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Commons Chamber

Volume 677: debated on Tuesday 23 June 2020

House of Commons

Tuesday 23 June 2020

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

Virtual participation in proceedings commenced (Order, 4 June).

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

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

Cancer Services

What steps he is taking to tackle regional variations in the restoration of cancer services after the covid-19 outbreak. (903679)

What steps his Department is taking to enable the resumption of cancer treatments delayed as a result of the covid-19 outbreak. (903723)

Essential and urgent cancer treatment has continued throughout the pandemic and cancer specialists, as always, are discussing the best treatment options with their patients. We are working to ensure that referrals, diagnostics and cancer treatment are back at pre-pandemic levels across the whole of England as soon as possible. Due to covid-19, the 21 cancer alliances in England have established hubs to ensure dedicated cancer care away from hospitals dealing with the virus. From the end of April, local systems and cancer alliances have continued to identify ring-fenced diagnostic and surgical capacity for cancer in line with issued guidance. Regional cancer senior responsible officers must now provide assurance that these arrangements are in place to help minimal regional variation.

I thank the Minister for that comprehensive reply, but she knows that people living with cancer are experiencing cancellation and delays to treatment all over the country, and that is causing anxiety and distress to many families. In getting people urgently back into treatment, will she look at the 12-point plan for restoration, recovery and transformation of cancer services outlined by Macmillan Cancer Support, Cancer Research UK and 23 other cancer charities, to ensure that cancer does not become the forgotten C during the coronavirus crisis?

I regularly engage with cancer charities and would be delighted to look at them to see where we are making good headway and where, perhaps, we could have discussions about other things that need to be targeted. While I have the hon. Gentleman on the screen, I would also like to highlight the fact that the Greater Manchester cancer alliance has led the way in its response to this pandemic. It was one of the first to establish a surgical hub model to ensure that cancer surgery was able to continue and that the local cancer system as a whole responded well. The alliance has also been looking to accelerate the rapid diagnostic centre to help promote diagnostics, so I thank everyone for that.

As the Minister knows, being diagnosed with cancer is devastating, and one of the most important things to get patients through this difficult time is for them to be able to focus on their treatment. What message does the Minister have to comfort those people who are worried and stressed because they still cannot access the treatment they need because of covid-19?

I would say that, as soon as people notice any signs that might worry them, they should seek help. We have worked at pace to ensure that services have been resumed and are able to deliver for patients. Ensuring both early diagnosis and that patients can access the treatment that they need swiftly is our key ambition. We know that, following the guidance that has been delivered, we are achieving that throughout the system. Covid-19 has upended all our lives, and some decisions have been made to ensure the safety of patients, but we are now firmly back on track and will ensure that patients get the care they need.

Yesterday, the One Cancer Voice network of 25 charities published plans for restoring vital cancer services. I wrote to the Minister on 17 April with my own suggestion. Ideas included advanced radiotherapy, new models of chemotherapy, better cancer pathways and renewed screening and communication plans. This is not just about rebuilding what we had, but about making services better. If the Government are slow to do that, we face a cancer bubble that risks thousands of lives. Will the Minister commit to working with those charities and with me and other interested parliamentarians to form a cancer recovery plan to head off this looming crisis?

I assure the hon. Gentleman that, just as we have seen from working closely on the Medicines and Medical Devices Bill that is going through Parliament, there are lessons to be learned. There have been improvements in certain areas of radiotherapy in which it has been determined that fewer treatments actually mean a quicker and—I would not use the word “gentler”—an easier path for the patient. I would be happy to continue working both with him and with the cancer charities to ensure that we can improve that pathway for patients.

Adult Day Centres: Reopening

What his timetable is for the reopening of adult day centres for people with learning difficulties after the covid-19 outbreak. (903680)

I know how difficult it has been for people with learning disabilities and their families during lockdown, particularly without the back-up of day centres. I want to see those important services reopening as soon as it is possible and safe to do so, but that decision will need to be made locally. We are talking to the Local Government Association and others about what guidance and support may be needed to get day services up and running again.

I thank the Minister for that answer, and I would like to wish her a happy birthday. Unlike schools, day centres such as Whitemoor in my Derbyshire constituency are normally open throughout the summer to provide desperately needed stimulation for many adults with special needs. What measures will she introduce to ensure that staff working at day centres are adequately supported to function as safely as possible, as soon as possible?

I thank my hon. Friend for her birthday greetings. She makes a really important point: as day centres reopen, they need to be safe for staff and users. Risk assessments will need to be carried out, and some may need to use personal protective equipment. Public Health England is developing guidance on the use of PPE in community settings. Local authority-run services should have PPE provided by the local authority, and services provided by other organisations that struggle to get PPE from wholesalers should be able to access emergency local supplies.

Referral-to-Treatment Waiting Lists

The most recent performance data published by NHS England for April 2020 shows an 8% reduction in the size of the waiting lists compared with April 2019, from 4,297,571 to 3,942,748. However, it is important to note that reduced referrals due to covid-19 are likely to be the cause of that, and there are a number of people waiting longer.

To address the inevitable increase in waiting times for non-covid treatments, back in March the Government contracted private health providers to supply some 8,000 bed spaces at a cost of millions of pounds to the NHS and taxpayers. It was reported that a significant proportion of that capacity has been paid for but underused. The Government are now considering further contracts with private sector hospitals. How can we be confident that money will not be wasted again and that those waiting will get the treatment they so badly need?

I gently say to the hon. Lady that I do not think that contracting to ensure sufficient capacity in our NHS at all times, so that it was never overwhelmed, which it has not been, was a waste of money. In response to her substantive point, we continue to work with the independent sector and the broader NHS to get elective surgery and other non-emergency procedures restarted at pace.

Covid-19: BAME Health

There was a passionate debate on this issue last Thursday. As I said then, there is no doubt that covid-19 has upended our lives. The virus cruelly discriminates by many factors, including age, gender and ethnicity. There are still gaps in our understanding of occupational risks and co-morbidity that need attention. My hon. Friend the Minister for Equalities will be taking forward important cross-Government work with the Equality Hub, Public Health England and others.

We now know the full extent to which covid and other health inequalities affect black and minority ethnic communities, and the extent to which that is reflected in regional inequalities, but does the Minister also understand how much such inequality prevails within boroughs? In my local authority, there is a 16-year life expectancy gap between the poorest communities and the wealthiest, which reflects the disparity with black and minority ethnic communities. Will she ensure that an equalities review tackles inequality within boroughs as well as between them, and will there be funding to support that?

We know that health inequalities are stubborn, persistent and difficult to change—we knew that before covid-19, but that is not a reason to accept them. We fully agree that more needs to be done to reduce the disparity in health outcomes within the BAME community and the broader community. That is why we will ensure that the work on health inequalities goes on at pace.

Test and Trace

NHS Test and Trace was introduced on 28 May, working with local authorities to prevent and contain the spread of covid-19. I am encouraged by the early results, which show that in the first two weeks of operation 87,000 people were contacted by NHS Test and Trace and agreed to self-isolate.

The Secretary of State will recall that I wrote to him a little while ago suggesting that an approach that was a bit more Shoreditch and a little less Whitehall might be effective. Given the lack of success of the app, maybe he could have taken that advice. I am pleased that Hackney Council is one of the five areas that is piloting this, working with GPs and other health professionals in public health and so on, but the critical thing is that we are not getting the data locally that we need to do the proper tracing of those who were close to someone who has tested positive. When will that data arrive? Without it, it is like working with one arm tied behind our back.

The amount of data flowing to local authorities has increased substantially over the past few weeks since the start of the operation at the end of last month, and there will be more coming very, very soon.

We all want to see lockdown eased, but that reopening will only be safe if the system to test, trace and isolate is working effectively. As more people return to work, start to travel on public transport, and perhaps even go to pubs, cafés and hairdressers—albeit keeping their distance—the ability to trace contact people we do not know will become much more important. The Secretary of State initially said that the app would be rolled out in mid-May; it is now the end of June. When are we actually going to see the app in action?

Obviously, as soon as possible. I agree very strongly with the hon. Lady about the importance of contact tracing—the Test and Trace programme is one of the largest of its kind—to ensure that, as we manage to lift national measures, which we can because the disease is clearly under control and the number of cases is coming down, we can then respond through local action.

NHS Test and Trace will play an important part in our continued fight against covid-19, but efficient co-ordination across Great Britain will be vital to its success. What steps has my right hon. Friend taken to ensure effective joint working between England, Wales and Scotland?

That is an incredibly important question. Of course, I would add Northern Ireland to that group. We have regular meetings. I have a weekly call with my counterparts in the devolved Governments. Of course, the devolved Governments have a huge role to play in this. I will give whatever support I can to help the Welsh Government to make sure that they can deliver contact tracing, and indeed the wider testing programme, as well as possible.

Will the Minister urgently set out a plan to support local authorities to implement local lockdowns if needed, along with providing them with all the resources they need to implement this?

NHS Test and Trace is currently tracing the contacts of about 700 people every day who have the virus, but the Office for National Statistics says that 2,500 new people are being infected every day, which means that since the programme started, up to a quarter of a million people have not been asked to isolate who should have been. It is a big achievement to get the programme going, but that is also a big gap. What are the Secretary of State’s plans to close it?

I am not sure I agree with my right hon. Friend’s figures in terms of the assumptions that underpin them. We have had this discussion and this exchange before. There are a whole number of asymptomatic cases. The critical thing about Test and Trace is to find as many of the asymptomatic cases, and as many of the positive test result cases, as possible. We need to do that over time by expanding the programme.

While a proximity app would assist in identifying casual contacts, many people were concerned that a centralised model would harvest their data. In the trial, this one failed to detect 96% of contacts. So why did the Secretary of State persist so long with an app that simply did not work on the majority of phones?

I am afraid the hon. Lady is wrong. The trials in the Isle of Wight showed that the app worked on Android phones, but was blocked from working effectively on Apple phones; hence we are now working with Apple and Google, as we have been over the past few weeks, to find a system that can be effective. But I will not sign off on an app where we do not know and have not been told by some multinational company what it is recommending to people because, after all, the critical thing that matters in test and trace is that people isolate to break the chain of transmission.

I would gently suggest that iPhones are actually quite common, so it is important that it does work on iPhones. The boss of Serco has admitted that its contact tracing system will not be fully functioning until the autumn, and we find that actually local public health teams are carrying out the vast majority of contact tracing, so would Government money not be better spent reversing five years of budget cuts to public health?

It is very strange taking these questions from the SNP spokesman, given that I am working with the SNP Government on resolving exactly these problems in Scotland, and maybe the SNP would do better to focus there. In response to the second question, honestly, we have put £300 million of support into local directors of public health to tackle this pandemic, and I know that her colleagues in the Scottish Government are working hard with local authorities in Scotland as well in exactly the same way.

The Prime Minister promised that 100,000 people a day would be tested by the end of April, so since that date, on how many occasions have more than 100,000 people been tested on any single day?

I have not got those data exactly—[Interruption.] If the Opposition would care to engage on the substance, rather than not taking this seriously, yesterday, we delivered the 8 millionth test in this country. We have delivered more than 100,000 tests on almost every day since the end of April and at the end of last week we were delivering 230,000 tests a day. I think what we need from the Opposition is support for the testing programme, because that is what people care about.

Infant Mental Health Awareness

I understand that Infant Mental Health Awareness Week was a great success. There is much to be gained from seeing the world through a baby’s eyes.

I am grateful to the Secretary of State for that short answer. We have heard much about the impact of lockdown on school-age children away from school, but little on the impact on babies and new parents facing particular challenges on their emotional wellbeing. Has the Secretary of State or the Minister, if she has got her voice back, seen the research published during Infant Mental Health Awareness Week by the First 1001 Days Movement last week, suggesting that three quarters of parents with children under two are feeling the detrimental impact of the lockdown, particularly BAME parents? What are the Government doing to put this crucial cohort on the radar and provide support before they grow up and take the problems to school and beyond?

My hon. Friend is absolutely right on this. I applaud the work of the First 1001 Days Movement. It is incredibly important. I strongly support the work that it has done to highlight the importance of the early days of life and the time before the birth of children. I have seen that report. I have discussed it with the Minister and we are working very hard to put that into effect.

Social Care Sector

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (903686)

Social care is at the frontline of this cruel global pandemic here in the UK and around the world. We have brought together support across Government, the NHS, Public Health England, local health protection teams, the Care Quality Commission and local authorities, and done our utmost to help care homes and home care services to look after those in their care. The majority of care providers have been covid-free. Our support includes access to testing, PPE, guidance based on evidence from around the world, improved oversight and funding.

I have received many emails from constituents who are desperate to see and visit their family members in care homes, after months of not seeing them. Will my hon. Friend assure me and care workers in Ashfield and Eastwood that the Government will do everything they can to ensure that care homes have the right support and guidance, so that they are prepared to deal with an influx of friends and family visitors as they begin to open their doors in a safe way?

My hon. Friend makes an important point. I know that the current restriction on visiting is hard for residents in care homes and their families, and has a real impact on health and wellbeing. We are updating our visitor guidance and intend to publish it soon.

I, too, wish the Minister a very happy birthday.

I am sure the Minister will agree that lessons must be learned from what has happened so far, because the virus is not over for social care. With 13,375 deaths from covid-19 in care homes, what does she think she should have done differently?

The hon. Lady is absolutely right that there will be a time when we will look back and learn lessons, and I wish that not so many people had died in social care, but right now we are looking ahead. We are making sure that we have in place the plans to support the social care sector through the months ahead, and we are also pressing ahead with work on social care reform.

Cancer Centres: Radiation Therapy

If he will publish the timetable for the NHS England plan to roll out stereotactic ablative radiotherapy to all cancer centres by April 2021. (903688)

I thank the hon. Gentleman and the other members of the all-party group on radiotherapy and cancer for meeting me and officials recently. It is expected that each of the 50 NHS trusts that provide radiotherapy will be able to deliver stereotactic ablative radiotherapy no later than 31 March 2021. Increased external quality assurance capacity means that we could complete the roll-out process for all commissioned indications quicker than that. I am sure the hon. Gentleman would agree that such a result would be fantastic.

I very much welcome the Minister’s response and thank her personally for her excellent attention to this matter and the progress that she has helped to make possible. Of course, with a 60% drop in the number of cancer referrals and a 20% drop in the number of people starting cancer treatment, we have late diagnoses and a backlog that could, tragically, kill more people than covid. Will the Minister therefore go further and faster and deploy expanded radiotherapy treatment this summer to clear the backlog? Will she commit to appointing a radiotherapy tsar and to a rolling radiotherapy fund, so that we can stop more lives being unnecessarily lost?

The hon. Gentleman will know which parts of that are still open for discussion between us, but we are of course driving hard to make sure that patients get their radiotherapy and treatment as quickly as they can. The NHS has a “Help Us Help You” campaign: it is open for business and people should make sure that they attend any appointment they are called to.

NHS Workers: Mental Health

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903689)

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903697)

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903703)

Our NHS workers—from the doctors, nurses and allied health professionals to the healthcare assistants, porters and all those who work behind the scenes—are truly heroes. I wish to say a special thank you to students: thank you to the medical students and nursing students who courageously stepped up to work at the frontline in a global pandemic. I am determined to do all that we can for our NHS workers. We have set up a round-the-clock mental health support line, which includes a freephone helpline run by the Samaritans and an out-of-hours text support service provided by Shout.

I thank the Minister for her answer and wish her a very happy birthday.

Due to physical challenges with geography in rural communities, such as much of my Truro and Falmouth constituency, there can be higher incidences of mental health issues, loneliness and isolation, and that has been intensified by the covid-19 pandemic. Will my hon. Friend provide an update on departmental plans for support for mental health issues in rural communities?

My hon. Friend is absolutely right: we anticipate an increase in demand for mental health support, including in rural communities, as a result of the pandemic. We are working with the NHS and a wide range of stakeholders to understand the need for mental health support all over the country and to make sure that that support is in place.

In my regular meetings with the Royal Wolverhampton NHS Trust, the issue of staff mental health has been repeatedly raised as a serious concern, especially among staff who are working with covid patients. Will the Minister join me in thanking those staff at New Cross Hospital and reassuring them that mental health support will be available for all staff who need it?

I would be delighted to join my hon. Friend in thanking the staff at New Cross Hospital for all that they have been doing in these incredibly difficult times. Mental health support absolutely should be, and is, there. There is the mental health support helpline and the text messaging service. It is also really important that NHS trusts take steps locally to ensure that their staff have the support that they need.

When we stood with our neighbours and clapped for the carers, we showed solidarity across the nation with them and recognised the strain, stress and anxiety under which many of them were working. Can the Minister assure me—and say what practical steps can be taken to ensure—that, as they work through the experiences they have had, they will get the care and support necessary for them, and that we care for our carers?

The clap for carers initiative was fantastic because it was a moment when we showed, as a nation, our support for our health and social care workers, but my right hon. and learned Friend is right that clapping is not enough. One thing that I want to do in the months ahead is bring forward the people plan—work that had to be paused because of covid—and to ensure that it includes all possible support for the NHS workforce, so that the NHS can be the best place to work in the world.

Even before the covid pandemic, our frontline NHS and care staff were already working in overstretched and under-resourced settings. It is heartbreaking to see how the virus has taken its toll on them. They have had to deal with redeployment, not enough PPE, a fear of losing patients and getting ill themselves. These are all factors leading to staff burnout and very poor mental health. After all their sacrifices, our frontline staff deserve their mental health to be taken seriously. Is the Minister satisfied with the Government’s current package of support for frontline NHS and care staff?

The hon. Member is absolutely right about how hard it has been for NHS staff stepping up, and we cannot say enough how grateful we are for what they have done. I also recognise the mental health burdens on the NHS workforce who have worked in these really stressful circumstances. It is important not only that the package of support is there now, but that it is there for some time to come, because we know that the trauma and effects of working in these environments may take a while to play through.

Cancer Targets

As my hon. Friend knows, one of our key commitments was to diagnose more cancers earlier. Through NHS England and NHS Improvement, the Government have committed over £1.3 billion to deliver this, including with an overhaul of screening programmes and new investment in state-of-the-art technology to transform the process of diagnosis and to boost research and innovation. I am sure that he will welcome the fact that 18 rapid diagnostic centres towards our target of 40 are already up and running, as well as the introduction of personalised care plans, which he and I both consider very important.

I do welcome that; I have visited many of the centres. Before the pandemic, we were battling to meet the cancer targets that I helped to set and that my hon. Friend now looks after so ably. Would she confirm that we have not lost sight of the 75% ambition in the long-term plan, and whether there will be a revision to the cancer section of the long-term plan in the light of the backlog of the stuff that we know? Of course, there is also plenty of stuff that we do not yet know that we know, as a result of presentations not coming forward through primary care.

There are lessons to be learned; that is essence of my hon. Friend’s question. I have met both Cally Palmer and Professor Peter Johnson throughout the crisis, and our focus on cancer has remained. Ensuring that we deliver on the long-term plan is a key objective, and I am sure that my hon. Friend will work with me on that.

Health and Social Care Workers

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak. (903691)

Our health and social care workforce are at the frontline in fighting this cruel disease. I would particularly like to talk about social care workers, who in the past have not had the same recognition as NHS workers. Let this pandemic be the moment when that changed and when we, as a society, recognise the skills, compassion and commitment of our entire care workforce. We have sought to put in place the same support for social care workers as there is for NHS workers and funding to local authorities to pass on to care providers, so that they can pay social care staff full wages for isolating due to covid-19.

I wish the Minister a happy birthday. The coronavirus pandemic has highlighted how vital social care workers are to our nation, and we as a House should thank them for the job that they do. Unpaid carers in particular have borne a huge weight throughout this pandemic, so will my hon. Friend tell the House what steps she has taken to support unpaid carers during this period?

Unpaid carers are vital in our society. Being an unpaid carer is hard at the best of times, but even harder during this pandemic, and my hon. Friend is right to draw attention to that. During the pandemic, we have published guidance specifically for carers. We provided funding to extend the Carers UK helpline, we made unpaid carers a priority group for testing, and we are working with local government to support the reopening of day care services as soon as it is safe to do so.

Covid-19: Continuing Healthcare

What plans he has in place for the provision of continuing healthcare for people recovering out of hospital from covid-19. (903692)

We know that people who have been very ill with covid will take some time to recover and may need ongoing help after they have left hospital. At the moment, as part of the covid emergency measures, continuing healthcare assessments are not required, which means that people can be properly discharged when they are well enough and have access to the ongoing healthcare they need.

Happy birthday to the Minister. Our wonderful NHS staff have helped so many people recover from this terrible disease and leave hospital, and many of them will have been ventilated for a long time. Is the Minister planning to set up a specialist service that helps with those very difficult cases where a lot of rehabilitation will be needed?

My hon. Friend raises an important point. We are still learning about the impact of this horrible disease, but we know it may take people some time to recover and they may need extra help after they have been discharged from hospital. We are indeed doing work to ensure that the right support is there for them.

Covid-19: Next Phase

What plans he has to ensure that the NHS has the capacity to tackle the next phase of the covid-19 outbreak. (903693)

What progress his Department has made on ensuring the provision of adequate critical care capacity in hospitals during the covid-19 outbreak. (903700)

What progress his Department has made on ensuring the provision of adequate critical care capacity in hospitals during the covid-19 outbreak. (903701)

What plans he has to ensure that the NHS has the capacity to tackle the next phase of the covid-19 outbreak. (903705)

Thanks to unprecedented action, we have protected the NHS. It was not overwhelmed during the peak of this crisis, and all covid-19 patients admitted to hospital were able to receive urgent treatment that they needed. We remain vigilant.

I thank the Minister for his answer, but after the end of the Brexit transition period, all four health services in the UK and Northern Ireland will face increased bureaucracy and increased costs to import drugs from Europe. On top of that, it has been estimated that a trade deal with the United States of America could increase the drugs bill from £18 billion to £45 billion. How will the Secretary of State prevent these extra costs from hampering NHS capacity?

First, there is no reason at all why the exit from the transition period should have the impact that the hon. and learned Lady describes. We have put in place a huge amount of work to ensure that Brexit works positively for our life sciences industry and indeed, as we do now, that we can buy pharmaceutical products from around the world, not just from within the European Union. As for the idea that somehow a trade deal will increase prices of drugs, that is flat wrong.

With the need for additional infection control measures, how can the Secretary of State ensure sufficient staff to support parents to spend time with their babies in special care baby units, when covid-19 is creating additional barriers to parents being with their baby as much as they want and need to be? Moreover, will he look at an emergency form of neonatal leave and pay, or a subsistence fund similar to Scotland’s, to allow parents affected by covid-19 to have the time they need with their baby?

We are putting in a huge amount of support for maternity services and other services across the NHS in England. Of course, when it comes to the hon. Gentleman’s constituents in Glasgow, he will have to ask the SNP Government.

Local construction firms are working around the clock to build the NHS Nightingale hospital in Exeter, based in my constituency of East Devon. I am sure the Secretary of State will agree that we all hope it will never have to be used. Can he assure my constituents that the Nightingale will help the Royal Devon and Exeter Hospital, our community hospitals and our health and wellbeing hub to continue to focus efforts on delivering the superb services that they are well known for across East Devon?

Absolutely. My hon. Friend is a great advocate for Devon, and for East Devon in particular. The Nightingale Hospital in Exeter will have more flexible uses than the previous Nightingales, so, for instance, it will be usable should there be extra winter pressures. This is all part of protecting our NHS. At the heart of our response to this dreadful disease, we protected the NHS, making sure it was always there for everyone. That has been down to, and is a testament to, the work of so many people, who delivered on that requirement.

Yesterday, our local NHS trust, the United Lincolnshire Hospitals NHS Trust, temporarily downgraded and closed emergency admissions at Grantham and District Hospital, in response to covid-19. After many years of uncertainty, there is understandable scepticism about this latest move by the trust. Will the Secretary of State join me in calling on the trust to ensure that these changes are indeed temporary and that covid is not used as cover to make them permanent?

Thanks to my hon. Friend’s assiduous work on behalf of his constituents in Grantham, and at his suggestion, I discussed this issue directly with NHS officials. Grantham’s unit will be open, 24/7, as an urgent treatment centre; this is part of plans to ensure that covid and non-covid services are kept as separate as possible. In addition, thanks to his intervention, we will ensure that that position will be reviewed quarterly.

The NHS in England had more than 40,000 nursing vacancies at the start of the covid pandemic, but student nurses stepped forward to contribute to the response. So why are many of their contracts now being terminated, given that they may well be needed this autumn? Would a better approach not be to increase nursing bursaries to £10,000, as they are in Scotland, where nursing vacancies are half those of England?

We have increased by about 10,000 the number of nurses in the NHS in the past year, and during the crisis that number increased further. We also set out at the start how we are paying student nurses, as they stepped up to the mark, as the hon. Gentleman rightly said. I am delighted that so many of them did, and we are sticking to the agreements that we set out with the student nurses at the start of the crisis.

Covid-19: Testing Kits for Care Homes

We are doing all we can to help care homes control and prevent covid outbreaks, and the majority of care homes have not had outbreaks. Testing is an important part of that. On 11 May, we launched a programme of testing all staff and residents in care homes, starting with older people and those with dementia, based on public health guidance. We met our target of offering tests to all these care homes by 6 June, which involved sending more than 1 million test kits to 9,000 care homes. We are now getting tests out to all the other Care Quality Commission-registered care homes for adults that ordered them on the testing portal.

Further to what my hon. Friend has said, will she confirm that there is a rolling programme to test for covid-19 in our care homes? Recently, a care home in my constituency had a whole-home test and found that someone was positive. When it then asked for another test for everyone, it was told by NHS England that it was not eligible, and that cannot be right.

I will say two things on that. First, when a care home has a new outbreak, either for the first time or after having recovered from a previous outbreak, it should contact its local health protection team to arrange for initial testing of symptomatic residents, in order to confirm the outbreak. The local health protection team or the director of public health can then refer the care home to the national testing team so that it can be prioritised for whole-home testing.

Mesh Treatment

What recent assessment he has made of the effectiveness of NHS services for the treatment of mesh complications. (903698)

Departmental officials have been working with NHS England and NHS Improvement to establish means of specialist support for those women requiring it. NHS England is in the process of commissioning a number of mesh removal centres, which it hopes to be operational later this year. We urge anyone who has concerns about their treatment to speak to a clinician.

I thank my hon. Friend for her answer, but I understand from constituents that many women have to travel miles for their operations in great discomfort, and that when they get there, they are told they are not eligible. As the Minister said, the mesh recovery centres have not yet been opened. I have met women who are going through utter pain and torment as a result of surgical mesh surgery. There are concerns that English and Welsh patients do not get the same monetary help as their Scottish counterparts. What is the Minister doing to address these issues?

On access to services, NHS England advises that it is aware of the negative impact that covid-19 is having on patients during what is a very challenging period. As a result of my hon. Friend’s question, I will ask officials to look into why women may or may not be eligible for services during this time. As healthcare is devolved, the Scottish element of his question is a matter for the Scottish Government. I would advise anyone who intends to make a claim for compensation or is having difficulty seeking services to seek independent advice or see a clinician. It is important to reiterate that NHS England is currently in the process of commissioning those specialist services for mesh removal, which it hopes will be operational later this year.

Covid-19: Vaccine

Vaccine development is progressing well, with human clinical trials underway by both the University of Oxford and Imperial College London. We are also exploring how other vaccines, both from the UK and internationally, can be deployed here should they show promise.

Can my right hon. Friend reassure me, the House and my Welsh constituents in Montgomeryshire that if and when a vaccine for covid-19 is developed, it will be rolled out in a UK-wide partnership? Will he work with the devolved healthcare systems but ensure that the vaccine is UK-accessed?

Yes, of course. That is an incredibly important question for anybody living in Scotland, Wales or Northern Ireland, like my hon. Friend’s constituents. The vaccine programme is being taken forward on a UK-wide basis. Of course people living in the devolved nations should have access to vaccines according to a prioritisation that is clinical and not based on where people live. We will absolutely work with the devolved authorities on the delivery and deployment of that vaccine. Of course, we want the whole country to get the vaccines, if they become available, according to clinical priority.

Topical Questions

Yesterday, clinicians set out our advice for those who are shielding because they are clinically extremely vulnerable. The whole House will want to pay tribute to the enormous sacrifice of that group, who are among the most vulnerable to covid-19. Very shortly, the Prime Minister will set out to the House the next steps to get the country back on her feet.

There is no doubt that lockdown has taken its toll on the mental health and wellbeing of many children of all ages, whether by way of social isolation, physical inactivity or a sense of loss. I know that my right hon. Friend is very exercised by that, so, as we understand more about the impact, will he look again at the long-term NHS plan to establish whether it is really able to meet what will be a more acute challenge in the future?

That is a very important question on supporting children’s mental health. We absolutely reiterate the long-term plan ambitions for service transformation and expansion. Indeed, one of the things we have learned during coronavirus is that when it comes to paediatric mental health, telemedicine can actually have a better and more effective impact than face to face. That is a good thing to have learned and will help the roll-out further.

On the app, the Secretary of State told us it was crucial and would be ready by mid-May. Experts warned him it would not work. He spent three months, wasted £12 million and has got nothing to show for it. It is a good job he is a tech-savvy expert on apps; otherwise, this would be a right shambles now, wouldn’t it?

On the contrary, ensuring that we use technology to its best possible effects is incredibly important. I would have thought that the shadow Secretary of State would want to side with and support the efforts of all those, including in the NHS, who are doing the work to ensure that we can get this up and running as quickly as possible.

In the past few days, I have been listening to the Secretary of State’s excuses. He is like the Eric Morecambe of the Commons: he has been playing all the right notes, just not necessarily in the right order. On test and trace, local areas such as Leicester, which has had a spike, still do not have local data; GPs still cannot refer people for testing; and NHS staff are still not tested regularly. He has spent £100 million on a Serco and Sitel call centre where the tracers are saying they have nothing to do. This is not a “world-beating” system; it is more like a wing and a prayer. When are we going to get a functional test, trace and isolate strategy?

The shadow Secretary of State is far better when he supports the Government than when he pretends to oppose them. We have all seen him explaining why the steps that the Government are taking are the sensible ones, why it is important to move from a national lockdown as much as is safely possible to local outbreak control, and why test and trace is important. When he gets on to saying that the money we have spent to protect the NHS and put in place the actions needed to get us out of the lockdown is wasted, I think that that is opposition for opposition’s sake.

Maintaining safe and healthy food standards is essential for public health. As we leave the European Union and sign trade deals around the world, what are Ministers doing to ensure that the system maintains public confidence? (903653)

As we sign trade deals around the world, we will have enhanced animal and food standards in this country, and of course the Food Standards Agency plays a vital role in ensuring that those standards are upheld.

On 21 May, the Prime Minister bowed to pressure and agreed to abolish the immigration health surcharge for NHS workers. However, NHS workers applying to renew their visas are being told by the Home Office that this policy is still being applied and is still in place. Why is this immoral and mean-spirited policy still being applied, in light of the Prime Minister’s clear promise? (903650)

We are putting this policy into action and it will be retrospective to the date of the announcement by the Prime Minister.

Yesterday’s announcement on easing restrictions for those like me who are among the 2.2 million people who have been shielding for months is very welcome. What reassurance can my right hon. Friend give on the scientific evidence that supported the decision to ease restrictions for shielders from 6 July and to finish them on 31 July? (903654)

I am absolutely delighted that my right hon. Friend will be able to follow guidance and take more steps out after 6 July. The decisions on shielding were all based on the best clinical advice. Dr Jenny Harries, the deputy chief medical officer, has led the medical advice on this programme with great élan and wisdom. The reason that we are able to make these changes and recommend these steps to my right hon. Friend and the 2.2 million others in his situation is that we have protected the NHS and got the virus right under control.

My constituent Jonathan e-mailed me to say:“Today for the first time my partner will see our baby and hear their tiny heartbeat. However, I’m writing to you from the car outside as she attends our 12 week scan. I’m banned from attending due to government guidelines.”Jonathan says he is being robbed of enjoying these special moments with Emma, yet they can shop together, travel on public transport and even visit the beach. What does the Secretary of State have to say to expectant fathers like him? (903651)

Of course it has been necessary to have tight controls over visitors in hospitals during this crisis, because people picking up nosocomial infections in hospital has been one part of the epidemic that we need to get under control. My heart goes out to those many people who have made sacrifices, including the hon. Member’s constituent, and of course we always keep this under review.

As we return to normality, we inevitably run a risk of a second wave of the virus. What infection threshold would my right hon. Friend consider sufficient to warrant further lockdown, and what criteria would be applied to determine the geographical ambit of any future lockdown? (903655)

My hon. Friend makes an important point. She may have seen this morning that in Germany, North Rhine-Westphalia has been put back into lockdown because of a local outbreak. So far, the local outbreaks we have seen have essentially been clusters in very small areas, and we have been able to bust those clusters and tackle them. We do, of course, hold the powers to have wider local lockdowns. Those will be based on judgments based on the epidemiological advice and advised by the joint biosecurity centre, working with all the relevant agencies.

The Secretary of State rightly says that black lives matter. The time for action is now, yet latest figures show that black African and black Caribbean people are four times more likely to be detained under the Mental Health Act. When will he bring forward the White Paper on the mental health Bill? Will he please ensure that that legislation enshrines the four principles laid out in the Wessely review, including treating the patient as an individual, so that we can start to tackle racial disparities in mental health treatment? (903652)

We will bring forward that White Paper. The work has been ongoing even while we have been dealing with coronavirus. As far as I am concerned, the Wessely review is one of the finest pieces of work on the treatment of mental ill health that has been done anywhere in the world.

We have just marked Loneliness Awareness Week. Does the Secretary of State agree that combating loneliness is vital in ensuring the health and wellbeing of elderly people? I have seen excellent work at the Rainbow Centre in Penley in my constituency and by the charity I helped to set up, the Concertina Charitable Trust, which provides live music in care homes and day centres. (903657)

Absolutely. When we set up the loneliness strategy in 2018, when I was the Culture Secretary, I had no idea that covid-19 would make it so vital. I very much hope that, in England at least, the measures the Prime Minister is due to set out very shortly might help in that regard. Covid has underlined the importance of loneliness as an issue that we must directly and actively tackle.

At the start of the crisis, as a former emergency planner for the NHS, I thought the Government would trust the local well-established emergency planning systems that were in place and they had my support. However, they have wasted time and money. My hon. Friend the Member for Leicester South (Jonathan Ashworth) is quite right to criticise the Government, because that has led to excess deaths and time lost. It is welcome that we are now supporting the local, but will the Secretary of State tell me why, when his friends at Deloitte have been set up to do the testing at Bristol airport, the complaints process is run through an NHS trust? (903659)

Because this is a big team effort by a combination of public and private sector partners. I pay tribute to Deloitte, without which the testing programme would not be possible. I pay tribute to all the pharmaceutical companies and I pay tribute to Amazon, which has delivered the home testing with remarkable success. Instead of trying to divide, we should unite and bring people together.

Dr David Rosser and his team at the University Hospitals Birmingham NHS foundation trust have done amazing work during the pandemic to make sure that people in Birmingham are safe and cared for. Will the Secretary of State give them all the flexibility and support they need to ensure that services at hospitals like Queen Elizabeth can go back to normal as quickly and as safely as possible? (903662)

Yes. David Rosser is a great leader of a very, very impressive trust. I was speaking to him only last week. There is an important lesson from covid, which is that many of the NHS central rules and much of the bureaucracy was lifted to allow local systems to respond as a health system. That has worked well. We need to learn from that. We need to not only make that permanent, but see where we can go further in that sort of system working.

My borough of Enfield has been allocated the equivalent of £4.58 per head to support the NHS test and trace programme. That is a third of what other London boroughs have received, despite the fact that it has the 12th highest number of covid-19 cases in London. That exacerbates the unfair share of public health grant received by Enfield and fails to take account of its health inequalities. Will the Secretary of State meet me to discuss the allocation of funding for Enfield’s needs? (903660)

We were scrupulously fair in the allocation of funding to local authorities, ensuring, for instance, that the support for social care went according to the number of beds. We have taken a great deal of care to make sure we get this right.

To allow the safe exit of hon. Members 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.

Covid-19 Update

Before I begin, I am sure the whole House will join me in sending our deepest condolences to the families and friends of James Furlong, Joe Ritchie-Bennett and David Wails, who were brutally killed in Reading on Saturday. To assault defenceless people in a park is an act not simply of wickedness, but of abject cowardice. We will never yield to those who would seek to destroy our way of life.

With permission, Mr Speaker, I will update the House on the next steps in our plan to rebuild our economy and reopen our society, while waging our struggle against covid-19. From the outset, we have trusted in the common sense and perseverance of the British people, and their response has more than justified our faith. Since I set out our plan on 11 May, we have been clear that our cautious relaxation of the guidance is entirely conditional on our continued defeat of the virus. In the first half of May, nearly 69,000 people tested positive for covid-19 across the UK; by the first half of June, that total had fallen by nearly 70% to just under 22,000. The number of new infections is now declining by between 2% and 4% every day.

Four weeks ago, an average of one in 400 people in the community in England had covid-19; in the first half of June, the figure was one in 1,700. We created a human shield around the NHS, and in turn our doctors and nurses have protected us. Together, we have saved our hospitals from being overwhelmed. On 11 May, 1,073 people were admitted to hospital in England, Wales and Northern Ireland with covid-19; by 20 June, the figure had fallen by 74% to 283.

This pandemic has inflicted permanent scars, and we mourn everyone we have lost. Measured by a seven-day rolling average, the number of daily deaths peaked at 943 on 14 April. On 11 May, it was 476 and yesterday the rolling average stood at 130. We have ordered over 2.2 billion items of protective equipment from UK-based manufacturers, many of whose production lines have been called into being to serve this new demand. And yesterday we conducted or posted 139,659 tests, bringing the total to over 8 million.

While we remain vigilant, we do not believe that there is currently—currently—a risk of a second peak of infections that might overwhelm the NHS. Taking everything together, we continue to meet our five tests, and the chief medical officers of all four home nations have downgraded the UK’s covid alert level from 4 to 3, meaning that we no longer face the virus spreading exponentially, although it remains in general circulation.

The Administrations in Scotland, Wales and Northern Ireland hold responsibility for their own lockdown restrictions, and they will respond to the united view of the chief medical officers at their own pace, based on their own judgment. But all parts of the UK are now travelling in the same direction, and we will continue to work together to ensure that everyone in our country gets the support they need.

Thanks to our progress, we can now go further and safely ease the lockdown in England. At every stage, caution will remain our watchword, and each step will be conditional and reversible. Given the significant fall in the prevalence of the virus, we can change the 2-metre social distancing rule from 4 July. I know that this rule effectively makes life impossible for large parts of our economy, even without other restrictions—for example, it prevents all but a fraction of our hospitality industry from operating. That is why almost two weeks ago I asked our experts to conduct a review; I will place a summary of their conclusions in the Libraries of both Houses this week.

Where it is possible to keep 2 metres apart, people should. But where it is not, we will advise people to keep a social distance of 1 metre-plus, meaning that they should remain 1 metre apart while taking mitigations to reduce the risk of transmission. We are today publishing guidance on how business can reduce the risk by taking certain steps to protect workers and customers. Those include, for instance, avoiding face-to-face seating by changing office layouts, reducing the number of people in enclosed spaces, improving ventilation, the use of protective screens and face coverings, closing non-essential social spaces, providing hand sanitiser, or changing shift patterns so that staff work in set teams. We already mandate face coverings on public transport.

While the experts cannot give a precise assessment of how much the risk is reduced, they judge that those mitigations would make 1 metre-plus broadly equivalent to the risk at 2 metres, if those mitigations are fully implemented. Either would be acceptable, and our guidance will change accordingly. That vital change enables the next stage of our plan to ease the lockdown.

I am acutely conscious that people will ask legitimate questions about why certain activities are allowed, when others are not, but I must ask the House to understand that the virus has no interest in such debates. Its only ambition is to exploit any opportunities to recapture ground that we might carelessly vacate, and to reinfect our communities. There is only one certainty, which is that the fewer social contacts someone has, the safer they will be, and our duty as a Government is to guide the British people, balancing our overriding aim of controlling the virus against our natural desire to bring back normal life.

We cannot lift all the restrictions at once, so we have to make difficult judgments. Every step is scrupulously weighed against the evidence. Our principle is to trust the British public to use their common sense in the full knowledge of the risks, remembering that the more we open up, the more vigilant we will need to be. From now on, we will ask people to follow guidance on social contact, instead of legislation, and in that spirit we advise that from 4 July, two households of any size should be able to meet in any setting, inside or out. That does not mean that they must always be the same two households; it will, for instance, be possible to meet one set of grandparents one weekend, and the other set the following weekend. We are not recommending meetings of multiple households indoors, because of the risk of creating greater chains of transmission. Outside, the guidance remains that people from several households can meet in groups of up to six, and it follows that two households can also meet, regardless of size.

Mr Speaker, I can tell the House that we will also reopen restaurants and pubs. All hospitality indoors will be limited to table service, and our guidance will encourage minimal staff and customer contact. We will ask businesses to help NHS test and trace respond to any local outbreaks by collecting contact details from customers, as happens in other countries, and we will work with the sector to make that manageable. Almost as eagerly awaited as a pint will be a haircut—particularly by me, Mr Speaker—and we will reopen hairdressers with appropriate precautions, including the use of visors. We also intend to allow some other close-contact services such as nail bars to reopen as soon as we can, once we are confident that they can operate in a covid-secure way.

From 4 July, provided that no more than two households stay together, people will be free to stay overnight in self-contained accommodation, including hotels and bed and breakfasts, as well as campsites, as long as shared facilities are kept clean. Most leisure facilities and tourist attractions will reopen if they can do so safely, including outdoor gyms and playgrounds, cinemas, museums, galleries, theme parks and arcades, as well as libraries, social clubs and community centres.

Close-proximity venues such as nightclubs, soft play areas, indoor gyms, swimming pools and spas will, I am afraid, need to remain closed for now, as will bowling alleys and waterparks, but my right hon. Friends the Business Secretary and the Culture Secretary will establish taskforces with public health experts and those sectors to help them to become covid-secure and reopen as soon as possible.

We will also work with the arts industry on specific guidance to enable choirs, orchestras and theatres to resume live performances as soon as possible. Recreation and sport will be allowed, but indoor facilities, including changing rooms and courts, will remain closed, and people should only play close-contact team sports with members of their household.

I know that many have mourned the closure of places of worship, and this year Easter, Passover and Eid all occurred during the lockdown. I am delighted that places of worship will be able to reopen for prayer and services, including weddings, with a maximum of 30 people, all subject to social distancing.

Meanwhile, our courts, probation services, police stations and other public services will increasingly resume face-to-face proceedings. Wraparound care for school-age children and formal childcare will restart over the summer. Primary and secondary education will recommence in September with full attendance, and those children who can already go to school should do so, because it is safe.

We will publish covid-secure guidelines for every sector that is reopening, and slowly but surely these measures will restore a sense of normality. After the toughest restrictions in peacetime history, we are now able to make life easier for people, so that they can see more of their friends and families, and to help businesses get back on their feet and get people back into work.

The virus has not gone away, however. We will continue to monitor the data with the joint biosecurity centre and our ever more effective test and trace system. I must be clear to the House that, as we have seen in other countries, there will be flare-ups, for which local measures will be needed. We will not hesitate to apply the brakes and reintroduce restrictions, even at national level, if required. I urge everyone to stay alert, control the virus and save lives. Let us keep washing our hands; staying 2 metres apart wherever feasible, mitigating the risks at 1 metre where it is not; avoiding public transport where possible and wearing a mask when we have to use public transport; getting tested immediately if we have symptoms; and self-isolating if instructed to do so by NHS test and trace.

Today we can say that our long national hibernation is beginning to come to an end. Life is returning to our streets and to our shops, the bustle is starting to come back and a new but cautious optimism is palpable, but I must say to the House that it would be all too easy for that frost to return. That is why we will continue to trust in the common sense and the community spirit of the British people to follow this guidance, to carry us through and to see us to victory over this virus. I commend this statement to the House.

I thank the Prime Minister for advance sight of his statement. I join him in sending our condolences to the families and friends of those who died or were injured in Reading on Saturday. This was a truly appalling attack, and I extend our thanks to the police officers and members of the public who showed incredible bravery in response. I spoke to my hon. Friend the Member for Reading East (Matt Rodda) at the weekend and I am sure that I speak for the whole House in saying to the people of Reading that we stand with them at this incredibly difficult time.

When I was elected leader of the Labour party, I said that I would offer

“constructive opposition, with the courage to support the Government”—[Official Report, 22 April 2020; Vol. 675, c. 41.]

where they are doing the right thing. We will, of course, scrutinise the details of the announcement and study the guidance, and there are obviously a number of questions that need to be answered, but overall I welcome the Prime Minister’s statement. I believe that the Government are trying to do the right thing, and in that we will support them.

There are no easy decisions to be made here. Any unlocking carries risks. It has to be phased, managed and carefully planned; it needs to be based on scientific evidence, properly communicated and accompanied by robust track and trace systems; and there must be support for local councils and communities to respond quickly and decisively if there are any fresh outbreaks. But there are risks of inaction as well—of keeping businesses and schools closed, of keeping our economy closed, and of keeping families apart. We all need to recognise that today.

I have a number of questions about the basis for these decisions, which I hope the Prime Minister will address in a constructive way. First, on the scientific evidence, I listened carefully to what he said about the 2-metre rule and the 1-metre rule. Can he assure the House that the package of measures is agreed by the Scientific Advisory Group for Emergencies, the chief medical officer and the chief scientific adviser? What assessment has been made of the overall impact on transmission of the virus and on the R rate, both nationally and regionally?

On preventing a second spike and reintroducing measures as needed, the Prime Minister knows that local authorities will have to be central to that, but they need the resources and the powers. What additional support is he providing to councils? What new powers for swift local lockdown will be needed should there be a spike in infections?

On protection of those working, particularly on the frontline, we all want people to go back to work, but it has to be safe and standards have to be enforced. What enforceable measures will the Prime Minister put in place to give confidence to those who are returning to work?

On support for businesses, these changes are necessary, but they will be complex. Many businesses have already spent thousands of pounds preparing to operate at 2 metres. These changes will particularly be felt by small businesses and those on the high street, so what support can be given to them to address that?

On schools, I do think that it is safe for some children to return. I completely support that; the question is how quickly we can get all children back to school safely, the sooner the better. It was the Education Secretary who told the House on 9 June that it would not be possible to bring all children back to school before the summer. One of the reasons we support today’s announcement is that it will make it more possible, and easier, to get children back to school more quickly. We will support that, and my offer to work with the Prime Minister on that stands.

Finally, on test, track and trace, the Prime Minister will know that we have very serious concerns about the gaps in the current system, including the absence of an app. Getting this right is essential to unlocking in a safe manner, and it is important that the Prime Minister clarifies when the full track, trace and isolate system will be in place.

Today is an important step in the fight against this virus. We will scrutinise the detail, and we do want more clarity, but we welcome the thrust of the statement.

I am grateful to the right hon. and learned Gentleman for the spirit, the manner and the constructive way in which he has responded. On his points, we do believe that all five tests have been met. That means that the chief medical officer and the chief scientific adviser have been intimately involved in every stage of developing the programme, and they believe it to be a step in our plan that allows us to go ahead while meeting that crucial test of not triggering a second wave.

The right hon. and learned Gentleman asked about support for local councils, and I have said that we are putting in another £3.2 billion to support them, as well as £600 million to support their responsibilities for social care. Clearly their responsibilities have not ended, but neither has our support. We will get this country through this crisis by doing everything it takes.

That brings me to the right hon. and learned Gentleman’s question about businesses. I do not think there is another country in the world that has done quite so much to support our workforce and our employees. Under the coronavirus job retention scheme, we have supported 11 million people. We have supported 2.6 million self-employed people and £26 billion in bounce-back loans alone have been given out by the Government, to say nothing of the huge support in grants. We are very confident that it is one of the most extraordinary packages to be provided by any Government around the world, and we will continue to support our businesses.

The right hon. and learned Gentleman mentions track and trace and isolate. Of course it is perfectly true that it would be great to have an app, but no country currently has a functioning track and trace app. The great success of NHS test and trace is that, contrary to some of the scepticism that we heard—alas—from those on the Opposition Benches, so far it has contacted 87,000 people who have been in contact with those who have coronavirus, and they have elected voluntarily to self-isolate and stop the disease from spreading in the community. That is a fantastic success by our NHS test and trace operation, and we will continue to develop and improve that so as to crack down on local outbreaks and enable our country to go forward.

May I finally say how welcome it was to hear from the right hon. and learned Gentleman that he actively supports children returning to school and that he believes that returning to school is safe? I think he said that.

I do not want to accuse the right hon. and learned Gentleman of making a U-turn, but there is more joy in heaven over one sinner that repenteth and so on. It is good to have his support on that matter today. I welcome the spirit and the manner in which he has responded to this statement today.

With continuing relatively high rates of infection across Bedford borough, I welcome the Prime Minister’s balanced transition from over-reliance on regulation to greater reliance on the common sense of British businesses and employees. Will the Prime Minister now build on the exceptional programme of economic support provided to businesses with an ambitious acceleration of his levelling up programme, in particular drawing on and unlocking the creativity of our entrepreneurs, our small businesses and our innovators?

My hon. Friend is on the money on that point. He will be hearing a lot more about exactly that in the course of the next couple of weeks, not only from me, but from my right hon. Friend the Chancellor.

May I associate myself with the remarks of the Prime Minister and the leader of the Labour party on the outrage that took place on Saturday in Reading? Our thoughts are very much with the family and friends of James Furlong, of Joe Ritchie-Bennett and of David Wails. We give grateful thanks to all our emergency services for the work that they continue to do. On this day, we also acknowledge the sad death of Harry Smith, the former political reporter for ITV and Scottish Television. He will be sadly missed.

I thank the Prime Minister for an advance copy of his statement. Today’s announcement will be understandably welcomed by many, but for every word of welcome, there must follow words of caution. The virus has not gone away. The margins for ensuring it does not take off again remain tight. Keeping people safe remains the first priority. We cannot put a price on human life. China and Germany are right now dealing with spikes in cases as a result of significant outbreaks. Health officials in South Korea have said they think the country is now experiencing a second wave. A similar experience here would amount to not just a health disaster, but an economic disaster. It would wipe out all the hard-won progress and self-sacrifice over recent months. It is vital that our collective efforts remain focused on preventing the disaster of a second spike.

We must remain cautious, too, because the public are well used to hearing grand announcements from the Prime Minister, only for a U-turn to follow days or weeks later. Not only have the UK Government wasted precious time on introducing a botched test and trace system, but they have wasted millions of pounds of taxpayers’ money in the process. That is why it is essential that the next steps are directed solely by the science, rather than political pressures. Can he confirm, therefore, that he will publish not just the conclusions but the full review on social distancing measures and the scientific advice given?

We know that a review of quarantining measures following foreign travel was due next week. Will the Prime Minister confirm that the introduction of any air bridges will be based on public health assessments, not economic assessments? Can he also confirm that the devolved Governments will be closely involved and party to any arrangements with any country on air bridges? Finally, to maintain full clarity, will he reaffirm that the announcements today are solely for England and that the citizens of Northern Ireland, Wales and Scotland should continue to follow public health advice from their own Governments?

On that last point, of course I can confirm that, as indeed I said in my statement, although I observe that the harmony between all four home nations is much closer than one might sometimes believe from listening to the right hon. Gentleman. But I agreed with a great deal of what he said. He is right to express caution and to anticipate the risk of second spikes. We will, I am afraid, see future outbreaks. I must be absolutely clear with the House about that. We will see future outbreaks and we will be in a much better position now to control them. I will of course publish the measures on social distancing and how the decision was reached on social distancing, and as I said we will place that in the Libraries of both Houses.

Mr Speaker, the right hon. Gentleman had one more question, which I am afraid I cannot remember. What was it—about public health? I cannot remember. I will write to him. [Hon. Members: “Air bridges.”] Air bridges! Thank you. Sorry, Mr Speaker. He asked an important question about air bridges. We will ensure that the devolved Administrations are kept in close contact as we develop our plans, and our plans for quarantine will be based entirely on public health, as he rightly suggested they should be. That will be our criterion. We will not be led by any excessive desire to risk life by opening up the economy too fast. We will have a policy on air bridges that is based on public health, as he rightly says we should.

I very much welcome the changes that my right hon. Friend has announced to the 2 metre rule, which is great news for pubs and restaurants such as the Moat House and the Staffordshire Bull, which are at the heart of the community in Staffordshire. Can he give me an assurance that, as we move to 1 metre-plus, it will be safe for us to trust in the common sense of the British people to reduce transmission? May I take this opportunity to invite the Prime Minister to have a pint in my constituency?

I join the Prime Minister in sending our condolences to the family and friends of the victims of the appalling attacks in Reading. The Prime Minister wants to reassure us that lockdown can be safely eased, while rightly warning that there is a danger of a second wave of coronavirus later this year. If he is right and there is breathing space now, surely it is urgent that we learn the lessons. So I ask him this again: will he urgently set up an independent inquiry into the Government’s handling of this pandemic?

I am sure there will come a moment when lessons need to be learned—indeed, we are learning them the whole time—but I do not consider at the moment that a full-scale national inquiry is a good use of official time.

I warmly welcome the Prime Minister’s statement, which reflects very closely the advice that my Select Committee has taken. He has a new advisory group, which I am glad about, because the best role for SAGE is on broad questions of science rather than every minute policy. Can he specify whether the ban on cricket has come to an end? Cricket is perhaps our most socially distanced team sport. We have lost half the summer, but there is another half left to be enjoyed by players and spectators alike.

I am grateful to my right hon. Friend. This goes to the point that I was trying to make to the House earlier—everybody will want to add something to the great wheelbarrow of measures that we are taking, and at a certain point, there will come a straw that breaks the camel’s back. The problem with cricket, as everybody understands, is that the ball is a natural vector of disease, potentially at any rate. We have been round it many times with our scientific friends. At the moment, we are still working on ways to make cricket more covid-secure, but we cannot change the guidance yet.

May I echo the comments in relation to the victims of the terrible atrocity in Reading? Our thoughts are with their families. I support the Prime Minister’s contention that a four-nation approach is very important. In that context, will he commit to share the rationale, data, scientific evidence and advice upon which these decisions are based with the Northern Ireland Executive and our chief medical officer and chief scientific adviser, to ensure that we continue to take that co-ordinated approach?

As I informed the House, the chief medical officers of all four home nations were unanimous in their view that the alert level should go down from 4 to 3, and we will continue to work together and share information as we go forward.

This news will be a relief for so many pub owners in Hyndburn and Haslingden, whether it be the Green Squirrel or the Heys Inn. The relaxation of the 2 metre rule will make it that little bit easier for micropubs such as the Vault, Hustle Bar and the Knuzden Tap. Can the Prime Minister assure me that the Government will work closely with local authorities so that pubs and restaurants are able to utilise their outdoor space, and will he visit Hyndburn and Haslingden?

There is hardly any area of the country that I do not intend to visit in the course of the reopening of pubs and hostelries. There is a massive opportunity now for our pubs, with all their inventiveness, to think of ways of making their businesses covid-secure, exploiting hitherto unloved and unvalued outdoor spaces that may become havens for tables and chairs and using their ingenuity to open up in all the ways that they can.

People crave confidence and competence. With England’s so-called world-beating app scrapped before it even launched, contact tracers unable to reach a third of positive cases and no financial scheme to support workers when public health requires them to self-isolate, what assessment has the Prime Minister made of the risks to business and public confidence if local lockdowns or a second peak prove beyond his Government’s ability to manage?

The right hon. Lady knows very well that the Government have invested record sums in protecting businesses, by comparison with any other country. We have done more to protect businesses around the whole of the country, including in Wales. I said that we are proceeding as one UK, and we are. I have my doubts about the 5 mile rule in Wales and wonder whether that might be something that was reviewed. But she makes a very important point about the need to protect against a second outbreak and to make sure that we are in good shape to crack down on flare-ups. I believe that we are and I believe to an extent that perhaps we did not think possible a month ago we are able to do local whack-a-mole in the way that she has described.

May I congratulate my right hon. Friend? This announcement, particularly the reduction of the distancing rule, will save hundreds of thousands of jobs, so he has already done a good day’s work today. May I ask him to ensure the practicality of future guidance? Complex rules about who can do what and where and when they can do it may seem rational when discussed around a table in Whitehall, but if they are too complex and too unclear, people will not obey them, so can he make sure that the rules for the future are as clear, simple and understandable as possible?

My right hon. Friend is entirely right. A message such as, “Stay at home. Protect the NHS” is very simple. Everybody can see what they have to do. Getting into the easing of the lockdown is much more complex, but I think that the guidance that we have set out today is intelligible. People will understand what they need to do. The British people have shown massive common sense so far and I am sure that they will continue to do so.

Last week in my constituency, in Cleckheaton, we had a covid-19 outbreak in a meat processing factory. Kirklees Council acted swiftly and efficiently. My concern is with the Government’s easing of lockdown. We will see these localised outbreaks. With the Health and Safety Executive having its budget cut by 50% since 2010, can the Government ensure that Kirklees and other councils will have all the money they need to keep our communities safe? And what investigations are going ahead from Government to look at why meat processing particularly is exposed to covid-19 outbreaks not just in this country, but around the world, so that we can keep those members of staff safe?

We will certainly look into what is happening to meat processing, and the hon. Member is right to draw attention to that phenomenon. We have seen it in Anglesey and in Germany. We need to get to the bottom of what is happening. We are putting more into the Health and Safety Executive, as she knows. We are giving another £14 million to bolster it, and local councils will be fortified in implementing local lockdowns by central Government and the joint biosecurity centre so that we are able to crack down very efficiently on these flare-ups as they happen.

Going to the pub is a great British institution and vital if we want to get our economy back on track. Will the Prime Minister therefore join me in calling on people from the 4th of July to do their patriotic best for Britain and go to the pub?

Yes. I do encourage people to take advantage of the freedoms that they are rightly reacquiring, but I must stress that people should act in a responsible way. I know that that is where the public are and that that is what people want to see. They want to see this reopening happening gradually. They want to see the frost leaving the tundra slowly. They understand the risks that we still face. So yes, I want to see people out in the shops—it is a fantastic thing to see. Yes, I want to see people taking advantage of hospitality again—a wonderful thing. Yes, I want to see people enjoying friends and family again, but they have to do it in a responsible way and observe social distancing.

As we attempt to move people back into the workplace, the job retention scheme is being abused by some companies to make employees redundant before August, when employers would have to pay a percentage of their salary. Moreover, others, like British Airways, are threatening to fire tens of thousands of loyal workers and rehire them, some on slashed pay and poorer conditions. The Prime Minister said that he was looking at what we can do, so will he back my hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands), whose Employment (Dismissal and Re-employment) Bill addresses this iniquity?

I will of course study the Bill to which the hon. Gentleman alludes. [Interruption.] I will cause it to be studied. He knows very well that this country has given unprecedented and unequalled support to workers and to businesses. I think that 1 million companies have taken advantage of the job retention scheme, and 2.6 million self-employed people. There is nothing like it around the world. We should be very proud of what the UK has done, and we will continue to ensure that no one is penalised for doing the right thing to beat this virus.

As my right hon. Friend has said, the primary aim of policy was to stop the NHS being swamped, and that was met, which is a great achievement. But will he take this opportunity to restate that in the absence of a vaccine or a cure, the virus will stay in circulation? What people refer to as a second wave is in fact a continuation of the first wave—it has not gone away. We can expect flare-ups, as we have seen in Germany. While the measures today are welcome—incidentally, they give a whole new meaning to the phrase “safe drinking”—their observation will be vital if we are to avoid a widespread second lockdown, which would be an economic and social disaster for the country.

That is absolutely right. There have been two important changes in our arsenal in the past six weeks or so. The first has obviously been NHS test and trace, which is getting better the whole time, and is invaluable in fighting the disease. The second is the treatments. Dexamethasone, which was tested in this country, really does make a big difference to the mortality of the disease, and I have no doubt that other progress will be made. He is right to be reserved about the possibilities of getting a full vaccine; that is going to be very difficult. But in the meantime, we will have to remain extremely vigilant and extremely cautious.

Today, despite a strong test and trace regime, a region in Germany had to impose a specific lockdown on several hundred thousand people due to a dangerously high R number. We know that unfortunately, while we are progressing, we are only at the end of the beginning of our restrictions. The Prime Minister is right to say that the job retention and self-employed schemes have been vital to many people. What contingency does he have in place for ad hoc localised lockdowns that may be required, and will he roll out localised versions of job retention schemes for those areas?

I shall repeat my previous answer: we do not want to see anybody penalised for doing the right thing.

There are approximately 1 million 16 to 18-year-olds in England, and some 700,000 study in colleges. Astonishingly, this week’s education catch-up plan omitted those colleges, including many in my constituency of Cambridge. Can the Prime Minister explain the Government’s thinking behind this, and will he sort it out?

We will of course do everything we can to ensure that not just our schools but our colleges get the attention that they need. As the hon. Gentleman knows, there is massive investment now going into the rebuilding of further education colleges and ensuring that our FE college sector gets the investment it deserves.

I warmly welcome the news from the Prime Minister regarding the tourism sector, which will be especially well received in East Devon. Of course, he is more than welcome to visit any time. Can he confirm that the Government will publish full guidance to ensure that businesses can keep themselves and their customers safe while keeping the virus under control?

The Prime Minister has highlighted examples around the world where restrictions have been relaxed and where there has been a subsequent resurgence of the virus, and he has said that he will not hesitate to reintroduce restrictions if required. I would just like to get an unambiguous commitment from him about not seeing anyone penalised for doing the right thing to combat this virus. If it was necessary to continue with the furlough and self-employment support schemes beyond October, would his Government do so?

We have said what we have said about the furloughing scheme. It is our intention, obviously, to make sure that we are not in a situation where we have to keep those national schemes going. That is why the furlough scheme is tapering off in October. But, clearly—and I have said what I have said—if there are localised outbreaks or, indeed, if it is nationally necessary to put the brakes back on, then nobody should be penalised for doing the right thing.

In the last few weeks, we have seen a real outpouring of love and kindness across our communities across the country for our older citizens, and that is quite right, but we have not seen the same thing for our youngest citizens. Can the Prime Minister tell me what the Government are doing for those who have had a baby during lockdown or, indeed, who are struggling to cope—as he might be—with the challenge of having a new baby with so little face-to-face support?

Oh, I am grateful to my right hon. Friend. I am personally coping fine, thank you—[Interruption.] Well, thank you. What we are doing, as she will have heard in my statement, is that wraparound childcare is coming back for the summer and, as she knows, early years is open and reception is open—and would it not be a fine thing to hear from the Labour party that it is safe for all young kids to go back?

This morning, I met those from Disability Rights UK who are worried that support for shielded people is being removed too quickly. In their words, “If Government can be sensitive to business until October, why can’t they be sensitive to personal needs?” Throughout this crisis, communication with shielded and disabled people has been poor. Will the Prime Minister commit to working closely with these groups to ensure clearer, more regular communication as we move out of lockdown and towards planning for a second wave?

The hon. Member raises a very important point. In fact, we have extended the shielding programme, as you know, Mr Speaker, till the end of July, and 3 million food parcels have already been delivered to shielded people. What we want to see is a situation in which the prevalence—the incidence—is so low that the shielding programme no longer needs to continue in its current way, and I think that should be a shared ambition around the House and around the country. Too many elderly, vulnerable people have been kept in close confinement for too long, and we must help them to a new way out.

This statement paves the way for Britain to bounce back with most of the hospitality sector reopening, and it gives us more confidence for the 10th anniversary Gloucester history festival in September. Does my right hon. Friend agree with me that, while many of us want to see cricket played again safely and air bridges established as soon as possible, the absolutely crucial goal is for all children, and pupils and students at FE colleges and universities to be able to go back to school, college and university in the autumn absolutely safely?

Absolutely. A point I perhaps could have made to the hon. Member for Cambridge (Daniel Zeichner), who I think is no longer in his seat, is that it is our intention to get not just schools but FE colleges back as well in September, and get our young people back where they need to be—in education and preparing for their future.

It seems the Prime Minister has given up working with all four nations. Cobra has not met for weeks, daily communications have ended and I am pretty sure the First Minister of Wales has forgotten what the Prime Minister even looks like. Does he not believe that his actions are leading to a disjointed rather than united Union, and given that recent data suggest that the people of Wales have far more confidence in the Welsh Government’s handling of this pandemic than the people of England do in his, should he not perhaps be following the strategy championed by the Labour Government of Wales?

I make no comment on the blessed amnesia that has descended on the First Minister of Wales, except to say that, actually, when we look at the facts and what the UK is doing together, we can see that we are in much closer harmony than someone would suspect from what the hon. Lady says. One detail—one wrinkle—to which I respectfully draw her attention is that I am not sure that the five-mile limit rule is entirely necessary; perhaps that needs to be rethought.

I thank my right hon. Friend for the clarity he has given today to the hospitality and tourism sector in the great south-west. Will he also give a glimmer of hope that the Government will look sympathetically at more support over the winter, if necessary, to ensure that this very seasonal sector can survive such a restricted season?

Yes, indeed—although, as my hon. Friend already knows, we are doing a massive amount to support businesses of all kinds, particularly by getting rid of business rates for the whole of next year. One thing that I would say, respectfully, to all those who represent tourist areas of this country, is that now is perhaps the time to send out a welcoming signal to those from other parts of our country and to roll out the welcome mat, rather than the “Not welcome here” sign. That is something that we could do together.

My right hon. Friend’s announcement will be welcome to hospitality businesses in Penistone and Stocksbridge, which are keen to reopen after a difficult period, but many workers and business owners are parents as well and cannot return to work until their children are back at school. Does my right hon. Friend agree that in order for those businesses to recover, we need all children to be back at school in September? Also, will he confirm that this announcement means that in the meantime people can start to ask friends and family for help with childcare?

Yes, it does mean that, but we are also committed, as my hon. Friend knows, to getting all our schools back in September. I do believe it that will be possible, if we stick to the plan and the guidance, to do so in a safe way.

We are witnessing even countries such as Germany, with good control of covid-19, develop outbreaks that centre around meat processing plants. What explanation has the Prime Minister been given for this trend, and how on earth does he think it will be improved by cutting the safe distance from 2 metres to 1 metre?

That is a very good question. We are looking at exactly what is happening in meat processing plants. Currently, two theories have been advanced to me: one is about the cold environment in the plants, which may be propitious to the virus, and the other is the possibility that staff are congregating in such a way as to spread the virus. We do not know what it is, but we are investigating. Wherever outbreaks take place, we will use local cluster-busting techniques to stamp them out.

I warmly welcome the statement and strongly endorse the move to relying on common sense and the responsibility of the British people from 4 July. However, the blanket quarantine proposal is not common sense when it applies to countries that are entirely safe and have no coronavirus. I urge my right hon. Friend to ensure that air bridges are in place no later than 4 July.

The House will have heard what I have had to say about air bridges repeatedly since the quarantine announcement was made. We do understand the balance, but we also understand the vital necessity of protecting our country from reinfection from abroad. Every serious country that has got this disease under control has had to introduce a quarantine for people coming into or back into the country.

A number of countries will be surprised by the Prime Minister’s claim that they do not have a functioning track and trace app.

Given that it is costing Britain thousands of jobs and millions of pounds a day and has no basis in the science, why is the Prime Minister waiting another two weeks to scrap his disastrous blanket quarantine policy?

I refer the right hon. Gentleman to the answer that I just gave. We have a very sensible policy and we do not wish to see our country reinfected, after all the efforts of the British people, by travellers coming in from abroad.

The Marina and Seagull theatres in Lowestoft, and the Fisher theatre in Bungay, play lead and irreplaceable roles in their local communities and economies. I welcome the Prime Minister’s statement that the Government will work with the arts industry so that theatres can reopen as soon as possible. However, they are really struggling, so may I urge him to look at putting in place specific support until the time that viable reopening is possible?

Yes, indeed. I know how valuable the theatre sector—and the whole entertainment sector—is to our economy. My hon. Friend should be in no doubt that my right hon. Friend the Secretary of State for Digital, Culture, Media and Sport is talking to those sectors right now to see what we can do to help them, while ensuring that they can come back in a covid-secure way.

What is the public health message that the Prime Minister is conveying by opening pubs ahead of the full opening of schools?

I think that most people will understand that we want as much of our business sector and economy to open as possible, in a covid-secure way. The hon. Lady will also understand that we want our schools to open in a safe way. That is why we have done what we have done and made the announcements that we have made. It has only been possible to open schools to some classes before the summer break, alas; but we are ahead of many other countries in Europe in doing so. As she will know, there are other countries that are not opening any of their schools. I must say that I welcome the logic of what she is saying, because if she is now actively going to encourage kids to go back to school and stop the long silence of the Opposition on this matter, that will be a great thing.

Will the Prime Minister cause his experts to be worked night and day until they find the fix and, when they have got it, to straightaway allow spas and nail bars to reopen? And when there are flare-ups, will he eschew the temptation to return to collective punishment?

That is a very good way of putting it. We want, so far as we possibly can, to confine our action to the localities where the flare-ups have happened. That is why it is vital that everybody listens to the balance of this guidance today, follows the guidance on 2 metres and on 1 metre-plus, continues to observe social distancing—and we will get this thing done.

It is good news that people can start socialising and meeting in public again, but what is the Prime Minister going to do to ensure that destination communities, such as the one I represent in Brighton and Hove, are extra safe? People will be meeting and drinking at places such as on the seafront and in parks, where it will be impossible to get the names and addresses of every customer. There will be other pinch points where lots of people from various destinations will be rubbing up against each other. What will he do, in the absence of the promised app, to ensure that these communities are destinations for investment and not destinations for covid?

I will be calling on local representatives such as the hon. Gentleman to show some guts and determination, and to champion their communities as venues for people to return to and support. He can do that with confidence because, as I say, we are introducing a sensible package of measures that allows businesses gradually to reopen while ensuring social distancing. It is that mixture—plus the NHS test and trace scheme—that allows us to go forward; that is the formula that I believe works. As for the issue of putting names behind the bar or registering in restaurants, I do think that that is something that people get. As far as possible, we want people to do that and businesses to comply with it. We believe that it will be very important for our ability to track back and stop outbreaks happening. The hon. Gentleman should encourage all businesses in his constituency to take the names of customers.

I very much welcome the statement from the Prime Minister, but he will be aware that my constituents will not get the benefit of the measures announced today, as the First Minister of Scotland is delaying Scotland’s release from lockdown. Does the Prime Minister agree that the First Minister should share the evidence to justify why Scotland has taken a different approach from the rest of the United Kingdom?

I am grateful to my hon. Friend, who has his finger on the pulse. I was earlier informed that the First Minister of Scotland was about to make a statement uncannily similar to the one that I have just made, as she has done several times before, but I may be misinformed about that. It remains none the less the case that the similarities between our approaches greatly outweigh the differences.

The Prime Minister referred to support for local authorities. The Rhondda, during this period, has had three very severe bouts of flooding, including last week. Many homes have lost absolutely everything because they have no insurance. The local authority now faces a bill of somewhere in the region of £67 million to repair culverts, drains, pumping stations and gullies, and replace many bridges. We also have a landslide from an old coal tip, which is in danger of doing very significant damage if we cannot remove the 60,000 tonnes of earth. That is still a Westminster responsibility. The Prime Minister may not have the answer now, but will he please make sure we get the £2.5 million very swiftly so that we can do that work quickly? We do not want another Aberfan.

The right hon. Gentleman is absolutely right, and I am aware of those risks. We are working with Mark Drakeford and the Welsh Government on those problems. As he knows, we are putting £4 billion into flood defences. If we face real problems of unemployment—no doubt we will—getting to work on putting in better flood defences for the future will be an important way of driving job creation.

My right hon. Friend will know that many people have been unable to attend routine hospital appointments throughout the lockdown. The reasons for that are many and varied. As the lockdown eases, what measures can be put in place to support hospital trusts as they work hard to catch up? Will he work with me to secure an upgrade to Scunthorpe General Hospital, which is needed now more than ever before?

I congratulate my hon. Friend on the way she represents her constituency. We will do whatever we can for Scunthorpe General Hospital. I have no doubt that it is on one of the lists of my right hon. Friend the Secretary of State for Health and Social Care. As she knows, we are investing record sums: £34 billion into the NHS—the biggest ever cash boost for the NHS. We are going to do 40 new hospitals—that remains an undimmed ambition. If anything, we are going to double-down on our ambitions for the NHS, so she should watch this space, particularly as regards Scunthorpe General Hospital.