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Covid-19 Update

Volume 675: debated on Tuesday 5 May 2020

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I ask if we can all recognise the loving care by social services staff and NHS staff,  especially those who have to go on hot or cold visits to people’s homes—not only the community nurses, dementia nurses and those who go to people with special needs, but the GPs and paramedics. Will the Secretary of State consider safer ways for those home visits, possibly using some of the offers of London black cabs, which can have a division between the driver and the clinician and also are much easier to clean down when necessary?

Yes, I am happy to look into all different ways of having safe working practices within the NHS and more broadly. Within the NHS, infection control is a critical piece of work. My hon. Friend is right to raise the point that this is a matter not just for acute hospitals—where, of course, it is mission critical—but for all parts of the NHS, including pharmacies, which increasingly have screens to make sure that there is a lower impact of transmission from customers to staff.

At least 140 health and care staff in the UK have lost their lives to covid-19, and we should pay tribute to them, but analysis of more than 100 of those tragic deaths has highlighted that there were not any among staff in critical care units, which are the most dangerous setting. Does the Secretary of State recognise that that shows the effectiveness of full PPE? He claims to always follow scientific advice, but NERVTAG, the new and emerging respiratory virus threats advisory group, advised him last June to add gowns to the stockpile, so why did he not do that? Why did Public Health England produce PPE guidelines for the whole UK that did not recommend gowns for staff looking after covid patients?

We are absolutely guided by the science. It is a very important principle of our overall response, and hence we upgraded the PPE guidelines a few weeks ago to include the use of gowns. The guidance is always looked into as we learn more and more about the virus. The plans that we had were plans not for a particular virus, but for the threat of a pandemic. We have learned more and more about this virus, which is novel and only came into being December last year. Hence, as the science changes, so the scientific advice to Ministers is updated, and Ministers update decisions.

At the start of this pandemic, with no effective drug treatment, the only way to save the lives of coronavirus patients has been to ensure that hospital treatment is available for all who need it, so I thank my right hon. Friend for overseeing such a massive increase in critical care bed capacity. We saw yesterday that the NHS Nightingale in London is not due to take any more patients. While some have oddly criticised that announcement, does my right hon. Friend agree that that should be viewed as nothing other than a success that shows how effective we have been in protecting our NHS?

Yes, I am incredibly proud of the work that was done to put in place the Nightingale hospitals across the country. Most of them were put in place in under two weeks. The London Nightingale, which was open first, is the prime example of the whole team—the NHS, the private sector and the armed forces—all pulling together. It was a great accomplishment, but a greater accomplishment still is that it was never full and that this country has managed to flatten the curve. Now we are able to put it on standby, meaning that it will be physically there in case there is a second spike, but as an insurance policy, rather than as an active hospital. That is a very, very positive step that should be welcomed by all. I tend not to take much notice of some of the noises off, which sometimes criticise me for not having full enough hospitals and sometimes criticise me for not having enough people wanting test capacity. Frankly, we will get the capacity up and then hope we do not use it. That is the attitude we should take to the extra hospitals, and I pay tribute to everybody involved in the project.

We all know the importance of PPE during the outbreak, how difficult it is to get and the great lengths to which the Secretary of State is going to procure it. On weekly calls with New Cross Hospital and the City of Wolverhampton Council, the same point is at the fore- front of our discussions: the consistency of the PPE deliveries. Will my right hon. Friend set out what plans are in place to ensure that what is promised arrives?

My hon. Friend is right to ask that important question. Getting the distribution of PPE to the frontline is critical. It has been a huge operation; the head of the Army has called it the largest logistical operation that this country has seen in 40 years. It is challenging because there is a global shortage of supply. We are working to get that supply as effective as possible. It is undoubtedly improving, but there is an awful lot of work still to do.

Having the national shortage call centre—the phone line that anybody can call if a shortage is coming up—is an important part of the response. So, too, are the automated online deliveries for the smaller settings. But we continue day and night to try to do everything we can to improve the flow of PPE to the frontline.

Disabled people are worried about who is expected to provide PPE for personal carers. Many are finding it difficult to procure appropriate equipment—and when they can, they are finding that prices are inflated. What are the Government doing to ensure that disabled people are not left without adequate equipment, or out of pocket, when attempting to protect themselves and their carers?

The hon. Lady is right that making sure that our whole social care system gets access to PPE is important. There is often a focus on PPE in hospitals and care homes, but on home visits, as she rightly says, access to PPE is also vital.

There has been a global increase in the prices of PPE. The prices that the Government pay for PPE have increased a number of times over the course of this crisis. That is a feature of the global shortage of supply as the demand for PPE across the world has shot up. We are seeing that the world over. What I hope to do is bring on stream more and more domestic manufacturers of PPE, both to ensure that we get the quantity and to see whether we can stop the price rises happening.

Elderly constituents of mine in Wantage and Didcot have been concerned by media reports suggesting that they will be forced to stay in their homes for an extended period. Can my right hon. Friend confirm that that is in fact not the case and that, through all his work on testing and the tracking and tracing app, he is working to make sure that we can all return to a normal life as soon as possible?

I am grateful to my hon. Friend for his question. I would like to take this opportunity to set out the exact policy, which a few media outlets have got wrong in the past few days. We set out from the start, and clearly on the website, that broadly there are three groups of people when it comes to the strictures of the social distancing guidelines. There are people of working age who do not have underlying health conditions, who must follow the social distancing rules. There are those in groups that are, according to the science, more susceptible to this disease, including the over-70s and some with underlying health conditions, who we say are clinically vulnerable and must pay particular attention to the social distancing rules.

Then there is the group who are shielded. These are people with specific underlying health conditions who will have received a letter from the NHS. It is only to this last group that we have said, right from the start of social distancing, that they will need to stay away from people as much as is practically possible for 12 weeks. We know that that is a very significant impact and burden, hence we have written individually to those people; in many cases, they will have specific requirements because of their condition.

It is really important that people understand those three separate groups. I hope that that clears up for the House some of the confusion seen on the front pages of some of the newspapers.

The Sunday Times this week had an extremely moving piece by photographer Stuart Franklin, featuring NHS workers and patients fighting the coronavirus at West Middlesex hospital, which is based in my constituency. The article demonstrated very clearly the emotional impact of the virus on frontline health and care staff as well as patients and their families, and we all know that post-traumatic stress syndrome will be a growing issue for many throughout and after this, so will the Government invest in both immediate and long-term mental health treatment for all those affected, and will they take into account that many, particularly health and care workers, are often reluctant to seek help?

Yes. The hon. Lady makes an incredibly important point, and I agree with every word of the question. We are already investing in more support for the mental health of frontline workers, making sure that resources are available to all. Of course, at the moment there are other challenges to delivering that because of social distancing, but I commit to continuing and strengthening that over the long term. It is something that I have thought important throughout my time as Health Secretary; I pushed this agenda even before coronavirus, and now it is even more important, and I look forward to working with the hon. Lady on it.

Across Watford, as a volunteer, I have seen first-hand the many inspirational frontline workers, ranging from pharmacists to hospital volunteers to GP receptionists to cleaners. Can the Secretary of State confirm that everyone—everyone—on the frontline will have the full support of the Government, so that nobody who works on the frontline is missed out as we continue our incredibly important fight against coronavirus?

Yes, it is a big team effort and all play their part. People have different roles, of course, and people on the frontline have been incredibly flexible in the roles that they play, but all play a critical part and all deserve our support.

In order to test, trace and isolate, to keep people safe and save lives, testing must work properly and be widely and locally available, so I was astonished to hear that yesterday people in my constituency were being sent as far afield as Brighton when we have a testing site right here at the Rugby Football Union in Twickenham. Other key workers tested last week at Twickenham have had their tests lost and no one in the NHS can find them, and we are also hearing reports that people sent home testing kits have no return address to send their completed tests to, yet those tests are being counted. Will the Secretary of State please confirm how people are being prioritised for testing at their local sites, how many tests have been lost—both at drive-through sites and among those sent to people’s homes—and when he thinks we will be doing enough testing to actually move to test, trace and isolate to keep people safe, as so many other countries have been successfully doing for several weeks now?

We now have one of the largest testing capabilities in the world; we are testing more people per day than Germany, and the whole country should be reassured by that fact. Of course there are individual examples of where the logistics go wrong; that is natural in any very large system. I would be very interested if the hon. Lady could send me the details of those specifics, and then we will look into them. But what I would say is that the availability of testing across the board is now huge. It is big enough to start the test, trace and track programme. We are piloting that, as the hon. Lady knows, in the Isle of Wight from today and then we will roll it out across the country.

In an earlier answer, the Secretary of State kindly went through the definitions of all the different vulnerable groups. Definitions are really important, especially as we start to consider releasing the lockdown. When that point comes, will he be crystal clear about exactly who is entitled to do what and when and ensure that everyone in the public knows that?

Can the Secretary of State confirm that directors of public health and environmental health officers will not just be consulted but will be leading the delivery of community tracking and tracing efforts, given that that is what they have been trained to do? Can he reassure us that the Government will not repeat the mistakes they have made with drive-through testing centres and PPE supplies by outsourcing those critical tasks to private companies such as Serco, Sodexo and Deloitte, which, frankly, have proved that they are not up to the job?

I agree with the hon. Lady on the first part of her question, but she is completely wrong on the second part. In the first part, she asked whether local public health officers and environmental health officers will be a critical part of test, track and trace, and the answer is yes, they will be vital. On the second part, she is completely wrong. There is no way that we could have delivered the testing programme without the unbelievable support, help and effort of private partners in the diagnostics industry and in delivery—companies such as Deloitte and Boots, which delivered that amazing expansion of the drive-through centres in such a short period. I pay tribute, hand on heart, to the work of every single person in that programme, whether they work in the private sector or the public sector—whether they work in the NHS, in the Department, for Boots or for Deloitte. Frankly, to try to divide people in that way suggests that she has missed the tone of where the country is right now.

In order to get London back to work, we need safer public transport. Does my right hon. Friend agree that the Mayor of London needs to provide more tube trains, to provide a safer service for Londoners?

Yes, I do, because the more people are spaced out on public transport in terms of the distance between them, the safer that public transport will be. I hope that the Mayor of London is working extremely hard to have as full a service as possible, so that as few people as possible can be on each individual service.

Widespread testing and contact tracing will be essential to contain future outbreaks, and such a system will need to be operational before we move from full lockdown. In addition to the Isle of Wight trial, will the Secretary of State consider the work being undertaken by Ceredigion County Council, in collaboration with Hywel Dda University Health Board and Aberystwyth University, on a community testing and contact tracing system that could offer local solutions and expertise to complement any UK-wide infrastructure?

I am happy to look at any examples that are effective in reducing the spread of the virus. Of course, parts of this are devolved, and parts of it are the UK Government’s responsibility. We have made available all the tools that we are developing at a UK level for devolved Governments to pick up. For instance, we have published the underlying source code behind the apps, so that people can have a look at it and suggest improvements or take it and use it in their own way.

Many of my constituents with cancer understood when their treatment was deferred. They are now keen to resume it but nervous about going to hospital, in case they catch coronavirus. Can my right hon. Friend assure them that their treatments will resume and that it is safe for them to go to hospital?

Yes. I want cancer treatments to resume as soon as is safely possible. In some cases, it is clinically not advised to resume treatment because there is a spread of the virus in the community—for instance, treatments that reduce immunity to very low levels. There are other areas—for instance, some surgery—where we are able to restart. This is a very important part of the restart of the NHS. The message I would give to my hon. Friend’s constituents is: if you are advised by your doctor to go to hospital, you should go to hospital, because they will have taken into account all the different risks and decided that that is the best advice to give. So if you are asked to go to hospital by your clinician, please do go.

The Government chief scientific adviser said that if we could keep deaths below 20,000, we would have done well in this epidemic, yet the death toll now stands at a devastating 32,313. It is not about whether we can use international comparisons; this is the Government’s own measure, so many are wondering how the Government can claim that their approach so far is a success. Is that not an insult to every family member who has lost a loved one, and does it not undermine public confidence that the Government are learning from their mistakes?

We are absolutely learning from everything that has happened, and constantly looking again, trying to make sure from the time we get up in the morning to the time we go to bed at night that we have the best possible response. That includes, for example, working across parties where cross-party work can help, as we have on the test, track and trace pilot on the Isle of Wight. That is the approach that we constantly take. Of course we look at all the information and the data, but in that spirit the hon. Lady should acknowledge, I think, that the approach is a success: the curve is flattened and is now coming down, and—critically—the NHS was at no point overwhelmed. That was one of our priority goals right at the start, and it has been achieved at every point so far in this crisis. Of course there are always things we can improve, but I think we should also, rightly, study the things that have gone well.

Will my right hon. Friend confirm that, thanks to the magnificent response of the British people, including those in Stoke-on-Trent, we have prevented our NHS from being overwhelmed at any point during this crisis, so that it has been able to offer world-leading care to every single person who has needed it since the very first case?

Yes. This comes off the back of the previous question. Not more than a few weeks ago, many people were saying that we would not be able to get through this crisis without the NHS being overtopped and not having enough capacity to deal with the number of cases. Through a combination of the expansion of the NHS that we have overseen and the public doing their bit by following the social distancing rules, we have managed to avoid that outcome. Instead, at every point in the crisis, the NHS has been there to provide the care that is needed as much as it possibly can, as well as it possibly can, and it has not been overwhelmed. That is something that this country can always look back on.

My inbox has been packed for days with questions from over-70-year-olds saying that they simply do not understand what the Government advice is. Is it that none of them should ever, whatever their medical circumstances and however healthy they are, leave the house for 12 weeks? When did the 12 weeks begin and when will the 12 weeks end, or is there going to be another 12 weeks? Further to that, I asked the Secretary of State on 3 February whether face masks worked, and at that time he was very sceptical about them. In the future, will he be advising people that we should all be wearing face masks on public transport, and if so, where are we going to get them?

I reiterate the point I made in response to earlier questions. I hope that in his response to all his constituents, the hon. Gentleman will send a link to the NHS website, where the answer to his question was set out extremely clearly right from the start. It is very clear that there are three groups of people. Those who have received a letter from the NHS saying that they must shield for 12 weeks are in that category; those who have not are not. I know that some media reports have stated otherwise, but I implore people to follow the guidance clearly set out on the NHS website, which the hon. Gentleman and any other Member who has questions about that should send to their constituents to inform them. It is a matter of our public duty. It is not a matter of political debate.

Getting new Government guidance to the visually impaired is of course a challenge. It is something we have been working hard on. In the first instance, the first port of call should be primary care—somebody’s GP or 111—if there are any queries. That is where I would point people in the first instance. It has been a challenge, because we have been making policy at speed, and writing and updating guidance at speed, but I would point those who are visually impaired to 111 and their GP if they have any questions.

The Trace Together app in Singapore has been down- loaded by 17% of its population since it was introduced in March. What estimate has the Secretary of State made of the numbers that will be required to download the NHS app, and have there been discussions about making it compulsory if not enough people do so?

The more people download the app the better it will be and the more effective it will be in keeping people safe. However, even small numbers downloading it will help us to spot hotspots and so will bring some value. I was really delighted yesterday afternoon to hear from Isle of Wight Radio, which stated that 80% of people on the Isle of Wight in an early survey said that they wanted to download the app. That would be a terrific result. I pay tribute to the work of Isle of Wight Radio and the local press on the Isle of Wight, who have taken to Isle of Wight’s important role in piloting this roll-out with enthusiasm. There is no numerical answer to the hon. Gentleman’s question. The answer is that as many as possible will make us as safe as possible.

I welcome the launch of the test, track and trace app, but one of the apparent challenges is that those who could benefit from it the most, namely the elderly, may be those who are least likely to be able to access it because they do not have a smart phone. What assessment has my right hon. Friend made of the probable lower take-up by that honourable cohort?

We have looked into this very important question. Of course, test, track and trace is a system. The app is one part of it, but the human contact traces are an important part of the system, as is the advice we give to people to contact their own significant contacts themselves. The whole system has been designed in the knowledge that a proportion of the population does not have a smart phone. There are many older people who do have smart phones. I am sure, for instance, that the shadow Secretary of State is probably sending a message to his parents right now on the smart phone he is using instead of listening to my hon. Friend’s question.

There is a serious point, which is that of course we have had to take that into account. It is another reason why the Isle of Wight is such a good place to trial it, because there are elderly residents on the Isle of Wight. We will work out and learn a lot from how effective that trial is.

It has become apparent that people from black, Asian and minority ethnic backgrounds are being disproportionately affected by covid-19. People in Erith and Thamesmead have also raised concerns about the disproportionate effects of covid-19 on disabled people, people from low socioeconomic backgrounds, women and children. Does the Secretary of State have plans to publish a report on the effects of covid-19 on people who fall under one or more protected characteristics?

Yes, we have today launched a piece of work by Public Health England to look into the disparities in the impact of covid-19. However, I will just pick the hon. Lady up on a couple of points from her question. The evidence shows quite clearly that the impact of covid-19 is lesser on children and lesser on women than it is on men. There is also growing evidence that obesity has a big impact. We have to look into all those considerations. We will listen to the scientists and the medics, and learn whatever lessons we can.

I thank my right hon. Friend for his answers and congratulate him and all the hardworking staff in the NHS, and carers, on looking after us. Will he support my campaign to have a memorial placed at the National Arboretum at the heart of the country as a fitting way to commemorate the sad loss of essential workers to covid-19?

Yes, I would be very happy to discuss that suggestion with my hon. Friend. It is important that, as a nation, we remember and commemorate the sacrifice of those who have lost their lives while serving on the frontline of this war; it is a war in which we are all on the same side, and we should commemorate those who have given their lives in it.

The seven-day average number of new cases in the UK has now levelled out at 4,500, but it is not yet decreasing significantly. Can the Health Secretary tell us what the number of new daily cases must fall to before he believes that test, track and trace can prevent another peak if restrictions are eased?

One of the five tests that we have set out before the restrictions are eased is that the number of deaths should be falling consistently. Indeed, the Scottish Government’s document includes a similar proposal, and we are working to ensure that the UK is as aligned as possible.

Does the Secretary of State agree with you, Mr Speaker, that changes to lockdown should be announced to Parliament first? He said earlier that transparency was the lodestar of Government policy. If that is correct, will he now release the findings of Exercise Cygnus and prove that that was not just a gesture, but is actually the real policy of the Government?

Exercise Cygnus was undertaken under my predecessor, and there are specific rules in Government around decisions over papers that were produced before one’s time. I will take away that point.

There is some evidence that under-10s are at much lower risk of getting and transmitting the virus. If true, this would be a huge comfort, both to teachers and to working parents. What evidence has the Secretary of State seen to that effect, and what work is being done to further explore this?

There is strong evidence that the under-10s are less likely to have symptoms of coronavirus, but unfortunately the evidence on the under-10s’ transmission of coronavirus is mixed and there is not a conclusive scientific base on that yet.

Is the Secretary of State content that the advice and guidance given to pregnant women working on the front- line of health and social care, on both safety and income, are sufficiently clear and consistent?

I congratulate my right hon. Friend on the fruits of his tireless work, along with officials and others in the Government, including delivering mobile testing in Wycombe, but could he please tell us a little bit more about what he is doing to restore the full range and scale of elective surgery in the NHS, so that people with non-covid conditions can get their treatment back on track?

That is a really important point. It is critical, because the overall impact of coronavirus is not just the direct morbidity—the number of people who sadly die from coronavirus itself; there is also the wider impact, including those whose treatment has been delayed owing to the necessity of ensuring that the NHS was ready to cope with coronavirus, or because, for clinical reasons, it was important to delay the treatment because there is such a virulent virus at large. We are working very hard to restore treatments for non-covid reasons. That work has started. I was able to announce last week, for instance, that fertility treatment has restarted and cancer treatment is restarting, and other elective surgeries will restart as soon as it is safe to do so.

I am in Orkney, where I have been receiving reports from category 2 key workers who have self-referred for a covid test through the website and been directed to testing centres in Thurso, Elgin or even Peterhead, all of which would require a journey by ferry or plane. There is local provision and the option of postal testing, so will we get the website sorted, to allow people to get the information they need, rather than be left thinking that in order to get a test they first need to get a plane or a ferry?

I am glad that we sorted the broad- band to Orkney, so that we could take the question. It is an important question and I will look into the specifics of it to make sure that our island communities get the appropriate response on the website. The right hon. Gentleman will appreciate that we put the testing website together at remarkable pace and so in the first iteration we were not able to address this sort of important nuance for Orkney and other island communities, but I will take that away and look at it. He mentioned the answer in substance—to get the home testing kits working for Orkney—and I am sure that there is a way through.

The Royal Surrey County Hospital in Guildford, under excellent leadership and in partnership with our community, has proved to be resourceful and innovative, ensuring best practice on patient care, safety for staff and the ability to continue treatment for patients presenting with non-covid-19 needs—feedback from those patients has been very positive. Will my right hon. Friend join me in paying tribute to our NHS leaders, and once again encourage those who need hospital appointments and urgent care to attend? Finally, will he give assurances that hospitals such as my local one, which are world-leading in cancer treatment, will be given the investment they need to ramp up diagnostics going forward?

Yes, absolutely. I think we have all learned the importance of diagnostics during this crisis, if we did not know it already. I pay tribute to the Royal Surrey County Hospital, its leadership and the staff there, who have done such a magnificent job, including treating friends of mine for coronavirus. If anybody in Surrey gets a message from their doctor saying that they need to go to hospital, they must go. That is important right across the country—in Guildford and beyond.

We still need to increase significantly the number of people being tested so that we can tackle the crisis. Companies such as Curative are supplying tens of thousands of saliva-only tests to the US military, but have faced road blocks in trying to supply in the UK. What is the Secretary of State going to do differently to improve the procurement of tests, so that companies that want to help can do so?

We are working with many, many companies on the expansion of testing, including new technologies. We have to be confident that the technologies are effective and work, because a test that gives a wrong result, and has too high a proportion of wrong results, can be worse than not having a test at all. I am not saying that that is the case in the specific individual example the hon. Gentleman gives—we are working with many companies on how the next generation of tests can be brought to bear—but it is important that we get this right as we ramp up testing. There is clearly a pressure to increase testing. Lyndon Johnson once said, “Politics is about ‘What have you done for me recently?’” It was only last Thursday that we hit the 100,000 target. I do not mind being urged to do yet more, but we have to do it using the right tests, in the right way.

What prospect is there of moving to robust, multi-use personal protection equipment that can stand being decontaminated many times?

My right hon. Friend, who probably has the most spectacular backdrop of any questioner in this session, is right to raise that issue. It is happening: the right personal protection equipment that can safely be decontaminated and reused is being decontaminated and reused. That is an important part of the solution to the challenge of getting the right PPE to the right people, right across the board. It does not work in all instances and first and foremost it has to be safe, but it is a part of the solution and my right hon. Friend is right to raise it.

The British Medical Association, the Faculty of Public Health and the Royal College of Physicians have all advised the Government to suspend the fees for migrants accessing the NHS during the coronavirus pandemic, to ensure universal access to healthcare. We know that the charging regulations disproportionately affect black and minority ethnic people; given the impact of covid-19 on the wider BME community, will the Secretary of State now suspend the charging regulations?

The regulations are important because it is important that people make a fair contribution. The question has been raised in relation to staff in the NHS, and in many cases in that respect the NHS trusts themselves pay the extra, which is a contribution towards the running of the NHS. That is the approach we are taking.

The Secretary of State is aware of my concerns about the discharge from hospital into care homes of patients with covid symptoms. Can he reassure the House that there will not be such discharges—that covid-positive patients will not be discharged into covid-free care homes because of the risks that they might spread the infection to other residents?

My right hon. Friend and I have been in discussions about this important issue. We have strengthened the rules on discharges to ensure that anybody being discharged from hospital into a care home gets tested and is then isolated ahead of the result of that test. If the test is negative, they can of course go into the home in the normal way; if the test is positive, that isolation must continue until they are through the virus and safe to go into the care home without taking coronavirus into the care home. I am glad to see in the latest numbers that the number of those who are dying from coronavirus in care homes is just starting to fall, but there is an awful lot more that we still need to do.

The Secretary of State said earlier that the tracing app would have privacy by design. It will be critical that there is a high degree of public confidence in the app if it is to work as he intends as part of efforts to trace the virus. What data protection will be put into place to ensure that the public are confident that this tool will be secure and that data cannot be misused?

The public can have confidence, not least because the data will be held on people’s own phones until they need to contact the NHS when, naturally, they will of course need to tell the NHS their identity in order to be tested. In that sense, privacy is there by design.

The wider point is that the app and the test, track and trace system will help to keep people safe. As I said yesterday when I launched the pilot in the Isle of Wight, people should download the app to protect the NHS and save lives. It is the civic duty of people on the Isle of Wight to do so, and it will be the civic duty of people throughout the country to do so. It has been designed with privacy at its heart. We are putting the source code on the internet so that people can see exactly what the app does. That reassurance, along with the motivation that they are helping to protect themselves and their community, will, I hope, lead to an awful lot of people downloading the app. I certainly will.

Mr Speaker, further to your opening remarks at the beginning of this urgent question about new policy being announced by Government in the House and not to the media first, the Secretary of State sidestepped the question when it was put to him by my hon. Friend the Member for Christchurch (Sir Christopher Chope), so I will try again. Does my right hon. Friend agree with Mr Speaker that statements of new Government policy should be made in this House first, and will he advise the Government to put off making the statement on Sunday until Monday and make a statement in the House?

The exact scheduling of any announcement is, of course, a matter that has to be considered across Government, but I will take away my hon. Friend’s concerns and ensure that they are looked into.

In better times, tens of thousands of people cross the land border in Ireland every day and, more generally, the UK and Ireland are committed to the common travel area. With regard to contact tracing apps, does the Secretary of State recognise the difficulties that will arise if the UK, including Northern Ireland, and Ireland use different systems, and will he undertake to work with the Irish Government to address any such operational issues?

We have considered all the different potential apps being used by different countries around the world. I am confident that any such concerns about international travel can easily be addressed, not least by the potential of someone having two different apps on their phone if they need to travel internationally.

My right hon. Friend has proved himself to be a brilliant multi-tasker, so will he kindly turn some of his attention to a firm in my constituency that has access to a network of manufacturers in southern China that believes it can supply a million items of gowns, visors, masks and other PPE equipment per week if only someone from the Government would get in touch? I am very happy to text him the details directly, but I have been trying for three weeks and still the Government have not got in touch with this firm.

Yes, of course; if I get the details, I am very happy to do that. I would also be very happy to know where my right hon. Friend had his hair cut, because it is extraordinary. No one else has such smart hair. Everyone is looking increasingly bushy.

Dozens of dentists have got in touch with me, saying that the measures put in place are not protecting them and their practices. They take on a combination of private and NHS patients. Many are fearing bankruptcy and, ultimately, closure. This will leave NHS dentistry in an existential crisis. What steps is the Secretary of State taking to ensure that NHS dentistry survives the current crisis?

This is an incredibly important question. My hon. Friend the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), who is responsible for dentistry, is working very hard with the British Dental Association and others to make sure that dentists get the support that they need.

Further to that question on dentistry, I have spoken to local dentists in my area and a number feel that they have the correct PPE and working conditions to be able to provide the sort of emergency dental care that many of their patients need. Can my right hon. Friend outline how we can move forward with dental practices in the same way as he has worked so hard in moving forward with the work that hospitals are able to do now, for which I would like to reiterate my thanks?

This is a really important point. I will write to my right hon. Friend with the proposed plans for reopening dentistry. Obviously, that has to be done in a safe way, and PPE is one important consideration. Dentistry by its nature requires close contact, and it can be an aerosol-generating procedure in certain circumstances, which makes it a higher risk to the dental practitioner—the dentist or nurse—and, in turn, to future patients, so we have to get this right. Emergency dentistry is available in dentistry hubs, which have been set up during the crisis. It is important to get this right, but it is also important to get dentistry back on its feet.

Thank you, Mr Speaker, and well done getting so far through the call list.

Progress notwithstanding, we are very much not out of the woods yet. Worryingly, the head of the European Centre for Disease Prevention and Control has confirmed that the UK is among five European countries not making substantial progress on cutting the overall rate of infections. Is the Secretary of State concerned by that analysis? Can he reassure the House that we will take account of the European centre’s data in any calculation about resuming normal activities and easing lockdown?

I have not seen the particular report that the hon. Gentleman refers to, but we take into account all data and considerations in making the decisions that we do.

I have a local care home that, thankfully, is free from covid-19 at the moment. The manager there is trying to get all his staff tested, just to check that they are free from covid-19 too. Not all those staff have a car, so they are not able to travel the miles to the local mobile testing facility. Can the Secretary of State tell me the best way for that manager to get his staff tested so that they can continue to look after all their vulnerable residents in a safe way?

Yes, we are rolling out testing to all residents and staff, symptomatic or asymptomatic, in elderly care homes. I announced that at the start of this urgent question. It is an important expansion of our testing now that we have built up the 100,000 tests a day capability. We will do that in part through mobile testing units, which are delivered by the armed forces; the testing unit goes to the care home, and staff and residents alike can be tested at the care home rather than having to travel. Clearly, whether people have a car of their own or not, when we test a whole care home, taking the testing to the care home rather than having to take everybody from the care home to a drive-through centre is a much better way of doing it.

I am very grateful to the armed forces for the part they have played in making this capability available. Our armed forces have done an amazing job in this whole crisis. Right across the board, the armed forces have stepped up where we have needed them. They have played a critical part in testing capability; we would not have got to 100,000 tests a day without them. The example that my hon. Friend rightly raises is just one of the ways in which our armed forces are playing their part and doing their duty in this crisis.

I am grateful, Mr Speaker. The Health Secretary told me that he would make public the evidence behind the Government’s repeatedly confirmed decision, in contrast with other countries, not to ask people arriving at our ports and airports to self-isolate. However, that evidence was not included in the Scientific Advisory Group for Emergencies papers published today, even though the papers say we were affected by many cases arriving or coming back from Italy and Spain. Surely we need to see the evidence and scrutinise it in order to get border policy right. Why has it been withheld?

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

Sitting suspended.

On resuming, the House entered into hybrid substantive proceedings (Order, 22 April).

[NB: [V] denotes a Member contributing virtually.]

Business of the House (5 May)

Motion made,


(1) The following arrangements shall apply to today’s business:



Remote division designation

Local Government: motion to approve the draft Greater Manchester Combined Authority (Fire and Rescue Functions) (Amendment) Order 2020

Up to 90 minutes


Social Security: motion to approve the Employment Allowance (Increase of Maximum Amount) Regulations 2020

Up to 90 minutes


(2) At the conclusion of each debate, the Speaker shall put the Question on each of the motions on the Order Paper relating to the business listed in the table for that debate.—(James Morris.)

The Deputy Speaker declared the Question to be agreed to (Order (4), 22 April).