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House of Commons Hansard
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17 June 2020
Volume 677

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(Urgent Question) To ask the Secretary of State for Health and Social Care if he will make a statement on coronavirus.

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I am grateful for the chance to update the House on the urgent matter of coronavirus.

Yesterday’s treatment breakthrough shows that British science is among the best in the world. As a nation, we can be incredibly proud of our scientists. The UK is home to the best clinical trials, the most advanced immunology research, and the most promising vaccine development work of any country. We have backed the science from the start, and I am sure the whole House welcomes the life-saving breakthrough that was announced yesterday. Today, I will briefly update the House on all three aspects of that national scientific effort.

First, on clinical trials, our recovery programme, which looks at the effects of existing treatments in real-world hospital settings, is the largest of its kind. As of yesterday, 11,547 NHS patients had been recruited to the programme, which is operating across 176 sites in all four nations. In Oxford University’s dexamethasone trial, over 2,000 NHS covid patients were given a course of the drug—a commonly used steroid—over 10 days. For patients who were ill enough to require oxygen, the risk of dying fell by a fifth, and for the most seriously ill patients on mechanical ventilators, the risk of dying fell by over a third.

This is an important moment in the fight against this virus, and the first time that anyone in the world has clinically proven that a drug can improve the survival chances for the most seriously ill coronavirus patients. In February we began the trial, supported by £25 million of Government funding, and in March we began recruiting patients, and started the process of building a stockpile in case the trial was successful. As of today, we have 240,000 doses in stock, and on order. That means that treatment is immediately available, and already in use on the NHS. I am incredibly proud that this discovery has happened right here in Britain, through a collaboration between the Government, the NHS, and some of our top scientists. It is not by any means a cure, but it is the best news we have had.

Throughout this crisis, our actions have been guided by the science, and that is what good science looks like: randomised control trials; rigorous and painstaking research; moving at pace, yet getting it right. The result is that we now have objective proof—not anecdotes, but proof—that this drug saves lives, and that knowledge will benefit many thousands of people all around the world.

Seven other drugs are currently being trialled as part of the recovery process, and a further nine drugs are in live clinical trials as part of the ACCORD programme, which is looking at early-stage treatments. We look forward to seeing the results of those trials. I thank everyone involved in that process, and put on the record my thanks to our deputy chief medical officer, Professor Jonathan Van-Tam, who led the work in Government, as well as to NHS clinicians, the scientific teams, and the participants in the trial who took the drug before they knew that it worked.

Our immunology research, again, is world leading. Last month I announced a new antibody testing programme to help us understand the immunological response to the disease, and whether someone acquires resistance to coronavirus once they have had it and recovered. I am part of that programme, and as of yesterday, 592,204 people have had an NHS antibody test. The nature of immunity research means that it takes time, and we must wait to see whether someone with antibodies gets reinfected. However, with every test, we improve our picture of where the virus has been, and we grow the evidence to discover whether people who have had the disease and have antibodies are at lower risk of getting or transmitting the virus again.

Crucially, that work will help to inform how we deploy a vaccine, and it is moving at pace. Earlier this week Imperial College began its first phase of human clinical trials, and 300 participants will receive doses of the vaccine. Should they develop a promising response, Imperial will move to a large phase-3 trial later this year. Yesterday, AstraZeneca signed a deal for the manufacture of the Oxford vaccine, AZD-1222, which is the world’s most advanced vaccine under development. Its progress, while never certain, is promising.

None of that happened by accident. It happened because the British Government, scientists, and the NHS put in place a large-scale, programmatic, comprehensive, well-funded, systematic, rigorous, science-led system of research and innovation. We have been working on it since the moment we first heard of coronavirus. There is more to do in this national effort, but that is how we will win the battle. We will leave no stone unturned as we search for the tools to hunt down, control, and ultimately defeat this dreadful disease.

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May I just say to the Secretary of State that he has gone way over the allocated time? It would have been easier for him to make a statement rather than having to have an urgent question. In future, perhaps he could come forward with a statement if he needs the extra time, and I will certainly grant that and support him in doing so. Some extra time for Jonathan Ashworth as well, and for Philippa Whitford.

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I am grateful, Mr Speaker. I welcome the news from the Secretary of State about Dexamethasone. As he said, this is an important moment and good news, and I congratulate all those involved. It is a reminder that we can be immensely proud of our science base in this country. I note what the Secretary of State said about vaccinations. A vaccine is crucial, and I hope he will join me—I am sure he will—in saying that when a vaccine is available, we must have no truck with those who spread poisonous anti-vax propaganda on social media. Vaccinations save lives, and ultimately that will be the exit strategy from this dreadful, horrific disease.

The good news is tempered by the high death rate. The Prime Minister likes to boast of flattening the sombrero, and it is certainly true that deaths from hospitalisations are coming down, but we still have 58,000 excess deaths across England and 13,000 in care homes; and 300 health and care staff have sadly lost their lives. All our NHS staff deserve great praise, so may I ask the Health Secretary about a specific matter that has emerged in the past couple of days? Why are student nurses who joined the frontline six months ago as part of the coronavirus effort now seeing their paid placement schemes terminated early, leaving them with no income? That is no way to treat student nursing staff.

This week, the World Health Organisation has warned that the UK remains in a “very active phase of the pandemic”.

The right hon. Gentleman will accept that if a second wave comes, especially if it coincides with flu season, that would be completely disastrous. Can he reassure the House that the decisions that he and the Prime Minister are making on easing lockdown measures, such as the mooted relaxation of the 2-metre rule and the opening of non-essential retail this week, will not precipitate a deadly second wave of the virus? Would he update us on the latest thinking on that by the Home Department? In the past, the right hon. Gentleman has said that he is prepared to institute local lockdowns, but local authorities continue to say that they do not have the resources or powers to enforce that. Can he update us on when he will give local authorities powers to enforce those lockdowns?

Yesterday, the Health Service Journal said that for people in the shielding group, shielding will come to an end at the end of July. We were promised a full update on shielding on 15 June, two days ago. Can the right hon. Gentleman update the House now on what is happening and what the future is for the shielding group with regards to getting their medicines and supplies and whether they will be able to leave their homes by the end of July?

We have always said that testing, tracing and isolating is crucial to the safe easing of the lockdown. On testing, local authorities say that they are still not getting the specific test data that they need. Indeed, the Deloitte contract, as confirmed in a written answer from the Minister for Patient Safety, Mental Health and Suicide Prevention, did not specify that it needed to report test results to GPs and local directors of public health. We need to fix that.

Why is the right hon. Gentleman still not publishing the number of people who have been tested, and can he explain something that is puzzling many of us? The tracing figures that he revealed—we are grateful for them—suggested that 8,000 people went into the contact tracing system in England, but in that week, the Government testing figures said that there were around 12,500 positive cases in the UK. Even if we can make an assumption about how many of those cases are in England, that still suggests that there are around 2,000, perhaps 3,000, cases not being traced and contacted. Can he explain why that is and what he is going to do to fix it?

Finally, we have now seen Public Health England recommendations on the impact of covid on those from black, Asian and minority ethnic communities. Those recommendations are welcome. Many of them, such as mandated ethnicity data collection and recordings on death certificates, should have been done years ago, but when will those recommendations be implemented? Black people are nearly four times as likely to die from covid as white people, and over 90% of doctors who have died during the pandemic were from black, Asian and minority ethnic communities, so surely this is a matter of urgency. We cannot wait, and we need those recommendations to be implemented straight away.

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I will try to answer as many of the questions as I can. First, I concur entirely that we should have no truck with anti-vaccination campaigners. The reason we are working so hard with full-blown clinical trials on these vaccines is to ensure that they are safe, and if they are declared scientifically safe, anyone who is recommended to have one should have one.

The hon. Gentleman made a case on student nurses. It is wrong to suggest that student nurses and midwives are being made redundant. All student nurses and midwives are required to complete placements during their training. As part of the response to covid-19, those hours have been paid and will be until the end of the summer. NHS England has been provided with the funding for student salaries as part of our response to covid-19. The chief nurse has taken that forward.

The hon. Gentleman made a point about local authorities getting data. We have provided more data to them, and we will continue to do more. He asked about the steps that will be taken in future on lifting the lockdown. As ever, we will move carefully and cautiously. Thankfully, all the main indexes—the main ways that we measure this disease—are moving in the right direction. We are winning the battle against this disease, but we will be careful and cautious in the next steps that we take.

We are working very closely with local authorities on local lockdowns. The hon. Gentleman specifically raised the point about powers, as he has before. I have powers under the Coronavirus Act 2020, passed by this Parliament. If powers are needed by local authorities, then there is a process to raise that requirement up through a command chain that leads to a gold command, which I chair, and then those powers can be executed on behalf of local authorities if they are needed.

The hon. Gentleman asked about shielding. We will bring forward the proposals for the next steps on shielding very shortly.

Finally, the hon. Gentleman asked about the positive cases that do not go into the NHS test and trace scheme. That is largely because they are in-patients in hospital, and therefore testing and tracing in the normal sense does not apply because we know exactly where the person is and who has been in contact with them as they have been in hospital, in a controlled environment. That is the case for the large majority of the gap.

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On that last point, 20% of the people with coronavirus in hospital are estimated to have caught the virus while in hospital. So when does the Health Secretary plan to introduce weekly testing of all frontline NHS and care home staff as a way of bridging the still very significant gap between the number of people we test and trace and the number of people getting the infection every week?

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The Chair of the Health and Social Care Committee makes an incredibly important point. The approach we are taking is a targeted one of repeat testing, which has started already but needs to spread much further. The reason is that some people in hospital settings are at higher risk, and it is better to focus the resources for repeat testing on those at higher risk. For instance, somebody working in finance might be at lower risk than somebody in a frontline setting. The NHS has a strategy on this, and I will write to him with further details of how that is going to work.

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We are now heading to the SNP spokesperson, Dr Phillipa Whitford, with some extra time.

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I, too, welcome the positive outcome of the recovery trial showing the contribution of dexamethasone—a drug that is cheap and accessible across the world.

Despite claiming to be well prepared for this epidemic, the Secretary of State has struggled to provide sufficient personal protective equipment to NHS staff in England. He has now awarded £350 million of PPE contracts, but can he explain why £108 million of that was awarded, without being advertised, to Crisp Websites Ltd, which trades as PestFix, a small pest extermination company? Why was such a large contract awarded to a company with no expertise in trading or supplying any PPE, let alone highly specialised equipment for NHS staff? How do the Government think that such a small company, with only £18,000 of registered assets, can manage the cash flow required to procure £108 million-worth of PPE? Is this not just a reprise of the Seaborne Freight scandal—the ferry company with no ships?

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No. We have enhanced, under the leadership of Lord Deighton, the supplies of PPE across the whole United Kingdom. I work very closely with the SNP Government on this matter. We have made sure that PPE is now available, in large part, across the whole NHS and social care workforce, and for all those others who need it. Demand for PPE rose exponentially across the world in this crisis. It was difficult for a time—there is no point denying that—but we have made huge strides in ensuring that we now have long-term contracts in place. I am really glad that the supply and distribution of PPE is much wider.

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I congratulate the Secretary of State on his science-led strategy, from which we are now reaping the dividends and which is genuinely saving lives. But the science also tells that as we reduce the propensity of the virus in the population, we can also reduce the social distancing that we applied. Businesses, residents and teachers across Arundel and South Downs are united in their appetite to move to 1 metre as quickly and as carefully as possible. Will he update us on that?

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The answer is that we keep all of our non-pharmaceutical interventions—the social distancing measures—under review. The 2-metre rule is another social distancing measure in the same way that other parts of the lockdown have been. It is the sort of thing that, of course, we want to lift, but we need to do that in a way that is careful and safe. The scientists, along with the economists, are reviewing it, and we will take forward further measures on this when it is possible and safe to do so.

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I declare an interest as vice-chair of the all-party group on pancreatic cancer. My colleague the other vice-chair is the hon. Member for East Dunbartonshire (Amy Callaghan), whom you referred to earlier on, Mr Speaker. After discussions with other Members, I am glad to hear that she is showing some improvement. Very clearly, Mr Speaker, that is an answer to our prayers.

The Secretary of State has been made aware of the concerns of the leading cancer charities, which say that it is estimated that 2.4 million people are waiting for cancer screening due to the delays caused, in part, by lockdown. Can he outline his intention to implement the 12-point recovery plan, which is backed by 24 cancer charities, including the one for pancreatic cancer?

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I am incredibly grateful to the cancer charities for the work that they are doing, highlighting the importance of people coming forward for screening, which has been part of the problem, and making sure that we get the screening programmes back up and running in the full sense as quickly as possible.

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Can my right hon. Friend confirm that, although we have reached the peak of the transmission later than other areas, the virus is in decline in the midlands, and my constituents in Stoke-on-Trent are safe to go out and shop and can do so as long as they follow social distancing guidelines?

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Yes, that is right. In the midlands, as in other parts of the country, this virus is abating. The number of cases is coming down, which is good news. That means that we were able to relax some of the social distancing measures, for instance, on Monday, saying that it is perfectly safe for people to go and shop and that the shops can open so long as they do so in a covid-secure way. I am glad to say that the vast, vast majority of shops have been very careful about how they have reopened, making sure that that social distancing is in place, and therefore it is safe to shop in the west midlands and in the rest of the country.

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One in six people in the UK have hearing loss and rely on lip reading and facial expressions to communicate. The use of face coverings, while important for controlling the virus, is a real barrier for them and risks increasing misunderstanding, anxiety and isolation. That is particularly the case when they are used in hospitals. What is the Secretary of State doing to accelerate the development, testing, production and use of clear-panel face masks, including for clinical settings, and, more immediately, will he support a public awareness campaign on good communication tactics?

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Yes, the hon. Lady is absolutely right to raise that matter. It is a really important consideration. I have been talking to audiologists in the NHS about what we can do to try to make sure that we have the least negative impact as possible. Obviously, a face covering has an impact on people who are lip reading. It is an unfortunate but entirely natural consequence of wearing a face covering, and anything that we can do to mitigate that, I am up for doing.

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Remarkable consultants, doctors, nurses, support staff and domestic workers at Princess Alexandra Hospital in my constituency of Harlow have saved and nursed back to health more than 270 patients from this awful coronavirus. Will my right hon. Friend pay special tribute to the workers at Princess Alexandra Hospital and the management team and also confirm—because of the pressures on that hospital—that we will get our new hospital and a new site as soon as possible?

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Absolutely. My right hon. Friend is the greatest friend that there is to the Princess Alex Hospital in Harlow. He has campaigned on it absolutely rigorously—ruthlessly, too—since he was first elected. First, I pay tribute to all the frontline staff and support staff, who have worked so hard at the Princess Alex through this crisis, for their service. Secondly, I reconfirm that we will rebuild the Alex and make sure that it is a world-class hospital.

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One of the recommendations of the now fully published Public Health England report into the impact of covid-19 on the BAME community is that the Government should look to reduce health inequalities, and fast. This is something the Welsh Labour Government are taking seriously, with a comprehensive risk assessment of BAME workers devised by Professor Keshav Singhal being rolled out across the NHS in Wales. The risk assessment is simple to use, produces clear outcomes and will save lives. Can the Secretary of State outline exactly how and when a comprehensive risk assessment will be implemented in England to protect our BAME communities and prove that black lives really do matter?

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The hon. Lady is right to raise this important issue. We are rolling out a risk assessment across England for all those with a higher risk of suffering from coronavirus, including BAME staff in the NHS in England, who do so much to keep the service on its feet.

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The impact of coronavirus has been significantly greater in less affluent areas, such as Stoke-on-Trent Central, where one in four children have free school meals. Does my right hon. Friend agree that tackling the health inequalities in constituencies such as mine is essential if we are to make progress on the issue of inequality of opportunity?

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I agree 100%. The need to level up is no greater than in health inequalities. The differences in life expectancy between different parts of our country is stark and has been laid bare further by this crisis. The crisis has been like sheet lightning that has laid a light on some of the health inequalities that were there before but which must with increased urgency be addressed. That is one of the big learnings from this crisis. It is something we all knew before but which we must redouble our efforts to resolve after this crisis is over.

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Last Friday, it was confirmed that the UK was eligible to participate in a European scheme to place advanced orders for vaccines currently in development and to ensure priority access to any successful vaccine. What is the Secretary of State’s assessment of the potential merits of UK participation in such a scheme?

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We are having such discussions—I have had conversations with my German, French and Italian counterparts on exactly this subject—but the most important thing is that we will not let those discussions get in the way of the much more advanced discussions we are having directly with the vaccine producers to make sure that even if the two great British vaccine hopes do not come off, or if one from somewhere else in the world comes off first, we have access to a vaccine for citizens across the UK.

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It is fantastic news for the whole country that Oxford University has successfully trialled a drug to reduce mortality rates by up to one third for covid patients on ventilation. Can my right hon. Friend confirm that that will be made available soon so that the people of North Cornwall can benefit from it as part of the wider NHS?

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I am delighted to say that, because we made the stockpile in advance, the treatment is already in place, as of yesterday afternoon, in Cornwall—in Treliske Hospital—and right across the country.

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Any reduction at all in social distancing inevitably carries a risk of increasing the spread of the disease, so can the Secretary of State give an assurance that before the Government announce any reduction, he will publish his assessment of the public health, transmission and infection implications of any such change?

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I am legally obliged by the Act that governs this area of policy to undertake such a review before those changes are made.

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The drug trial breakthrough is fantastic news and will save a huge number of lives, and it is great news that, as the Secretary of State said just now, the drug treatment is already available on the NHS. On the vaccination trials, it is great that Britain is leading the world, but this is a global problem. What steps are we taking to work with vaccination trials across the world so that we can get a vaccine as soon as possible?

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That is a really important point. Not only do we contribute more to the global vaccination funding programme than any other country—and we hosted the GAVI summit, which raised over £8 billion for global vaccine research—but we are engaged with other countries on the two British vaccine candidates, particularly the Oxford one, because it is so much further advanced. It is the most advanced in the world and the soonest hope for a vaccine, should it come off—touch wood; none of these things is certain. We secured early doses here in the UK, and it was confirmed yesterday that these are being manufactured, with the contract agreed between AstraZeneca and the manufacturer. AstraZeneca is now engaging with countries across the world—in Europe, in the United States where a deal has already been signed, and elsewhere—to ensure that, if the vaccine works, it will be available globally.

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All of us who grew up in Wythenshawe are very proud of Marcus Rashford today. Does the Secretary of State agree with the Health Foundation that people facing the greatest deprivation have a higher rate of exposure to covid and more severe outcomes when they contract the virus? Wythenshawe residents are twice as likely to die as those in neighbouring areas.

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Yes, I do agree. I pay tribute to Marcus Rashford. The way he has conducted himself in making his argument has been absolutely brilliant. I was reading Harry Potter to my son last night, and it was clearly still stuck in my mind at 7 o’clock this morning, when I started on the TV. We all make errors sometimes, and I apologise to Marcus for getting his name wrong on one occasion. I had no reason to make that mistake, but what really matters is his brilliant campaign and the volunteering that he has done throughout this crisis.

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It is great news that steroids can save some lives, and I pay tribute to those involved, but as the Secretary of State has said, many people will not get a treatment that works. He says that there are seven other treatments in tests, which presumably started at a similar time, using different groups and families of drugs with different impacts. When will we know the results of those?

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As soon as possible. The trials will also look at whether, in combination with dexamethasone, which we now know is effective, these drugs save lives. The way the trials work is that we will keep the treatments in trial until we know, to a point of rigorous scientific proof, that they work. As soon as that point is reached, we will roll them out. That point was met on Monday; I was told on Monday night about this success. We had stockpiled in advance, so we could immediately make the announcement and make the change through the NHS. I do not have a date, because it is all driven by the science.

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The Government’s handling of coronavirus has been marked by complacency. Complacency led to NHS cuts and PPE stockpile shortages; complacency led to a delayed lockdown, the disaster in care homes and the neglect of test, track and trace. We have one of the highest death tolls in the worlds, and scientists say that tens of thousands of deaths could have been avoided. Will the Secretary of State end the complacency, put public health before private profit, and ease lockdown only when it is safe to do so?

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We will of course ease lockdown only when it is safe to do so, but had the hon. Lady listened to my statement, she would know that the case I was making was that right at the start we put the science in place and started to stockpile. We gave scientists support and funding so they could deliver on the sort of research on which we have led the world and delivered ahead of anybody else.

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Despite the virus being with us since January, it took until mid-April for the Government to issue guidance for routine testing to take place before discharge into care homes, and now, regardless of whether or not people have the virus, homes are still expected to take residents. Every week, I speak to distressed staff and heartbroken families. Over 16,000 people have died in our care homes. Does the Secretary of State accept any responsibility for that?

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I accept responsibility for everything that happens across the health and social care piece. It is incredibly important to work with care homes, as we have, and to fund care homes, as we have, to put in place infection control. Of course, being in hospital is also not a safe place for people who do not need to be in hospital. The infection control procedures are now there in care homes, with the funding, and that has been the case since the start—since well before the date the hon. Lady mentioned. Although the challenge in care homes has been very significant, we have thankfully seen in this country a lower proportion of overall fatalities from this disease in our care homes than in those across the rest of Europe. That is a good thing, but that is not to say that there have not been significant challenges.

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What further examination of the potential use of co-trimoxazole has taken place, and when will we know the results?

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Co-trimoxazole is another the prospect that we are looking at, but I am afraid that, as with my answer to my right hon. Friend the Member for Wokingham (John Redwood), the timing has to be driven by the science. If we get success, when a result in which the clinicians have scientific confidence can be met, we will stick with the clinical trial methodology that leads to concrete results. Too many other places around the world have pulled clinical trials early because of promising results that have turned out not to be well founded.

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The Fawcett Society has completed an important report that addresses the mental health issues of women with disabilities during this pandemic. As chair of the all-party group on disability, I am particularly concerned that the report found anxiety and isolation in more than 50% of respondents. Will the Secretary of State increase funding to mental health providers, with a view to helping disabled people to access the specialist support that they so crucially need?

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The hon. Lady asks an important question. We have been increasing funding to mental health services, which are an incredibly important part of the response. Our mental health services, certainly across England, the area for which I am responsible, have risen admirably to the extraordinary challenge presented by coronavirus and I pay tribute to their work.

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I represent a number of aerospace manufacturing companies; the whole sector is currently very hard hit and is particularly worried about the impact of the 14-day quarantine. The Secretary of State will know far better than I, but is it not possible to do very simple temperature checks on people as they come into this country?

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I have looked into that idea in great detail, and I am afraid that I am advised, and have been persuaded by that advice, that it will not work. It has been tried in other parts of the world and they have found that the number of false positives is very high, meaning that they end up quarantining more people. The number of false negatives is also very high, so such checks actually find very few of the people they are looking for. I am afraid it is not a recommendation that I feel I could make on the current evidence that I have seen.

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Which are the countries in Europe that have a higher infection rate than us and from which we are protecting ourselves with the Secretary of State’s blanket quarantine policy?

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First, I would rather not see any new infection coming to the UK. Secondly, on a point of policy, the approach that we are taking is to ensure that we protect this country from the incidence of disease coming in from abroad, and also to look at travel corridors when we can be confident that we can have that travel without reimporting the virus.

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The chief executive of the Nuffield Trust has written:

“Even if a second wave is prevented, resuming routine hospital, primary care and dental services…is going to be all but impossible without a vaccine.”

The Secretary of State will be aware that losing such vital services will simply lead to lives being lost through a variety of other causes, so what discussions has he held with healthcare professionals about a medium to long-term strategy to allow vital services to resume under the changed conditions of the new normal?

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This is an extremely important point. Infection prevention and control within the NHS is vital, but it also leads to constraints on how the NHS can operate, and it is one of the main things that we are worried about as we get the NHS restarted.

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Will my right hon. Friend join me in congratulating the British Army units based in my constituency, in Wiltshire, on the support that they have given to the NHS in coping with the crisis on logistics, building the Nightingale hospitals and so on? Does he welcome the new spirit of collaboration and openness by the NHS, which has shown a great willingness to collaborate with other parts of the public sector? Can we hope that that might be sustained?

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Yes, it must. I agree with my hon. Friend strongly on both counts. The Army and all the armed services have played a huge role in responding to this crisis, on the logistics, the delivery of testing, the building of Nightingale hospitals right across the UK and much more. The NHS has worked like never before with organisations public and private outwith it, and that culture of openness, porous borders and working collaboratively with councils, the armed services, private companies and the rest of Government has been a huge step forward for the NHS and one that we should never take back.

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Research from Harvard and Queen Mary University clearly shows a dramatic increase in the level of deaths and infections from covid-19 in higher pollution areas. Given that BAME communities tend to live in higher pollution areas, will the Secretary of State accept that this is a major factor in their disproportionate death rate? What is he doing with colleagues to ensure that we have low pollution levels as we come out of covid? Will he meet me to consider proposals from scientists, businesses, academics and local authorities, published by the all-party parliamentary group on air pollution, on a strategy for coming out of lockdown with low air pollution to reduce death and infection rates?

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The hon. Gentleman—he is my hon. Friend when it comes to air pollution—and I share a passion for clean air. He is right about deaths being correlated with areas of high air pollution. We are looking at the reasons behind the disproportionate number of BAME deaths, and we will take air pollution into account in that work. On the final point, it is a bit like an earlier question asked by one of my hon. Friends from a completely different angle—some things have got better in this crisis. Overall, of course, the crisis has been terrible, but some things have got better. One is air pollution. Let us cling on to that and redouble our efforts to keep clean air for the future

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During the covid crisis, the relaxation of constraints on data sharing has enabled my local hospital, Stepping Hill, Stockport Council and other bodies such as the CCG and partners to work together. The information sharing that they have been able to do has given a better service to patients. Is that something we could take forward? Perhaps a report could be commissioned by the Department or the National Audit Office on the benefits of enhanced data sharing.

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Yes. This is the third question in a row on some of the benefits we have learnt about during the coronavirus crisis. We made clear at the start of the crisis that data-sharing rules should not get in the way of treatments that can improve and save lives. That has had a hugely positive impact on people’s capability to treat individuals and do research, and we will not be going back on that. The one pager that we put out to the whole NHS on how to manage information governance in a way that keeps information secure but does not get caught up by some of the out-of-date data protection rules that had been followed will stay. Indeed, I hope to strengthen it in order that data can be better used right across the NHS.

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I thank the Secretary of State for giving us this update. Groups such as Links Counselling in my constituency report that referrals to children and adolescent mental health services are down as much as 50% in some areas during lockdown, which he will agree is very concerning. Can he outline what recent assessments have been made of the impact of covid-19 on children and young people’s mental health—specifically the impact of school closures—and what steps he will take alongside the devolved regions to address this vital issue?

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This is a vital issue and the hon. Lady is right to raise it. We have to ensure that we have the mental health services and that, crucially, people come forward for support for their mental health if they need it. We have found in paediatric mental health that telemedicine—treatment and psychiatry over a screen—can in fact be more effective than face-to-face treatment, because it is easier to do it in one’s own home rather than having to go through the worry and concern of travelling. That is an interesting and important finding. We have to make sure that we seize those benefits, as well as, of course, ensuring that people come forward and that the availability of mental health treatment is there.

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In Buckinghamshire and the south-east, accident and emergency activity is still down by about 22%, and cancer referrals are running at about 60% of the baseline average. Will my right hon. Friend join me in sending out a clear message once more that if people think something is wrong and they need medical treatment, our incredible NHS is open and they should seek the help they need?

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Yes. The NHS is open and we need people to help us to help them by coming forward, especially if they have a fear of cancer, heart disease, stroke or any of the predictive signs of a much more serious illness. On A&Es, we have seen a very sharp decline in the number. We want people who need emergency treatment to come forward. The sharpest decline has been in the number of people attending with the lowest acuity problems. They may be able to find healthcare more appropriately elsewhere. People should consider carefully whether they really need to go to A&E. Instead, it may be beneficial to call 111.

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Further to that question, there are two other aspects of the coronavirus lockdown. First, a lot more people are using bicycles, which has led to a very significant increase in the number of head injuries, in particular to children who are not wearing helmets. Some areas are reporting that the total this year has already exceeded the total they had for the whole of last year. Secondly, a lot more people are in the open air and in the sun. Many of them are not covering up and getting sunburnt, which is a real danger in terms of future skin cancers. Can the Secretary of State please start two specific pieces of work: on skin cancer and ensuring we get the right message out about covering up in the sun; and on wearing a helmet and looking after people who have had brain injuries?

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Yes. I am very happy to write to the hon. Gentleman about what we can do in those two areas, on which I know he has campaigned very hard. The one thing I would say on the positive side is that over the past few months the early signs are that the likelihood of dying as a 5 to 14-year-old has probably been at its lowest ever. It has been much safer in lockdown because, for instance, there are far fewer road traffic accidents and because the likelihood of dying from coronavirus as a child is very, very low. Overall, it has been a safe time if measured by that ultimate measure of how many children have died. It is much lower than usual, which is a good thing, but he is right to raise the points he does.

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Over 10,000 people in the UK, including my wife, suffer from cystic fibrosis. Coronavirus adds a significant risk to CF patients, who already have a limited life expectancy. CF sufferers and their families were offered a significant lifeline when the Secretary of State agreed to fund the lifesaving drug Orkambi last year, but there is a new drug called Trikafta that has been granted a licence in the US. This is a wonder drug that will extend the lives of CF patients. The father of Sarah Jayne Lilliman, from Eastwood in my constituency, who sadly passed away a few years ago, has asked if the Secretary of State can assure the CF community in the UK that he will do all he can to make sure this drug is available and extend the lives of thousands of people.

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Yes, I will do absolutely everything I can. I did not know that my hon. Friend’s wife suffered from cystic fibrosis. I am absolutely determined to make this happen. I worked really hard with the CF community to land Orkambi and I was very proud when we managed to do that. Thank goodness we did that before coronavirus struck, because for many who caught coronavirus it was literally a lifeline. Trikafta has great promise: it promises to be able to treat almost all CF sufferers, as opposed to the approximately half that Orkambi successfully treats. I have been working on that even during the crisis and I really, really hope we can make some progress.

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On 5 May, the first trial of the NHS covid-19 app started on the Isle of Wight. Since then information on the app’s development has been scarce. It has been beset by delays, with media reports suggesting that the app has some technical problems with accurately estimating distance between phones. That is worrying because the app is intended to expand contact tracing in England. When will the Health Secretary publish the results of the pilot and outline his plans for a wider roll-out of the app?

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Those reports were wide of the remark and the app does not have a problem with the measurement of distance. But I will come forward with an update very soon.

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The staff at Epsom General Hospital and the Epsom and St Helier University Hospitals NHS Trust have done a fantastic job in recent weeks dealing with the virus. The Secretary of State will know that this is one of the trusts that has a provisional allocation of funds to build a new hospital in the area. I am particularly concerned to ensure that before final decisions are taken on exactly how that money should be spent, the lessons from the pandemic are learned and any changes that need to be made as a result of what we now know and that may be needed for future hospital services are taken into account. Can he give me an assurance that he will make sure that happens?

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My right hon. Friend is an incredible campaigner for Epsom General Hospital. The injection of approximately half a billion pounds into the local health economy will be a very welcome step. We absolutely have to ensure that the lessons of covid are learnt before the new development goes ahead, but I commend all those staff at the Epsom and St Helier hospitals for the work they have done, some of which has been done under great pressure. I also commend the leadership of the trust, who have done a fantastic job.

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The Secretary of State did not answer the question from the hon. Member for Central Ayrshire (Dr Whitford), so I thought I would give him another chance. Can he explain why £108 million of the £350 million of personal protective equipment contracts was awarded, without being advertised, to Crisp Websites Ltd, which trades as PestFix, a small pest extermination company? Why was such a large contract awarded to a company with no expertise in trading or supplying any PPE, let alone highly specialised equipment for NHS staff? How do the Government think that such a small company, with only £18,000 of registered assets, can manage the cash flow required to procure £108 million of PPE?

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When the demand for PPE shot up, as it did not only here, but around the world, we worked with so many companies to deliver extra PPE, and we have managed to deliver on what was needed. That is why we have now the medium-term supply chains in prospect. I pay tribute to all my commercial team, who did extraordinary and sometimes innovative things in order to make that happen, and that is what they did.

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From the very beginning, clinicians in every developed country in the world have thrown the entire contents of the medical cabinet at this disease in the hope of finding something that works. To what does the Health Secretary attribute the success that he has reported today?

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I attribute the success to great British science, Government-supported funding, the NHS, and the three working together. I put it down to British ingenuity in our brilliant university base, combined with the funding that we put in right at the start and with the fact that with the NHS we can get easy access to a very large patient base, which means we have the biggest clinical trials in the world. In addition, crucially, when we were under pressure and others around were saying, “Hydroxychloroquine is going to solve all your problems”, we stuck with the clinical trials and with the science, and we have successfully delivered this one treatment. It is not a cure, it is a treatment, but it is a good stride down the road.

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The Secretary of State mentioned student nurses who were taken on for six-month extended clinical placements back in March and said that he would continue to pay them until the end of the summer. Can he just clarify for the House that that means the full six-month contracts will be honoured? Many of these nurses gave up other paid jobs and will be left in hardship if they do not have their contracts honoured.

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The statement that I read out in response to the urgent question was drawn from work that Ruth May, the chief nursing officer, has been doing to ensure that that is what happens.

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Loneliness and isolation have been the constant companions of many over these past few weeks, so I warmly welcome the social bubbles that will help ease them. Will my right hon. Friend join me in thanking my constituents Tracy Carr of Talk It Out, Beverley-Jayne Last of Super Neighbours, and the occupational therapist Justine Norris, who have been working tirelessly over the past few weeks to support the mental health and wellbeing of so many people at home during this pandemic?

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My hon. Friend speaks movingly of the support that so many have given, and her three constituents deserve our praise for their work—along with hundreds of thousands, if not millions, of others—to support those who have been living alone. Whether the 2.2 million people who are shielding because they are clinically extremely vulnerable, or the over 8 million people who live on their own and therefore have had to stay on their own during lockdown, this has been a difficult time for many. I pay tribute to the community spirit and support for others that so many have demonstrated.

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The link between poverty and poor mental health is well understood. As the covid easing continues, we face the prospect of an economic depression the likes of which we have not seen since perhaps the 1930s, and ahead looms the potential for a post-covid mental health pandemic. What specific and additional resources is he prepared to commit to alleviate that risk?

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Nobody wants to see the sort of economic consequences that we have already seen—even if there are more to come—but we have to take these measures in order to tackle this pandemic. We have put extra support into mental health, and more is to come. It is a really important part of the solution.

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This is the first opportunity that I have had on the behalf of my constituents to thank publicly the Secretary of State, his ministerial team, the entire civil service team and all their families for what they have contributed in this national effort. I thank all those people through him.

Local authorities in Bedfordshire have the highest incidence rate of coronavirus across the east of England. The Secretary of State said in his statement that the processes are in place to escalate concerns if there needs to be a local lockdown, but there are local concerns about the availability of local data. What is the current state of localised data? What efforts is he making to improve its availability?

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Localised data is available through the work of Public Health England and local directors of public health, including the director for Bedfordshire, and then through our survey data, although that is stronger at the national level than at the regional or local levels. Pulling all this data together, and then ensuring that it gets to the decision makers so that they can base their decisions on it, is the task of the joint biosecurity centre. I will ask its head to write to my hon. Friend with details of the data it has on Bedfordshire and what further data it is working on in order to answer the questions that my hon. Friend rightly asks.

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Will the Health Secretary confirm that, in May, his Department wanted local councils to have local outbreak plans ready for 1 June, but that councils had to ask him to move the deadline to later this month because his Department had been so late in asking them?

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I do not recognise that, no.

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The nation’s health recovery and the important strides made in recent weeks give us an opportunity, as well as a responsibility, to leave no stone unturned in our drive for economic recovery. To that end, does my right hon. Friend agree that the regeneration of Winsford town centre, the building of the women’s football national centre of excellence, and the reopening of Beeston Castle and Tarporley station are all projects in Eddisbury that a go-getting Government can now get on and deliver?

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Yes, absolutely. Given the economic consequences of the pandemic, it is vital that we get on with these go-getting economic projects. I wish my hon. Friend well in his support of them, and I wish everybody involved in them well in delivering them.

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Test, trace and isolate is obviously key to stopping a second wave, particularly in England, where lockdown has been relaxed at quite the rate. Is it not therefore a little bit shambolic that the Government’s flagship app is still only available on the Isle of Wight?

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I would like to begin by congratulating my right hon. Friend on the successful roll-out of dexamethasone, but my question is about international comparison. We were one of the later countries to be hit by the virus. There are others who have begun the process of moving out of lockdown ahead of us. What countries does my right hon. Friend see as the paradigm for the United Kingdom, and what steps, if any, are we taking to share information with healthcare professionals to emulate best practice?

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This is a great question, and we look all the time for countries around the world that we can learn from. It is true that, in terms of where we were on the epidemiological curve, we went into lockdown before many European countries—before Germany, Spain and Italy—with lower cases per million. But we still learned from them. For instance, one of the lessons from Germany is that a massive testing regime is incredibly important, and we now have a much bigger testing regime than Germany, which is terrific, and we have built that up. We also look to the far east, with its lessons from severe acute respiratory syndrome and middle east respiratory syndrome, which it learned more directly. It has the contact tracing which we are putting in place. We are constantly learning. Probably the single most important thing that we can do in this crisis is constantly look around the world for places where we can learn best practice, and then implement it here.

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The Secretary of State will be reassured that on Monday the Select Committee on Housing, Communities and Local Government heard from representatives of the Local Government Association and directors of public health that relationships and co-ordination between the local level and the centre on testing, tracing and contacting people had substantially improved. But two concerns were raised. First was the number of people who were testing positive and refusing to give details of their contacts. Should we not bring in penalties to try to ensure that that happens? Secondly, there was concern about people who were contacted after having been traced, but did not want to isolate. Recognising that people can lose substantial amounts of income in this situation, should we not bring in something like the furlough scheme to recompense people who can lose out financially by isolating themselves?

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The hon. Gentleman raises three points. First, we have put a huge amount of effort into ensuring that the local-to-national links are strong in test and trace. I pay tribute to Tom Riordan, the chief executive of Leeds City Council, who has come into the programme on secondment from Leeds in order to deliver those links. He has done an absolutely brilliant job, and I pay tribute to him. On the hon. Gentleman’s second point, we do not rule out mandatory contact tracing, but we want to get the system up and running, and it would be far better if it worked on a voluntary basis in the first instance. On his third point, we have put in place more support to ensure that people get the financial support they need to be able to do the right thing. The evidence is that the vast majority of people do, but of course we keep this under review.

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I join my right hon. Friend in welcoming the tremendous news on treatment with dexamethasone. Following on from that, can he update the House first on what progress we are making towards a vaccine, and secondly on what progress we are making with our manufacturing capacity for a vaccine, so that when we get it we are able to roll it out at speed, including with Cobra Biologics in my constituency?

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I am absolutely determined that should a vaccine come through, we are able to roll it out—in the first instance to those who are most vulnerable—across the UK, including to my hon. Friend’s constituents in Newcastle-under-Lyme. That is incredibly important. As I said in my statement, AstraZeneca has now signed the contract to manufacture the vaccine, even ahead of the successful conclusion of clinical trials, which shows confidence. The Imperial vaccine, which is not as far ahead as the Oxford vaccine, but is promising and based on a different vaccine technology, which is important—it is slightly different—has gone into human trials as well.

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The findings of the PHE report into the disproportionate impact of the coronavirus on black and minority ethnic people are or should be embarrassing—they should be collectively embarrassing. If we agree not to point the finger and if we all take our share of the blame for the structural racism that so very clearly exists, can we stop denying it, stop making excuses for it and start working together to dismantle it? And can we do it quickly, because people have rightly had enough?

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I agree with every word that the hon. Lady says.

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I join my right hon. Friend in celebrating this best of British treatment that we are getting, but does he also share my concern that not everyone is going to the NHS who needs to for cancer and A&E? Will he join me in telling the people of Rother Valley, “If you need treatment, please go to Rotherham Hospital, please go to the NHS, please get treated.”?

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My hon. Friend is quite right. The NHS is open, and if people need NHS treatment, please come forward. If people are advised by a clinician to go to hospital, please do that.

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Including A&E. I call Chi Onwurah.

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Absent a vaccine, the key to unlocking our economic and social lives is an effective test, trace and isolate system. The app, which can really help save lives, is behind schedule, so can the Secretary of State update us on the Isle of Wight trial, and specifically whether it has raised issues with the technology on Apple and/or Android phones; the levels of take-up; and an idea as to when it will be more widely available?

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As well as being a huge enthusiast for the A&E in Chorley and working on that, Mr Speaker, I am also a huge enthusiast for the use of technology. The No. 1 lesson we learned from the Isle of Wight was that it is important to get the human contact first and use the technology to underpin the human contact tracing. What is interesting is that we are learning that to persuade people to isolate—it is obvious really—a human contact, a phone call with a real person on the other end, is the best way to do it. We have a much higher number of contact tracers per head of population in this country now than almost any of our comparators.

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I am pleased the Secretary of State is a fan of Chorley A&E: we look forward to it opening very shortly. I call Flick Drummond.

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I welcome the psychological first aid training that my right hon. Friend launched this week so that frontline workers can support people with mental health problems. However, I am also concerned about the mental health of key workers themselves, particularly those in the NHS who have been working non-stop since January, many with last-minute rota changes and no prospect of a break soon. Will my right hon. Friend outline what we are doing to support key workers at this difficult time?

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Yes. My hon. Friend makes an incredibly important point, which is that the mental health of our key workers, including those working in the NHS and social care, is incredibly important. One of the things we put in place in the crisis is a hotline. That support should have been there long before, frankly, and we will maintain it for as long as possible, because is so important to support the physical and mental health of the carers who care for us.

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

Sitting suspended.