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Volume 678: debated on Tuesday 7 July 2020

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

We are bringing coronavirus under control. Yesterday’s figures showed 352 new cases, the lowest since lockdown began. That is down from over 5,000 a day at the peak. Two hundred and nine patients are currently in mechanical ventilator beds with coronavirus, down from 3,300 at the peak. The latest number of deaths recorded in all settings in the UK was 16. New figures this morning show that for the last two weeks, the number of people who have died from all causes has been lower than the normal average for this time of year.

Because we are bringing the virus under control, we have been able to restore some of the things that make life worth living. This weekend, restaurants, pubs and hairdressers were buzzing with activity for the first time in months, and yesterday we were able to ease restrictions for the 2.2 million people who have been shielding across England so that they can now spend more time outdoors in a group of up to six, of course while maintaining social distancing.

Our plan has always been to lift the national lockdown while taking ever more targeted action to suppress the virus. We are seeing a similar approach in other countries, such as Germany, Spain and Australia, where overnight they locked down Melbourne. Last week, we took difficult but vital decisions about Leicester. Since then, we have been working with Leicester and Leicestershire, and I am pleased to say that together, we have brought down the seven-day infection rate from 135 to 117 cases per 100,000 people.

In reopening hospitality, we have also introduced contact tracing for customers. This system is working. I want to thank all those who are making the system work, and to pay tribute in particular to three pubs that have taken specific action: the Lighthouse in Burnham-on-Sea, the Fox and Hounds in Batley, and the Village Home in Gosport. They have all closed for a deep clean and staff testing after, in each case, a customer tested positive. They are doing the right thing by their customers and their communities. This is NHS Test and Trace working precisely as intended. Three pubs shut so that others can be open, and I think the whole House is grateful.

Coronavirus has been the worst global pandemic in a generation. Here, we protected the NHS. We built the new Nightingale hospitals in 10 days. At all times, treatment was available for all. Our medical research has discovered the only drug known to work. We have built, almost from scratch, one of the biggest testing capabilities in the world. We are getting coronavirus cornered, but this is no time to lose our resolve. The virus exists only to spread, so we must all stay alert and enjoy summer safely.

I am grateful to the Secretary of State for that answer. He is quite right: we are through the peak, but we must not be remotely complacent, as thousands could still die from this virus over the coming months and into next year.

I welcome the news about Leicester, and I am grateful for the way in which the Secretary of State and his officials have kept me updated. What is the exit strategy for Leicester? How does an area that has gone into a local lockdown escape it? I understand that in Germany, local lockdowns are lifted at around 50 cases per 100,000. Will he apply similar criteria here in the United Kingdom? I think people in Leicester, and potentially in other towns and cities that could go into lockdown, would welcome that clarity.

Of course, the pillar 2 data has been an issue of some contention. Much of it has now been delivered, but there are still complaints that the way in which the data set has been delivered is incomplete. Directors of public health need pillar 2 community data in real time on a daily basis. They need the total number of tests undertaken, as well as those that are just positive, and they need patient-identifiable data so they can put in place the extensive contact tracing needed to keep all our constituents safe.

In Leicester, there has been speculation that the textile trade or food manufacturing has been responsible for the outbreak—we still do not actually know why we had the outbreak in Leicester—but many of the places where there have been outbreaks, whether Kirklees or elsewhere, have usually been characterised by low pay, insecure work and lack of decent sick pay. Will the Secretary of State look again at sick pay entitlement, because people will not isolate unless they are given that financial security?

The Secretary of State said on “The Andrew Marr Show” on Sunday that asymptomatic transmission is a problem. We agree. Could he explain why he is not routinely testing healthcare workers? The position now in this country is that premiership footballers are tested twice a week, but NHS staff are not routinely tested.

Finally, the initial guidance from the Government downplayed the risk to care homes. Care providers were sent conflicting guidance throughout the outbreak. Staff could not access testing until mid-April and are still not tested routinely. Personal protective equipment supplies have been inadequate. Thousands of families have lost their loved ones in care homes to this disease. Care workers themselves have died on the frontline. Can the Health Secretary understand why people are so insulted by the Prime Minister’s remarks, when he said:

“too many care homes didn’t really follow the procedures.”?

Can he appreciate the hurt that has led to care home providers today describing those comments as “clumsy and cowardly”? Can he tell us which care homes did not follow procedures and what those procedures were that were apparently not followed? Will he take this opportunity now to apologise for the Prime Minister’s crass remarks?

First, the hon. Gentleman rightly asks about the process needed to bring Leicester out of lockdown and back to the level of freedom enjoyed in the rest of the country. What we said, when we took the measures just over a week ago, was that we needed to see 14 days of data, so we propose to make announcements on the next steps on 18 July. Of course, if further measures were needed in the meantime to tighten up we would take them immediately, but, as I said in my statement, the good news is that the data are currently moving in the right direction.

The hon. Gentleman asks specifically about a figure for the point at which such a local lockdown might be lifted. We are not going to use or give a specific figure, because both the level and the rate of change matter. If the level were lower but going up, that could be a worse situation than a higher level that is under control and falling. We have to look at both the level and the rate of change.

I am glad that the hon. Gentleman said that data are being delivered. He mentioned some more detailed data and I am very happy to look into those proposals.

The hon. Gentleman mentions asymptomatic testing and the asymptomatic testing of NHS staff. As this House debated 10 days ago now, we have worked with clinicians to come forward with a scheme that is supported by those clinicians for the regular testing of NHS staff. That scheme is now agreed and in place. Of course, we constantly monitor it and we monitor the number of cases among NHS staff. I am content with that scheme, which was set out almost two weeks ago.

The hon. Gentleman also asks about care homes. Throughout the crisis, care homes have done amazing work. The Prime Minister was explaining that because asymptomatic transmission was not known about, the correct procedures were not known. We have been constantly learning about the virus from the start and improving procedures all the way through. I pay tribute to the care homes of this country, which have done so much to care for the most vulnerable throughout the crisis.

Last week, the Regius Chair of Medicine at Oxford University, Professor Sir John Bell, told the Science and Technology Committee that saturation testing of NHS hospital staff was an absolute requirement, and should have happened from the get-go. Last week, the Secretary of State delighted the social care sector by announcing that care home staff would be tested weekly. Now is his chance to delight not just Sir John Bell, but 1.4 million people in the NHS, by saying that from the start of next month, they too can have weekly testing. Will he do that?

As I mentioned, we have put in place the procedures for regular testing of NHS staff, and those procedures are underlined by the clinical analysis. There is a difference between social care and NHS staff, not least because the impact of coronavirus, in terms of its prevalence, has been higher among social care staff in care homes. We must ensure that such decisions are clinically led, but of course I keep the issue under review and take the comments from the Chair of the Health and Social Care Committee very seriously.

I welcome the fact that the UK Government website has now been corrected to add the 80,000 missing covid cases in England, and gives a more accurate picture of the epidemic. Compared with Scotland, England currently has six times the number of new cases per head of population, and nine times the deaths. Even without a second wave, it is estimated that the current level of covid infections would lead to 27,000 additional deaths by next spring. Does the Secretary of State consider that level acceptable? Scotland, Northern Ireland, and the Republic of Ireland are following covid elimination strategies to drive down circulating virus, and reduce the risk of repeated lockdowns. Will the Secretary of State explain what his strategy is going forward?

Yes. Our strategy is to drive the virus right down, and as I said in my opening statement, the latest figures show just 352 new cases recorded in the previous 24 hours. We have been working closely with the Scottish Government, and giving them as much support as we can, for instance to get testing up and running. I am glad that right across the UK, we are succeeding in ensuring that the virus is increasingly under control.

Will my right hon. Friend give any encouragement that beauty salons will be allowed to open in the reasonably near future and does he share my concern and disappointment that even though campsites are allowed to reopen, the company in charge of those in the New Forest is threatening to keep them closed until spring next year?

My right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy is working closely with the beauty industry regarding how it can open in a covid-secure way, taking into account clinical advice. We have, however, been able to change some advice to allow for the reopening of camp sites. I am very pleased about that, and it will help lots of families to enjoy summer safely. It is disappointing to hear of the blanket approach taken to not having any camping in the New Forest—I went camping there as a child, and enjoyed it very much. On a campsite people must be particularly careful of shared facilities, and ensure that they are cleaned properly, but there is a way to open campsites safely and securely, and doing that in the New Forest, and elsewhere, will help people to enjoy summer safely.

The Secretary of State’s comments on Sunday, when he suggested that my Greater Manchester public health colleagues needed help in interpreting the pillar 2 data that they received from centrally contracted private labs, was nothing short of insulting. These are some of the most talented, dedicated and professional people with whom I have had the privilege to work. They do not need help; they need timely, patient-identifiable, and complete data, which they have not been getting. Instead of trying to shift the blame for the Government’s mess in handling the covid crisis on to our amazing public health teams and care home staff, what is the Secretary of State doing to ensure that people get those data? Why will he not announce local thresholds for easing and reinstating lockdowns, as Germany and other countries have done? Finally, will he apologise for his patronising remarks to my public health colleagues?

I will not allow a divisive approach to tackling this crisis. We will all work together. We will work together with local authorities, local Mayors and local areas, and we will do that in Manchester and across the board. I just hope that the hon. Lady will take the message back to Manchester about how keen we are to work collegiately and together. That is the right way forward.

I have already answered the question on thresholds for changes to local lockdowns. We have to apply judgment. Again, we do this in consultation with and working hand in glove with the local area. On the point about data, the hon. Lady might want to have a word with her friend, the shadow Secretary of State, because he was right to acknowledge that the sharing of this sort of data, which is a complicated task, is constantly improving.

Is there more that we can do to help dental practices that are struggling with the need to see fewer patients and with increased costs to provide all the PPE? Many local dental practices are telling me that they will struggle to survive until they get back to normal volumes if they cannot get some help with the increased costs.

My hon. Friend raises a really important point. PPE is a significant extra cost right across the health and care system. Dentists who are on NHS contracts have of course had those contracts paid throughout, even when routine dentistry was not open. I am really glad that we have now managed to get routine dentistry open. We are working with dentists and their representatives to ensure that we tackle the real-world challenge of having high-quality and safe dentistry while ensuring that dental practices can also be financially sustainable. It is a challenging problem and I pay tribute to the dentists who are working with us on it.

Does the Health Secretary agree with the Prime Minister’s despicable comments, blaming care workers for the huge death toll in care homes, or will he admit that his Government’s own failings left these low-paid and undervalued carers with little or no protective clothing, and many without access to sick pay, fighting a losing battle against this awful disease at the height of the pandemic?

I have been clear that we have been learning about this virus and how best to deal with it throughout. My admiration for those who work in social care is second to none. One of the good things about this crisis is that it has shown the whole country how much we value not just those who work in the NHS, but those who work right across social care, caring for the most vulnerable.

Cancer takes the lives of loved ones far too early, including that of my father. The pandemic has made it very difficult for people to access the necessary treatment. Can my right hon. Friend reassure me that everything will be done that can be done to ensure that those who need treatment get it soon?

Yes. That is an incredibly important point. When people talk about the lives that have sadly been lost to coronavirus and how many might be in the future, we also have to take into account the health impact of non-coronavirus diseases such as cancer whose treatments are affected by the actions that we have had to take. My heart goes out to all those who have not been able to get cancer treatment because it would not have been appropriate clinically to do so when there was a virus about. We are now putting an enormous amount of effort into getting cancer treatment services up and running. Perhaps the most important message—and the biggest barrier to more early diagnosis—is that people must come forward if they suspect that they have a cancerous lump. If they find a lump, they must call a GP, and if they are asked to go to hospital, they must; it will be safe to do so. It is really important that people help us to help them.

Clearly, it is vital to have health services fully prepared for the possibility of a second wave of coronavirus while reopening normal health services. With that in mind, I have a simple question for the Secretary of State: what estimate has he made of the additional funding required for the NHS between now and the end of 2020?

We are constantly putting more money into the NHS and have put in an extra £30 billion over the crisis thus far.

Could the Secretary of State remind us how big an increase in intensive care capacity there has been for the health service? That increase is a great achievement. Were the unthinkable to happen and there was another surge in the virus, could we have isolation hospitals that dealt with that so that the rest of the hospitals and surgeries could carry on with their other work?

Yes. We have doubled the intensive care capacity, which, alongside the Nightingale, has been a remarkable achievement of the NHS. There are now green and blue areas in hospitals, or whole hospitals, depending on the geography—in a rural area, we could not make a whole hospital covid-secure or covid-free, because it would have to serve both covid and non-covid patients. That separation of the NHS into blue and green areas is an important part of their being able to reduce the impact of infection control procedures, which are obviously having a big impact on the provision of services.

What is the current level of funding for research projects on the long-term effects of covid-19 funded from the National Institute for Health Research, in which I think the Government claim to put £1 billion?

This is a really important point. The hon. Gentleman will have heard at the weekend that the NHS has opened a long-term covid impact service. That is on the health side. On the research side, we have so far put £8.4 million into a research call, but of course we will be happy to expand that if we get research projects that are worthwhile.

What advice and guidance have been developed for shielded adults who have children of school age? It is a question not simply of the transmission risk between children but of the unavoidable contact with other adults. I am sure my right hon. Friend will understand that the earlier such advice is developed and disseminated, the less unnecessary anxiety there will be for these parents during the school holidays.

I will write to my right hon. Friend with that advice. Of course, thankfully, as the virus has been brought under control, the restrictions on those who are shielding can be lifted, so I am glad to say that this is a lessening problem, but certainly ahead of September, in particular, and the full return of schools, we will have to make sure the advice is very clear, and we will do that.

Day respite care centres, such as Homelink in my constituency, provide much-needed support for people with dementia, learning difficulties and other complex needs and are a lifeline for unpaid carers. Homelink and others are desperate to open as quickly as possible and are working on covid-secure guidelines, but they cannot get free access to testing for staff and their users. Will the Secretary of State please consider making testing for respite carer centres available on the same basis as for care homes?

Yes, we have a project under way on this. It is something that the Chair of the Science and Technology Committee has been working on for weeks as well. Again, I will write to the hon. Member with the full details of the plan to make this happen.

May I take this chance to thank the people of Leicester and Leicestershire, the police and public health services for dealing with the local lockdown that has been implemented? When it comes to a local lockdown being announced, the people of Hinckley and Bosworth need two vital pieces of information: what the measures are, and where the boundary is. The Government were quick to put up on their website what those measures were, and they rightly allowed Public Health England and the councils to draw the boundary. What lessons has the Health Secretary learned from the Leicester lockdown, including about passing on information quickly, to be used in future lockdowns, which may well happen in the rest of the country?

My hon. Friend is right to praise the work that has been done by Leicestershire County Council, as well as by the city council, with which we are working hand in glove. We are looking at the way that the lockdown was brought in at pace in Leicester, to ensure that, should we need to do that again, it is a yet more effective process. One of the lessons is that the boundary for the action is a critical piece of information. We managed to publish that overnight, within about 12 hours of the decision being publicised. I pay tribute to the county council, which led on that decision. Ensuring that we have both the actions and the boundary ready as soon as possible is critical, because, naturally, local people immediately want to know whether they are in the lockdown area.

I do not know whether the Secretary of State saw today the comments by the president of the Royal Society about the benefits of wearing face masks in indoor public settings, drawing attention to the fact that the prevalence of wearing face masks is much lower in the UK than it is in Spain or Italy. I therefore want to ask him to look at two things. First, will he look at a scheme for issuing a pass or badge to those who have an exemption from wearing a face mask on public transport, so that those who are not exempt can be required to wear them? Secondly, will he look again at the lack of any advice about wearing face masks in supermarkets and other shops? Surely it is just as easy to catch the virus in a supermarket queue as it is on a bus.

I congratulate my right hon. Friend on answering this urgent question with the usual aplomb, and I also congratulate my hon. Friend the Member for Derbyshire Dales (Miss Dines) on asking about cancer treatment, which is very important up here in Derbyshire. Is there any news about reopening swimming pools? We have fantastic swimming clubs in South Derbyshire that want their kids to get back to swimming. Although I am grateful for all the pubs that are open, some families prefer to go to bowling alleys. Does he have any news on when they will be able to open?

I would love to get swimming pools open as soon as safely possible. As my hon. Friend knows, the emphasis has to be on safety. Alongside gyms, we are working with swimming pools. Of course, there is also some beautiful open water swimming in Derbyshire. Swimming in all its forms—in the sea, in open water and in swimming pools—is very good for your health, and we should try to get it all open as soon as we possibly can, but the nature of swimming and changing rooms means that there are risks, and we have to ensure that those risks are properly taken into account.

Given the Secretary of State’s earlier comments, will the Government back the campaign by Macmillan Cancer Support and commit themselves to urgently publishing a national cancer recovery plan, to ensure that cancer does not become the forgotten “C” in this pandemic? Will he meet Macmillan to discuss that?

I would be very happy to meet Macmillan. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is the Minister responsible for cancer, has been working on exactly this subject, but I would of course be happy to meet Macmillan and other cancer charities, because this is such an important thing to get right.

The Secretary of State will have received the letter I sent him as chair of the all-party parliamentary group on vascular and venous disease, highlighting the suffering that vascular patients are facing because of delayed treatment caused by covid-19. As I have said before, time is tissue—the longer the delay in treatment, the more likely it is that these patients will need an amputation. What are the Government’s plans for addressing this backlog?

The hon. Lady is quite right to raise this issue. She has raised it before and we have been working on it. In the first instance, the best way to tackle this backlog is to get treatments open as much as possible and to get the number of treatments back up to par—to where they were before the crisis—and then we will have to work on any backlog. In some areas, there are bigger backlogs than in others. The NHS did a remarkable job during the crisis. We protected the NHS during the crisis, but it has a huge amount of work to do—and we will support it to do that work—because of the inevitable and necessary consequences as part of the response to covid.

Last week, it was revealed that Rotherham had one of the highest rates of infection in the entire country. What reassurances can my right hon. Friend give to the people of Rother Valley that it is safe to go out, it is safe to patronise our businesses, and we are getting control of this virus?

It is true that Rotherham has a higher proportion of positive cases than the country as a whole. Nevertheless, that rate is much lower than it was in Leicester, and we are working with the council to ensure that the necessary action is taken. Everybody in Rother Valley should take comfort from the fact that, nationally, the virus is under control. In rural parts of Yorkshire, the rate is not that much higher than it is anywhere else. People should go out and enjoy summer safely; the emphasis should be on both “enjoy” and “safely”.

At the end of March, the Department of Health and Social Care announced that Clipper Logistics would be contracted to provide a portal for community healthcare partners such as local authorities and social care providers to order PPE for their staff. Can the Secretary of State confirm what the value of the contract awarded to Clipper was and how many items of PPE it has delivered?

I do not have those figures to hand, but the delivery of PPE through this portal has been a very important part of the response in some parts of the country. I am very glad that, thanks to the incredible hard work of thousands of people in the public and private sectors, we have managed to deliver 2 billion items of PPE and that the very sharp spike in demand for PPE has now been met with a very sharp increase in supply.

May I thank care home workers in my constituency? I have been called out to patients in care homes a number of times over this period in my role in the ambulance service and seen staff in full PPE locked down and without the support that they normally get from families. I want to thank them for that and say that I am absolutely full of admiration for them. On the issue of nurses, for my trust to catch up it will require a large number of overseas nurses as well as having to train new ones. Part two of the Nursing and Midwifery Council qualifications has to be completed within three months, but some of the test centres are not open yet, so can we look into extending that period, or see whether we can get these test centres open and the backlog cleared?

Yes. The whole House should pay tribute to my hon. Friend for his work as a first responder during this crisis. He has first-hand experience of the matters of which he speaks. The particular issue that he has raised is not one that has been previously drawn to my attention, but we are doing everything that we can to hire nurses and we are seeing the results of that: over 12,000 more nurses than this time last year in the NHS. We are well on our way to the 50,000 more nurses over this Parliament, on which everybody on the Conservative Benches was elected. I will look into the particular issues he raises and try to solve the problem.

Last week’s “Panorama” had a public health expert from Germany saying that, if we only look for people with symptoms, we get not the whole iceberg, but just the tip of it. The Faroe Islands, which have the highest testing in the world per population—between a fifth and a third of the population—found, as far back as March, that 80% to 85% of covid-19 carriers were asymptomatic. What strategy does the Secretary of State have to find those people who are asymptomatic, because we either test and search out the whole iceberg or we keep using the blunt instrument of lockdowns?

The hon. Gentleman is absolutely right that around 70% to 80% of positive cases in surveys are of people who are asymptomatic. It is one of the most difficult things about this virus. Hence we have built one of the largest testing capabilities in the world. It is significantly bigger than all the other major countries, bar a small number. We are using that testing capability for asymptomatic testing as well as for symptomatic testing across the NHS and social care. We are supporting Scotland as much as we possibly can in its testing effort, too.

The  Secretary of State has set out how important data is to his strategy.  Can he therefore explain why his Government have a contract with Deloitte to cover the testing for covid-19 which does not require Deloitte to report positive cases of covid-19 to Public Health England or to local authorities?

Does the Secretary of State share my admiration for careworkers on the Yorkshire coast, including those in a care home in my constituency where an outbreak among admin staff in the office was contained and not spread to forward-facing staff or residents? Will he also undertake to support local authorities such as North Yorkshire County Council, which in the past fortnight has had to close two care homes in Scarborough run by the same company, where evidence from the Care Quality Commission showed that the level of care was unacceptable and potentially dangerous?

Yes. My right hon. Friend raises an incredibly important point. I pay tribute to those care homes, in Scarborough and across the country, that have done the right thing and are tackling outbreaks when they find them, including some that go to extraordinary lengths to protect their residents, not least because we know that care home residents are among some of the most vulnerable to coronavirus. But at the same time, we must ensure that the level of care remains high, and the CQC does have an incredibly important role in that.

Professor Michael Baker, who formulated New Zealand’s world-leading elimination strategy, has told the UK:

“You have all the tools you need to pursue containment and elimination if you choose to. The alternative is going in and out of lockdown for months, if not years.”

Does the Secretary of State agree with that, and will he therefore confirm that the UK Government’s strategy for covid-19 is going to be centred on elimination rather than suppression?

We are absolutely bringing the case rate right down, and the fact that across the UK as a whole there were only 352 positive cases in the last 24-hour period, which is the lowest since before lockdown, demonstrates that that action is happening. It is because of this action that we have been able to allow people more freedom to enjoy the things they enjoy, and I am glad to say that that strategy has been followed by all four Governments in the UK. There may be differences in detail and differences of a few days in a few bits of the timing, but essentially this has been a UK-wide strategy, followed both by the Labour Welsh Government and by the SNP Government in Scotland.

Like so many across our country, I was delighted to visit the pub for the first time over the weekend. I had my first pint in a socially distanced fashion at the Durham Ox in Coundon. I was really impressed by the work that Susan and Phil had done to enforce social distancing and by the ingenious measures they had put in place, including diligently collecting the contact information of the people who entered. So on that note, will my right hon. Friend outline how the covid-secure guidance from the Department for Business, Energy and Industrial Strategy is helping to support the vital NHS test, track and trace efforts?

That is true. The actions we have put in place mean that we can open hospitality such as pubs, and doing that safely means that we have been able to open more hospitality than we would otherwise have done. I, too, went for a haircut and a pint on Saturday morning—[Laughter.] The haircut was on Saturday morning; the pint was early in the afternoon. I am glad to say that my name and phone number were taken when I turned up at the pub. I have not been back to Suffolk since February. That is one of the things I have missed most about this whole crisis. I am going on Friday and I will go to the pub there. No doubt they too will take my number.

We have heard much in recent weeks about the risks of a second wave. Will the Minister please outline the current science on that and outline when we might be most at risk?

The policies we have put in place with the local action are precisely targeted to reduce the risk of a second wave nationally. Nevertheless, as we turn to winter and the weather gets colder, there are signs of some seasonality in this virus, meaning that we will have to be much more careful, both because of the potential impact on how easily the virus transmits and because of changes in behaviour—we know that outdoors is safer and it is just harder to be outdoors in winter. So we must remain vigilant as a country.

When the impact of covid-19 on the beauty industry was raised in the Chamber last week, the Prime Minister laughed, despite the fact that it contributes £30 billion to the economy and accounts for one in 60 jobs. Further to the question from the right hon. Member for New Forest East (Dr Lewis), what engagement have the Government had with the sector? Given that hairdressers and pubs are now open, when can beauty salons expect to open too?

The decisions that we have taken are based on clinical advice on the risk, because we know that being face to face, when in close contact, is more high-risk than not being face to face. That has been the basis on which the decisions have been taken. Of course I understand the impact on the beauty industry. As I said, my right hon. Friend the Business Secretary is leading on this issue and we will make progress when we safely can.

Last week, I visited St Giles School in Retford, where people very kindly gave me one of their excellent cloth face coverings to wear when travelling to Parliament. Will my right hon. Friend join me in reiterating that while cloth face coverings can help to reduce the risk of transmission in some circumstances, face masks worn as part of PPE for healthcare and other workers should be reserved for those who need it?

The use of face coverings that are not formal face masks is valuable, especially in some circumstances, and therefore it is mandated on public transport and has long been recommended in some shops. The use of masks, especially the high-end masks, should be reserved for those who need them in clinical settings. However, I am glad to say that the supply of PPE is now much, much more secure than it was a couple of months ago, which means that face masks are more readily and widely available and are increasingly used in non-clinical settings. The low-end surgical masks are the ones that would typically be used in a non-clinical setting. Nevertheless, face coverings are an incredibly important part of our armoury.

People working in aesthetics—the professionals who tattoo on eyebrows for alopecia sufferers or tattoo on the nipples of cancer patients who have had reconstructive surgery—have been horrified to discover that they are categorised alongside strip clubs. Will my right hon. Friend please look at this issue urgently to understand how the NHS is referring patients to these people, who are still not allowed to open?

I will certainly look into the last point. However, that categorisation is not quite right. The beauty industry is an important industry in and of its own right. While we do still have restrictions in certain areas and categories, that does not mean that they should all be lumped in together. The beauty industry is an incredibly important industry and we will get it open as soon as it is safe to do so.

At the start of this crisis, the guidance for care homes was unclear. They could not get PPE, and patients were being discharged from hospitals to care homes without being tested for covid. The Prime Minister’s comments have given offence. Does the Secretary of State accept that care home providers cannot be blamed for the deaths of their residents, and that it is time to give care staff the pay and respect they deserve, and to bring forward plans to fund social care properly?

The need to reform social care is no less urgent than before the crisis. Indeed, we have learned through the crisis yet more about the nature of the reforms needed, because we have seen the positive impact of much closer, system-level working between the NHS and social care and local authorities. That should inform our thinking about the long-term social care reforms that this country needs to see.

I thank the Secretary of State very much for all he has done—for his leadership, and his direction and courage.

Macmillan estimates that disruption to normal cancer services could lead to almost 2,000 cases of cancer a week going undiagnosed, with almost half cancer patients seeing their cancer treatment delayed, cancelled or changed as a result of coronavirus. Given the level of disruption, what additional resources will the Secretary of State put in place to protect and sustain the delivery of cancer care if further waves of the pandemic should occur?

The hon. Gentleman has repeatedly raised this vital question; I think he was the first in the House to raise the importance of restarting cancer services, right at the peak of the pandemic. We have been working incredibly hard to do so. Of course, we have put extra funding into the NHS this year—very large sums—because of the crisis, and of course we want to see cancer services fully restored as safely as possible. I just repeat the point that I made to my hon. Friend the Member for Derbyshire Dales (Miss Dines): it is critical that people come forward if they suspect that they might have cancer.

As the Health Secretary knows, Hampshire Hospitals NHS Foundation Trust is currently doing a big engagement process called Hampshire Together, which will look at the future of health services, not just in the acute sector, over the next 30 to 40 years. That is a critical piece of work, going on throughout June and the rest of July. My constituents are emerging from a pandemic; understandably, many are worried about whether they will still be within furlough in a few months’ time and are not thinking about the next 40 years of health services. Will the Health Secretary be minded as to big decisions being taken now while the public are understandably distracted?

I take my hon. Friend’s point very seriously. We are planning significant investment in the health service in Hampshire. That has to be done in a way that enhances services locally, in Winchester and across the county. We have learned a huge amount during covid about how the health system works best, with system working, much more community activity, and much more treatment at home by telemedicine, which is one of the things that have gone incredibly well in this crisis.

Polling from YouGov shows that so-called anti-vaccination sentiment is on the increase in the UK, with 16% of UK adults saying they would probably or definitely avoid a covid-19 vaccine. What does the Secretary of State feel that means for the hopes of achieving immunity?

The Government of the United Kingdom will recommend a vaccine as soon as one is available that is safe, but only when it is safe. It is so important, and it is incumbent on every single Member of this House, that we make the case for why vaccines are both safe and effective. The hon. Gentleman is absolutely right to raise this issue, and I am grateful to him for doing so. It is an issue, I think, on which all parties agree. Should a vaccine come off, it will be such good news for humanity, frankly, and we will need to make sure that people are given the support and the confidence, and of course the logistical convenience, to be able to get the vaccine should that be clinically appropriate.

Will my right hon. Friend consider a comprehensive review of Public Health England to see what lessons can be learned and what improvements can be made for any future crises?

We are constantly learning what we can do to improve the response to coronavirus. We have been clear about that right from the start. The gathering evidence on asymptomatic transmission that we saw during March and April is a case in point, because it changed policy and how we deal with this virus.

The welcome opening of pubs in England has made a major difference to the morale of a nation. In Wales, pubs will not be able to open until next Monday, and then only outside. Will my right hon. Friend share the best practice of one-way systems and appropriate screening to ensure that landlords, pubs and breweries do not go out of business needlessly, if only Wales follows the English model?

I am very happy to work with my Welsh colleagues on how it is possible to open pubs and hospitality in a covid-secure and safe way. Wales has a great tradition of great pubs. I very much hope that they can be open as soon as the Welsh Government make their decision.

I remind the Secretary of State about another virus: HIV. As chair of the all-party group on HIV/AIDS, I met colleagues from across both Houses this morning to hear about the impact of the covid-19 crisis on people with HIV in terms of mental health, access to treatment and many other issues, including the disproportionate impact on black, Asian and minority ethnic communities. Will the Health Secretary say what he has been doing specifically to support people with HIV? Will one of his Ministers meet the group to listen to our specific concerns?

Yes, this is an incredibly important issue. Our goal as a country to reach no HIV transmissions by 2030 stands unaffected by covid. It is a vital objective, and there is a huge amount of support and effort behind that goal. Access to treatment has, of course, been made more challenging. We talk about the epidemic and think about it as being the biggest since the Spanish flu, but it is not. The biggest epidemic before this one was the HIV epidemic, which we are still working to rid the world of. I have every hope that in our lifetimes we will get there. We will play our part.

People in Broxtowe have written to me about their fears that due to lockdown their mental health has declined and vital treatment, including therapy, has been postponed. The coronavirus has made them more anxious to seek help and, like many, I am worried about the impact a lack of early intervention can have on vulnerable people. Can my right hon. Friend reassure me that mental health support will be part of the NHS “Open for business” campaign and that people who are concerned about their mental health can safely seek help?

Yes, mental health services absolutely are open and people who need support with mental ill health should come forward. They should go to their GP in the first instance. The good news in this area is that telemedicine is particularly effective for psychiatry. Of course, it cannot be effective for all mental illnesses, but it can for many, and it is being used very effectively by psychiatrists across the country.

The initial findings of the investigation into Bedford’s now decreasing infection rate shows that women between 30 and 59 have been most affected. Will the Secretary of State remind everyone that this invisible virus does not just affect the older generation? Does he agree that the published data must include details on ethnicity, the older generation and workplace factors if we are to eliminate the virus and keep the public safe?

Yes; we are publishing more and more data about the virus and who has caught it, in the same way as we are giving more and more information to directors of public health so that they can use it for the same purposes. The hon. Gentleman is quite right to say that the virus does not only affect those who are older. Although more people who are older tend to die from the disease, anybody can transmit it, and that is the big risk. I am glad to say that the numbers of cases in Bedford are coming down. We keep a watchful eye to ensure that that continues to be the case.

Obviously coronavirus has impacted all of us, but one group impacted is the parents of premature and sick babies. I commend to the Secretary of State the briefing paper from Bliss, “Parents aren’t visitors”. Is the Secretary of State willing to meet me, as chair of the all-party group on premature and sick babies, and Bliss to consider the impact the virus has had on the parents of premature and sick babies, and to ensure they get the support they need to support their families at this time?

Yes, I would be very happy to meet the hon. Gentleman and the group. This is an incredibly important issue and one that is very close to my heart. I think that many in this House will know that one of our Members lost premature twins very recently. It affects many, many families and we must ensure that NHS services are available to give premature babies the very best chance of life.

Screening programmes help to keep people healthy and this Government have expanded them. As the NHS communicates that it is open and that people should seek treatment, will my right hon. Friend ensure that its leaders focus on getting screening programmes back up to full speed and then encourage people to use them and get screened?

I am really glad that my right hon Friend has raised that point, because screening services are so important, including for cancer, which is a subject that has been raised many times in this debate and in the House in general. We are working very hard to expand and reopen screening services, making sure that infection control is possible and that we are using testing effectively, so that when people come forward for screening, they can do so with confidence. My right hon Friend is right to raise the issue. We will keep pushing it, because screening is so important to keeping people healthy.

Last night’s “Panorama” programme showed the awful truth that we could lose more people to cancer due to delayed treatments and interventions than we do to covid-19 itself. We know we can avoid that tragedy in a number of ways, one of which is to expand the operation and to bring forward the implementation of radiotherapy around the country—this summer, especially—to clear the backlog and to give people hope. That should include delivery close to home in places such as Westmorland General Hospital in Kendal. Will the Secretary of State meet the all-party parliamentary group on radiotherapy to discuss our six-point plan to help give people hope and to save lives immediately and in the long term?

We share a common mission in this space, because we have already invested £200 million in expanding diagnostics, and that is an incredibly important part of the reopening of the NHS. I am very happy to meet the hon. Gentleman and his group and all those interested in the expansion not just of radiography but of all types of diagnostics. We need to ensure we do that in a way that works for patients and therefore opens access. That is incredibly important. We are putting in the investment and we are rolling out the programme. It is happening as we speak, and if he has further ideas to throw into that area, I am very happy to listen to them.

I am grateful to the Secretary of State and all involved first for the temporary testing site, and secondly for the permanent testing site now available for the people of Gloucestershire in Gloucester, but the reality is that capacity is much greater than demand and resources are considerable. Does my right hon. Friend therefore agree that we could make the testing capacity available, for example, to teachers with concerns or to members of black, Asian and minority ethnic communities who need reassurance much faster, before symptoms develop? How can we make that happen?

I am absolutely thrilled to get a question on the problem of having too much testing capacity, as opposed to too little. We have one of the biggest testing capacities in the world. We have built that almost from scratch as a country, and we must use it effectively. We have, for instance, rolled out the extra testing in the NHS that the Chair of the Select Committee was asking about earlier. We have rolled out the weekly testing of staff and the monthly testing of patients in care homes. We will follow a clinical path.

My hon. Friend asked about teachers. We are currently survey-testing teachers to find out if they are more at risk than the general population, in the same way that care workers, care home workers and NHS staff are. If they are, we will put asymptomatic testing in place. We are doing exactly the same survey testing for taxi drivers, because taxi drivers are at higher risk than the rest of the country. If he will forgive me, we are taking a scientific approach to how we allocate that capacity, but it is true that one of the policy challenges we face as a Department is making sure we use all the testing capacity, and long may that be so.

In order 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 four minutes.

Sitting suspended.