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Covid-19 Response

Volume 675: debated on Wednesday 22 April 2020

We will run the statement for 45 minutes. The time available for opening contributions is 10 minutes for the Secretary of State, five minutes for the Opposition, and two minutes for the Scottish National party.

With permission, Mr Speaker, I would like to make a statement on coronavirus.

First, may I say how pleased I am that the House is sitting once again? At this important time, it is critical that we have the scrutiny and debate that the House provides. I thank everybody who was involved in setting up the new arrangements, which demonstrate that no virus or threat will thwart our democracy.

Coronavirus continues to spread throughout the world. The latest figures show that 17,337 people have sadly died here. Our hearts—the hearts of the whole House—go out to their loved ones. I know that across the House we are united in our determination to fight this virus with everything we’ve got; today I want to update the House on each part of our battle plan.

First, on the resilience of the NHS, I can tell the House that for the first time we now have over 3,000 spare critical care beds in the NHS. That is more than three times more than we had at the start of this crisis. It is thanks to the incredible work of an awful lot of people that we now have this extra spare capacity, even before we include the new Nightingale hospitals. Over the past two weeks, I have been lucky enough to attend, either in person or virtually, the opening of four of these new Nightingales—in London, Manchester, Birmingham and Harrogate—and there are several more to come, all across the UK, including in Belfast, Glasgow, Cardiff, Exeter and Sunderland. These incredible efforts from dedicated staff, supported by our armed forces, mean that our NHS has not at any point been overwhelmed by coronavirus. Some said this would be impossible.

Today I want to reinforce the message that non-covid NHS services are open for patients: the NHS is there for you if you need advice and treatment. I want to address that message very clearly to those who might be vulnerable to heart attacks or stroke, to parents of young children, to pregnant women and to people with concerns that they may have cancer. I want to emphasise that people with non-coronavirus symptoms must still contact their GP. If you think you need medical help, please contact your GP, either online or by phone, to be assessed. If you need urgent medical advice, use NHS 111 online; if you cannot get online, call 111. And, of course, if something is serious or life-threatening, call 999. If you are told to go to hospital, the place you need to be is in hospital. The NHS is there for you and can provide the very best care if you need it.

The second part of our battle plan is on supply and working to boost supplies of core equipment. The full weight of the Government is behind this effort. Again, we have brought in the armed forces to help us to meet this demand. This includes ventilators—both purchasing extra stock and increasing the production of new ones. We now have record numbers of ventilators, with 10,700 available for use for patients. This also includes medicines, so that we can make sure everyone has access to the supplies and treatments they need, and of course it includes personal protective equipment, too. In normal times, the NHS PPE supply chain supplies 233 hospital trusts. Currently, 58,000 separate health and social care settings are being supplied with PPE, so we are creating a whole new logistics network from scratch, and we have some of the best minds in the country working on this.

I am grateful to colleagues from the NHS, Public Health England, the Crown Commercial Service, the Cabinet Office, the Ministry of Housing, Communities and Local Government, the Ministry of Defence, the armed forces—again—the devolved Administrations, territorial offices, the Department for Business, Energy and Industrial Strategy, the Treasury, the Foreign Office and the Department for International Trade, because they are all playing their part. Last week, I appointed Lord Deighton, who delivered the Olympics, to a new role in driving forward PPE manufacturing here.

Since the start of this crisis, we have delivered over 1 billion items of PPE. We are constantly working to improve the delivery system and buying PPE from around the world. We are also working to make more at home, and I would like to thank the UK businesses that have generously come forward with offers to turn their production lines to this national effort. I also thank Members from across the House who have put us in contact with businesses in their constituencies. We are actively engaged with over 1,000 companies who buy from abroad and are working with 159 potential UK manufacturers. We have a rigorous system of verifying the offers that we receive, because not all offers have been credible and it is important to focus on the biggest, most credible offers first. This work is crucial so we can get our NHS and care staff the kit they need so that they can do their job safely and with confidence.

The third part is to scale up testing. I have set the goal of 100,000 tests a day by the end of this month, and I am delighted to say that the expansion of capacity is ahead of plans, even though demand has thus far been lower than expected. We are therefore ramping up the availability of this testing, expanding who is eligible for testing and making it easier to access the tests. The tests are conducted in NHS hospitals, and through our drive-through centres, mobile units and home deliveries. These tests are then sent to laboratories. We have completed the construction of three Lighthouse Labs in Milton Keynes, Glasgow and Cheshire. Each site took just three weeks to complete and begin testing.

As we have reached the peak and as we bring the number of new cases down, we will introduce contact tracing at large scale. The introduction of the new NHS app for contact tracing is also in development. As we do this, we are working closely with some of the best digital and technological brains, and renowned experts in clinical safety and digital ethics, so that we can get all this right. The more people who sign up for the new app when it goes live, the better informed our response will be and the better we can therefore protect the NHS.

Fourthly, we need to make sure that we make the best possible use of science and research to pursue the vaccines and treatments that are essential to defeat the virus once and for all. Here, the UK is at the forefront of the global effort. We have put more money into the global efforts to search for a vaccine than any other country, and yesterday I announced over £40 million of funding for the two most promising UK projects—at Imperial and Oxford. The vaccine from the Oxford project will be trialled in people from tomorrow, and I am sure that the whole House agrees that that is a very promising development. I repeat what I said yesterday: in normal times, reaching this stage would take years. The innovative groups of people at both the Jenner Institute in Oxford and the regulator, the Medicines and Healthcare Products Regulatory Agency, deserve our special praise. They are ensuring that the process is safe, yet conducted probably more rapidly than ever before. They deserve the support of the whole House in that work. At the same time, we will invest in manufacturing capability. If either of those vaccines works, we must be able to make them available for the British people as soon as humanly possible.

The fifth measure that I will talk about in the time available is the one in which everyone can play their part: social distancing. I want to thank everyone across the country for their steadfast commitment in following the rules, including in this House. It is making a difference. We are at the peak. But before we relax or make changes to any social distancing rules, we have set out five tests that need to be met: first, that the NHS can continue to cope; secondly, that the operational challenges have been met; thirdly, that the daily death rate falls sustainably and consistently; fourthly, that the rate of infection is decreasing; and fifthly, and most importantly, that there is no risk of a second peak.

Finally, we are working to protect the most vulnerable through shielding—this is the sixth part of our battle plan. There has been a huge effort across Government to contact and support those at risk. We have been boosted by the support and help of the heroic NHS volunteer responders, who signed up in droves within two days of our call to action. An unbelievable 750,000 people put themselves forward for this initiative. With those volunteers, and with the support of the Ministry of Housing, Communities and Local Government, the NHS and local councils, which have done amazing work on this, we are shielding the most vulnerable.

These are unprecedented times for us all. We have all seen the extraordinary impact of coronavirus in our constituencies and across the country. And even though today we are physically separated, the House is at its best when we are united in our purpose and our resolve. I will keep working with Members from right across the House in the fight against this invisible killer. This may be akin to a war, but it is one where the whole of humanity is on the same side. I commend this statement to the House.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I hope we can speed up the answers a little. I think that answer was twice as long as the question. I know you want to make sure you are thorough, Secretary of State, but we have quite a few questions to get through.

I now call the Chair of the Health and Social Care Committee, Jeremy Hunt.

The World Health Organisation says that one of the six essential criteria for lifting a lockdown is that we should be able to track and trace every single new covid case in the community. Will that be place in the next two weeks, so that when the Cabinet come to consider whether they can lift the lockdown, they will be able to do so in a way that is compliant with what the WHO is recommending? Will the Secretary of State appoint a big hitter from outside frontline politics to make sure that happens within a short period, as he has very sensibly done with Lord Deighton on PPE?

We are ramping up our testing capacity and our capacity for contact tracing in a matter of weeks. We will have it ready to ensure that we can use that capacity as and when the incidence of transmission comes down. It is not tied to the specific decision that we are required by law to take in just over two weeks’ time. The effectiveness of test, track and trace to keep the reproductive rate of the virus down is determined by the incidence in the community, and our goal is to get to a point where we can test, track and trace everybody who needs it.

Like all MPs, I pay tribute to health and care staff across the UK. Particularly in view of the key role of care workers and in recognition of their contribution, will the Secretary of State undertake to ensure that they are paid at least the real living wage, as has been the case for some years in Scotland?

Like everyone, I welcome the stabilisation of covid cases, but does the Secretary of State accept that the testing and contact tracing must be in place before any easing of the lockdown, to avoid resurgence and a second peak? Will he achieve 100,000 tests a day by next week? If not, when? How accurate are the tests? A 25% false negative rate has been reported.

I know the Secretary of State is a fan of phone apps, so I am glad to hear him recognise the need to increase public health staff both to conduct and co-ordinate contact tracing. Will he reverse the 20% cut in public health funding in England since 2015, to ensure that those staff can be recruited now?

Finally, when I raised the issue of asymptomatic spread on 11 March, the Secretary of State claimed that it was rare, but actually it accounts for about 50%. How is he taking that into account in his covid strategy?

The hon. Lady asks a number of questions. First, on the living wage, all health and social care staff in the UK are paid the living wage, because that is the law. I am very proud that we introduced the living wage, which has led to a significant rise in pay, especially for people in social care who were on the minimum wage previously. She asks about asymptomatic transmission. The scientific evidence shows that asymptomatic transmissions occurs, which is one of the very significant challenges that this virus presents. She also asked about test, track and trace. I absolutely agree that that is a critical part of keeping the spread of this virus low. The lower the number of new cases is, the more effective test, track and trace is. We are therefore building now the capacity for the very large-scale contract tracing necessary to go alongside the large-scale testing—the 100,000 tests at the end of this month that I mentioned in my statement—and the technology that can help us to do that.

It is important that decisions should be informed by good advice, so has SAGE advised on whether the 100,000 tests a day target is the right one?

The target was set at 100,000 because that is what we estimated was needed—scientific advice was provided into that target—and it is what is practically achievable. As I said, we are ahead of our trajectory on capacity, but we need to make sure that demand increases. Increasing demand is about widening access to this testing. We did take scientific advice. I am not sure whether that came directly through the SAGE route or directly from Public Health England, but of course these decisions are based on the science.

First, I want to pay tribute briefly to all those health workers, care workers, delivery workers, street cleaners and cleaners, and so many other groups all over the country, who are doing such an incredible job, together with all the volunteers, to deal with this crisis. It is an amazing moment in this country’s history. However, Parliament’s job is to hold the Government to account, so I have a simple question. The World Health Organisation indicated that there was a danger of an epidemic from coronavirus in January—it later declared this to be a pandemic. The WHO’s director general said, in terms, that the way to deal with it is by “test, test , test”, in order to ascertain the levels of infection across our society, but we did not do that. The Secretary of State came to the House in January to say that he was going to increase the amount of testing. This issue was raised with the Prime Minister on 24 February and again in a meeting we had in March, at which the Secretary of State was present. He told us then that the level of testing would increase, but it is still nowhere near the level that is necessary. Can he assure us that there is going to be a really rapid increase in the level and availability of testing, in order to get on top of this dreadful virus?

The development of testing has been at pace throughout this crisis, entirely contrary to the story told by the right hon. Gentleman. We were one of the first countries in the world to develop a test. We rapidly increased the number of tests, from 2,000 at the start of March to 10,000 during March—a fivefold increase—and it is now going up further. This is an area where we had our foot on the gas all the way through, because it is incredibly important.

I am grateful to the Secretary of State for his statement. Would he kindly update the House on the provision of a new covid testing site in north Wales and on the UK Government’s role in delivering it, in the context of devolution?

Testing is an area with UK and devolved responsibilities. The drive-through testing sites are being provided right across the UK under a programme being driven by the UK Government with the support of the devolved authorities. It is incredibly important that we make testing available in north Wales, as it is right across the country, so that people can access those tests, as my hon. Friend said. I should also mention the home testing, which will be available through the post. Especially in more rural areas, such as his constituency, that might be one of the most effective ways of people accessing testing.

It seems increasingly likely that part of what will be required to tackle this virus in the future will be the wearing of masks by members of the public in certain situations. If the Government concludes, based on the scientific advice, that that should be recommended, will it be their policy to provide masks to the public, and if so what is the Secretary of State’s plan to source them, bearing in mind the difficulties with PPE supply? Or will members of the public be expected to source their own?

We will follow the advice and listen to what SAGE says on masks, and then we will implement that. I cannot promise that we will give everybody free masks. That would be an extraordinary undertaking. We have to make sure we have the supplies available, especially for health and care staff, where the scientific advice throughout has been that the wearing of masks is necessary. We have to ensure the provision for them.

I start by paying tribute to the excellent staff at Epsom Hospital for all the work they are doing tackling this dreadful disease. I absolutely agree with the Secretary of State that it should be business as close to usual as possible across the NHS, but of course there are many people working in our healthcare arena—dentists, physiotherapists, and others—for whom it is very much not business as usual. Will he do everything he can, together with other Ministers, to support those people, particularly to get them back working as soon as possible?

Yes, absolutely. It is incredibly important that we support NHS staff to get back to work as much as possible if they are in an area where demand has fallen because people have not been coming forward in the numbers that normally do—for instance, for emergency admission—or in a specialism where work cannot be undertaken because of the prevalence of the virus. My right hon. Friend makes an incredibly important point, and I can give him that assurance.

At present, only patients actually admitted to hospital with symptoms are being swabbed, leaving many with presumed covid being discharged into the community. At the same time, only healthcare workers currently with symptoms are being offered tests. Should not the main priority now be to test all patients and all health and social care workers, whether symptomatic or not, given that after a month of lockdown, hospitals and care homes are likely to be the major transmission hotspots?

We are testing all those who leave hospital for a care home setting, to make sure we control the spread of the disease and stop it moving from that group as much as possible. On the broader points about expansion, absolutely we are looking at these things. The hon. Lady makes some good points.

The Secretary of State is rightly making sure that all patients being discharged from hospital to care homes are being tested, but there remains concern in the care home sector about normal procedures and assessments to make sure that patients or new residents coming to them are appropriate for the care setting, given the emergency admissions that always take place. Before Easter, he kindly agreed to look at whether care homes could be indemnified or have some waiver of liability in these circumstances. I wonder whether he has reached a conclusion.

We are looking into that question and I will write to my hon. Friend as soon as we have an answer.

On contact tracing, I welcome the fact that the Secretary of State is working with experts in digital ethics because if it is not run transparently by a public company with code open to public oversight and data anonymised, people will not trust the system and it risks failing. Does he agree that only a community-led process of human contact tracing can provide the fine-grained and reliable data that such an app would depend on? Will he learn the lesson from the over-centralised organisation of the testing approach and instead adopt a more decentralised approach for contact tracing, using local environmental health officers and PHE’s regional outbreak management teams?

I agree with the first two points, including the importance of people for contact tracing as well as technology—in fact, the two working hand in hand will be the most effective approach. I also agree with the need for ethicists on this. We are all giving up a huge amount of our liberty because of social distancing, so measures to reduce social distancing through the use of data need to be considered in that context. We are making sure that that is done in a way that can provide assurance to people with concerns in that area.

On the final point, we have to make the appropriate use of both national and local resources. In testing, for instance, organising drive-through centres across the country and home testing is inevitably an issue that needs to be done centrally, and then other testing laboratories are organised locally. It is about getting the best of both worlds.

The Secretary of State has talked today about the test, track and trace strategy, and he has indicated that the effectiveness is determined by the incidence in the community. Can he give us guidance on what the incidence level is and when, based on current modelling, we might achieve it?

The current level of incidence is unknown until we expand testing yet further, but it is far higher than where it needs to be. Although, as I have said, we have high confidence that we are at a peak in this disease, obviously we need to see that come down. The reason I am not giving a numerical answer is because it is a question of degree. The fewer new cases, the more effective test, track and trace are as a way of keeping the disease down, and therefore the more social distancing measures can be lifted. This is all a question of degree, and we do not have an answer to the question of when that will all be doable, because we have not yet seen the curve start to come down and we do not know the pace at which the curve will come down under the current social distancing rules.

I have known the Secretary of State ever since he came into Parliament. I know he has been unwell, but he would expect me to be robust in my question. As the Member of Parliament for Huddersfield and from the Yorkshire point of view, I think the management and leadership of the present crisis has been shambolic. We should never have been in a position where we lag so far behind Germany, a similar country to ours, and behind many of the other European nations. We are predicted to be the worst. Eight hundred and twenty-three people died—that is like two jumbo jets crashing. It is a large number. Every time the Secretary of State speaks, he thinks what he is doing is a triumph, but it is a shambles of leadership and management, and we are letting down NHS staff. They have been let down, and I am particularly angry about the fact that—as I understand—the early whistleblowers were leaned on and threatened with disciplinary action to stop brave young doctors and nurses standing up and telling us what it was like on the frontline. Is that the fact? Can he get his act together, because many of us do not believe that he is telling the truth to the people of this country—

The hon. Gentleman has completely missed the tone and the point of what we are trying to do, as a nation, to pull together in this time of grave difficulty. It is absolutely the case that our prime goals at the start of this crisis—our two objectives to flatten the curve and to make sure that the NHS always has the capacity to treat everybody who needs it—have thus far been met. Of course there are challenges. There are enormous challenges—distributing 1 billion pieces of PPE is not straightforward.

On the hon. Gentleman’s point about whistleblowers, he is completely wrong to say that it is not possible to raise an issue in the NHS; by contrast, thousands of people do it in public and private every single day. It saddens me that a Member of this House might get the tone wrong so badly. There are reasonable questions to be asked and we try to answer them in a reasonable way. That is the best way for the House to proceed.

May I put on record my personal thanks to the Secretary of State for his remarkable personal efforts over the past few weeks? He is doing a terrific job in unprecedented circumstances. I welcome what he said earlier about non-covid-19 treatment. Will he set out, as soon as possible, a clear plan to enable elective surgery to take place again in hospitals that have capacity, so that we do not build up a nasty backlog of unmet health need?

Yes; that is an incredibly important issue. We want to get non-covid-19 treatment back up and running as quickly as is safely possible. We are of course putting in place the arrangements to make sure that when people do go into hospital without covid-19, they are not infected by people who are in hospital with covid-19—that segregation is a very important part of our considerations. The answer to my hon. Friend’s question is that yes, within very short order we will start to restart the NHS. He asked about elective operations, which are an important part of the matter, but so too is people presenting themselves. It is important to give people the confidence to call their GP if they have a problem or, if it is urgent, call 111, because with cancer, for instance, we know that early diagnosis is critical, and I want people who think they have a risk to come forward for treatment.

In the statement today, and before the Health and Social Care Committee last week, the Secretary of State has implored cancer patients to come forward and assured them of treatment, yet since that Committee meeting I have been inundated with messages from all over the country from desperate patients whose treatment has been stopped, interrupted or not even started because of covid-19. What is the Secretary of State doing to ensure that there is no gap between his welcome words and what is actually happening? Can he guarantee that treatment will go ahead and give patients confidence that we have covid-free hospitals through the frequent and widespread testing of staff? Finally, will he ensure that death in service benefits will be paid for all healthcare workers who have died of covid-19, both now and retrospectively?

I would like to be absolutely clear—as I was at the Health and Social Care Committee meeting, which was a very good discussion—on the point about cancer treatment. There is some cancer treatment that it is clinically inadvisable to undertake during an epidemic like this, because if somebody’s immune system is taken down to very low levels, that puts them at significant risk, so I cannot give the guarantee that all cancer treatment would go ahead. Even though we now have capacity in the NHS and confidence that that capacity will not be over-capped by the virus, the virus is still at large in the community, so there are some cancer treatments, especially in relation to immunotherapy, that it is clinically inadvisable to undertake now.

Having said all that, yes, we do want people to come forward, and we want as much cancer treatment as possible to go ahead, where it is safe to do so considering the impact of the virus. That is why I want people to come forward if they have a risk, and we will treat them as best as we possibly can within the constraints of the fact that we have a very serious virus stalking the land.

Frontline workers such as those in ITU and care homes are used to death—that is part of the job—but not on this scale and not in these circumstances. What are the Secretary of State and his Department doing to support the mental health of frontline workers now and in the future, when the pandemic passes?

That is an incredibly important question. We have put in place a helpline for all frontline workers in the NHS to ensure that they have the support they need. Working with my hon. Friend and others, I will make sure that that support stays in place long after this crisis is over.

Will the Secretary of State join me in welcoming the extraordinary effort by all those involved in getting NHS Louisa Jordan in Glasgow ready to receive patients, if needed? Will he outline what discussions he has had with his Scottish Government counterpart about the different operating model of NHS Louisa Jordan from NHS Nightingale in London? Will he outline what steps he is taking to address the long-term nursing shortages in England, especially given the flight of nurses from the European Union that reports suggest is impacting on the operation of NHS Nightingale?

I am terribly sorry, I do not recognise those reports at all. There is no impact at all from Brexit on our coronavirus response. The good news is that thousands of nurses and other clinicians have come back into service since the crisis started.

Daniel Falush, a professor of infectious diseases based in Shanghai, points to the fact that part of China’s successful efforts to control the virus was immediate quarantining: people go to a clinic, they are tested immediately, they wait for the results—it is a 15-minute test—and, if the test is positive, they are quarantined there and then. Will the Health Secretary consider that as we open up our economy, because it has the potential for significant mitigation of the chances of a second wave of the virus?

Well, of course we look at all options. Under the test, track and trace strand, the policy advice on how people should isolate if they test positive is an important part of that. That advice is in place, but of course test, track and trace also relies on self-isolation to ensure that it is implemented properly. Test, track and trace is about finding out who needs to take action—they then need to take the action set out.

Thank you, Mr Speaker. On 11 March, I asked the Secretary of State whether it was right to allow more than 3,000 Atlético Madrid fans to travel to Anfield to watch a Champions League game when they could not have watched their team in Madrid, as attending football matches there was banned because it was a covid hotspot. The Liverpool city region now has a higher than average incidence of covid-19 than the UK and English average. The mayor of Madrid and the director of public health for the city of Liverpool have both said that it was a mistake to let the match go ahead. The Government’s deputy chief scientific adviser has said that the idea that there is a link is an “interesting hypothesis”. Does the Secretary of State now admit that the Government were behind the curve in not banning such a gathering, and will he undertake to investigate any possible link between that match and the higher incidence of covid in Liverpool?

This is, of course, a question for the scientists. What matters now is making sure that people—including in Liverpool and across the north-west—get the treatment that they need and that we get the curve under control.

More than two hours having elapsed since the commencement of hybrid scrutiny proceedings, the Speaker brought them to a conclusion (Order, 21 April).

Order. Before suspending the House, I wish to place on record my thanks, and I believe the thanks of the whole House, for the commitment and the ingenuity of all those who have made today’s proceedings possible. I can say that almost everything has gone smoothly, but we will learn lessons as we do this more.

Officially, following the remarks made yesterday in the debate on hybrid proceedings, I wish to explain how I will deal with points of order from Monday. Members must give notice of a point of order to my office before the start of sitting. If I am satisfied that the matter to be raised is a genuine point of order, the Members will not be called to raise it, instead, I will make a statement at the conclusion of scrutiny proceedings, setting out the point of order that the Member has raised and my ruling on it.

I will now suspend the House for 15 minutes to allow Members to leave the Chamber safely and our broadcasting colleagues to make the necessary technical changes to our physical-only proceedings. I thank all who have taken part.

Sitting suspended.

On resuming—