS Trusts and CCGs, almost 9,000 FTE more than April 2020.
Salaried GMPs
For salaried GMPs the minimum and maximum pay range set out in the model terms and conditions will be uplifted. As self-employed contractors to the NHS, it is for GMP practices to determine uplifts in pay for their employees.
Clinical excellence awards
The Government also acknowledge the DDRB’s comments on clinical excellence awards and their reasons for not recommending an increase in their value. With this in mind, we will progress our plans to reform these awards with a view to introducing new arrangements from 2022.
General dental practitioners
For general dental practitioners, there will be a 3% general uplift in the pay element of their contract backdated to April 2021.
The Government recognise the significant impact that the covid-19 pandemic has had on NHS dentistry, as discussed within the DDRB report. In response to these challenges, the Government have ensured that dentists receive their full contract value, minus deductions which are pre-agreed, in exchange for a reduced threshold of activity.
[HCWS233]
(3 years, 1 month ago)
Written StatementsToday I am announcing the publication of “the national strategy for autistic children, young people and adults: 2021 to 2026”. The strategy is aimed at significantly improving the lives of autistic people in England.
This strategy builds on improvements made over the decade since the inception of the Autism Act in 2009. The Autism Act was enacted to tackle the multiple disadvantages that autistic people face. It is estimated that around 560,000 people in England are autistic and that autistic people die on average 16 years earlier than the general population. They experience poorer overall health outcomes and face substantial health inequalities in comparison to non-autistic people.
Since the Act’s introduction, there have been two strategies, which have resulted in improved availability of services for autistic people, including diagnostic services, and significantly improved public awareness of what autism is. I want to pay particular tribute to our late colleague my right hon. Friend Dame Cheryl Gillan DBE MP, who was so instrumental in bringing forward this Act in 2009. She worked tirelessly to improve autistic people’s and their families’ access to services through her role as chair of the all-party parliamentary group on autism (APPGA).
Today, I am delighted to announce the publication of the third iteration of the autism strategy, which sets out our vision for how we will make further progress on improving the lives of autistic people over the next five years. We have worked with the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), who is the Minister responsible for children and families, on this new strategy, which extends to children and young people for the first time. This is in recognition of the importance of supporting autistic people throughout their lives, from the early years of childhood and through adulthood.
We have also worked in partnership with other Government Departments to ensure the strategy addresses the wide range of issues that affect autistic people's whole lives.
The focus of this new strategy and the actions we are committing to have been informed by evidence including our national call for evidence undertaken in 2019, which received 2,745 responses from autistic people, their families and unpaid carers as well as organisations. We also involved self-advocates and family members in the development of the new strategy through our autism strategy executive group. In addition, the strategy was informed by the APPGA’s “The Autism Act, Ten Years On” report and independent research we commissioned about the impact of the covid-19 pandemic on autistic people, both of which involved autistic people and their families. I know the pandemic has created new challenges and exacerbated problems many autistic people already faced, including higher levels of loneliness and social isolation.
Today we also publish our response to the CQC’s “Out of sight - who cares?” report and our response to Baroness Hollins’ and the independent Oversight Panel’s recommendations regarding independent reviews for people with a learning disability and autistic people detained in long-term segregation.
The new autism strategy is supported by an implementation plan for 2021 to 2022, which sets out actions we will take forward in the first year of the strategy. We will publish further implementation plans for subsequent years of the strategy, in line with future spending review rounds. The strategy sets out our vision for what we want autistic people’s and their families’ lives to be like in 2026 across six priority areas, and the specific steps we, local government, the NHS and others will take to this end in this first year:
Improving understanding and acceptance of autism within society. To ensure that autistic people can take part in their communities without fear or judgment, just like everyone else, we are funding the development of and will test an autism public understanding initiative.
Improving autistic children’s and young people’s access to education, and supporting positive transitions into adulthood. To enable children and young people to access the right support, we are providing funding to train education staff in autism, and we are strengthening and promoting pathways to employment, such as supported internships, traineeships and apprenticeships.
Supporting more autistic people into employment. We will continue with our efforts to make Jobcentres more autism-inclusive, improve employer awareness, and promote better access to employment support programmes for autistic people.
Tackling health and care inequalities for autistic people. To tackle these inequalities, we are investing £13 million to begin reducing diagnosis waiting times for children and young people, as well as adults, in line with the NHS long-term plan and the mental health and wellbeing recovery action plan.
Building the right support in the community and supporting people in in-patient care. To make progress towards our targets of reducing the number of autistic people and people with a learning disability in in-patient mental health settings, we will take a number of actions. We are proposing to change the detention criteria in the Mental Health Act 1983 to prevent autistic people without a co-occurring mental health condition from being detained for treatment under section 3 of the Act. In addition, we are investing £40 million to improve community support, over £18 million to drive improvements in the quality of in-patient care, and providing £21 million as part of the community discharge grant to speed up discharges.
Improving support within the criminal and youth justice systems. To improve autistic people’s experience with the criminal and youth justice systems, we will develop a training toolkit for frontline staff on neurodiversity and the additional support people might need. We will also take a number of steps to improve staff awareness and understanding of autism and improve people’s access to adjustments.
Over the next five years, we will work together to create a society that truly understands and includes autistic people in all aspects of life, one in which autistic people of all ages, backgrounds and across the country have equal opportunities to play a full part in their communities and to have better access to the services they need throughout their lives.
[HCWS226]
(3 years, 1 month ago)
Written StatementsThe Government have today published the joint Department of Health and Social Care and Ministry of Justice consultation response to the White Paper Reforming the Mental Health Act, published in January this year.
The publication of this report represents a significant milestone on the road to reform of the Mental Health Act, a once-in-a-generation reform programme. It summarises the invaluable and constructive responses that we have heard from the public and stakeholders, and takes us a step closer towards the fulfilment of two manifesto commitments:
That we “will legislate so that patients suffering from mental health conditions...have greater control over their treatment and receive the dignity and respect they deserve”.
That we “will make it easier for people with learning disabilities and autism to be discharged from hospital and improve how they are treated in law".
In January we published a Mental Health Act White Paper, responding to the independent review of the Mental Health Act which was conducted by Sir Simon Wessely and published in 2018.
This White Paper set out that we will be accepting the vast majority of the recommendations and asked a series of consultation questions on the detail and implementation of the proposals.
Since the consultation closed in April, we have analysed more than 1,700 responses. In parallel to the consultation, our Departments have held policy development workshops to get richer insights from service users, clinicians, and those with lived experience of detention under the Act, on the details of the proposals.
The consultation response, published today, includes no new policy announcements, and instead reports on the feedback from clinicians, service users, those with lived experience of detention, and other key stakeholders on the 35 questions posed in the White Paper to gather views on the best way to implement the reforms and ensure they achieve their aims, and inform further policy development as we progress towards a Bill to reform the Act, which we will bring forward when parliamentary time allows.
The response has been overwhelmingly positive, with general support for the proposals and direction of travel set out in the White Paper. The responses have provided valuable insights on the practicalities of implementation, which our Departments will work through, and continue to engage as we do so. We are committed to continue the open policy making approach, in order to bring forward a Bill which will improve how the Act works for everyone. There are a small number of areas where the consultation response did not support the direction of travel set out in the White Paper, or there were mixed views on the proposals. We will reflect on the feedback received, and continue to engage with key stakeholders, prior to taking final policy decisions to inform the Bill.
[HCWS189]
(3 years, 1 month ago)
Commons ChamberI beg to move, That the Bill be now read a Second time.
The covid-19 pandemic has tested our country like never before, and nowhere more has this been seen than in our health and care system. Everyone delivering health and social care in this country has risen to meet these tests in remarkable new ways. We have seen bold new ways of working, of overcoming bureaucracy and of people working seamlessly across traditional boundaries. New teams were forged, new technologies adopted and new approaches found.
There is no greater example of this than the extraordinary success of our vaccine roll-out, where health and care colleagues have been able to draw on the collective scale and strengths of our Union to deliver one vaccination programme for the whole of the United Kingdom. Today, I can confirm to the House that two thirds of adults have received both jabs against covid-19 one week earlier than planned. It is a remarkable achievement. Everyone working in the NHS and social care can be proud of what they have achieved, and we are all in this House very proud of them.
As we look to the post-pandemic world, we know there is still no shortage of challenges ahead—an ageing population, an increase in people with multiple health conditions and, of course, the chance to embrace the full potential of data and technology.
Will the Secretary of State give way?
It is just, Secretary of State, because you mentioned the issue I wanted to bring up about people getting older. I spoke to your colleague, the Minister for Health, yesterday and I am appreciative of that—
Recent statistics show that over 40,000 people under 65 in the UK have dementia, and many more have not been diagnosed as of yet. It would seem that these figures are not addressed in the Health and Care Bill, so can I ask the Secretary of State what more will be done to offer support to those suffering with dementia and Alzheimer’s in the UK through this social services care Bill?
I am pleased that I gave way to the hon. Gentleman as he raises a very important issue. In this Bill, as I will come to, one of the central themes is integration. When I come to that, I hope he will see how that integration between NHS and social care will help to deliver a better service for those with dementia.
Everything I refer to—these challenges—are all in addition to the challenges of the pandemic that of course we still face and the elective backlog that we know is going to get worse before it gets better. Meeting the future with confidence relies on learning lessons from the pandemic—what worked and what did not work—and building on a decade of innovation in health and care.
Sometimes the best intentions of the past cannot stop what is right for the future. Bureaucracy can still make sensible decision making harder, silos can stifle work across boundaries and sometimes legislation can get in the way. We have seen how unnecessary rules have meant contracts have needed to be retendered even where high-quality services are being delivered, we have seen the complicated workarounds needed to help the NHS and local government to work together, and we have seen the uncertainty about how to share data across the health and care system. People working in health and social care want the very best for people in their care. That is what they have shown time and again, not least in the way they have embraced integration and innovation to save lives through this pandemic. They want to hold on to the remarkable spirit of integration and innovation, but they want to let go of everything that is holding them back and we want to help them to do it.
On that point of bureaucracy, I recently saw the apotheosis of the NHS, where an Anglican church had draped an altar with a flag saying, “O Praise the NHS”. So when we have a new Secretary of State, can we have a really hard-hitting attitude to NHS bureaucracy? We all praise our doctors and nurses, but the fact is that, like any other bureaucracy, it is prone to underperformance, waste and incompetence. There is no harm, as long as we preserve the principle of being free at the point of delivery, in having innovative private sector solutions.
I hear what my right hon. Friend has said and I think that, as I progress through my opening remarks, he will like what I have to say about integration and cutting bureaucracy.
All these things that I refer to and all these changes we want to make are exactly what this Health and Care Bill will do. I want to thank the thousands of hard-working staff who, through two years of consultation and engagement, have come forward and told us what they think works and what they think needs to change. In the words of Lord Stevens, chief executive of the NHS, the overwhelming majority of these proposals are changes that the health service has asked for. The Bill supports improvements that are already under way in the NHS. It builds on the recommendations of the NHS’s own long-term plan. It is a product of the NHS, it is for the NHS, and it is supported by the NHS.
I am grateful to all the organisations that have helped to shape these important proposals—everyone from the NHS Confederation to the Local Government Association. I have spent many of my early days in this job talking to them, and they have all told me the same thing, which is that they are ready to take forward the reforms. I want to continue to work with them and to listen to their specific concerns, just as much as I want to listen to the concerns raised by hon. Members across the House and by Members in the other place.
The Secretary of State referred to Lord Stevens and what the NHS has asked for in trying to get rid of things that stand in its way. Something that it has not asked for is a massive power grab by the Secretary of State, which is in the Bill and will lead to political interference in day-to-day operational and reconfiguration decisions, which may not always be in the best interests of patients. Why does he think that that is a sensible way forward and something that the NHS wants?
Clinical decisions should always be made by those with clinical expertise—I think everyone in the House would agree on that—and that should be independent of any outside interference. The Bill does nothing to alter that. What it does is recognise that the NHS is one of the public’s top priorities. We spend over £140 billion of taxpayers’ money on the NHS, and it is right that there is proper accountability for that spending to Ministers and therefore to the House. I think that most people would welcome that.
The Secretary of State has talked about people he has consulted, so would he confirm that he has consulted the trade unions, particularly on schedule 2, which says that integrated care boards may appoint employees to address remuneration, pensions and terms and conditions. Can he confirm that that is a departure from Agenda for Change terms?
There have been wide-ranging consultations on the Bill, as I mentioned, which have taken place over the past two years. While I cannot say specifically which trade union or which particular organisation has been spoken to, as I was not in the Department at the time, I know that the conversations have been wide ranging.
The Bill is not the limit of our ambitions on the nation’s health. We are also transforming public health; we are bringing the Mental Health Act into the 21st century; and, by the end of this year, we will set out plans putting adult social care on a sustainable footing for the future.
We are also ambitious for our workforce. I have commissioned Health Education England to refresh its strategic framework for health and social care workforce planning. HEE will work in partnership across the sector and gather views from the widest possible range of stakeholders to help us to shape a workforce with the right skills, the right knowledge and the right values for the year ahead.
My right hon. Friend has set out his plans to introduce a plan for social care by the end of the year, and I know that he is looking for a cross-party solution. In a joint inquiry by two Select Committees—the Housing, Communities and Local Government Committee and the Health and Social Care Committee—one of the recommendations was a system with a German-style social care premium. Would that potentially feature in his recommendations, and does he agree that that is a much fairer system than a Dilnot-style system that incentivises people to spend their assets or move them somewhere where they cannot be touched?
First, my hon. Friend is right to say that it would be great if all or most Members of this House, and certainly the different parties, could agree on a new system. I look forward to speaking to all hon. Members about what a future social care system could look like. In terms of the detail, I am afraid that he is just going to have to wait a moment longer, but I agree that the work by the Select Committees will, of course, inform our decisions.
I turn in a little more detail to the measures and themes that are captured in the Bill. The first is more integration. We know that different parts of the system want to work together to deliver joined-up services, and we know that, when they do that, it works. We have seen that with the non-statutory integrated care systems in the past few years. They have united hospitals and brought together communities, GPs, mental health services, local authority care and public health, and it works. We recognise that there are limits on how far this can go under the current law, so this Bill will build on the progress of integrated care systems by creating integrated care boards and integrated care partnerships as statutory bodies. England’s 42 ICSs will draw on the expertise of people who know their areas best. They will be able to create joint budgets to shape how we care for people and how we promote a healthy lifestyle. With respect to the specific geographies of the ICSs themselves, as I have said elsewhere, I am willing to listen.
In passing, may I congratulate my right hon. Friend on his appointment? I also very much welcome part 4 of the Bill, which introduces the health services safety investigations body. This is a great innovation that was promoted by the Public Administration Committee and scrutinised by the Joint Committee that I chair. Can I just reinforce the points that I know he is now receiving from NHS England with a warning about changing the boundaries of the integrated care systems that are already operating? In Suffolk and north-east Essex, we have a very high-functioning de facto integrated care system operating already. Please will he not change it?
My hon. Friend has raised an important point, and this may be on the minds of other hon. Members as well. It is important to point out that several factors will be helpful in fostering stronger partnerships between the NHS and local authorities, including the alignment of boundaries. Earlier this year, the former Secretary of State asked NHS England to conduct a boundary review of integrated care systems, to understand the best way forward and the best alignment where local authorities currently have to work with more than one ICS. I have met my hon. Friend and other hon. Members, and I know that hon. Members may have made representations to my predecessor. I have been informed of those, and where the information might not be remembered easily, I am sure we can get hold of some video evidence. [Laughter.] I want to thank all hon. Members for their input into this, and I stress that no final decisions have yet been made on the boundary review.
Will the Secretary of State give way?
Order. Just a reminder that interventions need to be short and to the point, because there is a lot of pressure on time in this debate.
My point is about boundaries. Lancashire and south Cumbria have a perfectly reasonable boundary, but does the Secretary of State agree that there is concern that, because most rural communities are attached to bigger, more populated urban ones, that can lead to an imbalance in decisions? One of the proposals that our community faces is that the Preston and Lancaster hospitals could be replaced by a single super-hospital somewhere in the middle. HIP2—the health infrastructure plan 2—is a good thing, but that would be very bad thing, because it would mean that people in south Cumbria could have a two-hour round trip just to get to A&E. Will he intervene and ensure that any proposals under HIP2 that undermine access to healthcare in rural communities are taken off the table?
I listened carefully to what the hon. Gentleman said. As I have said, no final decisions have been made, but if he would like a meeting with a Health Minister, we can arrange that so that the matter can be discussed further.
I am also very grateful to another of my predecessors, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), first for his leadership of the Health Committee, whose valuable report and recommendations we have taken on board, and secondly for his tireless dedication to the cause of patient safety, which sees its culmination in the Bill’s creation of the Health Services Safety Investigations Body. We must continue, in his words, that quiet revolution in patient safety. I have asked my officials to consider whether the Care Quality Commission could look broadly across the integrated care systems in reviewing the way in which local authorities and providers of health, public health and social care services are working together to deliver safe, high-quality integrated care to the public.
The Secretary of State talks of patient safety. May I ask him why the Bill contains none of Sir Bruce Keogh‘s recommendations on the cosmetic surgery industry, which are now 10 years old? In response to questions that I have asked, Ministers keep saying that the recommendations are going to be implemented. Could this not be an opportunity to improve patient safety in that area?
The right hon. Gentleman has raised an important matter. There are issues surrounding the cosmetic surgery industry, and I know that he has spoken eloquently about them in the House before. I do not necessarily agree that this Bill has to be the vehicle for any change, but if he wishes to discuss the matter further, I should be happy to meet him in due course, because it is important and it does require a fresh look.
Whenever the NHS is subject to change, it is tempting for some, who should actually know better, to claim that it is the beginning of the end of public provision. We know that that is complete nonsense, and they know it is nonsense, but they say it anyway. So let me very clear: our integrated care boards will be made up of public sector bodies and those with a social purpose. They will not be driven by any private interests, and will constantly make use of the most innovative potential of non-NHS bodies.
The spirit of this Bill is about holding on to what is best about the NHS and removing what is holding it back. That is something that we all want, and I am looking forward to a mature debate—[Laughter.] Perhaps that is too much to ask in this Chamber with this Opposition Front Bench, but I hope for, and I think the public expect, a mature debate on the Bill and on how we can achieve these sensible changes together.
In that spirit, the second theme of the Bill is cutting bureaucracy. As we have been tested during these past months, we have looked at the rules and regulations through new eyes. It has become increasingly clear which of them are the cornerstone of safe, high-quality care, and which are stifling innovation and damaging morale. It is that second group of rules and regulations that the Bill strips away, removing the existing procurement regime and improving the way in which healthcare services are arranged. Yes, this is about how we deliver better value for the taxpayer, but fundamentally it is about how we can free up NHS colleagues to deliver better care. We know that patients are better served when experts are free to innovate unencumbered by unnecessary bureaucratic processes. That is why the Bill will repeal section 75 of the Health and Social Care Act 2012, giving the NHS the flexibility for which it has been asking. I know that this is a point of agreement with the Labour party—
We said it 10 years ago.
The Labour party said it not just 10 years ago but in 2015, 2017 and 2019—in all those manifestos—so I am sure that its members agree with this direction. [Interruption.]
Order. If Members want to intervene, let me say to them that the Secretary of State has been very generous in giving way, but just shouting at him is not working.
They are excited, Mr Deputy Speaker, and I understand that. Let me excite them much more.
The third theme of the Bill is greater accountability. We have never seen so clearly as we have in the past 16 months how critical the health of our constituents is for the House. The Government of the day always work hand in hand with the NHS to deliver that priority. That is what people would expect from a responsible Government. People also rightly expect there to be clear lines of accountability for how this priority is delivered. Accountability is the foundation of our democracy, and on that I hope we all agree.
On the nation’s greatest priority, our health, this Bill sets out clear lines of accountability to the people we all serve. The Bill simplifies what has been a complex structure, bringing the three different bodies that oversee the NHS into just one, as NHS England. NHS England will continue to have clinical day-to-day operational independence, but it is right that the NHS must be accountable to Ministers, and Ministers must be accountable to Parliament, where we are all accountable to the people we serve.
Naturally, that accountability will extend to these integrated care systems. The right hon. Member for Leicester South (Jonathan Ashworth) is on the record, in an interview with the Health Service Journal in December 2019, as saying that he agrees with the principle of the legislative changes that had been put forward by the NHS for “democratically accountable” ICSs. He cannot have any objection to this point. We will see what he has to say from the Dispatch Box.
I hope we can all agree that this is a sensible and pragmatic step. Let me quote once more:
“We will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.”
Those are not my words but the words of the 2017 Labour manifesto. I look forward to working with the shadow Health Secretary on this and other aspects of the Bill, and I urge him to set aside petty party politics and point scoring and do what the NHS wants him to do, which is to back this Bill.
Before I finish my opening remarks, I turn to the reasoned amendment in the name of the Leader of the Opposition and other Opposition Members. What is claimed by the reasoned amendment is entirely wrong. This is exactly the right time for these reforms. The response to covid-19 has quickened the pace of collaboration across health and social care, showing what we can do when we all work together, when we adopt new technology and when we set aside bureaucratic rules. The pandemic has also brought home the importance of preventing ill health in the first place. The Bill lays the framework to achieve all that.
More than that, this Bill is what the NHS has been asking for. It builds on the NHS’s long-term plan and the work the NHS has already started to do voluntarily. We have invested record sums in the NHS, both before and, of course, during this pandemic, and we will continue to do so.
The systems are telling us that they are ready, that they want us to go ahead with this Bill. They do not want to see any delay, which is why this is important work for all of us. Hopefully Parliament can deliver what the NHS is asking for.
The unprecedented challenges of the pandemic have only deepened our affection for the NHS, and it has reinforced the noble idea that the NHS is there for all of us when we need it. I started learning about the NHS from a very early age when I used to go to check-ups with my mum and translate for her. It was there for her, it has been there for me, it has been there for my family, it has been there for my children and it has been there for all of us and our constituents.
Even in this fast-changing world, with the new and evolving threats to our health, the founding principles of the NHS are as true today as they ever were. It is our responsibility to build on this incredible inheritance. Our NHS is the envy of the world, so it is right that this Government should work across health and care to shape a system that is truly fit for the future. Our colleagues in health and social care have achieved extraordinary things in the most extraordinary times, and we in this place must give them the firm foundations they need to build back better in the years that lie ahead.
(3 years, 1 month ago)
Commons ChamberI want people to be able to get the care they need when they need it and to have the choices they want. I want people to live their life in full and to live independently as part of a community for as long as possible without facing an astronomical care bill. We are committed to social care reform, and we will bring forward proposals this year.
I thank the Secretary of State for responding to my initial question. Eleven years into this Tory Government, 10 years on from Dilnot and almost 700 days since the Prime Minister promised
“to fix social care, once and for all”,
looking at it and studying the options is not enough for the four out of five people who say, “We need a solution now.” Is this just another of the Prime Minister’s promises that will not quite materialise?
We have already seen substantial increases in adult social care funding, but the Government have said that we want a long-term, sustainable solution, so we will bring forward proposals on that. The hon. Gentleman will know that later today we are debating the Health and Care Bill, which is also about structural reform, so I look forward to seeing him in the Aye Lobby.
May I just say to the Chancellor—the Secretary of State, rather—that when he brings forward the proposals, will he make sure that he addresses social care for working-age adults, which actually accounts for more than half of public spending? The debate is always focused on older people, and people of working age often get forgotten. The reason for my slip just now is that he will be aware, as a former Chancellor, that the tax burden was at a 50-year high before covid. When he brings forward the proposals, can we not just default to putting up taxes, however they are disguised, but look at overall Government spending, set some priorities and make some choices about what we think is important? Social care is important, but we need to make those choices about overall Government spending.
First, my right hon. Friend is right to bring to the House’s attention the way that the Government are also working on social care for working-age people. He is also right to point out—I was thinking about this the other day—that around 55% of total adult social care spending is for working-age adults, and it is important that we continue to provide that support. He will be pleased to know that I am working with the current Chancellor and other Cabinet colleagues on bringing forward a more sustainable long-term plan, and I hope he will support it when it comes forward.
I welcome what my right hon. Friend has said so far and the moves he is making to deal with the social care issue. One thing that elderly people particularly are worried about when they are in care or in hospital are the recent reports of “Do not attempt cardiopulmonary resuscitation” orders. Will my right hon. Friend give an assurance that they will only be put in place with the authority of the patient or their next of kin? Is he making inquiries into recent reports of their widespread use?
My hon. Friend will be interested to know that the Department commissioned the Care Quality Commission to review the DNACPR decisions that were being made during the first wave of the pandemic. That review was published in March, and the Department then established a new ministerial oversight group that will be responsible for delivery and the required changes that were recommended in the review. We want to ensure adherence to the guidance throughout the system whenever DNACPR orders are used. The first meeting of this new group will take place on 8 June.
I welcome the Secretary of State to his new position. I wondered whether he might be able to clarify something for me. Five days ago, he told the Local Government Association conference that for social care reform,
“we may not be able to announce the whole plan…with all the details there”,
but that he hoped to
“set out…the general sense of direction”.
The general sense of direction! It is two years since the Prime Minister made a clear promise to fix the crisis in social care “once and for all”. Since then, more than 40,000 care home residents have died from covid-19 and 2 million elderly and disabled people have applied for care but had their request turned down. Millions more families and staff have been pushed to breaking point, so may I ask the Secretary of State: what is the plan? When will we see the plan? Will it provide the full details that he and the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately) have promised, or does keeping your word mean nothing to anyone in government anymore?
I think the hon. Lady may well have misunderstood what I said at the conference; I am not sure she listened to the whole session. It is worth repeating that the Government are absolutely committed to coming forward with a sustainable plan for adult social care and to bringing forward that plan to make sure that every person when they reach old age in our country can have the dignity they deserve. We will bring forward full proposals—a full plan—this year.
Since the start of the pandemic, we have acted swiftly to reduce the spread of the virus and to keep the public safe. As our vaccine programme progresses, links between cases and hospitalisations weaken, and that means that we are confident we can move forward with step 4, as I set out in the House yesterday.
I thank the Health Secretary for that answer. After the planned changes next week, the Health Secretary is predicting that covid cases will reach 100,000 a day. Research is suggesting that that could result in 3,000 hospital admissions and again put our health services under pressure. What is his response to Dr Mike Ryan of the World Health Organisation, who described the proposals to remove all covid measures and simply let people get infected as “epidemiological stupidity”?
The hon. Gentleman talks, understandably, about pressure on the NHS, and he will know that the restrictions we have necessarily had in place during the course of this pandemic so far have also led to considerable pressure on the NHS, especially when it comes to non-covid health problems. He may be aware, perhaps for his own constituents, that mental health problems are up, there are many undiagnosed cancer cases, domestic violence is up and child abuse is up. I hope he will agree with me that one of the things we can look forward to as we gradually start removing restrictions is helping people with their many non-covid health problems too.
I also welcome the Secretary of State to his new role. I hope he will soon see that the Department performs best when it follows the scientific advice. This morning, Professor Graham Medley, the chief modeller for the Scientific Advisory Group for Emergencies, said of mask wearing that
“if it’s not mandated it probably won’t do any good.”
That advice would explain why, last year, the Government moved from just guidance on mask wearing in May 2020 to making it compulsory on public transport in June and in shops in July. So if the advice is clear and the Government took that advice last year, why on earth are they moving away from it now?
The hon. Gentleman will know that the Government’s decisions are rightly informed by the best possible scientific advice there is and, as well as that, looking at the data and then taking all of that into account when reaching decisions. The hon. Gentleman asks about masks, and I have answered that question a number of times at the Dispatch Box. I am very happy to repeat that we are moving away from a system of regulation to guidance, but in that guidance, which was published yesterday, we have made it very clear that in certain situations masks will still make sense, and we believe that people will use their common sense and follow that guidance.
The Government have committed to taking a cautious approach to easing restrictions, guided by the data and not by dates. As I set out in my statement to Parliament yesterday, the decision to lift the remaining measures on 19 July and proceed to step 4 is based on an assessment of the four tests that were set out in the road map.
I thank my right hon. Friend for his answer and welcome him to his new post.
For me and most of my constituents, 19 July cannot come early enough. It is refreshing to see the Secretary of State’s new approach to the wider issues of health provision, and the huge success of our vaccine roll-out has surely ensured that there should and will not be any more lockdowns or restrictions on our civil liberties. Will he assure me that no matter what vested interests have held sway in his Department and across Government in the past 18 months, he is clear that lockdowns and state intervention in the lives of our constituents have gone far enough and need to be curbed?
First, I am pleased that my hon. Friend agrees with the decision we have made to proceed with step 4. It sounds like he agrees with the central decision to move from a system of regulation to one of guidance. As he knows, the pandemic is not over, so we are rightly moving forward in a measured way. I am pleased that he agrees with the approach.
I also welcome yesterday’s step 4 announcement. Does the Secretary of State agree that his Department should embrace a bit more risk by working with the Department for Transport to open up the international travel sector fully? Will he also ensure that GPs return to fully physical appointments and that we open up the full range of dental services?
I am pleased to tell my hon. Friend that, now that we have begun the process of opening up, more work is being done between my Department and the Department for Transport on international travel. The announcements made by my right hon. Friend the Transport Secretary last week will certainly help and be welcomed by the sector and travellers. On GP access, now that we have started to open up, working together with GPs we can see better direct access, and especially face-to-face access.
We can no longer just think of a health system; we have to think about the health and social care system. We want people’s experiences of care to be seamless, which is why we have introduced the Health and Care Bill and will debate its Second Reading today.
In order to better integrate and support local services in Nottinghamshire, we would benefit greatly from working with a single integrated care footprint for a simpler and fairer service. A boundary congruous with our county boundary would allow us to offer more equitable care across the whole area. I understand that the decision on the integrated care system boundaries is imminent, so will my right hon. Friend meet me to discuss the potential benefits?
I am aware that several factors are helpful in fostering stronger partnerships between the NHS and local authorities, including alignment of boundaries. My hon. Friend will know that the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), asked NHS England to conduct a boundary review for integrated care systems. That review, which is just being completed, will certainly look at and give advice on the best ICS footprint for alignment. No final decision has yet been made, but it is a priority for me. I would be happy to arrange a meeting for my hon. Friend with Ministers to discuss the matter further.
It is an honour to be here for my first oral questions as the Secretary of State for Health and Social Care, and I thank the Prime Minister for bringing me back from furlough. I accepted this role because I love my country and the NHS. I know that I join this Department at a pivotal time, and I have three pressing priorities for these critical few months. The first is getting us on the path out of this pandemic. The second is busting the backlog of non-covid services. The third is putting social care on a sustainable footing for the future. I want to draw on what I have learnt during this time of adversity and what we have all learnt together. I want to make this great nation a healthier and fairer place, and I am looking forward to working with all hon. Members in this House.
You missed the fourth: a 24-hour accident and emergency unit for Chorley.
East Sussex Healthcare NHS Trust has the potential to get hundreds of millions in investment as part of the Government’s NHS estate infrastructure improvement plan. Will funding be allocated on a two to three-year basis, so that the NHS can better plan its funding and estates plans? Where funding has been indicated for a longer term, what plans are there to ensure that providers have sufficient resource in the shorter term to address immediate issues, or to support covid or recovery?
We have put more and more capital into the NHS. There are always representations from hon. Members, including you, Mr Speaker, for even more capital. My hon. Friend is right to raise the issue of the importance of local healthcare systems, which will need more capital funding as we progress. She will know that we set out our capital plans for this financial year, 2021-22, but she is right to say that multi-year funding will mean that trusts can plan better, and that is a priority; we want the spending review to have more sight and better planning for capital.
Let us consider these words about mental health services:
“prior to 2017, no government invested in or prioritised MH services.”
Those are not my words but the words of the Minister for Patient Safety, Suicide Prevention and Mental Health, the hon. Member for Mid Bedfordshire (Ms Dorries). Indeed, the new Secretary of State was the architect of these cuts, during his time as a Treasury Minister. The unparalleled devastation he left behind has been simply staggering, so does he agree with his Minister? Can he explain to us why 140,000 children were turned away from mental health services last year? Can he explain why a quarter of mental health beds have been cut since 2010? Is he ashamed of his track record?
The hon. Lady will know that the NHS long-term plan that has been set out by this Government is committed to a transformation in mental health services and mental health spending; some £2.3 billion extra is being invested by 2023-24. In addition, she will be aware of the mental healthcare White Paper and the mental health recovery action plan. I hope these are all initiatives she will support.
May I welcome the Secretary of State to his place? I am sure he will do an excellent job. As he thinks about a 24-hour A&E for Chorley, I hope he will also think about the urgent need for a cancer institute at the Royal Surrey County Hospital as only second on his list.
The Secretary of State will know that this morning the Health and Social Care Committee published a worrying report about the inhumane treatment given to 2,000 people with learning disabilities and autism in in-patient units, often because no community provision was available. When he brings forward his plans for social care, will he make sure that there is adequate funding for local authorities to give care to such people? Will he also make sure that care workers are always paid the minimum wage, including for the time taken to travel between appointments?
I welcome my right hon. Friend’s comments and the work that he and other Members do through the Select Committee to scrutinise the work of the Department. He just referred to some of that work, especially in his comments about learning disability and autism, which will remain a huge priority for the Government and certainly for my Department.
My right hon. Friend also rightly raised the issue of care workers and the minimum wage; it is worth pointing out that the Care Act 2014 requires local authorities, when they provide funding, not just to support the minimum wage but to take account of the costs that care workers might incur, such as travelling costs. I look forward to working with my right hon. Friend and the members of his Select Committee.
As the Government have said, we want to make sure that every person in this country has the dignity that they deserve in old age. We have recognised that the current system needs substantial reform. The process of reform has already begun in, for example, the Health and Care Bill that will have its Second Reading tomorrow, but we do need a new, sustainable way to fund care and we will come forward with the plans later this year.
I agree with my hon. Friend that it is good news that we can move away from restrictions and towards guidance. On the rationale for the decision he referred to, it is about vaccine effectiveness: we know that for those with both doses, vaccination is estimated to be 78% to 80% effective against symptomatic covid-19. The introduction on 16 August of the changes to which my hon. Friend referred will mean that more people will have been vaccinated and will help to reduce severe illness.
I want to reassure the hon. Lady—because this is such an important question for so many people across the country—that cancer remains a huge priority for this Government. She is right to refer to the work that Macmillan has done on this issue because, sadly, during the restrictions thousands of people have not come forward in the usual way and their cancer sadly remains undiagnosed. We urge anyone who feels that this is an issue for them: please, go to your GP—please come forward. That is one reason why we have launched the “Help Us, Help You” campaign. We have also provided additional funding for rapid diagnostic centres.
I think we would all agree in this House that GP practices have done a magnificent job in responding to the pandemic, and I want to take this opportunity to thank all GPs and their staff for the work that they have done and that they continue to do. My hon. Friend is right to raise the issue of face-to-face access. We can all understand why it changed during the pandemic, but as we open up, we can start to provide more of this, particularly for older people. Over the coming weeks and months, that will be a priority for my Department.
As I said in response to an earlier question, this is a huge priority for the Government and, again, I am pleased that the hon. Lady has raised the issue. It is an issue for her constituents and for constituents throughout the country. She referred to the research by Cancer Research UK. I am afraid that it is right: there are thousands of people who did not come forward. We can understand why, so let me say this again as it is so important: for anyone concerned, please do come forward. We have provided additional funding—more than £1 billion—for more diagnostics and we will continue to provide additional support.
The hon. Lady is right to raise this issue. As she has rightly explained, there will be a number of people who, understandably, will be concerned about the move away from regulations to guidance. None the less, there must come a point when we start to remove the restrictions slowly, in a measured way, as we are doing—not least because we want to be able to start dealing much more with all the non-covid health problems that have been created as well. We have provided very clear guidance on masks and it was published yesterday. I hope that the hon. Lady can share that with people who are concerned.
Yes, I can confirm that. Removing restrictions is not without risk—I accept that—but keeping restrictions is not without cost. As my hon. Friend points out, the restrictions have led to increased domestic violence, child abuse, mental health issues and undiagnosed cancer, which we have heard about today, to name but a few. As we start lifting restrictions, that means that we can better deal with all these major non-covid health problems.
Throughout the pandemic, my predecessor and other Ministers have rightly been working with the devolved Administrations, and of course that work continues; it will remain a priority. I myself have already started weekly meetings with all my counterparts in the devolved Administrations. We discuss a number of issues and keep each other informed, but we also respect that in certain areas, in dealing with this pandemic, we may take a different course.
The hon. Lady understandably talks about the link between case numbers and hospitalisation. She will know that the last time we saw cases at 30,000 and above on a daily basis, we saw a lot more hospitalisations. The reason for the difference now is the vaccine wall of defence. Masks do have an important role to play, but we think that that role can be played by moving from regulation to guidance.
I am suspending the House for three minutes to enable the necessary arrangements to be made for the next business.
(3 years, 1 month ago)
Commons ChamberBefore I update the House on the pandemic, I would like to take a moment to congratulate the England football team on making history and on the way in which they have brought us all together with their skill and spirit over the past few weeks. Last night’s result may not have been the one that many of us were hoping for, but they played like heroes and the nation is proud of each and every one of them.
I also want to take this opportunity to condemn the shameful racism experienced by several members of the England team after the match. Racism has no place in football; it has no place in our society. I know that the whole House will agree that we must always show zero tolerance to this appalling behaviour.
With permission, Mr Speaker, I would like make a statement on our path out of the pandemic. All the way through our fight against the virus, we have looked forward to the day when we can roll back the legal restrictions and get closer to normal life. Now, thanks to the shared sacrifices of the British people and the protective wall of our vaccination programme, we have made huge advances. Today I would like to update the House on the next decision in front of us: whether to proceed to step 4 of our road map next Monday.
As I set out to the House last week, this will be a major milestone for the country, taking us another step closer to the life that we all used to live. It means carefully removing more of the restrictions that have governed our daily lives, such as how many people we can meet, how many people can attend weddings and how many visitors people in care homes can see, bringing them together with their loved ones. We have all been yearning to get there, and we all want this to be a one-way journey, so we have acted in a measured way, taking one step at a time, and looking at the very latest data and at our four tests before deciding whether to proceed.
The first test is the success of our vaccination programme. Ever since 8 December last year, when the world’s first clinically authorised vaccine was given right here in the UK, we have been putting jabs in the arms of people at a phenomenal pace, giving over 18 million doses in just seven months. We have given more doses per capita than any other large nation. As a result, around nine in 10 adults in the UK now have covid-19 antibodies, which are so important in helping us and our bodies to fight this virus. To bolster this protective wall even further, we made the tough but necessary decision to take a four-week pause to step 4, so that we could protect even more people before easing restrictions. Since making the decision, we have been able to give 7 million extra doses across the UK. We have pledged that, by 19 July, we will have offered every adult a first dose of vaccine and given two doses to two thirds of all adults. I am pleased to inform the House today that we are on track to beat both of these targets, so as we make this crucial decision, we are in a stronger position than ever before.
We have looked not just at how many jabs we have put in arms, but at what impact they are having on hospitalisations and the loss of loved ones. This is our second test. There is increasing evidence that the vaccine has severely weakened this link—a link that was once a grim inevitability. Data from Public Health England estimates that two doses of a covid-19 vaccine offer around 96% protection against hospitalisation, meaning fewer covid patients in hospital beds and fewer people mourning the loss of a loved one. The data also estimates that the vaccination programme in England has prevented between 7.5 million and 8.9 million infections. It has prevented some 46,000 hospitalisations and prevented about 30,000 people from losing their lives, all because of the protection that the vaccines can bring.
Our third test is around whether infection rates would put unsustainable pressure on the NHS. I want to be open about what the data is telling us and why we have reached the decision that we have. Cases are rising, propelled by the new, more transmissible delta variant. The average number of daily cases is over 26,000, and this has doubled over the past 11 days. Sadly, the case numbers will get a lot worse before they get better. We could reach 100,000 cases a day later in the summer.
Hospitalisations are also rising, with sustained growth over the past month. Once again, they will rise too, but we should be encouraged that hospitalisations are far lower than they were at this point during the previous wave, just as we should be encouraged that people over the age of 65, who are more likely to have had both doses of a vaccine, made up 31% of covid admissions last week, compared with 61% in January. This is further evidence that our vaccination programme is doing its job and protecting the NHS. As more people get the jab, our protective wall is getting stronger still.
We will stay vigilant and keep a very close eye on the data, as well as on the impact of long covid, on which we are investing £50 million into new research. But on the basis of the evidence in front of us, we do not believe that infection rates will put unsustainable pressure on the NHS. It is so important that everyone still does their bit in helping the NHS to stand strong. The best thing that each and every one of us can do, if we have not done so already, is get the jab and, crucially, get both doses.
Our final test is that the risks are not fundamentally changed by new variants of concern. We have seen from the growth of the delta variant, which now makes up 99% of new cases in this country, just how quickly a new variant can take hold. However, although the delta variant is more transmissible than the alpha variant, the evidence shows that two doses of the vaccine appears to be just as effective against hospitalisation. But we know that the greatest risk to the progress we have made is the possibility of another new variant, especially one that can escape immunity and puncture the protective wall of out vaccination programme, so even as we look to ease restrictions, we will maintain our tough measures at the borders and we will expand our capacity for genomic sequencing, which is already one of the largest in the world, so that we can come down hard the moment we detect a new variant.
We have looked closely at the data against these four tests and we firmly believe that this is the right time to get our nation closer to normal life, so we will move to the next stage of our road map on 19 July. To those who say, “Why take this step now?”, I say, “If not now, when?” There will never be a perfect time to take this step because we simply cannot eradicate this virus. Whether we like it or not, coronavirus is not going away. Moving forward next week, supported by the arrival of summer and the school holidays, gives us the best possible chance of a return to normal life. If we wait longer, we risk pushing the virus towards winter, when the virus will have an advantage, or, worse still, we will not be opening up at all. We delayed step 4 by four weeks so that we could build the vaccine wall even higher. We believe that this wall means that we can withstand a summer wave. While the wall would be higher still if we waited until winter, we know the wave would be much more dangerous. So while we know that there are risks with any decision, this is the most responsible decision that we can take.
This step forward is about balancing the harms that are caused by covid with the undeniable harms that restrictions bring. These restrictions were vital to protect the NHS, but we must be upfront about the impact of keeping them just as we are about removing them: the rise in domestic violence, the impact on mental health and the undiagnosed cancer, to name just a few. So we will ease the restrictions next week while at the same time maintaining the defences we have built against this virus, like our vaccination programme, where we still need more young people to come forward; our work to support the most vulnerable; and the contingency plans that we have put in place to stay one step ahead of this virus.
But this is not the end of the road: it is the start of a new phase of continued caution while we live with this virus and we manage the risks. We are today publishing a plan showing the safe and gradual approach that we will be taking throughout the summer. It includes details of how we will be encouraging businesses and large events to use certification in high-risk settings to limit the risk of spreading infection, how we will use guidance for those who are clinically extremely vulnerable, and details of a review that we will be conducting in September to assess our preparedness for autumn and winter.
As we make these changes, it is so important that people act with caution and with personal responsibility. For example, everyone should return to work gradually if they are currently working from home, they should try to meet people outside where that is possible, and it is expected and recommended that people should wear face coverings, unless they are exempt, in crowded indoor settings like public transport.
I also want to take this opportunity to update the House on our policies for self- isolation. Last week I announced to the House that from 16 August double-jabbed adults and under-18s will no longer need to self-isolate if they are a close contact of someone with covid-19. Until then, with case rates expected to rise, it is vital that we ensure that our systems for self-isolation are proportionate and reflect the protection given by our vaccine programme. As part of this approach, we will be working with clinicians and the NHS to explore what more can be done for colleagues in patient-facing roles—this would be used only in exceptional circumstances where the self-isolation of fully vaccinated close contacts could directly impact the safety of patients—so that we can keep our vital services going as we safely and gradually get closer to normal life.
Mr Speaker, 19 July will mark another step forward in our road to recovery. Getting here has been hard fought, and it has been long awaited, but this battle is not over yet. Let us move forward in a confident but measured way so that we can get closer to normal life and protect the progress that we have already made.
I thank the Secretary of State for advance sight of his statement. I join him and others across the House in paying tribute to the England side. They did indeed unite the country, and we are proud of each and every one of them. Of course, those players did take the knee to show they were taking a stand against racism. Labour again offers them our solidarity and joins with others in condemning utterly the racist, vile abuse that we have seen in the last 24 hours.
We want to see the economy reopen in a balanced, safe and sustainable way. That means maintaining certain mitigations to contain the speed at which infections are rising, to help reduce transmission and to help to limit the numbers exposed to the virus before they are fully vaccinated. Instead, the Secretary of State has taken a high-risk, fatalistic approach, trying to game what might happen in the winter and deciding that infections are going up anyway. Instead of caution, he is pushing his foot down on the accelerator while throwing the seatbelts off. He admits that that could mean 100,000 infections a day, which means potentially thousands suffering debilitating long covid and that, as more cases arise, more may escape, with the threat of a new, more transmissible variant emerging.
Two weeks ago, the Secretary of State justified unlocking by suggesting that it would make us healthier. Today, hospital admissions are running at more than 400 a day and there are now 393 people in intensive care units, up by more than 100 since the start of July. Of course, significant increases in admissions have a knock-on effect on the NHS’s ability to provide wider care. He says that infection rates will not put unsustainable pressure on the NHS, but last week cancer patients at Leeds were having their surgery cancelled and ambulance trusts across the country were reporting some of their busiest days ever. The 111 service is under intense pressure.
At the weekend, the Secretary of State warned that the elective waiting list could rise as high as 13 million. Perhaps he could therefore define what he means by “unsustainable pressure”. What does he predict that hospital admissions will peak at? He has told us he expects 100,000 infections, so how many hospital admissions does he expect? Does his confidence mean that there will be no extra resources for the NHS this summer to get through this summer wave? He again highlights vaccination, but why are vaccination rates slowing down? What will he do to drive up rates among younger people, which are still at only about 56% of 18 to 24-year-olds? When will we begin vaccination of adolescents? Other countries are doing it—why are we not?
To rely only on vaccination as infections climb is the approach of the one-club golfer. The Secretary of State needs to put other measures in place as well. First, Labour would continue with mandatory mask wearing. I notice that his tone has shifted in the last week or so and now his view is that it would be irresponsible not to wear a mask in a crowded room. Surely it is equally irresponsible for the Government to abandon mandatory mask wearing.
Secondly, on working from home, yesterday Susan Hopkins from PHE suggested that for the next four to six weeks at least people should try their best to work from home, so will the Secretary of State guarantee that anyone who wants to continue working from home will have the right to do so?
Thirdly, we know how important fresh air is. Germany has funded air filtration systems in public buildings. Last week, the Secretary of State referred to the infection control funding given to social care, but that was not for ventilation. There are British firms that manufacture air filtration and ventilation units, so let us support those firms and British jobs, and offer grants to premises to install air filtration units. Will he also use the summer to install air filtration systems in every school?
Fourthly, as more virus circulates, more people will be exposed, more people will become ill and more will have to isolate, but some people still cannot isolate because of their finances, and those with caring responsibilities for someone who has had to isolate can also be financially penalised. Furlough is beginning to be withdrawn, so financial support for isolation will become even more urgent. Will the Secretary of State ensure that those who need to isolate can access adequate sick pay and support?
Fifthly, to get through this third wave and flatten the curve, we will need ongoing testing, and contact tracing will need extra capacity. Will the Secretary of State give local authorities the resources to lead the enhanced retrospective and forward contact tracing they need to do, and will he now abandon the proposed charges for lateral flow tests, which he is set to introduce?
Finally, when the Secretary of State was appointed, he said that any easing on 19 July would be, in his word, “irreversible”. Other countries have thought the same with their road maps, yet Israel has reintroduced masks, and the Netherlands reopened nightclubs and had to close them again after two weeks. Is it still his view that the 19th is terminus day and that everything he has announced today is irreversible, or does he agree that it would be more sensible to have regular review dates in place through the summer as we deal with this third wave and rising infections?
The right hon. Gentleman started by saying that he supports a balanced approach in a sustainable way, and that is exactly what I have set out today from this Dispatch Box. That is the Government’s approach, so I agree with him. We as the Government have set out the detail, but I am still not sure what his plan actually is. However, given that he set out those objectives, I hope he can support this plan. He talks about the risks that are involved, and I have been very up front about that. The Government have been up front: there is no risk-free way forward. Opening up is not without risk, but ongoing restrictions are not without cost, and I hope he appreciates that.
The right hon. Gentleman raised a number of questions, and one of his first was about hospitalisations. As I have said, case numbers are going up and we expect them to continue going up, but the most important difference today versus the last wave is vaccination—the wall of defence that our country has built—which has meant that hospitalisations, although they are rising as case numbers rise, are rising at a rate that is a lot slower than before. I have set out specifically regarding test 3 in a road map that we believe the pressure, with all the data we are seeing at this point, is not unsustainable for the NHS.
The right hon. Gentleman talked about vaccinations, and I am pleased he is highlighting that, especially for more young people to come forward. As I mentioned in my statement, we are ahead of the plans we set out when step 4 was temporarily pushed out by four weeks. He also asked about the vaccination of children. He knows that we have a group of expert science advisers—the Joint Committee on Vaccination and Immunisation—and this is something it is actively looking at. At some point, we will reach a final decision, but I hope he will agree with me that we should take the scientific advice on that and consider it very carefully before making such a move.
On air ventilation units, some of the £90-plus billion extra the Government have provided to the health and care system during the course of this pandemic has of course gone on air ventilation units, and we should continue to support that. A lot of extra funding has also gone to people to support them financially if they are asked to isolate, and it is important that that is both kept under review and continues to be taken seriously.
The right hon. Gentleman mentioned lateral flow tests and something about charging for them. That might be his policy, but it is not this Government’s policy. I do not know where he has got that one from, but we have no plans to charge for lateral flow tests.
Lastly, 19 July is a step forward on our road map. As we have clearly set out, the pandemic is not over, but it is a very significant step forward. The right hon. Gentleman talked about reviews. I have just said that we will have a review in September to make sure that we are properly set up for autumn and winter.
The virus today is a totally different creature from a year ago, with only one in 40 new cases being hospitalised, an average age for new cases of 25, and all over-40s being offered two jabs, accounting for 99% of the age group that have had covid fatalities to date, so the Government’s approach is entirely reasonable. However, does the Health Secretary agree that there remain, to paraphrase the late Donald Rumsfeld, a number of unknown unknowns and known unknowns, not least the impact of long covid, the potential for vaccine escape and the potential for new variants? Will he reassure the House that if the data deteriorates beyond what is currently envisaged, he will not hesitate to take decisive action, not just to save lives but to head off the need for a further lockdown which would be enormously damaging for our jobs and businesses?
I am very happy to give my right hon. Friend that assurance. He made some excellent points. I thank him for his support for the Government’s action, but he is right to point out that there is still uncertainty for us and countries across the world in dealing with this pandemic. I am very pleased to assure him that if that risk matrix changes, for example with variants of concern, we will not hesitate to take the appropriate action.
I would first like to associate myself and my colleagues with the Health Secretary’s condemnation of the racism sadly faced by members of the England football team after their impressive performance throughout the Euros.
Turning to covid, the Secretary of State himself has suggested that covid cases could soar to 100,000 a day once all restrictions are removed next Monday. While research shows that hospitalisation rates have, thankfully, dropped to 3% of cases because of vaccination, that would still mean up to 3,000 admissions, the same as during the first wave. Can he explain how he will avoid such a surge putting pressure on health services, which would further delay clearance of the backlog of patients waiting with other conditions?
With the likelihood of such high transmission rates, how does the Secretary of State hope to prevent the generation in the UK of yet more new variants, perhaps with significant vaccine resistance? Evidence is growing of the debilitating impact of post-covid morbidity, and the Office for National Statistics estimates that it could affect 10% of those who have had the virus, so how does he plan to avoid an unacceptably high risk of long covid in young adults and children, who are not fully vaccinated?
Finally, why is the Secretary of State ending the mandatory wearing of masks in indoor spaces and on public transport, given that they reduce viral spread and cause no economic detriment? Does he not recognise that, as vulnerable people cannot count on others wearing masks, for them 19 July will not be freedom day but the exact opposite?
I thank the hon. Lady for what she said about the English football team, but I noticed that she did not say who she supported. I hope it was England.
The hon. Lady is right to raise hospitalisations, as other colleagues have. Of course, as cases rise, which sadly they will for the reasons I have set out, hospitalisations will rise too. However, again for reasons I have set out—No. 1 being the vaccine—the rate of hospitalisation will be far, far lower than anything we have seen before. She will also know, given her experience, that the treatments available are a lot better and more effective than what we had at the start of the pandemic and during the last wave. That is also helping should people, sadly, find themselves in hospital. That is part of the three tests, test number three, that we have looked at very carefully. We have looked at the data and we of course work very closely with our colleagues in the NHS on an almost minute-by-minute basis to ensure that the increased pressure—I accept there will be increased pressure; I have been very open about that—can be met in a sustained way.
The hon. Lady mentioned the backlog. It is important to understand that the backlog built up over the pandemic because people stayed away from the NHS for perfectly understandable reasons, but we need to start to get back to normal as quickly as we reasonably can so that we can start to see more and more people in the longer term and improve the backlog more quickly.
As for masks, I believe I have answered that question. The most important thing is that our guidelines will be very clear. They will be published later today, too.
Enterprises are having to shut because key members of staff, despite having been vaccinated twice, are having to isolate as contacts. As infections increase, so will contacts who have to isolate and there is every possibility that the economy will grind to a halt. Will the Secretary of State review the need to self-isolate for those who are twice vaccinated and showing a negative test?
It is precisely for the reasons my right hon. Friend sets out, and for other reasons, that we have already reviewed the rules on self-isolation. That is why we have announced that there will be a change from 16 August. We will keep them under review.
For the 3.8 million clinically extremely vulnerable people, the prospect of a so-called freedom day next week is actually anything but. They and many clinically vulnerable people, such as pregnant women, are living in fear of what living with covid means for them. Last Monday, the Secretary of State promised me that guidance was forthcoming. Last Wednesday, Members in the other place and charities met his ministerial colleague Lord Bethell and officials, who admitted that this was not good enough and that something more had to be done. Can the Secretary of State tell us today what support and guidance will be forthcoming and when, or is he pursuing a survival-of-the-fittest policy, whereby the most vulnerable will be thrown to the wolves?
This is one of the most important issues. As the hon. Lady says, many people are immuno-suppressed or severely clinically vulnerable. It is important that at every stage of dealing with this pandemic we are thinking of them and having them at the front of our mind. That is what I believe we have done. Of course, when people in that category are able to take the vaccine they should, but not all are able to do so. She asks about advice, and I can tell her that we are publishing it today.
First, it is worth saying that I strongly welcome the statement from the Secretary of State. When he is back at the Dispatch Box in the autumn, as I fear he may be, announcing further restrictions, guidance or even another lockdown, one of the things that will have driven that will be hospitalisation data. The big flaw in that data at the moment is that it includes anyone who tests positive for covid who goes into hospital, not whether they have gone into hospital because they are ill with covid. That will drive poor decision making, and it is vital that it is fixed urgently. We cannot have hundreds of thousands of livelihoods and wellbeing sacrificed on the altar of dodgy data.
That is an important point from my right hon. Friend. He will know—I judge that is why he asked the question—that at the moment the figures available are “with covid”, which does not make a distinction about what is causing that individual to be in hospital, so the data are not precise and detailed enough. I think that is what he is getting at. It is a very good point and I have asked for advice on it. I hope we can start to get clearer data precisely for the reason he raises.
Primary care is not only the frontline of the fight against covid; it is also the front door of the NHS and many staff are on their knees at the moment. May I ask the Secretary of State to help more medical students to choose general practice and to stay in it, as that is absolutely fundamental to helping more people get in to see a GP easily?
I agree. My parents wanted me to be a doctor—a GP—so they were a bit disappointed, although my mum did say that my current role might make up for it. My hon. Friend is absolutely right. He knows our commitment to 50 million more appointments and to having more GPs. That remains a huge priority, which I think this pandemic has made even more important than before.
I join the Secretary of State and other colleagues in deploring the appalling racism shown against a football team who have shown the absolute best of our country.
The Secretary of State says that caution is absolutely vital, given the soaring infection rates. I agree, but if caution is absolutely vital, why is he weakening the measures to deliver it? The message around face masks on public transport, for example, has been downgraded from being a clear legal requirement to being an optional personal choice. As more than 100 scientists and medics said last week in a letter to The Lancet, this is reckless and risks driving up infections. He asks, “If we do not open up now, then when?”. The answer has to be: when a far higher percentage of the total population is vaccinated; when basic public health protection such as test, trace and isolate is properly functioning; when people can afford to self-isolate; and when measures such as air filtration systems are in our classrooms. Frankly, the Government seem to be pursuing a Darwinian strategy, relying on immunity by natural infection. Does he realise how dangerous that is?
I am afraid that the hon. Lady is just not being realistic. I have set out very clearly in my statement the issues around timing. No one is pretending that there is a perfect time to start lifting some of these restrictions. It therefore requires a balanced and measured approach, and that is exactly what we are doing.
Steroid inhalers, of the type used by millions of asthma sufferers worldwide, are known to be safe and cheap, and trials show that they are also very effective in reducing the severity of covid symptoms and the length of time they are suffered. Will my right hon. Friend take rapid steps to revise the guidance to ensure that this becomes an immediate part of GPs’ armoury in dealing with people who present with covid symptoms?
When my hon. Friend wants something done rapidly, I listen very carefully to him. I am pleased to tell him that the clinical guidelines have been published today that allow the central alerting system to recommend to clinicians that they prescribe inhaled steroids on a case-by-case basis for exactly the purpose that he set out. I hope that is quick enough for him.
I hope that I will get an equally happy response to my question. The Secretary of State has said that he is anticipating as many as 100,000 covid infections daily. If that were actually to happen, according to his figures how many people would he expect to be hospitalised, and how many would he expect to develop long covid as a result?
I can tell the hon. Lady that there are currently about 30,000 infections a day. In the last 24 hours in England, we have seen about 400 people being hospitalised. The last time that infections were around the same level—at 30,000 cases a day—I believe that more than 2,000 people a day were being hospitalised. That is what I mean when I say that the link has been severely weakened, and for that we have the vaccines to thank.
I look forward to having a look at and scrutinising the new road map when it is published this afternoon. Further to the point raised by my right hon. Friend the Member for Forest of Dean (Mr Harper), I am just trying to get clear the data on hospitalisations. I was told today of a lady admitted this weekend to a hospital in my region to give birth. She was, of course, tested on admission and was positive, so she is a covid-positive person in hospital. Given the advice that the Secretary of State has just confirmed to the House that he has sought, when does he think he will be able to advise us of the figures for those admitted with covid versus those admitted for covid?
I know that my hon. Friend speaks with experience, and I am glad he has raised this point again. I have asked for that advice, because it is important that we try to analyse better the primary diagnosis of anyone coming into hospital. I can understand why that was not easily possible in the early days of the pandemic, but I think we have now reached the stage at which we can provide better data, and I hope I can get that done as quickly as possible.
The recent report from the Health and Social Care Committee on NHS staff burnout showed that low pay was a particular issue for care workers, and that most NHS staff were working unpaid hours on top of their contracts. Those are hours that could otherwise be spent with family members like the brilliant student I met this morning, Brendan from Cardinal Newman School, whose dad works for the NHS. How does the Secretary of State plan to clear the backlog and fill the 40,000 nursing and 112,000 care worker vacancies if this Government continue to say no to the pay rise that NHS heroes like Brendan’s dad deserve?
I agree with the hon. Lady that the workers in the NHS, no matter what their role, have been the heroes of this crisis, as have care workers. I think we agree on that, and that making sure it is recognised also requires us to ensure that they are paid properly. The hon. Lady is also right to link this issue to, for example, the backlog and the huge amount of work that lies ahead. I hope she will bear with me, and in due course we will set out our response to the pay review recommendations.
I welcome my right hon. Friend’s statement. He will know that on 29 April, a pilot scheme to test and release was introduced to avoid the disruption caused by the need for contacts of people with covid to isolate for 10 days. He will also know that our right hon. Friend the Chancellor of the Duchy of Lancaster was a beneficiary of that scheme. Will he say what the results of the pilot have been, and when it might be available to the rest of us, which I hope will be before the third week in August?
I thank my right hon. Friend for his support for my statement. That scheme is very important. I have not yet seen the final results, but results are starting to come into the Department. As my right hon. Friend will know, while the pilot has been going on the Government have also made an announcement about more flexibilities for double-vaccinated people from 16 August onwards, but I will endeavour to say more about this and publish more data as soon as I can.
I have heard what the Secretary of State has said about masks today, but as was pointed out by my hon. Friend the Member for Central Ayrshire (Dr Whitford)—the SNP spokesperson—there will be no “freedom day” for vulnerable people if the legal requirement to wear a mask is scrapped. Many of my constituents wrote to me over the weekend expressing concern about this issue. Along with leading scientists, trade unionists and large sections of the public, they are keen for the legal requirement to wear masks in indoor spaces and on public transport to be kept at least for now. Why can the Secretary of State not make that commitment?
I think I have set out the general approach at the Dispatch Box a number of times. As we begin to move towards a more normal position, we want to start removing the regulations and replacing them with guidelines, and then to ask people to follow those guidelines. For example, we have made it very clear that in crowded and enclosed spaces we would expect everyone to wear a mask, and we would recommend that. Given all the data that we have set out, including the vaccination rate, we think that now is the time to take that kind of more measured approach, and we will keep it under review.
I welcome what the Secretary of State has said. On Friday I visited Blue Bay Travel, an international travel company based in my constituency which strongly supports the easing of public health restrictions from 19 July for those who are fully vaccinated. Will my right hon. Friend continue to do all he can to ensure that we help jobs and industries of that kind, which have been hit hardest by the covid measures, to recover fully as soon as possible?
Yes, I can give that commitment to my hon. Friend. He is right to raise this issue. The travel sector has been one of the hardest hit, and I hope that as we take this measured approach and start opening up more, the sector will, in terms of both jobs and opportunities, start to benefit in his constituency and elsewhere. I hope that the company he referred to in his constituency welcomes the changes we have set out so far.
The Secretary of State mentioned the serious problems being caused in the NHS by the Government’s pinging system, but schools and businesses are also suffering. Now, in the transport and travel sector, scores of trains were being cancelled over the weekend because drivers and other train staff had been pinged. If he will not bring forward his 16 August date, why on earth will he not continue to mandate masks on public transport, both to protect staff and passengers and to give them the confidence to travel at least up until that 16 August date?
The right hon. Gentleman may know that when we set the 16 August date, and I think I made this clear in the statement last week, it was based on clinical advice—the public health advice that we received and in particular that it was better to make sure that more people are vaccinated than will be on 19 July, and I think that is valuable advice. When it comes to masks, I think I have made the Government’s position clear.
Lifting legal restrictions is a massive relief for all those who rely on pubs, restaurants and nightclubs for their livelihoods, the overwhelming majority of which are taking their responsibilities seriously at enormous cost to themselves. Does my right hon. Friend agree that as we open up our society and economy, not only must all hospitality businesses take sensible steps to protect us from disease, but all customers must also play their part and respect venues and their staff, who are working so hard to do the right thing?
Yes, I agree wholeheartedly with my hon. Friend. It is a responsibility as we open up not just for the owners of the businesses, the nightclubs and the pubs to take that sensible, measured attitude, but for customers to give a thought to those who are serving them at the table or behind the bar and to be respectful of their needs.
Last week, the Chancellor of the Duchy of Lancaster’s review was reported to this House as having concluded that covid vaccine certification was not necessary and would not go ahead. Since then, however, there seems to have been a review of the review, because the Secretary of State said today that
“the Government will be encouraging businesses and large events to use certification in high-risk settings”.
Can the Secretary of State tell the House now what constitutes a high-risk setting in this context, and who will be the judge of what is a high-risk setting? What constitutes “large events”, and who will judge what they are? What is meant by “encouraging businesses” and what will be the consequences for any businesses that resist the encouragement from Government in this way? Finally, how will the data that is captured in this way, which belongs to us all, be held and protected?
The remarks that the right hon. Gentleman refers to by the Chancellor of the Duchy of Lancaster are absolutely correct. As we move away from regulations, there will no longer be a legal requirement for any establishment to have covid vaccine certification, but the guidelines, which we will publish today, will be very clear that we expect corporate bodies and responsible businesses to have a system. We will continue to provide the infrastructure, where we will work with them and with the respective Government Departments. The Department for Digital, Culture, Media and Sport and the Department for Business, Energy and Industrial Strategy are already talking to industry leaders and working with them, and the industry welcomes the work on a basis of guidelines, rather than regulation.
A rate of 87% for first vaccinations is truly impressive, and it is in excess of all the estimates that I read about when the vaccination programme was first launched, but there is evidence of a worrying fall-off in people coming forward for their second vaccinations in London and the south-east. Can my right hon. Friend say what steps he is taking to ensure that people, especially young people, are committing to completing the vaccination course?
My hon. Friend is right to raise this. As she says, the rate of vaccination that we have achieved in this country is the envy of the world. We want to make sure that is maintained. We definitely want to make sure that more young people are coming forward. The walk-in clinics that have popped up around the country, and the mass vaccination events that have been taking place in parts of the country, are part of that. We are also looking actively at other ways to promote the importance of vaccination.
A schoolteacher recently told me that some families cannot afford to self-isolate. If we are learning to live with the virus, why has the Secretary of State for Health and Social Care refused to introduce proper financial support to self-isolate, to ensure that those who test positive can safely self-isolate at home?
The hon. Lady will know that we have in place financial support for those who need it and who are asked to self-isolate. It is something that is important. It continues to be important, and it is something that we will keep under review.
Thanks to jabs and far better treatment, the case fatality rate is now 0.085% and falling. Had it been so a year ago, is there the remotest possibility that jurisdictions would have embarked on restrictions of the same breadth and scope? Does it not follow that now is the right time to move to step 4 and release burdens on people, so that we can get society going? Will the Secretary of State please caution the Opposition on their undue reliance on masks? They are not the solution; vaccinations are.
My right hon. Friend is absolutely right to raise the importance of vaccination. That has been the key to getting us to where we are on our road map, which is why we cannot emphasise enough the importance of continuing with the programme. That is why we have set out that we plan to have a booster programme in September.
I have constituents who are absolutely ready for restrictions to be lifted, and I have others who are very concerned about the effect of the Johnson variant, which is prevalent in my area, so I can understand entirely the Secretary of State’s desire for balance. That balance is not provided by the Prime Minister saying one thing—usually incoherent bluster about freedom day or terminus day—and other Ministers, such as the Secretary of State, saying other things about the need to continue wearing masks. Does he understand that the continued mixed messaging from the Government is not helping us to get through this crisis?
The Government are speaking with one voice, and I believe our view is very clear.
Tomorrow, my right hon. Friend will be asking the House to approve regulations that will put thousands of care workers in England out of a job. Two weeks ago, we were promised that a regulatory impact assessment was available. As of midday today, it is still not available. When will it be available, and why has it not been made available so far?
I believe my hon. Friend is referring to the measures that the Government have already announced around vaccinations and people who work in care homes. Ideally, I would like to make sure that the impact assessment is available. I do not know the full detail as to why it has not been completed, but at the same time, I think it is important to get on with this part of building our vaccine wall. We will have more to say about it tomorrow.
The Secretary of State will be aware that Singapore has announced its plan to navigate from pandemic to endemic and to co-exist with the virus—they could almost have been reading my speeches and articles. Will the Secretary of State get the economy and society moving again and, in particular, take a fresh look at vaccine passports or certificates, including the vaccine card that we all carry? Let us allow our people to get back to normality.
I take it from that that the right hon. Gentleman supports the measures that I have set out today in this statement, and I thank him very much for his support.
I very much welcome this statement today on the back of the successful vaccine roll-out programme. However, given the rising numbers of people having to isolate and the impact this is having on businesses and our economy, can I reiterate the call to my right hon. Friend to consider bringing forward changes to the requirement to isolate after contact with a confirmed case for those who are fully vaccinated? There has to be a better way forward that does not have the economic impact that the current isolation policy is having.
I understand the importance of the point my hon. Friend has made. As I said in response to another question, the date of 16 August is based on the best advice that we can get at this point in time. He may be interested to know that, as well as the test and trace system, there is the NHS covid app. A number of people have referred to the so-called pinging. I want to take a careful look at this to ensure that it can also provide a more proportionate and balanced system, given the rate of vaccination.
There is understandable concern among those who are immunosuppressed, particularly those with blood cancers, about the effectiveness of vaccines and I know that the Secretary of State mentioned this earlier. Can he be really clear: are the vaccines working? Will those people get booster doses early? When will detailed and specific advice on the whole range of conditions be available? I declare an interest, as somebody in my own family and many of my constituents are affected. When will they get clear advice so that their concerns can be put to one side?
The hon. Gentleman is right to raise this issue. The vaccines are working and I have set out clearly why. The Government have published much evidence on that. The booster programme begins in September and the immunosuppressed and clinically vulnerable will get priority in that; they will be in the initial cohort. The advice that I referred to earlier will be published today.
In what circumstances or conditions does my right hon. Friend consider that it will be responsible to work in crowded spaces, such as in retail or hospitality—or, indeed, in this place—without wearing a mask?
My hon. Friend is right to raise this and our guidelines on mask wearing will be very clear. If people are in retail spaces and they are crowded—as we know, most of them are enclosed—they should consider wearing a mask. They should be thinking not just about themselves but about the people around them and the people serving them.
The Secretary of State will have seen the huge and rising number of covid infections in the north-east, and the decision to remove controls will clearly accelerate that and increase concerns about the short-term and long-term impacts of covid and the risk of vaccine-resistant variants. Regardless of the proposed covid passports, businesses in the north-east—especially in sectors such as hospitality, where large numbers of young unvaccinated people work—are already struggling to function with reduced staff and customers cancelling at the last minute to self-isolate. With the Government withdrawing economic support at the same time, does the right hon. Gentleman appreciate the concern that, for many hospitality businesses, the Government’s summer of high covid may be too much to survive?
The hon. Lady will know that there is still significant economic support in place, and of course it is the job of the Treasury to keep that under review. When it comes to self-isolation and the impact that it has on businesses, it is important, now that we have such a high level of vaccination, including in the north-east, that we can take a more proportionate and balanced approach, and that is exactly what we are doing.
It is great news that we are moving back to personal responsibility next week, and I thank the Secretary of State for that. However, the rates are increasing in Redcar and Cleveland. Although hospitalisations are not climbing in the same way, my concern is that more and more people are having to self-isolate due to the dreaded ping from the NHS app. We all remember the difficulties of last year when people struggled to get a test, but since then the Government have massively increased the testing capability and getting a test is no longer an issue. What more can be done to utilise this immense testing capability to prevent people from having to self-isolate unnecessarily?
My hon. Friend is right to raise this. The so-called ping does serve a purpose and it has served a huge purpose as we have been dealing with this pandemic, particularly during the last wave. If someone is pinged, it might be very useful information to them if they were planning in the days ahead to visit a vulnerable person, perhaps a grandparent or someone, so I think it is valuable information to give people. But as I said earlier, I think we can look at the approach and make it more measured, given the high rate of vaccination, and then also, as he suggested, make more use of tests, which is exactly what we are doing.
What assessment have the Secretary of State and his Department made of the number of children with long covid, and when will children get vaccinated?
On children and covid—the hon. Gentleman asked about long covid—a huge amount of research is being done both in the NHS and in my Department. I mentioned, for example, the extra £50 million of funding that we are providing to do even more research and to step this up. As he knows, long covid is a problem the world over, and I hope that the UK can become a world leader in trying to help with this problem and share the research that it does with other countries. On the vaccination of children, as I said in response to a similar question, the JCVI is actively looking at this issue. Once we have its final advice, we will set out our plans.
I welcome my right hon. Friend’s confirmation of the return of our freedoms. Knowing what we do now about the impact of some of our interventions, we must never return to those dark days. While we have taken a huge backward step in this regard, does he agree that we should use this great unlock to usher in a new era of personal responsibility? Perhaps we could start with a review of clause 125 of the Health and Care Bill, which would appear, on the face of it, to prevent UK food manufacturers from advertising their products anywhere online, not just in the UK, while conferring advantage on huge, globally recognised brands.
Obesity is a real problem in this country and others and its causes are very complex, but we do want to make sure that we have the best approach possible. My hon. Friend will know that we are planning to debate this Bill on Wednesday and I look forward to seeing him in the debate.
I want to press the Secretary of State a little further on wearing masks. He said that he has been perfectly clear, but the opposite is the case. His Government were dithering on mask wearing in this very week last year, and the dithering and mixed messages continue. He tells us that masks will no longer be compulsory but that wearing them will be expected, as the Chancellor boasts that he will stop wearing a mask on 19 July. The Government chief medical officer and the chief scientific adviser say that they will continue to wear masks. Why has this important public health tool been so undermined by the dithering and mixed messages of his Government?
I believe I have answered this question a number of times during this session.
It is 16 months since I contracted a fairly mild bout of coronavirus, which, unfortunately, developed into terrible long covid, and the symptoms still persist all these months later. The vaccination programme has been a game changer and I want a return to normality, like everyone else, but does the Secretary of State understand that the consequence of his decision may well be more people with long covid? The money for research is welcome, but what more is he planning to do to support those with long covid with health, rehabilitation and social security measures and to support employers with the reality that sections of their workforce might be unfit for work for periods, too?
First, as I have said a number of times in this debate, opening up is not without risk, but I hope that the hon. Gentleman understands that keeping restrictions in place is also not without cost, so the Government have to take a balanced approach. He is right to raise the issue of long covid. As I mentioned, this is something that the Government take very seriously. I have announced another £50 million of funding for research into it. This is a problem not just in the UK; it is an issue the world over. We still do not know enough about long covid. We are learning more all the time, but it will be an absolute priority of this Government to work with people with long covid and do everything that we possibly can.
More double-vaccinated people than ever are being asked to self-isolate because they have come into contact with someone who has tested positive for covid. That is incredibly difficult for individuals and families and of course it disrupts jobs and businesses; I have heard cases of people being asked to self-isolate more than once in the same month. May I add my voice to others across the House and ask my right hon. Friend to consider bringing forward before 16 August some form of test and release measure for people who are double-vaccinated?
Again, this is an important issue. My hon. Friend may have heard the response that I gave earlier about the test and release scheme. I am eagerly waiting to look at the results of that and see whether we can provide further flexibilities. I hope she will also welcome some of the flexibilities that we have already announced, including the changes that will take effect on 16 August.
I take this opportunity to condemn the vile online racism against some members of the England football team yesterday after they had given their all for their country.
The World Health Organisation has expressed its concerns about rising infections in England and the risk to the 17 million people who still remain unprotected by vaccination. But even those who have been vaccinated are at risk of long-term illness and disability if they become infected; Office for National Statistics data indicates that one in seven infected people of working age will experience ill health after 12 weeks.
May I follow my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) in chasing the Health Secretary about his estimates of the incidence of long covid as a result of the third wave? What discussions has he had with the Work and Pensions Secretary about what that means when it comes to support through the social security system if people are unable to work?
The hon. Lady raises the importance of vaccination, and she is right to do so. As I mentioned earlier, according to the ONS, nine out of 10 adults in this country have antibodies, which are part of the wall of protection.
The hon. Lady is right to mention that cases will rise in this wave. We have been very open about that. I hope that she heard earlier in my statement that there is no perfect time to start opening up. The risk is that, if we do not do it now and wait until after the summer, the schools will be back, and if we wait longer it will be winter—there is a real, serious risk, which we have been advised about, that the wave could be even bigger than what is anticipated at this point. Many more people would then end up getting infected and, by extension, getting long covid.
I hope that the hon. Lady can consider all that together in a balanced way. If she would like to meet any Ministers or officials in my Department to understand the situation better, I will be happy to arrange that.
From previous answers given, I am delighted that my right hon. Friend is now looking at the underlying settings of the Track and Trace app—I ask him to do that as a matter of urgency. Those settings take no account of vaccination status or any other behaviours; it is just a blunt, bluetooth signal. It might have had value when there were few other tools in the box, but it must now be highly questionable to condemn potentially millions of people to unnecessary self-isolation and the economic impact thereof.
My hon. Friend makes an important point. I hope that he noted my comment that, precisely for the reasons he set out, given the high rate of vaccination, we are taking a fresh look at the app. I have asked for advice—and have just started to receive some of it—about how we can take a more proportionate and balanced approach.
It is clearly right to take further steps towards unlocking, but it is not the all-or-nothing choice that the Secretary of State has suggested and vaccines are not the only tool available. The wearing of masks in enclosed spaces reduces infection and therefore hospitalisations and deaths. It is supported by health experts and backed by the public. The reasons why the wearing of masks was made mandatory remain the same as when the Government recommended it all those months ago. With hospitalisations up 34% on a week ago, will the Secretary of State not put public health before the pressure from his more vocal Back Benchers and retain mandatory mask wearing for public transport and other enclosed spaces?
I agree with the hon. Gentleman that it is not all or nothing, which is why the Government have been very clear that as we start opening up other measures will rightfully stay in place—I mentioned earlier the border controls, the test and trace system and the plan for booster vaccines. I hope that he would welcome that.
I have had the privilege of seeing some of the terrific work being done in Aberconwy by Betsi Cadwaladr University Health Board on the delivery of the UK vaccine throughout north Wales. Does my right hon. Friend think that the pandemic has shown us, or perhaps reheated or reinforced, the importance of working together on health matters? Does he agree that the UK Government and the devolved Administrations should now explore opportunities to work together on better health outcomes for all UK residents in all parts of the UK?
Yes, I agree wholeheartedly with my hon. Friend. During this pandemic we have seen that, by working together on all types of public health issues, but especially the vaccine and its delivery, we are stronger together. We should draw some long-term lessons from that about how we can use it not only to protect against future pandemics—sadly, there will be some—but in respect of other public health issues that we face collectively to find a way to do a better job together.
I have written to the Secretary of State to urge him to do everything that he can to protect immunocompromised people as restrictions are eased. We urgently need the results of the OCTAVE study into the efficacy of covid-19 vaccines on this population; when will we get them? In the meantime, will the Government provide antibody tests for immunocompromised people, allowing them to make informed decisions? Better communication and proper support will go a long way towards alleviating the escalating levels of concern.
On the study to which the hon. Lady referred, I will look into that and write to her, if she will allow me. Immunocompromised people and what we can do to help them has come up a number of times during this statement. I direct the hon. Lady to the comments I have already made and highlight the fact that we will publish some guidance today.
I welcome my right hon. Friend’s statement. Last week, I heard from a self-employed small business owner in my constituency of Keighley and Ilkley who has been told to self-isolate three times in the past two months, despite not testing positive on any of those occasions. Such an experience is both impractical for the individual and harmful to our local economy, so will my right hon. Friend assure me that he is exploring all possible options to remedy the situation, whether through adjustments to the NHS app or changes to the self-isolation rules?
On the app and the so-called pinging—my hon. Friend referred to an individual in his constituency who has perhaps been pinged too many times—it is right, as I have said, that we take a fresh look at any changes that we can make in the light of the success of the mass vaccination campaign. If my hon. Friend will bear with me, I think he will be pleased with our course of action.
In response to my hon. Friend the Member for City of Chester (Christian Matheson), the Secretary of State said that the Government speak with one voice. Well, clearly on masks they change in response to whatever the latest YouGov poll says. He has been very clear today that people should wear a mask in confined spaces, so I ask him a direct question: what is his advice to retailers? Should they insist on their customers wearing masks when they enter their shops?
The guidance that we will publish today will be very clear on that.
On a point of order, Madam Deputy Speaker. It arises directly out of the response that the Secretary of State gave to me. Tomorrow this House is being asked to approve the Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021. When that instrument was laid on 22 June, the explanatory memorandum said:
“A full impact assessment of the costs and benefits of this instrument is”—
I emphasise “is”—
“available from the Department of Health and Social Care…and is published alongside this instrument”.
As of 12 o’clock today, I have been trying, through the good offices of our excellent colleagues in the Library, to get an answer from the Department as to when we are going to get that impact assessment. The officials at the DHSC are quoted by the Library as having said, “The impact assessment has not been laid yet”—we knew that—and, “We will be laying it at the earliest opportunity.” This is very serious, because on 6 July the Secondary Legislation Scrutiny Committee referred to the impossibility of being able to scrutinise the legislation properly without the impact assessment. Despite the Secondary Legislation Scrutiny Committee recommending that the debate be deferred, nothing has happened and all that the Secretary of State said in response to me was, “Well, we don’t know where it is but don’t worry about it—we’ll carry on tomorrow anyway.” That is just not good enough. I would be grateful for your guidance, Madam Deputy Speaker, as to what we can do to ensure that we have an informed debate with the impact assessment before us.
(3 years, 1 month ago)
Written StatementsPart 1 of Dame Carol Black’s independent review of drugs was published last February and provided this Government with detailed analytical insights into the complexities of the illicit drugs market. It highlighted the considerable scale of the challenge we face with an illicit drugs market in England and Wales worth £10billion a year and 3 million users of illicit drugs in the same population.
The drugs trade is also intrinsically linked to the crime experienced in our communities: 45% of all acquisitive crime is committed by people who regularly use heroin, cocaine or crack cocaine and nearly half of homicides are drug related. Increases in global production and supply have led to a violent and exploitative supply chain in which ruthless criminal gangs exploit children and vulnerable people in our communities. This cannot and will not continue.
This Government remain committed to tackling drugs and the harm they cause to individuals, families and communities. Since part 1 of Dame Carol’s review was published, we have built a powerful set of policies in co-operation with police and operational partners to tackle drug supply, exploitative criminal gangs, and we have increased drug treatment funding for 2021-22. We are also piloting a more co-ordinated approach to treatment and recovery support in some high areas of need.
In January 2021, we announced £148 million of new money to cut crime and protect people from the harms caused by illegal drugs. This has delivered the largest increase in drug treatment funding for 15 years. The funding means that we are delivering more interventions to reduce the number of drug-related deaths and we are making sure that more drugs users in contact with the criminal justice system get the treatment they need to reduce the amount of offending associated with drug dependency. It also ensured £40 million of dedicated funding is invested in tackling drugs supply and county lines. This has allowed us to expand and build upon the successful results of our county lines programme. This has seen over 780 lines closed, 5,000 arrests and 1,220 safeguards since it was launched in November 2019.
It is my honour to announce that today part 2 of Dame Carol’s review has been published, providing this Government with concrete evidence-based recommendations for how we can reduce the demand for illegal drugs, turn the tide on drug related deaths and get more people into higher quality services. It intelligently and clearly wraps up three years of research and investigation into the treatment and recovery system and I would like to thank Dame Carol for her dedication to this agenda and for this accomplished review.
As part 2 highlights, many Departments of State need to redouble their efforts to tackle drug supply and also provide a stronger system of treatment and recovery support to people dependent on drugs, particularly those in contact with the criminal justice system. That is why I am pleased that today we can announce the establishment of a new joint combating drugs unit to co-ordinate and drive a genuinely whole-of-Government approach to drug policy, recognising that treatment alone is not enough and that housing and employment support is essential to aid recovery. This Government are determined to address the challenges raised in the review and the new Unit will oversee the Government’s response to Dame Carol’s recommendations which apply to numerous Departments across Government.
I am pleased to announce that in the coming weeks my right hon. Friend the Home Secretary and I, along with the Minister for Crime and Policing, will publish an initial Government response to the findings in part 1 and part 2 of the independent review. This response will set out our clear cross-Government commitment to this agenda and to taking effective action given the urgency of addressing these issues. Dame Carol has made a powerful case for a comprehensive drug treatment and recovery system coupled with the need for a more effective approach to enforcement. While many aspects of drug policy are devolved, we will continue to build partnership and collaboration with the Scottish, Welsh and Northern Irish Governments on significant UK-wide issues. The Government response to Dame Carol’s reviews provide a fantastic opportunity to engage with our colleagues and partners on combating drug misuse.
A copy of part 2 of Dame Carol’s Review will be deposited in the Libraries of both Houses.
[HCWS167]
(3 years, 1 month ago)
Commons ChamberWith permission, I would like to make a statement on the pandemic and the road map to freedom.
Freedom is in our sights once again, thanks to the protective wall of this country’s vaccination programme and the huge advances we have made in getting this virus under control. Yesterday, I stood at this Dispatch Box and set out the details of what step 4 in our road map will mean for this nation. After the arduous 18 months that we have all endured, it was so wonderful to describe a world where we no longer have to count the number of people that we are meeting; where theatres and stadiums are bustling with people once again; and where care home residents are able to see their loved ones without restrictions.
Of course I understand that some people are cautious about the idea of easing restrictions, but we must balance the risks—the risks of a virus that has diminished, but is not defeated, against the risks of keeping these restrictions, and the health, social and economic hardship that we know they bring. This pandemic is far from over, and we will continue to proceed with caution. But we are increasingly confident that our plan is working, and that we can soon begin a new chapter, based on the foundations of personal responsibility and common sense rather than the blunt instrument of rules and regulations.
Today, I should like to provide an update on another area where we will be able to ease restrictions: the rules on self-isolation. Self-isolation has played a critical role in helping us to get this virus under control, by denying the virus the human contact that it needs to spread. And I am so grateful to the many, many people right across the UK who have selflessly done their duty, making sacrifices so they can help keep the virus at bay. Even though we have done everything in our power to support the people who have had to self-isolate—and yesterday we announced that we will be extending financial support until September—I am fully aware of how difficult it has been. But we can take hope from the fact that science has shown us a solution, just as it has done so many times in our fight against this virus. That solution is our vaccine, which we know offers huge protection.
The latest data from Public Health England shows that our vaccination programme has saved over 27,000 lives and has prevented over 7 million people from getting covid-19, and it shows that both doses of covid-19 vaccine can reduce symptomatic infection by almost 80%. That protective wall—because that is what it is —means that the odds have shifted in our favour, and we can look afresh at many of the measures that we have had to put in place. That is especially important when almost two thirds of adults—64%—have had both doses of a vaccine, and so have the maximum protection that the vaccine can offer. As a result, we will soon be able to take a risk-based approach that recognises the huge benefits that vaccines provide both to the people who get the jab and to their loved ones.
From 16 August, when even more people will have the protection of both doses and when modelling suggests the risk from the virus will be even lower, anyone who is a close contact of a positive case will no longer have to self-isolate if they have been fully vaccinated. If someone gets their second dose just before or just after 16 August they will need to wait two weeks, after which their second jab will have taken effect, to get these new freedoms. Those two weeks will allow the vaccine time to build up the maximum possible protection.
As we make this change, we will draw on the huge capacity we have built for testing and sequencing and will advise close contacts who are fully vaccinated to take a PCR test as soon as possible, so that they can have certainty about their condition. Of course, anyone who tests positive will have to self-isolate, whether they have had the jab or not. This new approach means we can manage the virus in a way that is proportionate to the pandemic, while maintaining the freedoms that are so important to us all.
As hon. Members will be aware, we are not currently offering vaccines to most people under the age of 18. We have thought carefully about how we can ensure that young people get the life experiences that are so important to their development, while at the same time keeping them safe from this deadly virus. In line with the approach for adults, anyone under the age of 18 who is a close contact of a positive case will no longer need to self-isolate. Instead, they will be given advice about whether to get tested, dependent on their age, and will need to self-isolate only if they test positive. These measures will also come into force on 16 August, ahead of the autumn school term.
I know that hon. Members will have questions about the changes and about step 4 of our road map and the impact on schools and colleges; my right hon. Friend the Education Secretary will update the House immediately after my statement. We are looking at the self-isolation rules for international travel, to remove the need for fully vaccinated arrivals to isolate when they return from an amber list country. The Transport Secretary will provide an update to the House later this week.
Step by step, jab by jab, we are replacing the temporary protection of the restrictions with the long-term protection of a vaccine, so that we can restore the freedoms that we cherish and the experiences that mean so much to us all. Let us all play our part to protect ourselves and to protect others as we enter these crucial few weeks, so that in this battle between the vaccine and the virus, the vaccine will prevail. I commend this statement to the House.
I thank the Secretary of State for advance sight of his statement. This morning, he warned that he expected infections to hit 100,000 a day. Will he confirm that he is saying that will be the peak? By his expectation, when will we hit it? Infections at 100,000 a day will translate to around 5,000 people a day developing long-term chronic illness—long covid. What will the long covid waiting list look like by the end of the summer?
The Secretary of State justifies allowing infections to climb by pointing to the weakened link between hospitalisation and deaths, and saying that we are building a protective wall. But the wall is only half built. We know from outbreaks in Israel and research that the delta variant can be transmitted through fully vaccinated people, even if they do not get sick.
Indeed, data in the last 24 hours or so from Israel’s Ministry of Health points to the Pfizer vaccine being just 64% effective at stopping symptomatic and asymptomatic transmission of the delta variant. Sadly, being double jabbed means a person is still a risk to others, yet the Secretary of State is releasing controls on transmission at a time when infections are rising. Hospitalisations will rise, too, given what we know he is doing.
Can the Secretary of State tell us the percentage of intensive care beds, and general and acute beds, that need to be occupied before, in his view, wider NHS care is compromised? We have heard him in the last week or so tell us that he wants to unlock because he rightly wants to focus on the monumental NHS backlog, but the rising hospital admissions that are baked into the plan, into the path he has chosen, will mean operations cancelled, treatments delayed and waiting times increased. Will he now be clear with patients, who are waiting longer and at risk of permanent disability, that the increase in hospital admissions will mean they have to wait longer? What is his assessment of the waiting list, and what will it hit by the end of the summer?
I understand the rationale for the Secretary of State’s announcement today, but I have to tell him again that the biggest barrier to an effective isolation policy has been not the inconvenience but the lack of financial incentive to stay at home. If we are to live with this virus, the days of people soldiering on when unwell are over. Sick pay is vital to infection control. Will he please now fix it?
Getting back to normal, which we all want to do, depends on people feeling safe. Does the Secretary of State appreciate that those who are immunocompromised, or for whom the vaccination is less effective, will have their freedoms curtailed by ditching masks on public transport? Blood Cancer UK warned yesterday that people with blood cancer will feel like their freedoms have been taken away when mask wearing lifts. What is his message to those with blood cancer? It is not good enough simply to say that people should travel or go to the shops at less busy times.
Of course, the Secretary of State understands the importance of masks. I have now read his Harvard pandemic paper, to which he likes to refer. He praises the use of masks in this paper, but he also warns:
“Changing course in policy making…is an essential feature of good policy making. Yet, politicians find it hard”—
because of—
“the tendency for decisions to become psychologically and emotionally anchored.”
Well, I agree with him, and I hope he still agrees with himself. Let us have a U-turn on mask wearing. Yes, let us have freedom, but not a high-risk free for all. Keep masks for now, fix sick pay and let us unlock in a safe and sustainable way.
Let me turn to the right hon. Gentleman’s questions. First, he asked about infections. As I said yesterday from this Dispatch Box, we expect infections to continue to rise for the time being, for the reasons I set out yesterday. By 19 July, when we enter step 4, the advice we have received and the modelling suggests infections could be as high as 50,000 a day, double what they are now. Beyond that, as he says, we believe infections will continue to rise. As the modelling goes out further, it is less certain, but infections could go as high as 100,000 a day. I have been very up front about that.
What I have also been very clear about is that the reason we can make the decisions that we have made, as set out yesterday and today, with the decision just announced on self-isolation rules for those who are double vaccinated if they come into contact with someone who is infected, is because of the vaccine. The vaccine has been our wall of defence. Jab by jab, brick by brick, we have been building a defence against this virus.
Although no one can say at this point that the link between cases and hospitalisations has been definitively broken—there is not enough evidence for that—there is enough evidence to show us that the link between cases, hospitalisations and deaths has been severely weakened.
The right hon. Gentleman asked how many hospitalisations there have been or there may be. What I can tell him will help to demonstrate how this link has been severely weakened. In the last 24 hours, there have been approximately 27,000 reported new infections, and the total number of people in hospital in England with covid-19 is just under 2,000. The last time we had infections at that level, we were certainly above 20,000. That is a demonstration of how much the link has been weakened. In making sure that it stays that way, we of course want to see more and more people getting vaccinated. We have announced a booster programme that will start in September, to make sure that the immunity that comes from the vaccine remains.
The right hon. Gentleman also rightly talked about non-covid health problems, which a number of hon. Members have raised. I would like him to try to understand that one reason why so many people who wanted to go to the NHS with non-covid health problems such as cancer, heart disease and mental health problems but were prevented from doing so, is the restrictions that we had in place. The restrictions caused many of those problems—for example, the right hon. Gentleman should think about the mental health problems that have been caused by the restrictions. If we want to start dealing with non-covid health problems, we must start easing and moving away from the restrictions because of the protection that the vaccine has provided us. As the shadow Health Secretary, the right hon. Gentleman should be just as concerned about non-covid health problems, as I am, as he is about covid health problems.
The right hon. Gentleman also asked me about the immuno-suppressed. Again, he and other colleagues are absolutely right to raise this issue. The vaccines are there to protect everyone, including many people who are immuno-suppressed but who can take vaccines. For those people who cannot take vaccines, the fact that the rest of us do helps to protect them. We would them to take the same precautions that they would usually take in winter—for example, trying to protecting themselves against colds, flus and other viruses. I also encourage people to ensure that they are in contact with their GP to see what other measures or precautions they might be able to take.
Lastly, the right hon. Gentleman asked me about masks. He referred to a paper that I authored before I took this position, but he should understand that it is a strange question for him to ask. There is a role for masks in dealing with a pandemic, particularly when we have no wall of defence against it. When we have a vaccine, when that vaccine works and when we have the best vaccine roll-out programme in the world, we need to start moving away from restrictions, including on masks.
One of those other illnesses, apart from covid, that has been very badly affected by the pandemic is cancer. My right hon. Friend will know that, last year, 40,000 fewer people started cancer treatment, which will sadly lead to a number of preventable deaths. Will he be looking at the workforce required to deal with the cancer backlog? Will he also look at the capital requirements of many hospitals, including in my area? The Royal Surrey County Hospital is trying to build a cancer institute, but many hon. Members will have similar stories. May I make him a bold and generous offer to come in front of the Select Committee in September to talk about those plans? He can come for a couple of hours, but we do up to seven hours, should he so wish.
My right hon. Friend is absolutely right to raise the issue of cancer, and of course it is a huge priority for the Government. I mentioned earlier how, sadly, because of the rules that we have had in place for well over a year, there are many people who would have come forward to the NHS with cancer or suspected cancer, and they have not been seen. That has really built up a terrible problem, and it is an absolute priority for me to tackle with the workforce and with capital. Of course, I look forward to coming and sitting in front of my right hon. Friend’s Select Committee. I am not sure about the seven hours—I hope he will be a bit more lenient with me than that—but I do look forward to it.
Given that the UK Government have repeatedly got things wrong on covid—the timing of lockdowns, which allowed the Kent variant to spread; the lack of border controls, which allowed the delta variant into the UK; the delay in red-listing India; and now the surge in cases of the delta variant while millions of people are still to be fully vaccinated and more than 1 million are already living with long covid—many people will be concerned that they are actively trying to snatch defeat from the jaws of a vaccine victory. What confidence can the public have that the latest round of measures abandoning all restrictions is not another reckless gamble in the face of increasing transmission?
In a poll by New Scientist, a majority of disease experts said that some form of mask-wearing would be required until 2022. Others thought that 2023 or later was the correct time to lift mask requirements—more than agreed with the Government’s position of ending the requirements this year. For the sake of clarity and honesty, can the Secretary of State confirm that the UK Government have stopped listening to the science on their covid policy? Tragically, we have 150,000 people dead already, and the Prime Minister has said that we must reconcile ourselves, sadly, to more deaths from covid, so perhaps the Secretary of State can enlighten us as to how many more deaths the UK Government think acceptable.
The hon. Gentleman refers to the announcement on masks that we made yesterday, about moving away from rules and regulations to guidance and personal responsibility. He asks how we can make such a decision; the answer is the vaccine. The vaccine is working. We have more people vaccinated than any other large country in the world, thanks to the work of the NHS, the volunteers and everyone else involved—including, of course, in Scotland. That has weakened the link between cases, hospitalisations and deaths. Contrary to what the hon. Gentleman says, these decisions have been informed by the science. The science is working.
The Secretary of State said in his statement that he was
“grateful to the many, many people right across the UK who have selflessly done their duty”.
We all are.
Last week, a friend of an NHS intensive care doctor emailed me in despair. The doctor contracted covid-19 on Christmas eve while doing her duty in hospital and has been unable to work since, as covid then developed into long covid. Now HR has issued her with papers to file for statutory sick pay at the jobcentre and she stands to lose her salary entirely. Surely that is completely unacceptable and an insult to NHS workers’ sacrifices during the pandemic. Does the Secretary of State believe that it is fair? I hope not. If not, will he look into this case and similar cases urgently, so that the frontline staff—the heroes of this pandemic—receive the proper financial support that they need while they recover?
I am pleased that the hon. Lady has raised this issue. First, I give my personal thanks to the doctor in her constituency to whom she refers and to the many other doctors and clinicians for everything that they have done for the country and continue to do throughout this pandemic. I am not aware of the details of the case that she refers to, but if the hon. Lady writes to me I will certainly respond to her and look at it carefully.
We all recognise that the tremendous success of the vaccine programme has changed everything—my right hon. Friend has made that point eloquently again this afternoon—but it is also clear from recent daily figures that take-up appears to be falling. Can he explain why that is happening? What is he doing to make sure that as many people get vaccinated fully as fast as possible?
I can tell my right hon. Friend that our take-up, compared with that of any other large country, is the best in the world. That said, of course we would like to see even better take-up. At the moment, four fifths of adults have had at least one jab, and three fifths have had two jabs. We are seeing many vaccine centres moving to walk-in; I visited the one at St Thomas’ Hospital just last week. That has certainly encouraged more people. As I announced yesterday, we are also shortening the gap between the first and second dose to eight weeks for all under-40s, which I think will help as well. We continue to push take-up, but every time the matter is raised in Parliament it is a good thing: it is an opportunity for us all, as parliamentarians, to ask our constituents to come forward, take the vaccine and help to build that wall of defence.
I thank the Secretary of State for his statement today and for all that he and the staff of the NHS have done on behalf of us all. I recognise that there must be a risk-free approach in place, as he has said, and I welcome that, but what steps will his Department be taking to meet the psychological needs of young people with cancer to ensure that they can access timely, high-quality support regardless of the covid statistics and variants, which have seen their treatment delayed, causing them additional mental health strain?
The hon. Gentleman is right to point out that there is no risk-free way forward. For the whole world, this pandemic is unprecedented, and leaders across the world are having to balance risks and take the approach that they think is right. He is also right to raise the challenges created by the pandemic and our response to it that are not directly linked to covid itself, such as the increase in mental health issues we have seen across the nation, including in Northern Ireland. We have provided much more funding for mental health, but we need a long-term, sustainable plan to deal with mental health challenges, which have, sadly, increased.
I very much welcome the statement and I welcome my right hon. Friend to his place. It emerges that the AstraZeneca vaccine made in India—particularly batches 4120Z001, 4120Z002 and 4120Z003—may not be recognised by the European Medicines Agency, despite being recognised by the Medicines and Healthcare Products Regulatory Agency. This has implications for the digital covid certificate that will enable many constituents to travel to Europe this summer. Can the Secretary of State clarify the negotiations with Europe on this, and say whether regulatory bodies in other jurisdictions, notably the Food and Drug Administration, are taking a similar line to that of the EMA?
I can tell my right hon. Friend that the AstraZeneca-type vaccine being used in India is, I think, referred to as Covishield. We have not used Covishield in the UK, and we are in intensive discussions with our European friends to ensure that they have the facts to hand and that they can respond accordingly.
Today’s Health Foundation covid report adds to evidence from Professor Sir Michael Marmot on the UK’s high and unequal covid death toll. It shows not only that the UK has suffered high levels of mortality with the second highest level of excess deaths for working-age people in Europe, but that people of colour and disabled people were five and six times respectively more likely to die than their white counterparts and their non-disabled counterparts. On top of that, those in poverty were nearly four times more likely to die from covid than those in more affluent groups.
Following my question to the Health Secretary yesterday, when I asked whether the Government were committed to levelling up, I am now asking when they will implement the recommendation from Sir Michael Marmot and the Health Foundation to address these inequalities and build back fairer.
I am looking closely at those recommendations. I want to look at the expert advice of everyone out there who is providing good, sensible advice about how we can come together to tackle this pandemic. The hon. Lady is right to point out that the pandemic has, sadly, been disproportionate in certain communities and in its impact, including, sadly, on disabled people and people from ethnic minorities. That is true not just in the UK; it is true across the world, and we need to work out a plan to deal with that, and also, if there is ever a future pandemic, to ensure that we have learned the lessons.
Clearly, our protection against further waves of the virus depends on the uptake of vaccines. Will my right hon. Friend look at how the daily infection, hospital admission and death statistics can be broken down by age group and by vaccination status, so that everybody can see the benefits of vaccination for themselves and for others?
The vaccines are our wall of protection. That is what is allowing us to make the decisions that we have made to restore our freedoms and continue down that road, and I think providing more information and detail on the take-up, especially by age group and locality, can be helpful.
The flu season that we have just been through was the mildest on record, thanks in no small part to the fact that we have all been wearing masks to protect against coronavirus. Public Health England has warned that we could see a flu surge in winter, as we have not had much recent exposure to and therefore immunity from other respiratory viruses. What is the Secretary of State doing to prepare for this? Does he agree that we should keep the wearing of masks compulsory on public transport to keep covid cases down and prepare for the flu season?
The right policy on masks is the one we set out yesterday, but the hon. Lady is right to raise the concerns about flu this coming winter, for the reasons she mentioned. She asked what we are doing about it; one of the things we are doing—this is by no means everything—is this: we recently announced that we plan to have a covid vaccine booster programme in September, starting with the more vulnerable cohorts, and our plan, based on the advice of the Joint Committee on Vaccination and Immunisation, is simultaneously to offer the flu vaccine, which will mean that the take-up of the flu vaccine should be at record highs.
I welcome my right hon. Friend’s statement. An increasing number of constituents contact me about access to GP appointments, with many still struggling to see their GP face to face. We know how that will impact on early diagnosis and the treatment of other illnesses. What steps is the Department taking to encourage and support GPs to see patient patients face to face, which will help to address many of the other challenges?
As my hon. Friend says, it is essential that we get GP access back to normal. We can all understand why, during this pandemic, GPs have had to do other jobs such as help us to get the vaccines out, and have not been available in the normal way because of social distancing rules and for other reasons, but I think we are gradually starting to see things going back towards normal. The changes announced yesterday will help with that. As the vaccine programme—which will continue for a while, as we have set out—settles down and we get more people dedicated to it, we can release GPs from some of those duties. All that put together will help.
The Secretary of State has already acknowledged the importance of dealing with the mental health problems we have seen arise in this pandemic, and it is now urgent that the issue is addressed, so when will the Government publish a clear statement on where Public Health England’s vital public mental health and suicide prevention work will sit in the new arrangements for our national public health system?
The hon. Lady is absolutely right to draw attention to this issue. One of the worst outcomes of all the restrictions we have necessarily had to have during the pandemic is the significant rise in depression and many other public health problems. We need to start to make tackling that much more of a priority now that we can move past what I hope is the worst of this pandemic. I want to come forward as quickly as I can with a new plan on mental health, to set out what more we can do not only to clear the backlog of cases, as it were—we need to put more effort and resources into that—but to look at what more we can do through investment in both skills and capital.
I thank my right hon. Friend for his statement. Many constituents are asking me about the role that booster vaccines will have in ensuring that we do not have to go back into lockdown. Does he agree that providing additional booster jabs to the most vulnerable and all those over 50 will strengthen the protection and gains delivered by our current vaccine programme?
Yes, I do agree. The vaccine programme is our wall of protection, and every jab builds that wall higher. As immunity wears off, we need to make sure that people get a booster with a third jab. As we have announced, the boosting programme will begin with the most vulnerable cohorts in September.
I thank you, Mr Speaker, for your indulgence in allowing me to acknowledge the passing from covid last night of Father Stan Swamy, a humanitarian Jesuit priest who had been held in custody in India since October last year. I hope the House will join me in expressing our condolences to all who knew him.
On today’s statement, there is a fundamental weakness in the Secretary of State’s comments. The covid virus did not get the memo and has not read his statement. Vaccines are really important, but if he wants to build a ring of defence around the continued spread of the virus, he will find that surveillance is absolutely key. Last week, I was promised evidence from Porton Down supporting the continued use of Innova lateral flow devices across the country, but that information has not been passed to me. I also asked for the MHRA’s letter recommending the extension of the exceptional usage authorisation, but, again, that has not been forthcoming. When can I expect to receive this important information?
First, may I associate myself with the hon. Gentleman’s expression of condolences? On his substantive question, I am not fully aware of the information he has requested, but I have noted it and will look into it and write to him.
I welcome the statement from the Secretary of State and welcome him to his place. Does he agree that the UK’s portfolio of 517 million vaccine doses is evidence of the world-leading effort of this Conservative Government in securing our route out of this pandemic, allowing the restrictions to be lifted?
I agree absolutely with my hon. Friend on that. It is fair to say that our effort on vaccines, as a country, has been world-leading. It is certainly the best in Europe in terms of the number of people who have received the vaccine—ours is the largest of any of the large countries. That is down to the efforts of so many people, especially the scientists, the vaccine taskforce and all the NHS workers—the doctors, nurses and volunteers. It is a group effort, and when we look back at this pandemic it will be one of the things we will know has saved so many lives.
Some experts are warning that easing covid restrictions too quickly could contribute to the emergence of new, more dangerous variants, which may well be resistant to the vaccine. Will the Secretary of State inform the House of any contingency planning by his Department or the UK Government as to how they will cope in the event of such an alarming eventuality?
The hon. Lady is right to highlight the risk that absolutely exists—this pandemic is not over—of new variants. We have seen the impact of variants already, and no one knows what is going to happen. Of course, reasonable experts will have different views on this.
As for the measures we are taking, I will point to a couple. We are keeping border controls in place. Yes, we are making some proportionate and balanced changes, but border controls are staying in place. We are keeping the test, track and isolate policy in place; again, some sensible changes are being made, but through that policy and the huge amount of testing that will still be done, with our genome sequencing programme being the best and largest in the world, we will be able to detect any changes in the virus sooner than perhaps other countries. Lastly, the team in my Department and in Public Health England, and the chief medical officer, are very much aware of this issue of new variants. It is not only an issue for us; it is an issue around the world, and we will continue to work with our international partners.
The UK’s world-leading covid-19 vaccination programme has been phenomenal, but, unfortunately there are some immunosuppressed and immunocompromised people, such as those with blood cancer, for whom the vaccine is not nearly as effective. May I have a commitment from my right hon. Friend the Health Secretary that those who fall into that category will be properly informed and advised by the NHS as to how to protect themselves better?
Yes, I can give my hon. Friend that assurance. He is absolutely right to raise this issue. As we develop our plans, we are absolutely thinking about all those more vulnerable cohorts and the impact that there may be on them. That is why when we set out the details of step 4 regarding those who are immunosuppressed there will be new guidance, and GPs will be able to use it in working with those patients.
It is clear from comments made by the chief medical officer, the Prime Minister and the Secretary of State over the past 24 hours that, in their view, it is better to have a third wave of covid now than it is in the winter when the NHS is struggling. Will the Secretary of State please confirm explicitly whether that is the policy aim of the Government and, if so, will he confirm the estimate of his officials of how many excess deaths and additional cases of long covid that that third wave will result in?
No one wants another wave of covid cases. As the hon. Lady will have heard, what is different this time, as we sadly see cases rise, is the vaccine. The link between case numbers and hospitalisations has been severely weakened, as I have set out to the House in quite some detail, and that is what matters.
I welcome my right hon. Friend’s appointment as Health Secretary and his sensible statement today further easing restrictions. Following on from what other colleagues have said, will he confirm to Southend residents that the booster vaccine will be available this winter and that enough centres will remain open to administer it efficiently?
I am very happy to confirm to my hon. Friend that the booster programme will start in September. We still have to get the final advice from the JCVI on exactly how it will work, but it will be administered throughout the United Kingdom and that, of course, includes to his constituents in Southend.
Parents in my constituency have been in touch regarding ventilation in their children’s schools. What advice will health officials give to the Department for Education about putting ventilation in schools and paying for extra measures, which might mean that children can stay in school longer without the fear of covid transmission and that staff will be protected as well?
That is another very good question. The Education Secretary will be speaking right after me about some of the changes that we are making and how they will affect schools. When it comes to ventilation, there has been, during the course of this pandemic, more funding to schools to make certain adjustments. Not only will that kind of support continue, but some of the measures that we are announcing today will help schools and schoolchildren.
I welcome my right hon. Friend’s statement. Earlier today, I spoke with Tracy Bullock, the fantastic chief executive of one of our local NHS trusts in Stoke-on-Trent, who oversees the Royal Stoke University Hospital. Tracy has told me that there has been a significant increase in emergency department attendances, above those usually seen in winter. Can he outline what additional resources can be given to help our NHS get on top of that, because winter is coming?
My hon. Friend will know that the reason we have seen an increase in demand for A&E across the country is that many people have not been able to go to their GP in the usual way. Quite understandably, when their problem gets to a point that, in normal circumstances, it would not have reached, they go to A&E. That is what I meant when I talked earlier about the backlog of cases. Yesterday, I said that there are some 7 million people who, in normal circumstances would have come forward to the NHS either through their GP or in another way, but have not done so because of the rules and restrictions around the pandemic. Easing those restrictions will make a big difference.
More than a quarter of my Vauxhall constituents are aged between 20 and 29 and many of them have not had the chance to come forward for their second vaccine. Obviously, the lockdown restrictions that we are under will ease in two weeks’ time. This morning, the Secretary of State has confirmed that numbers are expected to rise after 19 July. He will be aware that a number of young people—one in eight—are still vaccine-hesitant. We know about the link between cases and hospitalisation and that the link is not broken. Young people are fearful of getting long covid, so can the Minister inform the House what specific resources are being made available through the NHS for those suffering with long covid?
The Government have made more than £90 billion of additional funding available to deal with the consequences of the pandemic. Much of that has gone to the NHS and other parts of the healthcare system, and it is helping in every aspect, including with those sadly suffering with long covid. Younger people are, of course, affected by the virus—no one could pretend otherwise—but the hon. Lady will know that they are less affected and impacted than older people in their communities. That is why older people have been the priority in the vaccination programme. One of the reasons that the date of 19 July was set was to allow every adult to get their first jab. Yesterday I announced the decision to shorten the time period between jabs from 12 weeks to eight weeks, so that some more people, including all the younger people to whom the hon. Lady referred, can get the full protection of a double dose by September.
May I thank my right hon. Friend for his statement today? He will know that the normal winter preparedness programme is just about to start. Will he confirm whether he will examine the medical evidence for vaccinating people under the age of 18 as part of this year’s programme? What extra measures might he also put in place regarding social care and discharge, to ensure that the pressure on beds, which normally increases, is taken care of this winter?
My hon. Friend is absolutely right to raise the issue of the normal winter pressures. The measures that we had for the pandemic mean that this winter there will be less immunity from flu and other viruses that tend to come around in winter, so we are actively making plans in that regard. There were already plans in the Department when I arrived. I am reviewing those plans and this matter will be a priority.
The Secretary of State stated quite rightly last week that he was looking at the numbers very carefully immediately after being appointed. No doubt he will have looked at Japan and Korea, where the death rates are something like 2% or 5% of the UK’s death rate. Case rates are currently eight or nine per 100,000 in Korea and Japan, yet those countries—certainly Korea—are still mandating the wearing of masks. In the light of that, what does the Secretary of State think we should be doing, because those places are clearly having success?
We all know that the impact of this terrible virus has been very different across the world. The hon. Gentleman has talked about countries in the far east. The impact in South America, India and Europe has been very different. I do not think we can simply draw a conclusion that the reason for that difference is the policy on masks. The primary reason that we were able to announce the step 4 measures yesterday was the vaccine. If the hon. Gentleman looks at the countries he mentioned, particularly Japan, he will see that their vaccination rates are a lot lower than ours. That will partly explain why they may be taking a different approach to tackling the pandemic at this point.
I congratulate my right hon. Friend on his new role and warmly welcome his statement about the importance of addressing non-covid health issues. Sadly, for the last 17 months our children have been not seen and not heard. I know from my own children and those of my constituents the devastating impact that lockdowns have had on the wellbeing of our children and young people. Will my right hon. Friend set out what measures he is taking, as we return to normal, to focus on the physical and mental health of our young people, and ensure that the anxiety and physical inactivity of the pandemic is not leaving permanent scars?
My hon. Friend is absolutely right to raise this issue. Sadly, because of the necessary measures that we have had to take, the impact on children has been immense in the negative ways that she set out. She will know—as I know just from my own research that I did before coming back into Government—that we have seen a huge rise in reports of child abuse. For example, reporting to the NSPCC’s Childline has rocketed during the course of the pandemic. That is a direct result of children not being in school and not having enough people to report that kind of activity to. We need to respond to that. The Education Secretary will have more to say about the measures in a moment, but I hope and know that the measures that we announced yesterday and today will make a dramatic difference to children’s wellbeing.
The pandemic is not over, and learning to live with the virus means putting in place measures to reduce risk. Flamefast, based in Woolston Grange in Warrington North, manufactures CO2 monitors that alongside measures such as air filtration and improved ventilation can help dramatically to reduce the risk of indoor transmission of the virus. Why has the Secretary of State ignored calls from the Labour party to put in place measures such as air filtration, improved ventilation and CO2 monitoring to reduce the risk in indoor confined spaces, particularly in hospitals and care homes, for the most vulnerable in our communities, which could help to save lives and to give a vital boost to our manufacturing sectors?
I think it is not right for the hon. Lady to suggest that the Government have ignored the need to combat the virus with better air filtration and better ventilation. A lot of the funding that the Government have provided during the course of the pandemic—for example, extra funding to care home providers—has been there precisely to introduce and help to fund some of these measures.
I welcome my right hon. Friend to his new post. I know that he will share the view of many of my constituents in west Berkshire that we must do all we can to avoid another national lockdown. In the event that vaccine efficacy should falter as we head into the winter months because of, say, a new variant, what extra steps is his Department taking to ensure that this winter will not be a repeat of the last?
I can tell my hon. Friend about just one of the measures that we are taking. A huge number of tests are carried out—over half a million a day—and that gives us a certain insight into how the virus is changing, if it is. The genome sequencing resources that we have are the best in the world; we do almost half of the genome sequencing in the world. That is fed directly to our scientists and our world-leading vaccine programme and taken into account as we develop new vaccines. My hon. Friend knows about the booster programme, which will continue into next year—and for who knows how long? Every time we have a booster we will be doing everything we can to take into account changes in the virus.
The Health Secretary has referred to the pressures on our GPs and our hospitals from non-covid patients, and that is of course real. Most health professionals—doctors, nurses and others—have been double-jabbed and regularly use at least the lateral flow test to ensure that they are not infected with covid. However, one of the local hospitals in my constituency, Fairfield General Hospital, tells me that some 30% of doctors were not available recently because they had been pinged as they had, not surprisingly, come into contact with somebody with covid. This happened not because they found they were infected but because they had to go into quarantine for the 10-day period. We risk a build-up of cases when we increase the number of times that our medical professionals are likely to find themselves pinged. Will he see whether there is some way, at least for medical staff, of bringing forward the August date?
The hon. Gentleman raises the issue of people who are pinged, so to speak, for coming into contact with an infected person and who have to self-isolate. The announcement that I have made today will clearly make a huge difference to everyone that is pinged in such a way, including all the fantastic people that work in our health service—the doctors, the nurses and others. As I said, it will come into force from 16 August. We thought carefully about whether we could do that earlier, and it is a fair question, but we decided not to do so, based on the best public health advice, because by 16 August many more people—even more than now—will be double-jabbed, and that extra layer of protection made us more comfortable in sticking with that date.
I welcome the Secretary of State’s statement. Primary care has shouldered the brunt of the vaccine deployment, and many GP surgeries in Stoke-on-Trent South are not yet back to full capacity with general appointments. A number of my constituents have raised the difficulties of getting to see their GP. Will my right hon. Friend do all he can to ensure that primary care services are able to recover fully?
Yes, I can absolutely give my hon. Friend that assurance. As well as the extra resources we are putting in, the measures that I have announced today about people not needing to self-isolate if they are in contact with an infected person but have been double-vaccinated will help across the board, and that certainly includes our NHS and primary care providers.
I am now suspending the House to enable the necessary arrangements to be made for the next business.
(3 years, 1 month ago)
Commons ChamberThank you, Mr Speaker, and I am extremely grateful to you for accommodating the timing of this statement.
I would like to update the House on the pandemic and our road map to freedom. This morning, I joined some of the remarkable people who have been at the heart of the pandemic response at a service to mark the NHS’s 73th birthday at St Paul’s Cathedral. Together, we reflected on a year like no other for the NHS and for our country. I know that hon. Members on both sides of the House will join me in celebrating the decision by Her Majesty the Queen to award the NHS the George Cross. I can think of no more fitting tribute to the NHS. I know that everyone in this House—indeed, everyone in this country—will celebrate that award.
There is no greater demonstration of our high regard for the NHS than the manner in which we all stepped up to protect it. Now, it is thanks to the NHS and many others that we are vaccinating our way out of this pandemic and out of these restrictions. Eighty-six per cent. of UK adults have had at least one jab, and 64% have had two. We are reinforcing our vaccine wall of defence further still. I can tell the House that we are reducing the dose interval for under-40s from 12 weeks to eight, which will mean that every adult should have had the chance to be double-jabbed by mid-September.
And those vaccines are working. The latest data from the Office for National Statistics shows that eight in 10 adults have the covid-19 antibodies that are so important in helping our bodies to fight this disease. When we look at people aged over 50—the people who got the jab earlier in the programme—that figure rises to more than nine in 10. Allow me to set out why all this is so important.
Before we started putting jabs into arms, whenever we saw a rise in cases, it would inevitably be followed by a rise in hospitalisations and, tragically, a rise in deaths. Yet today, even though cases are heading upwards, in line with what we expected, hospitalisations are increasing at a much lower rate and deaths are at just 1% of the figure that we saw at the peak. Our vaccines are building a wall of protection against hospitalisation. And, jab by jab, brick by brick, that wall is getting higher.
For those people who sadly do find themselves having to go to hospital, we have better treatments than ever before. Last week on my visit to St Thomas’ Hospital, clinicians were telling me just how transformative dexamethasone has been in their effort to save lives. Taken together, the link between cases, hospitalisations and deaths is being severely weakened. That means that we can start to learn to live with covid.
As we do that, it is important that we are straight with the British people. Cases of covid-19 are rising and will continue to rise significantly. We can reasonably expect that, by 19 July, the number of daily cases will be far higher than today. Against this backdrop, many people will be understandably cautious about easing restrictions. After many months of uncertainty, that is entirely natural. But we can now protect the NHS without having to go to the extraordinary lengths that we have had to in the past. That is not to say that this is going to be easy.
Of course, the pandemic is not over. The virus is still with us; it has not gone away. The risk of a dangerous new variant that evades vaccines remains real. We know that, with covid-19, the situation can change and it can change quickly, but we cannot put our lives on hold forever. My responsibility as Secretary of State for Health and Social Care includes helping us to turn and face the other challenges that we know we must also address, from mental health to social care to the challenges of long covid. I am also determined to get to work on busting the backlog—the backlog that has been caused by this pandemic and which we know will get a lot worse before it gets better.
As I set out to the House last week, I remain confident that we can move to step 4 in England on 19 July and that the Government will make their final decision on this on 12 July, so today I wish to set out further details of what step 4 will look like. In essence, our national response to covid will change from one of rules and regulations to one of guidance and good sense. We will revoke all social distancing guidance, including the 2 metre rule, except for in specific settings such as ports of entry and medical settings, where of course it would continue to make sense.
It will no longer be a legal requirement to wear face coverings in any setting, including public transport, although we will advise this as a voluntary measure for crowded and enclosed spaces. It will no longer be necessary to work from home. There will be no limits on the number of people we can meet. There will no limits on the number of people who can attend life events such as weddings and funerals, and there will be no restrictions on communal worship or singing.
We will remove legal requirements on how businesses operate. Capacity caps will all be lifted and there will no longer be any requirement to offer table service. All businesses that were forced to close their doors will be able to open them once again. And we will lift the cap on named care home visitors so that families can come together in the ways they choose to do so. Ministers will provide further statements this week on self-isolation for fully vaccinated people, including for international travel, and on restrictions in education settings, including the removal of bubbles and contact isolation in schools.
Today, I can also confirm to the House that we have completed our review of certification. While already a feature of international travel, we have concluded that we do not think using certification as a condition of entry is a way to go. For people who have not been offered a full course of vaccination and for businesses, we felt that the impact outweighed the public health benefits. Of course, businesses can use covid-status certification at their own discretion and, from step 4 onwards, the NHS covid pass will be accessible through the NHS app and other digital routes. This will be the main way that people can provide their covid status—a status that they will achieve once they have completed a full vaccine course, a recent negative test or some other proof of natural immunity.
Taken together, step 4 is the biggest step of all: a restoration of so many of the freedoms that make this country great. We know that, as a consequence, cases will rise, just as they have done at every step on our road map, but this time our wall of protection will help us.
While step 4 will be the moment to let go of many restrictions, we must hold on to those everyday, sensible decisions that can help make us all safe. The responsibility to combat covid-19 lies with each and every one of us. That means staying at home when you are asked to self-isolate. It means considering the guidance that we are setting out, and it means getting the jab—both doses. When you are offered it, please, please take the jabs. This is something that everyone can do to make a contribution towards this national effort. It may even mean, for some people, that they will get three jabs in a single year. Last week, the Joint Committee on Vaccination and Immunisation provided interim advice on who to prioritise for a third dose, and our most vulnerable will be offered booster covid-19 jabs from September in time for the winter.
And preparing for the winter ahead is not just about covid, but flu as well. Because of the measures in place this winter, almost nobody in the UK has had flu for 18 months now. That is obviously a good thing but it does mean that immunity from flu is down. This winter’s flu campaign will be more important than ever, and we are currently looking at whether we can give people the covid-19 booster shot and the flu jab at the same time.
Step 4 is the next step in our country’s journey out of this pandemic. I know that, after so many difficult months, it is a step that many of us will look upon with a great deal of caution, but it is one that we will all take together, with a growing wall of defence against this virus—a wall that each and every one of us can help build higher. It is vital that each of us plays our part to protect ourselves and to protect others into better days ahead. I commend this statement to the House.
I start by paying tribute to our NHS on its 73rd anniversary and thank again our extraordinary health and care workforce. The best birthday present they could have, of course, is a fair pay rise, not the proposed real-terms pay cut that is currently on offer.
We all want to see these restrictions end. Lockdowns are a sign of policy failure and I hope that, when the Secretary of State makes the final decision next week, it will be based on the data, the modelling and the Scientific Advisory Group for Emergencies advice, but let us be absolutely clear about what he is talking about today. When only 50% of the total population across England are fully vaccinated and another 17% are partially, his strategy, as he indeed was gracious enough to concede, accepts that infections will surge further and continue to rise steeply, and accepts that hospitalisations will continue to rise until they reach a peak—presumably later this summer. Some of those hospitalised will sadly die, and thousands upon thousands of mostly children and younger people, but others as well, will be left exposed to a virus mainly because they have no vaccination protection—we also know that even double-jabbed people can catch and transmit the virus—and many of them will be at risk of serious long-term chronic illness, the personal impact of which may be felt for years to come.
Even though vaccination may have broken the link with mortality, there are still questions about the link to morbidity. As part of the Secretary of State’s strategy of learning to live with covid, will he spell out today for the British public what that actually means? How many deaths does he consider are acceptable when we are living with covid? How many cases of long covid does he consider acceptable when we are living with covid? Given that we know that covid can escape and evolve when the virus circulates at high rates, what risk assessment has he done on the possibility of a new variant emerging? Will he publish it?
The Secretary of State says that every date for unlocking carries risk and that that is why we need to learn to live with covid, but we should not have to take a high-risk approach. We should be pushing down risk. Indeed, we mitigate risk across society all the time. We do not just accept other diseases; we take interventions to try to prevent them. Why is he therefore collapsing all mitigations completely when he knows that covid rates will continue to rise? He will be aware that Israel has reintroduced its mask mandate because of the delta variant, so why is he planning to bin ours? Masks do not restrict freedoms in a pandemic when so much virus is circulating. They ensure that everyone who goes to the shops or who takes public transport can do so safely, because wearing a mask protects others. If nobody is masked, covid risk increases and we are all less safe. He must understand that those in the shielding community are particularly anxious. Why should they feel shut out of public transport and shops because he has abandoned the mask mandate? That is no definition of freedom that I recognise.
Who else suffers when masks are removed? It is those working in shops, those who drive the buses, those who drive taxis and those who work in hospitality—it is the low-paid workers who have also been without access to decent sick pay. Many of them live in overcrowded accommodation. It is those who have been savagely, disproportionately impacted by the virus from day one and now the Secretary of State is asking them to bear the brunt of the increased risk again. Will he explain why he thinks abandoning masks is a sensible proposal to follow?
Given that people will still need to isolate, as the Secretary of State recognised, and that test and trace will still be in operation, will he accept that living with the virus will mean that, more so than ever, those who are sick will need to isolate themselves from the rest of society? Will he therefore ensure that they are paid proper sick pay and isolation support to do it? Does he agree that it has been a monstrous failure of the past 15 months that isolation support has not been in place?
Now, masks are effective because we know that the virus is airborne. The Secretary of State could therefore further mitigate covid risks by insisting on ventilation standards in premises and crowded buildings. He could offer grants for air filtration systems. Instead, all we get is more Government advice. Ventilation in buildings and grants to support air filtration systems do not restrict anyone’s freedoms. Indeed, they would probably help get back into school some of those 400,000 children who have been off school because of covid.
Yesterday, the Secretary of State said that he believed the best way to protect the nation’s health was to lift all restrictions. I know he boasts of his student years at Harvard studying pandemics, but I think he may well have missed the tutorial on infectious disease control because widespread transmission will not make us healthier. We are not out of the woods yet. We want to see lockdown end, but we need those lifesaving mitigations in place. We need sick pay, local contact tracing, continued mask wearing on public transport and ventilation in buildings and schools to prevent further illness. I hope, when the right hon. Gentleman returns next week, he has put those measures in place.
I thank the right hon. Gentleman for his comments. First, I think he started by asking for reassurance on whether the final decision on go or no go for 19 July, which we will make on 12 July, will be informed by the very best expert data. Of course it will be, just as every decision has been informed in that way. I am only about a week into the job, but I must say that I am incredibly impressed by our scientists, medical advisers and Public health England. I take this opportunity to pay tribute to all they have been doing.
Turning to the right hon. Gentleman’s second point about the link between cases and hospitalisation and death, that is absolutely central to the next step we are taking. Case numbers are high. As I said, they will go significantly higher and we need to be ready for that, but what is far more important is how many people are ending up in hospital and how many, sadly, are dying. That is where the vaccines have worked, alongside the treatments we now have that we did not have a year or so ago. That has meant that the link between cases and deaths has been severely weakened. The last time we had 25,000 new cases a day, we had around 500 deaths a day. The level now is a thirtieth of that. I know the right hon. Gentleman will welcome that and understand that there is no absolutely risk-free way to move forward, but we need to start returning things back towards normal and learning to live with covid.
The right hon. Gentleman asked about masks. Again, we have taken the best public health advice. He will know from what I have said that, although we will remove all legal requirements for anyone to wear a mask in any setting, we expect people to behave sensibly and think about others around them. The guidance will be there. If one is on public transport—let us say on a very crowded tube—it would be sensible to wear a mask, not least to show respect for others. However, if you are the only person in a carriage late at night on the east coast main line, then you can choose much more easily not to wear a mask because there is hardly anyone else around. We expect and trust people to make sensible decisions. That is the way we should move ahead.
The right hon. Gentleman asked about compensation and sick pay. He knows that many measures are in place and we will continue to keep them under review.
I support the approach the Secretary of State is taking for the simple reason that two doses of the vaccine work against the delta variant, but with 350,000 new cases daily across the world the battle against this pandemic is far from over. Does he agree that if we want to prevent another lockdown in the run-up to winter, apart from the booster jab programme the most important thing we can do is to improve the way test and trace works? In Korea, they managed to use it to stop any lockdowns. Here, it failed to stop three lockdowns. The head of test and trace told my Health and Social Care Committee that between 20% and 40% of people were not isolating when they were asked to. With his fresh eyes in the job, will he ask officials for new advice on what we can do to improve test and trace to stop further lockdowns?
First, may I thank my right hon. Friend for his support for the measures? He speaks with great experience and I want to thank him for that. Regarding test, trace and isolate, he is right. There are many successes over the past year that we can be proud of, but there are also many improvements that can be made. I have already asked for such advice and I look forward to talking to him about that in future.
This pandemic is very far from over, so, with cases soaring across the UK, I am surprised that the Health Secretary is planning to end all covid measures. The delta variant, which was allowed into the UK due to the failure of border quarantine, is twice as infectious as the original, and is infecting younger age groups, including children. It also shows significant vaccine escape, with only 33% protection against infection from the first dose. While receiving two doses of either vaccine dramatically reduces hospitalisation, the numbers are rising and only half the population are fully vaccinated. That means that the other half are not, and many will not have that opportunity until near the end of September.
The Secretary of State talks about the percentage of adults who are fully vaccinated, but he must know that that is not how herd immunity works. It is achieved by reducing the number of susceptible people in the whole population to stop onward spread of the virus. The UK Government’s failure to lock down last September allowed the alpha variant to emerge in the south-east of England and spread across the UK and, indeed, the rest of the world. If the Health Secretary is going to just let it rip, how does he plan to avoid generating yet another UK variant with even greater vaccine resistance?
With more than 150,000 people dead, why has the Secretary of State returned to the false narrative that covid is just like flu? Is it just wishful thinking? Why is he planning to end even simple measures such as mask wearing? He has suggested that people need to learn to live with it, but appears to be completely ignoring the risk of long covid, which is already affecting more than a million people, including children. How does he plan to avoid soaring cases of long covid in unvaccinated young adults and children? Does he consider them to be collateral damage, or just a price worth paying?
The hon. Lady started off well, but her contribution completely degenerated into political point-scoring. She should know much better than to engage in scaremongering among the Scottish people and the British people. She has no respect for what is happening, as we try to treat this whole issue with a degree of respect and seriousness. She used the phrase, “Let it rip”. If anything, the only part of the UK where cases could be described as “ripping” is in Scotland where the case rate is higher than in any other part of the UK. In fact, it has seven of the 10 highest hotspots in Europe in terms of its number of cases, and she should reflect on that.
The hon. Lady claimed that I had suggested that covid is like flu. I have never said that. It would be complete nonsense for anyone to suggest that covid is like flu. She should think about the millions of people across the world affected by this and the thousands of people who have died in the UK. How dare she even raise that—it is as if she is suggesting that it is like flu. In the same way that we have had to learn to live with flu, even though, sadly, in some years, we have had 20,000 deaths from flu, we will have to learn to live with covid. The hon. Lady should reflect on what she has said and stop playing political football with this serious issue.
I welcome the Secretary of State to his role and say to him in public—I hope that I have also said it to him in private—that, when he was Secretary of State for Housing, Communities and Local Government, he was one of the few Ministers who understood the plight of residential leaseholders, and I thank him for that, and I hope that he will do as well in this job. May I put it to him that, as well as the recognition of the National Health Service, it would be a good idea if we found some way of recognising the role of teachers and their assistants in schools who have done so much to keep the young people of this country in education and occupied, even though remotely. Many people have contributed to that. May I also say to him that, despite the occasional political remarks that any of us may make, I hope he will work with the other nations of the United Kingdom and around the world so that we can defeat the impact of this condition together.
I thank the Father of the House for his kind comments. He may have heard me say earlier that the Education Secretary will talk much more tomorrow about the action we will be taking around schools and educational settings, including the removal of the bubble requirement from 19 July. He made an excellent point about working not just across the United Kingdom—despite what the hon. Member for Central Ayrshire (Dr Whitford) said a moment ago there is great co-operation between us, which will continue—but internationally, both through our leadership of the G7 and the COVAX alliance.
The Secretary of State will be aware that, compared with the rest of the population, double vaccination provides a much reduced level of protection for clinically extremely vulnerable people with compromised immune systems. He will also be aware that pregnant women in their third trimester are considered clinically vulnerable. Many people in such groups are anxious about what today’s announcements mean for them. Will he confirm what advice is being published for the clinically extremely valuable? Specifically, will he consider allowing pregnant women to have their second jab after 21 days?
There will, of course, be people who are sadly more vulnerable to this virus who will be concerned about step 4. I entirely understand that caution and anxiety, and we will publish further guidance along the lines that the hon. Lady mentioned. As for her question on second doses for pregnant women, I will have to take advice on that.
Order. I warn colleagues that this statement will finish at 6 o’clock due to the need to get back to the debate on the Bill, so I urge colleagues to be brief.
The majority of my constituents will welcome the Secretary of State’s statement, but NHS Digital data shows that the case rate in the council area is 591 per 100,000. That is considerably ahead of the national average and is causing inevitable concern, particularly among elderly and vulnerable groups. I have full confidence in the local NHS, the council and other officials dealing with the situation, but if it continues to worsen, will my right hon. Friend meet me and my hon. Friend the Member for Great Grimsby (Lia Nici) to discuss whether additional support and resources are required?
I of course understand the importance of my hon. Friend’s question. As I said in my statement, I believe that the case rate nationally, including in his constituency, will worsen, but the hospitalisation and death rates are far more important. He will have heard what I said earlier, but I am more than happy to meet him on any occasion to discuss such issues further.
I thank the Secretary of State for his statement and for the central Government approach to drive the vaccine roll-out across all of the United Kingdom of Great Britain and Northern Ireland—better together, as always. The approach outlined by Government seems sensible. Will the Secretary of State outline what discussions have taken place with his Health counterpart in Northern Ireland to ensure that Northern Ireland moves forward cautiously and carefully at a similar pace, bearing in mind our level of transmission, in tandem with the need to be wise and wary?
I thank the hon. Gentleman for his remarks about the vaccine. As he says, it is a successful UK-wide programme, and the take up of vaccinations in Northern Ireland is just as high as in any other part of the UK. I am working closely with my counterpart in Northern Ireland. We have already had two discussions in a week, and we will be speaking and co-ordinating on a regular basis. Things are working well.
I welcome my right hon. Friend’s statement, which will be greeted with a sense of relief across the country due to the profound challenges that people have faced during the lockdowns. This success is, of course, possible only because of the vaccine roll-out, so will he keep up the pressure to ensure that as many people as possible are vaccinated? While doing that, will he also focus on the significant catch-up required to deal with other health conditions? I am thinking particularly of mental health and cancer.
My hon. Friend is right to raise that matter. He points out—certain Members of this House sometimes miss this—that the pandemic has caused many other non-covid health problems, and he mentions two of the most important. We are seeing plenty of evidence of increased mental health problems, and departmental officials think that at least some 40,000 people who would have come forward for cancer referrals in a normal year have not done so. That is a reminder of why it is important for us to move back towards freedom and to learn to live with covid.
The Welsh Government have suggested that an easing of Welsh restrictions is unlikely before 19 July, and any divergence in the rules applicable on either side of the border will raise questions of enforcement. The responsibility for enforcing social distancing rules on trains lies with the British Transport police, so what discussions has the Health Secretary had with the Secretary of State for Transport and, indeed, the Welsh Government regarding the status of restrictions on cross-border rail travel?
It is understandable that there has been a difference in approach between Wales and England, and clearly that will continue, but we will continue to co-ordinate. I know that my predecessor, my right hon. Friend the Member for West Suffolk (Matt Hancock), co-ordinated on a regular basis with his Welsh counterpart, and when it comes to transport, my Welsh counterpart and I will work carefully with the Secretary of State for Transport.
It is hugely significant and welcome that the link between cases and hospitalisation seems to have been broken by the vaccine. I would like to echo what my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) has just said. Can my right hon. Friend assure me, notwithstanding the risks he has pointed out such as potential variants and increased cases, that the NHS will have the focus and the resources to continue to bear down on the backlog of cases such as cancer, which is scaring my constituents and everyone else?
Yes, I can give my hon. Friend that assurance. The backlog is already at 5 million, and as I have said today, it is unfortunately going to get a lot worse before it gets better. I think we can all understand why, but today’s announcement will certainly have helped in our march to clear the backlog. My hon. Friend will know that the Government have given significant additional funding, in the billions, to help with that, but there will be a lot more to come in dealing with the priorities, especially cancer.
All the warm words from the Secretary of State towards the NHS at the top of his statement were completely demolished by his attitude towards a breast cancer surgeon when he said that she should know better. The reality is that she does know better, and he should apologise to the hon. Member for Central Ayrshire (Dr Whitford) for those absolutely outrageous comments. And to use the escalation of cases in Scotland as a political tool is absolutely disgraceful. I want to talk about the—
I apologise for any discourtesy to the House in not being able to be there in person. The Prime Minister has confirmed that there will be contingency measures in place for winter, and even if they are not legal restrictions, they will have an effect on business. Can the Secretary of State confirm what they are, and publish the details so that Members can scrutinise them at the earliest opportunity?
I believe that my right hon. Friend is referring to our keeping in place contingency measures, particularly for local authorities—the so-called No. 3 regulations—at least until the end of September in case those powers are needed in the event of a local break-out. Of course, there is no intention at this point that those powers will be used, but we believe it is necessary to have powers in place just in case. He will have heard me talking earlier about the risk that still exists from new variants. That is the plan, but I would be happy to discuss that with him further.
Can the Secretary of State explain why, when other public health and safety measures are not left up to individuals to decide, he thinks that that is an appropriate approach to covid? Failing to mandate mask-wearing in stuffy crowded places such as public transport, where people are often pressed together for much longer than 15 minutes, risks high costs, and allowing people to choose whether or not to put others at risk is both reckless and unfair. If the freedom to pelt down the motorway at 100 mph is restricted because it poses risks to others, why, with millions still unvaccinated, with some immunosuppressed and with the risk of long covid rising, does the Health Secretary not apply the same logic to mask-wearing?
I understand where the hon. Lady is coming from, but the important thing is that we have to learn to live with covid, which means that we have at some point to confront and start removing the restrictions that have been necessary until now. Now is the best time to do that, because of the defence that has been built by the vaccine.
We will never again sacrifice free enterprise, freedom of association and freedom of worship in order to manage hospital admissions, will we?
I take it from that that my right hon. Friend is pleased with today’s announcements.
Some have suggested that removing all restrictions in the way that the Secretary of State has announced will create factories for new variants in parts of our communities. What advice has he received from experts about the potential for new variants? What contingencies has he planned for containing such an outbreak if one were to occur?
The hon. Gentleman will have heard in my statement that no course of action that we take now is without risk, and I think he understands that. There is still a pandemic—as I said, it is not over—so we will of course continue first to monitor for new variants, and to have border restrictions and some test, trace and isolate procedures in place. Those measures, taken together with the success of the vaccine programme, are the best answer to his question.
One headteacher in my constituency tells a tale of losing more than 2,700 days of education, having 390 children sent home and zero transmission among pupils in school. So will my right hon. Friend assure me that swift action will be taken to ensure that children can get back to school and headteachers can get back to teaching as soon as possible, without the damage the current situation is creating?
Yes, I can give my hon. Friend that assurance. The Education Secretary will be saying more later this week, but I can confirm to my hon. Friend that on 19 July it is our plan to remove bubbles and end the requirement for early years settings, schools and colleges to carry out contact tracing routinely. I will have more to say on how we intend to exempt under-18s who are close contacts from the requirement to self-isolate.
Given that masks help to reduce the spread of not just covid, but all kinds of respiratory diseases, is it not important to avoid mixed messages and encourage everyone to continue that kind of practice and the likes of good hand hygiene as a relatively routine part of a new normal, to stop coughs and sneezes from spreading diseases?
I think the hon. Gentleman is suggesting that people should have the freedom to wear a mask if they wish, but it should not be mandatory—it should not be mandated by law. There are countries—I lived in Singapore for three years—where people would wear masks if they were feeling unwell, out of respect for others. If people choose to do that here, that will be a good thing, but it will not be a requirement from the Government. As I said, in certain settings—crowded places such the tube in London—many people would choose to wear masks, despite its not being a legal requirement.
The immunosuppressed want to know what the plan is for them. Will they be allowed tests for spike antibody levels on the NHS? Will they be able to get a booster before September if their antibody tests show that they have no protection, despite being vaccinated?
My right hon. Friend asks an important question and we are still considering what more we can do to give more confidence to the immunosuppressed, and we will be saying more on this shortly.
Until recently, Ministers were saying that decisions would be based on the link between infection and hospitalisation, but although the link has been weakened, it has not been broken. Hospitalisations are up 20% in the last week, and they have doubled in a month. We all want to unlock the economy, but surely we should maintain barriers to infection where we can. The Secretary of State has said that wearing masks would be a good thing, so will he accept that requiring them on public transport, in essential shops and in similar locations would make sense and would reassure people?
No one is suggesting that because of the vaccines, the link between cases and hospitalisation has been completely broken. What I have said, and this is a fact based on the evidence we are seeing, is that it has been significantly weakened. That is clear from the data we are getting on a daily basis. If we look at England, with a case rate of 25,000, I think less than 2,000 people are currently with covid in hospital. That is far lower than we saw before when we had such a high case rate.
I am grateful to the Secretary of State for his statement setting out the way forward. In the 150 years since the foundation of Cheadle’s Together Trust, it has championed and cared for people from 18 to 30 years old with disabilities. When I met its dedicated team last week, it was clear that having navigated the challenges of covid, it was preparing for the future. As the Government look to set out a new vision for health and social care, can the Secretary of State reassure voluntary and third-sector bodies such as the Together Trust that they will have their invaluable contribution recognised and be included as equal partners in its design?
I am very happy to give my hon. Friend that assurance. The Cheadle Together Trust and many other third-party and voluntary organisations across the country really stepped up during the pandemic when the country most needed them. We will continue to work with them, and I think that, at a suitable moment, we should give them the recognition they deserve.
It is a dereliction of duty by the Secretary of State for Health to tell people to live with the virus while denying people the basic financial and other support they need. In two weeks’ time, with restrictions lifted, there could be over 60,000 cases per day, and the Government say this will surge further. Huge numbers are denied the self-isolation payment and tens of thousands of people each day will be forced to isolate on statutory sick pay of just £96 per week. I ask the Secretary of State: could he live on £96 per week?
It is right that we provide support, including financial support, for those who are isolating and finding things difficult. We will continue to do so, and we will keep that under review.
I draw the House’s attention to the story over the weekend about three batches of AstraZeneca vaccines affecting 5 million people and their prospects of travelling to the EU. I must declare an interest in that I have vaccinated many people with this batch and, indeed, had the batch myself. Can the Secretary of State confirm that this is purely a bureaucratic issue and that the vaccines are exactly the same, and will he update the House about what talks he has had with the EU to resolve this problem?
I thank my hon. Friend for the work that he has personally been doing during the pandemic. I can tell him that all doses used in the UK have been subject to very rigorous safety and quality checks, including individual batch testing and physical site inspections, and this is all done by the medical regulator, the Medicines and Healthcare Products Regulatory Agency.
Given that Americans and other Europeans have already been free to travel again for some time, and given that we were promised a vaccine dividend, when can the millions of British families who are separated from loved ones abroad or who simply want a foreign holiday expect to get back the same freedoms that other Europeans and Americans already enjoy?
I can tell the right hon. Gentleman that that will happen very soon, and the Secretary of State for Transport will have more to say on this very shortly.
Last week, I said that I wanted to see from the new Secretary of State
“a change in policy as much as a change in tone.”—[Official Report, 28 June 2021; Vol. 698, c. 60.]
We have had that today, or at least an indication of it for next Monday, and I am grateful. Will my right hon. Friend give us an insight into his thinking about the future of test and trace? Surely it cannot continue as now, with contacts of contacts—even if they are double-vaccinated—being forced into isolation for 10 days at a time, with all the knock-on effects that that has on society and the economy.
I will be making a statement to Parliament on just that issue. I think I will probably make it tomorrow.
Last December, Professor Sir Michael Marmot revealed that the high and unequal covid death toll across England was down to historic structural inequalities that successive Conservative Governments have allowed to go unchecked. Last week, he quantified that, showing that Greater Manchester had a 25% higher covid death toll because of those structural socioeconomic inequalities. When will the Health Secretary deliver on the Prime Minister’s promise to me in January to implement Sir Michael’s recommendations to address those inequalities in my constituency and others, and ensure that we build back fairer?
The hon. Lady raises an important issue. We have seen, sadly, that through the pandemic, because of various inequalities up and down the country, some people have suffered a lot more than others. It is an important point, and we need to do more—we all collectively need to learn from this. I give her the assurance that I know that Public Health England and the chief medical officer are looking into it and will report to Ministers shortly.
I welcome the Secretary of State’s statement, but may I ask for clarity? On the legal requirement to wear face coverings, including on public transport, he stated that
“we will advise this as a voluntary measure for crowded and enclosed spaces.”
Should that be “crowded enclosed spaces”? Does he intend to put out guidance? What will he do to ensure that private operators cannot mandate it outside that guidance?
I can tell my hon. Friend that the guidance is really asking people to use their common sense. If there are many other people around them, particularly if those people might be more vulnerable—older people, let us say, or groups who for some reason may be unvaccinated—we are really just saying, “Use your common sense.” I think that everyone in Britain will do just that. In private settings, it will be up to private businesses—shops, for example—to decide what they wish to do.
I thank the Secretary of State for his statement. We will suspend the House for one minute to make arrangements for the next business.