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Covid-19: R Rate and Lockdown Measures

Volume 677: debated on Monday 8 June 2020

(Urgent Question): To ask the Secretary of State for Health and Social Care to make a statement on the R value and lockdown.

Thank you, Mr Speaker, for this opportunity to update the House on progress on our plans for controlling coronavirus.

Thanks to the immense national effort on social distancing, as a country we have made real progress in reducing the number of new infections. As we move out of lockdown, we look at all indicators to assess progress in tackling the virus. Last week’s Office for National Statistics infection survey estimated that the number of people who have had coronavirus in England fell from 139,000 between 3 and 16 May to 53,000 between 17 and 30 May—a drop of over half. In terms of new cases, an ONS estimate released on Friday shows that there are now around 5,600 new cases each day within the community in England: a huge drop since the peak.

The number of new fatalities each day is, thankfully, falling too. Today’s figures record 55 fatalities, the lowest number since 21 March, before lockdown began. They also show that there were no deaths recorded in London hospitals. That is a real milestone for the capital, which, of course, in the early stages of the pandemic, faced the biggest peak. Yesterday, we saw no recorded deaths in Scotland, which is very positive news for us all. Sadly, we expect more fatalities in the future, not least because the figures recorded at the weekend are typically lower. What is more, Mr Speaker, 55 deaths is still 55 too many and hundreds of people are still fighting for their lives. Each death brings just as much sadness as when the figure was much higher in the peak. I know that the thoughts of the whole House are with those families and communities who are grieving for their loved ones.

We, of course, also look at the R rate. The Scientific Advisory Group for Emergencies confirmed on Friday that its estimates, taking into account 10 different models, are that R remains between 0.7 to 0.9, and that it is below 1 in every region of the country. That means the number of new infections is expected to continue to fall. So there are encouraging trends on all critical measures. Coronavirus is in retreat across the land. Our plan is working and those downward trends mean that we can proceed with our plans, but we do so putting caution and safety first.

Even at the peak of the pandemic, we protected the NHS and ensured that it was not overwhelmed. We will not allow a second peak that overwhelms the NHS. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on the virus in our communities, aided by our new NHS test and trace system, which is growing every day. We are bearing down on infections in our hospitals, including through the new measures to tackle nosocomial infection, such as face masks for visitors, patients and staff. Finally, we are strengthening protections for our care homes, including by getting tests to all elderly care home residents and staff.

I am glad to be able to tell the House that David Pearson, the eminent social care expert who has previously led the social care body ADASS—the Association of Directors of Adult Social Services—and has decades of experience of leadership in both social care and public health, will be chairing our new social care taskforce to drive our covid action plan yet further. David has an impressive track record and I am delighted that he will be supporting us in leading this important work. Together, we are getting this virus under control and now more than ever we must not lose our resolve.

I note what has just been said about the social care taskforce, but may I say that it probably should have been set up some months ago? The Government are easing restrictions, but even when looking at their own tests we know that PPE supplies are still not secured—dentists are warning about PPE today; that tracing is still not fully operational—the chief operating officer of test and trace has warned that it will not be fully operational until September; that testing is still not sufficient—we are still not routinely testing all NHS staff, whether asymptomatic or not, even though we know that such testing will arrest the spread of the virus in hospitals; and that the R value, according to the PHE Cambridge model, is close to 1 in many regions and is at or above 1 in the north-west and the south-west. The modellers of that model warn that that may result in the

“the decline in the national death rate being arrested by mid-June.”

The British people have shown great resilience and fortitude in observing this lockdown and helping to slow the spread of this deadly, horrific virus, but we have still had more than 40,000 deaths. As the Secretary of State said, infections are still running at more than 5,000 a day. We should proceed with caution, but many now fear that the Prime Minister is starting to throw caution to the wind. I therefore wish to put some specific requests to the Secretary of State: will he agree to start publishing, on a weekly basis, the regional R value estimate, alongside the national estimates? Does he agree that the voices of regions must be heard in future decisions about lockdown? Will he start including the various metro Mayors, such as Andy Burnham, in the covid Cobra meetings? Will the Secretary of State ensure, this week, that local authorities and general practitioners start receiving specific data about who has tested positive so that they can start putting in place area-based responses? Will he issue, this week, written guidance on defining what a “local lockdown” is, how it will be enforced and what resources and powers local authorities and agencies will be able to draw upon?

Finally, we know that the more deprived an area is, the higher the covid mortality level. There are pockets of deep deprivation in the north-west and in the south-west, such as in parts of Cornwall. What financial support will be given to those who are asked to isolate? Given that we also know that black, Asian and minority ethnic people are more at risk from covid, will he now publish the PHE report on disparities in full—all the chapters, all the analysis, all the recommendations—because action to protect BAME people, especially BAME health and care staff, must be an urgent priority?

Let me make a couple of points in response. First, we have turned around an incredibly difficult situation when the demand for PPE shot up. Thanks to the incredible work of Lord Deighton, we now have good PPE supplies to all sectors. We are working with the dentists to ensure that they, too, will be able to get the PPE they need. The hon. Gentleman talks about testing, but he omitted to mention that we have hit every goal on our testing expansion, and we now have capacity for more than 200,000 tests a day and last week we were achieving that level of testing, which is a testament to the work of so many people, in companies and in the public sector, who have done an incredible piece of work on testing.

He picked on the results of one particular model that we look at, but he surely understands that actually the way to get the best advice is to look at all the different models, rather than just one. I mentioned one other survey, which is based on data rather than modelling—the ONS survey—and I also told him already the SAGE view, taking into account all the evidence, which is that R is below one in each region.

As the hon. Gentleman said, we do publish R. He is quite right about the importance of working with local authorities and local leaders. I spoke to the Mayor of Greater Manchester on Friday about the higher rate of R in the north-west, albeit that it is assessed to be below one. Local leaders are incredibly important in the local action that we will be taking.

The hon. Gentleman asked about local authorities and GPs getting access to data. We are working with them on the appropriate data that should flow to local authorities and GPs. He asked, rightly, for guidance on how local action will work, and that is an important early piece of work for the JBC—the joint biosecurity centre. I am glad he has recognised the importance of the work that Public Health England has done and published on the disparities between people of different ethnic backgrounds and also other differences, for instance the fact that older people are much more likely to die from covid-19. It is very important that we base our response on all this evidence.

The Prime Minister’s testing turnaround target does not apply to postal tests. Given that the majority of infections can happen less than a week after the person who gives someone the virus develops symptoms, will the Secretary of State consider replacing postal testing with same-day delivery and collection of testing? If it is good enough for Amazon Prime, it should be good enough for NHS test and trace.

My right hon. Friend is right to raise this matter, because testing turnaround speeds are very important, and they are improving. The answer is that we are intending increasingly to use the routes that have a 24-hour turnaround for the symptomatic testing, which needs that rapid response, and to use the routes that have a slower turnaround for asymptomatic testing, where the timing of the test is less important. That is the direction of travel, and we intend to solve the problem that he rightly highlights in that way.

We now head north of the border to Dr Philippa Whitford, the SNP spokesperson, who has one minute.

The R number is close to one across England and may even be above that in some areas. As the R number reflects lockdown changes made a couple of weeks ago, does the Secretary of State not accept the need to assess the impact of sending people back to work and school before making further changes to lockdown?

With Serco admitting that its tracing system will not be fully operational until September, would the Secretary of State not have been better investing in public health systems instead of a private company with no expertise? Why are the test results from the commercial labs still not being sent to local GPs and public health teams to allow contact tracing? Finally, we all recognise the economic impact of lockdown, but does he not accept that the worst thing for the economy would be a second wave needing a second lockdown?

As a clinician, the hon. Lady will recognise that taking into account all the evidence of the rate of transmission is incredibly important, and I think that it is an error and it is wrong and it is beneath the normal standards of her questioning to focus on just one report, rather than on all the reports. I hope that when she speaks to people in Scotland and across the whole country, she will take into account all the evidence, rather than just focus on one report. I urge her to do that, because it is important for the public communications.

The other point I would make is that the NHS test and trace programme is being built at incredible pace. The Prime Minister committed that we would get it up and running for 1 June, and we have delivered that, and that it will be world class, and we will deliver that, but we could not deliver it without the public and private sectors working together. I think the divisiveness that comes through from the other side is a real mistake in these difficult times. Instead, everybody should be working together.

Parents in my constituency have been in touch overnight to say how disappointed they were by a decision taken by local councillors yesterday afternoon not to open primary schools today. Does the Secretary of State agree that local authorities need to look at a number of local factors, not just regional R data for a wider area, when taking important decisions on getting our children back to school?

I do, absolutely. It is particularly a mistake to look at just one model rather than the overall assessment of R in each part of the country, which is assessed to be below 1 in each area. With the number of new infections coming down, we can take the plan forward, as we ought to, because the education of children matters, as well, of course, as controlling the virus.

The Government have repeatedly said that lockdown will be eased only when the R rate is below 1 and the threat level is coming down. The threat level is still at 4, and as the right hon. Gentleman has said, in the north-west there are some calculations of R that have it above 1. Many of my constituents are really worried about this, yet the Government are accelerating plans to end the lockdown more quickly than they announced they would. Why?

We are continuing with the plan that we have, which is cautious, takes a safety-first approach and is based on all the information, not just, as the hon. Lady rightly pointed out, just one part of it. We said we would take the next steps when the five tests have been met, and they have been met. R is below 1, and the other four tests have also been met, which is why we are able to proceed. The evidence that we are increasingly seeing of the number of new cases and, thankfully, fatalities coming down is good news that demonstrates that the plan is working.

We are all so grateful to our NHS and careworkers. So many people have made so many difficult sacrifices during this period of lockdown. They are furious to see the lack of social distancing in some of the protests that took place over the weekend and want to know what impact that might have had on the reproduction rate of the virus.

I thank my hon. Friend for that question. It is incredibly important that people follow the social distancing rules. Where the demonstrations that we saw over the weekend did not follow the social distancing rules, they risk increasing the spread of the virus. That is the clear scientific evidence. It is a mistake for people to participate in demonstrations that help to spread this vile disease. Instead, we should all be doing our bit to reduce the spread.

With the R number above 1 in the north-west in one model, we need action to prevent a second wave of infections and deaths. The Secretary of State has talked about local lockdowns, but will he commit to ensuring that Public Health England supplies more local information on the spread of the virus to assist in that? Will he also tell us whether there will be additional powers and financial support for areas covered by a local lockdown, as called for yesterday by our Greater Manchester Mayor, Andy Burnham?

Yes, we hope very much to be able to publish more and more granular, localised information and to work with local leaders to deliver on what is needed to act upon it.

Given the Secretary of State’s great success in expanding the number of tests, will we soon have more precise and accurate R figures, along with the other information now accumulated, and is there not a danger, in interpreting back trends, that they are unreliable because of differential test rates?

The answer is yes and yes. Survey testing is the most reliable way of assessing the prevalence of the disease and its downward trajectory, because it takes into account a randomised approach to working out where the disease is—much like the opinion polls that we are familiar with in this House—because as testing has gone up, inevitably more cases have been found. It is a good thing that more cases have been found, but we need to know the prevalence, which is best done by surveys.

The Secretary of State has just spoken about the importance of people following the rules, but it is clear that Dominic Cummings’s rule-breaking trip across England has undermined the little confidence that there was in the UK Government’s public health messaging. Does the Secretary of State appreciate the harm that has been done by the outrageous spin and shape-shifting on this issue, and what will he do to repair the damage?

No, I do not think that has anything to do with it. The most important thing is that people follow the social distancing rules, and that should apply even if they have a strong and heartfelt case to make in a public discussion, such as at the weekend.

The success of the Government’s strategy rests, to an enormous extent, on public support and consent for the lockdown measures. What advice is the Secretary of State receiving from his behavioural experts on the viability and sustainability of localised lockdowns? It is a challenging thing to set the country on a path to easing restrictions, but then to dial it back again.

Of course it is important to ensure that people are fully informed about the reasons why we may need to take action in a particular local area, and that is an important part of the consideration. Ensuring that local bodies—for instance local directors of public health—are fully engaged, is an important way of doing that. In Wales, where my right hon. Friend has his constituency, that is done through the devolved nations, with their responsibilities locally for public health.

The R number is one indicator of infection, but it is only reliable at regional level. Currently, directors of public health tell me that they receive only high-level reports, and that they need more localised information, with data that relate to the number and location of cases, and state when infection occurred. That information is vital to stopping transmission, especially as restrictions are lifted. By what date will that information be made available to local authorities, so as to inform their local outbreak plans?

Many of my constituents are now sending their children back to school and will soon be returning to work in sectors such as retail. They want confidence that in doing so, they are doing the right thing for their families. Will my right hon. Friend assure my constituents that each step the Government take is based on the advice and on science?

Absolutely. Throughout this period we have based our decisions on the science and scientific advice, taking into account all considerations. Scientific advice, for instance from SAGE, is so important, and it is critical that we take into account all the science. That is why it is a mistake for people to pick on one report and focus on that, as opposed to considering all the science in the round.

People living in residential care homes who receive support for learning and other disabilities are at high risk of catching covid. It is good to know that in Hounslow, those living in residential care have not yet contracted covid, but unlike those in settings for older people, they cannot access testing kits. When will the Government ensure that all residential care settings, including those for under-65-year-olds, are able to access testing?

The hon. Lady is right to ask that question. On the clinical advice, and indeed the scientific advice that we were just discussing, we introduced whole-home testing for residents and staff to care homes for older people, because older people are 70 times more likely to die from covid-19 than those who are younger, which is a significant age gradient. Now that we have got tests to all eligible care homes for the elderly, we are moving to delivering the same thing for people of working age.

The Secretary of State is quite right that it is important to protect our older citizens. It is true that older people and workers in care homes are able to get tests, but that is not the case for people who live or work in retirement villages and supported accommodation. Will he intervene to correct that anomaly immediately, so that we can protect all our older and vulnerable people?

Yes, of course, that is taken into account in the clinical decision on the order of priority for testing. My right hon Friend makes a very important point that I will ensure is taken away and looked at, to check this for people in those settings outside formal social care, which are often not Care Quality Commission registered but still have a much higher proportion of elderly people who are vulnerable to this disease in them. I will ensure that that is properly looked into and, if I may, I will write to the Chair of the Science and Technology Committee on that point.

The Secretary of State says that the Government are taking a safety-first approach, and yet Professor John Edmunds has expressed concern that if we relax, the infection will come back very fast. In Wales, there has been a more cautious approach to people being able to travel such long distances, as we saw the weekend before last in Dorset. What will the Secretary of State do if the R number drifts back above 1?

I do not want to see the R number go above 1. I spoke to Professor Edmunds at the weekend, as it happens. He said, quite rightly, that a cautious approach is needed, but there is scope to allow some opening up, according to our plan.

Of course, the international R rate matters too. I welcome the Prime Minister hosting the global vaccine summit in the UK last week, which raised an astonishing $88 billion. Given that the UK is the largest contributor to Gavi, the Vaccine Alliance, what support are this Government giving to low-income and developing countries, particularly in the Commonwealth and overseas territories?

That is an incredibly important point, because being able to get a vaccine everywhere around the world is incredibly important to us here at home. Of course, our top priority is access to the vaccine for the citizens of this country, but we are also using our aid budget to ensure that, should a vaccine work and become available, we can not only deliver it here but be good global citizens. As my hon. Friend says, we have put more into this than any other country on the planet.

Professor Edmunds also said yesterday that the R value was largely being driven by outbreaks in care homes and hospitals. Despite the Secretary of State’s statement, we know that there are still some care homes, including in my constituency, where residents and staff have yet to be tested. How can we effectively bring down the R rate without regular testing? Will he commit to regular testing in all care settings, including for the under-65s and those with learning disabilities?

The hon. Lady is absolutely right that testing in care homes is important. I am very pleased that my team hit their target of ensuring that all elderly care homes had access to tests by Saturday. Almost 9,000 care homes got kits for all their staff and residents to be tested, and the important thing is that that did not show a huge amount of infections that we did not previously know about. I am delighted that David Pearson—who, it is worth the shadow Secretary of State acknowledging, has been working with us throughout this period—will now be taking a leadership role in driving forward this work to protect our care homes further.

Quite rightly, many of my constituents have contacted me with concerns about mass gatherings and a lack of social distancing, which we unfortunately witnessed in Ilkley last weekend, when many visitors came to enjoy the sunshine. Can my right hon. Friend confirm that the R rate is below 1 in West Yorkshire? Will he consider local lockdown if appropriate, so that we can take action where necessary if we see a flare-up in infections in one part of the country?

Yes. I want to protect all the residents of Ilkley from the disease. As we have got the number of new infections right down to between 5,000 and 6,000 each day, according to the ONS—a long way below where it was at the peak—and as the number of deaths has fallen, I want to keep that down. Where there is evidence of a specific cluster or flare-up, we will take local action that will help to protect the residents of Ilkley, elsewhere in Yorkshire and throughout the country, so that we can then safely release other lockdown measures while keeping the community safe.

Following on nicely from that, what local resources and funding will be put in place for local authorities to deal with local lockdowns where they are needed?

We have already allocated £300 million for precisely that task. Making sure that local authorities are properly funded for their important role in local action is of course an important part of the task.

The Secretary of State will be aware of the media reports saying that the R rate in the north-west is above 1, which have understandably caused concern to my constituents in Burnley. Can he reassure them and people throughout the north-west not only that the R rate is below 1 in the north-west, but that we have to look at all the evidence, and on that evidence we are still defeating this virus?

That is right. I set out some of the evidence in my statement. It is important that we look at the overall base of evidence and take scientific advice on that. There are 10 models that go into SAGE, and it is important that the media reports the facts, which are that if we take into account all the models, R is below 1 in each region of the country, according to SAGE. Of course, different scientific models will come out with different results, and it is right that the scientists should publish and discuss those—that is how science advances—but it is also important that the media play their part responsibly. I reassure the residents of Burnley and elsewhere in the north-west that our overall assessment is that R is below 1 in the north-west and everywhere else in the country. Of course, we keep it closely monitored at all times.

Can the Secretary of State advise whether the R number has been rising or has fallen since the Prime Minister announced, without consultation and with a day’s notice, that people should get back to work in England? Given that some reports suggest that some areas of England have an R number at or close to 1, what consultation has the Secretary of State had with the devolved nations? When will he publish details on what local lockdowns will look like to ensure that the virus is contained?

I have already answered all those questions. The estimate from the scientists, taking into account all the evidence, is that R is below 1.

The hon. Gentleman may shake his head, but if he asks the same question, he is going to get the same answer.

I strongly welcome the progress made with testing in Harrogate and Knaresborough—we have had mobile testing at the council-owned Hydro unit—but we are seeing black, Asian and minority ethnic members of the community being disproportionately impacted in this pandemic. What steps is the Secretary of State undertaking to provide further testing for those who are most vulnerable?

The use of the testing capability that we now have, which is one of the biggest in the world and the biggest capability in Europe, means that we can focus the testing where it is most clinically needed. Reports such as the one by PHE on the impact of the disease on different parts of the population, whether that is in respect of age, sex or ethnic background, are incredibly important in making that assessment. Where the clinical judgment is that tests should be used specifically for one group because they have a higher risk, we will follow that clinical judgment.

Given the varying rates of infection across both England and Wales and the need to isolate covid, will the Secretary of State now adopt the Welsh guidance that people should not normally travel more than five miles from their home, in order to stop people travelling from high-infection areas to low-infection areas and thereby spreading the virus unnecessarily?

We talk to the Welsh Government all the time about making sure that the public health matters that are devolved are exercised in as co-ordinated a way as reasonably possible, and I fully respect the Welsh Government’s capability in making these sorts of assessments for Wales.

Can my right hon. Friend assure me that steps to ease lockdown will be taken cautiously and carefully so that we can examine the effect on our R rate in different parts of the country before proceeding?

My hon. Friend is absolutely right to raise this question. Of course, we proceed cautiously. That is why we take steps in turn to see the effect. The good news is that the evidence thus far is that the steps we have taken have coincided with a continued reduction in the incidence of the virus. That is why it is safe to proceed on the plan that we have set out.

How can it be that, when we are coming out of lockdown and starting to relax some of the restrictions, local authorities do not know what they are expected to do in the event of a local outbreak and they do not know what powers they are to be given? How can it be that the Government can say only that they will tell them when it is practicably possible?

I am afraid that I do not recognise that picture at all. The local directors of public health have been heavily engaged in addressing local outbreaks throughout this pandemic. In the past few weeks, for instance, there have been outbreaks locally that have then been addressed, with a leadership role played locally by the local director of public health. Perhaps the hon. Gentleman was not listening to the answer given to one of his hon. Friends that we have also put £300 million into local authorities to assist them to make sure that they have that capability on the ground.

The work that PHE has done with Cambridge to understand the R rate at a regional level is very welcome. It might yet, of course, prove invaluable if needed. Can my right hon. Friend say how local is realistically possible? I think that I am right in saying that we could not hone in on Winchester, as an example, if we needed to stamp on an outbreak. Would other factors come into play, such as how effective an area was on the test and trace programme, for instance?

Yes, absolutely. As I tried to say in my opening statement, R is one of many measures that we need to look at. The number of new infections—the level of new infections as opposed to the rate of change—is also important and more directly measurable both through test results and through the surveys that we discussed earlier. Of course, the surveys, the number of test results in particular and the number of people presenting for testing, which we get from the test and trace programme, are much more granular local data that can give us a view of local outbreaks. If there is evidence of a local outbreak, then symptomatic testing can be done in that community in order to find out how serious the problem is locally, so a whole suite of tools are at our disposal.

Does the Secretary of State not agree that, while the Kingdom of Great Britain and Northern Ireland must move forward together, regional variation of the R number will mean differentiation? What discussions or input will the Secretary of State and Government have with regional authorities to ensure that there is UK-wide understanding, and will all R numbers be calculated using the same scientific criteria?

The answer to the hon. Gentleman’s last question is, emphatically, yes. I have regular discussions and exchanges both with the First Minister in Northern Ireland and also with my opposite number Robin Swann. We work to ensure that the response to this virus across the whole United Kingdom is as closely aligned as it reasonably can be respecting the different impacts of the disease in different parts. Thankfully, the impact of the disease in Northern Ireland has been less than in the rest of the country, and long may it remain so.

What assessment has my right hon. Friend made of the progress in countries that are operating social distancing at 1.5 metres or 1 metre, and when does he think that we may have a review of those measures in this country?

That is constantly kept under review. In fact, I was reading some of the most recent science on this over the weekend. The interaction of the distance put in place and the other measures, for instance, on mask wearing and ventilation in particular, are what matters for the progress of the disease. The problem is not whether the rule is 2 metres or any different distance but that the virus transmits especially face to face—less so if people are side to side or back to back—in close quarters. Of course, being outside helps as well.

I welcome today’s news from the Scottish Government that we have just had a second day in Scotland of no additional deaths from coronavirus, but I am concerned about the level of testing, particularly in a community setting, where it is nowhere near capacity. If we cannot have comprehensive testing, how can we have confidence in the R number? So how is the Secretary of State working with the Scottish Government to ensure that all the testing capacity, including in drive-through centres, is in use?

Absolutely; I work closely with the Scottish Government to do everything we can so that they can increase their testing capacity. Part of the testing programme, as the hon. Lady mentioned, is the drive-through centres. That is essentially UK-wide, likewise the postal testing services, and then the hospital-based testing is run, of course, by the Scottish NHS and is therefore devolved. This requires a higher level of co-ordination. Across the UK, in England we have the highest level of testing and we do everything possible to help the Scottish Government to get their testing capacity up.

No new deaths in Scotland, no new deaths in Northern Ireland, and no new deaths in London hospitals: while I agree with my right hon. Friend that even one death from coronavirus is one too many, does he not agree that this is evidence that the whole-UK approach and the measures adopted across the entire United Kingdom at the beginning of this virus are working, and that this is reason to be hugely positive?

My hon. Friend is absolutely right that there has been very encouraging progress, and all the significant data point in the same direction, which is downwards. That is incredibly important. It is a testament to the efforts of everybody across the whole United Kingdom, because everybody has played their part in the social distancing. The more that we do this as one United Kingdom, the better. Of course there are sometimes substantive reasons for local variation—sometimes, for instance, north of the border—but ultimately this country is coming through this and we are winning the battle against this disease.

Local directors of public health need comprehensive, granulated data in order to do their job. Currently there are holes in the data that they are receiving, particularly on testing, in order to then follow through on tracing. So when—not “soon”, but when—will they actually receive that comprehensive data, together with the local R value, in order to then keep our communities safe?

They get data now, we want them to get better data, and we will keep improving the data flows. It is as simple as that.

As we control the R rate and move forward, may I welcome the steps that are being taken to reduce restrictions for the most vulnerable in society? Will my right hon. Friend confirm that these steps are being taken in line with scientific advice and in the safest way possible?

Yes, that is absolutely right. I pay tribute to my hon. Friend, who makes the case for the evidence being the basis of policy and following and being guided by the science, as we have done throughout this crisis. He makes the case very eloquently. It is very important, because that is the best way that we can get the best possible response in what are inevitably very difficult circumstances.

We know that the Secretary of State does not want to see the R rate rise above 1—none of us does—but the high-profile recent mixed messages that have come from his Government might well lead to that happening anyway. In those circumstances, is he prepared, if necessary, to reintroduce restrictions on movement and activity, and will he do whatever it takes to persuade the Chancellor to continue with financial support to the employed and self-employed for so long as it is necessary?

I am very grateful to the hon. Gentleman for that question and for the manner in which he asks it. We have always said that we are prepared to reintroduce measures if that is necessary. He has already seen from the Chancellor one of the most generous packages of support in the world for people dealing with and coping with the consequences—in some cases incredibly difficult and painful consequences—of this disease.

As my right hon. Friend works with medical and scientific advisers to lift lockdown measures cautiously, what hope can he give the millions of grandparents in this country that they too may soon be able to play a full role in their grandchildren’s lives, in particular those who engage in childcare to enable parents to go to work?

Like anybody who has a heart, I yearn for grandparents to be able to see their grandchildren. My own children saw their grandmother at a social distance, appropriately, rigorously according to the rules, for the first time this weekend, and it was a real joy—the first time in months and months—but they have not seen their other grandparents, and of course they are not allowed to hug them yet. I am with my hon. Friend and no doubt you, Mr Speaker, and everybody else in this House in wanting to see a restoration of that basic human contact for which we all yearn.

The concern over the R rate in Greater Manchester on one measure has focused attention on possible local lockdowns, which would have a financial impact on people who are unable to work from home. In those circumstances, will the Government consider a form of local furlough for people whose workplaces are closed down or who are unable to get to work?

I am sure that Treasury Ministers will have heard the hon. Gentleman’s suggestion, but we do not need such a scheme now, of course, because the full furlough scheme is in operation nationally.

We know the significance of the R rate being 1, but what level does the R rate have to get to, and for how long, for the Government to initiate a response and bring restrictions back; then, what does it need to be reduced to, and for how long, before the new restrictions are removed?

The reason having the R below 1 is important is that that is the rate at which the number of new infections continues to fall. When R is below 1, the question is how fast it is falling. The number of new transmissions for each person who has the virus is currently, on average, less than one, so R is below 1 and therefore the number of infections is falling. We do not have a specific figure or target for R; we just want to keep it below 1 and we want to keep the number of new infections falling. Our response in the first instance to new outbreaks will be the local action we have been talking about for much of this session, and that is greatly to be preferred to a reinvigoration of the need for national lockdown.

If it is not because we locked down too late or because of any of the Government’s other blunders, why does the Secretary of State think we have the highest excess death rate in the world?

I am not sure which evidence the right hon. Gentleman is pointing to, but I would be happy to talk to him afterwards.

The circulation of an unofficial R rate of 1.6 for Blackpool, and the publication of this by the local press, created a great deal of alarm in my constituency. The fact that the figure was adjusted to 0.5 only days later just demonstrates the difficulties with believing unofficial statistics and taking them out of context. Will my right hon. Friend confirm that R rate figures are accurate only at regional level, and does he agree that the media have an obligation to report data accurately and within context, to make sure that members of the public are properly informed?

Yes, I do. My hon. Friend makes the point extremely strongly, and the people of Blackpool should be proud that they elected him December. He makes the case very clearly, and what he says is true in the example he cites, of Blackpool, and in the wider north-west. I am sure you feel, Mr Speaker, that a single report should not be taken out of context and that all the science should be looked at. Members in all parts of the House should respect that if they really want to respect the science.

The Secretary of State has made very clear the importance of co-operation between the various health directorates in all four nations of the United Kingdom. I think we all welcome that, but we also need to see co-operation in other Government Departments. What discussions has he had with his Treasury colleagues about the need to vary furlough to different degrees across the United Kingdom when we come out of lockdown at different rates?

One of the reasons why it is valuable to move together as one single country is that we have one overall economy and economic policy is for the whole country. That is one of the very many reasons why we are stronger together. It is important that the Scottish Government take that into account when they make their judgments on what is best for Scotland.

I am very pleased to say that my home constituency of Eastbourne has a low incidence of infection, but it has a high number of care homes and a high number of residents who have been shielding. Equally, it is a tourist destination. With lockdown easing, what reassurances can my right hon. Friend give us that we are moving forward safely?

It is important that those engaged in the tourism industry follow the guidance on social distancing as carefully as possible. They should always follow those rules and ensure that social distancing is in place. As we manage to open things at the right pace—cautiously and safely—in due course, it is incumbent on industries such as the tourism industry to ensure that they follow the guidelines. The proposed next step, subject to formal confirmation, is the opening of non-essential retail. Non-essential retailers will have to follow clear guidelines about ensuring that their shops are safe and that they do not add to the spread of the disease. If we are able to take further steps after that, it is so important that a whole industry, such as the tourism industry, helps everybody to help it by following those sorts of rules.

I have received a letter from a little boy called Charlie, who is clinically extremely vulnerable and has been shielding with his family for about 11 weeks. He wants to know why non-vulnerable people can be allowed to have unlimited exercise wherever and whenever they want, while people who are still shielding feel trapped in their own homes without even 30 minutes to go outside. Now that we have stopped clapping for carers, would the Secretary of State agree that, for just once a day, we could stay home for shielders?

The hon. Lady asks an important question. We did make a change to the guidance, in order to recommend going outside. I know that some people were very worried about doing that, but it is safe to do so safely—by staying 2 metres away from others. Let me say this to all those who are shielding: the shielding guidelines are there for your own protection; you are particularly at risk if you catch the disease and these are the guidelines for how you can stay safe. We appreciate that the guidelines have a significant impact on those who are shielding, and are always looking at what we can do to make the lives of those who are shielding better and to improve the guidance.

May I urge the Government to follow the lead of other European countries and move to a 1 metre social distancing rule? That is the only way that we are going to save millions of jobs in hospitality over the next few months.

We always keep these things under review. The challenge is that being 1 metre apart, face to face, means that there is a much greater chance of transmission of the disease than at a further distance.

Many of my constituents were deeply concerned to read about the high R rate in the north-west. In the same week, they were told to send their children back to school. Has the Secretary of State made any assessment of the impact of reopening schools on the R rate in the north-west?

Yes, and I have reconfirmed this with the chief medical officer. It is safe to take the steps that we have recommended to open schools for reception year, year 1 and year 6 right across the country. I am glad to be able to reassure the hon. Gentleman—I hope that he can then reassure his constituents and others across the north-west—that the assessment of SAGE, taking into account all the evidence, is that R is below 1 in all regions.

May I remind the House that this week is Carers Week? Will my right hon. Friend assure me that SAGE, when providing advice to Ministers, looked at a rage of information to ensure that it is presenting an overall view, and that its belief is that the R rate is below 1 in all regions?

Yes, that is absolutely right. It is just so important that we take into account all of the evidence and all of the studies that are published, and not just strongly focus on one.

Some of the people who have had the toughest time during these months are the people who work in care homes. They have had to deal with things they never thought they would have to deal with, including keeping family members apart from the people they have been looking after, even when they are dying. In Wales, the Welsh Government have decided to give everybody working in a care home, including chefs and ancillary workers, £500 as a bonus. May I please ask the Secretary of State to try to make sure that the Chancellor of the Exchequer does not tax it?

I will talk to the Chancellor about that. It is obviously a question for a Department other than mine.

It is essential that the spread of covid-19 is understood in different settings, such as hospitals and care homes, so will my right hon. Friend confirm that the R rate can be unduly distorted at a regional level by these figures and that local lockdown measures should be used very carefully?

In the first instance, where we have taken local action, it can often be in a care home or in a hospital. That would be the action that is needed, and it has been successful, in many cases, in ensuring that an outbreak where we see a rise in the number of new cases does not then transmit into the community. So in the first instance, local action is very local: it is in a single hospital or in a care home. I think understanding that as the starting point for local action is important in thinking about how we take this forward.

We have already heard about the good news from Scotland, where we have gone two days without a death, but we do need to be careful and also mindful of the fact that the R rate may increase in the future; indeed, others in the Chamber have concerns for their areas. Can the Secretary of State give a commitment that if the R rate does rise and the lockdown needs to be reimplemented, he will make every effort to ensure that the Chancellor makes sure that businesses, employees and the self-employed receive the financial support they deserve?

The hon. Gentleman asks an extremely reasonable question, and I hope that he sees that the Government have been incredibly front-foot about ensuring that that sort of provision is available and has been available right from the start of this crisis. We have one of the most generous schemes in the world.

I, too, would like to pay tribute to all the many carers throughout the country—people who are just relatives, but who are looking after someone through love and are unpaid for that. Because they do not see themselves as carers, they often do not have the information that they might otherwise need. Will my right hon. Friend see if there is anything more he can do to work with colleagues in councils and of course the relevant Departments to ensure that those carers have access to everything they need, because carers are a massively important part of making sure that the R rate is controlled?

Yes. I think the whole House will join me and my hon. Friend in thanking all carers, paid and unpaid, in this Carers Week. This Carers Week is so different from normal because of what has happened during coronavirus. One of the things we have seen during coronavirus is that people have got together to celebrate and thank our carers right across the board. He is absolutely right to raise the point that he does, and I will certainly look into it.

No one wants to see the R number go above 1; hence the robust questioning the Secretary of State is facing. This weekend, the Government’s incongruous messaging continued. SAGE member John Edmunds told Andrew Marr that the decision not to lock down earlier had cost a lot of lives. Later in the show, the Secretary of State dismissed this view in the face of Channel 4’s “Dispatches” programme and the growing number of scientific experts who are warning that the Government’s premature relaxation of lockdown could see a significant second wave of infection. If the Government are no longer following the science provided by their own advisers, whose advice are they following?

I am afraid that the hon. Gentleman has misquoted Professor Edmunds, and I think he should go and look at what was actually said.

Will my right hon. Friend join me in praising the carers in Beaconsfield for their tireless work? Can he confirm that the only reason we are now able to consider local lockdowns is because of our testing capabilities, along with NHS test and trace, which are helping to build a more accurate picture of what is going on in different parts of the country?

Yes, I would like to thank the carers of Beaconsfield for the work they have done through this crisis and before. I tell them that the value and esteem with which we hold them is so high and we are so grateful for what they do. My hon. Friend is right that you simply could not have a localised approach, and therefore the safety of reducing safely and cautiously the overall lockdown measures, without a significant testing capacity. Thanks to the teamwork of the NHS, Public Health England and many, many private companies, we have built the largest coronavirus testing capacity in Europe from almost nothing. It is a testament to so many people, to the team effort and to the way the country has rallied behind that need.

In order to allow safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for five minutes.

Sitting suspended.