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Coronavirus Update

Volume 678: debated on Tuesday 14 July 2020

With permission, Mr Speaker, I would like to make a statement about coronavirus.

Thanks to one of the greatest national efforts in peacetime, this deadly virus continues to diminish. Yesterday’s figures show 530 new cases, down around 90% since the peak, while 162 patients are currently in mechanical ventilator beds with coronavirus, down around 95% since the peak. The latest number for deaths recorded in all settings across the UK is 11—the lowest figure since 13 March. According to today’s Office for National Statistics data, for the third consecutive week, total deaths are lower than normal for this time of year.

Owing to this substantial progress, we have been able to restore freedoms and carefully and methodically restore the fabric of this country. However, we cannot let our progress today lead to complacency tomorrow, so we must remain vigilant to keep this virus under control. Our strategy is to protect the NHS, get the virus down and keep the virus down, while restoring as much of normal life as possible. Our tactic is to replace national lockdown with ever more targeted local action as we work hard to defeat this virus once and for all.

Our NHS test and trace system gets stronger all the time. Since its launch six weeks ago, 144,000 people have been asked to self-isolate who otherwise simply would not have known that they had to. Where we find clusters or outbreaks, we take local action, tackling over 100 incidents a week. Mostly these are small, in an individual care home, pub or factory. But we are prepared to take action on a wider basis if that is what it takes, just as we did in Leicester. Four permanent test sites and 10 mobile testing units have been deployed across the city, meaning that Leicester now has the highest rate of testing in the country. We have launched one of the biggest communication programmes that Leicester has ever seen, including targeted social media posts, website banners, radio ads, billboards and even bin stickers. We have been working closely with all parts of the local community, including community leaders, local businesses and the local football and cricket clubs, to get the message out. We have also established a process for making decisions to lift the lockdown, with the first decision point later this week.

Local action is one way in which we can control the spread of the virus while minimising the economic and social costs. Another is to minimise the risk as we return more to normality. In recent weeks we have reopened retail and footfall is rising. We want to give people more confidence to shop safely and enhance protections for those who work in shops. Both of those can be done by the use of face coverings. Sadly, sales assistants, cashiers and security guards have suffered disproportionately in this crisis. The death rate of sales and retail assistants is 75% higher among men and 60% higher among women than in the general population. As we restore shopping, we must keep our shopkeepers safe.

There is also evidence that face coverings increase confidence in people to shop. The British Retail Consortium has said that, together with other social distancing measures, face coverings can

“make shoppers feel even more confident about returning to the High Street.”

The chair of the Federation of Small Businesses has said:

“As mandatory face coverings are introduced, small firms know that they have a part to play in the nation’s recovery both physically and financially, and I’m sure this will welcomed by them.”

We have therefore come to the decision that face coverings should be mandatory in shops and supermarkets. Last month, we made face coverings mandatory on public transport and in NHS settings, and that has been successful in giving people more confidence to go on public transport and to a hospital setting when they need to, providing people with additional protection when they are not able to keep 2 metres away from others, particularly people they do not normally come into contact with. Under the new rules, people who do not wear face coverings will face a fine of up to £100 in line with the sanction on public transport, and, just as with public transport, children under 11 and those with certain disabilities will be exempt.

The liability for wearing a face covering lies with the individual. Should an individual without an exemption refuse to wear a face covering, a shop can refuse them entry, and can call the police if people refuse to comply. The police have formal enforcement powers and can issue a fine. That is in line with how shops would normally manage their customers, and enforcement is, of course, a last resort. We fully expect the public to comply with these rules, as they have done throughout the pandemic.

I want to give this message to everyone who has been making vital changes to their daily lives for the greater good. Wearing a face covering does not mean that we can ignore the other measures that have been so important in slowing the spread of this virus, washing our hands and following the rules on social distancing. Given that as the British people have acted so selflessly throughout this pandemic, I have no doubt they will rise to this once more. As a nation, we have made huge strides in getting this virus, which has brought grief to so many, under control. We are not out of the woods yet, so let us all do our utmost to keep the virus cornered and enjoy our summer safely. I commend this statement to the House.

I thank the Secretary of State for his statement. After days of ministerial muddle, we finally have a decision. I have long warned that this virus exploits ambiguity and that mixed messaging in a pandemic is so damaging. On Friday, we had the Prime Minister saying he favoured face masks. On Sunday, we had the Chancellor of the Duchy of Lancaster saying he did not favour face masks. Yesterday, the Justice Secretary, unsure what to say, had to say in the end he was perhaps in favour of face masks.

It did not have to be this way: we did not have to have this confusion. We have long known about airborne transmission via aerosols. The Secretary of State has long warned about asymptomatic transmission. The Royal Society and the World Health Organisation have long recommended wearing face masks. Even Donald Trump now wears a face mask, although admittedly it is because someone told him he looks like the Lone Ranger. The former Chair of the Health Committee has long warned about wearing a face mask. The Secretary of State’s own advice, published on 11 May, was in favour of wearing face masks. So why has it taken two months for him to make this advice mandatory, and why will it take another 11 days for the measure to come into force? The World Health Organisation has said throughout this pandemic, “Act with speed”, but yet again this Government appear to be in the slow lane.

All that we need and want is clarity, so may we have it in other areas? What is now the position on workers returning to offices? Do the Government want them to return to offices, yes or no? Will the Health Secretary offer greater clarity to the people of Leicester, who are now in the 17th week of lockdown in my city? What metrics will be used to judge whether Leicester can ease out lockdown later this week? When will he make that decision and how will he communicate that decision to the people of Leicester? Will he clarify why the Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), has ruled out extra support for Leicester businesses and employers, contradicting the indications that the Health Secretary gave to the people of Leicester? When people are worried about their jobs, this mixed messaging is the last thing they need.

On the other parts of the country that have been identified as being of concern, will the Secretary of State instruct the Health and Safety Executive to inspect all factories, meat packing plants, distribution centres and large employment sites as a matter of urgency?

On testing, local authorities still need specific data that can facilitate action. [Interruption.] The Health Secretary disagrees, but they still need person-identifiable data, not just postcodes. They need not just positive test results, but the negative results, so that they can understand the overall infection prevalence, and they need contact- tracing data, so that they know who has been asked to isolate by Test and Trace and can follow them up. They need this data daily. The virus does not wait a week, so why should local directors of public health have to wait a week? I note that in the financial statement £10 billion has been allocated to Test and Trace. Can the Health Secretary itemise what that £10 billion has been spent on? Can he rule out spending more on private outsourced companies, and invest more in NHS labs and testing instead?

Finally, today we have a report from the Academy of Medical Sciences warning of a new wave of infection this winter. The Scientific Advisory Group for Emergencies has also warned that the transmission of the virus

“could be elevated under UK winter conditions”.

Yet missing from last week’s financial statement was any increase in NHS England’s revenue budget. Instead we have a mooted NHS reorganisation, with suggestions that Public Health England could be abolished and speculation that a new centre for disease control could be set up in its place instead. NHS staff need certainty, now more than ever, so will the Health Secretary ensure that the NHS and the social care sector get the winter funding they need to prepare for a second wave? People want to do the right thing. Muddled messaging hinders that. As George Osborne said yesterday, people just “want answers”. Can the Health Secretary give our constituents answers today?

I can certainly answer some of the genuine questions that were under there. The tone of constructive engagement that the hon. Gentleman used to employ was a better one for him.

We clearly follow the evidence on face coverings, and I set out some of the reasons why now is the right moment to introduce the policy. Trying to turn this into a party political football ill behoves the hon. Gentleman, not least because when his colleague the hon. Member for Norwich South (Clive Lewis) was asked yesterday whether he knew what Labour’s policy was on face masks, he said:

“On that specific detail…I don’t…I would like to know…if we are going to call for clarity…it would be good to have clarity on our own policy.”

So we can take the criticisms from the Opposition Front- Bench team with a pinch of salt.

I come to the specific substantive questions asked by the hon. Member for Leicester South (Jonathan Ashworth). I have set out that there is a process for whether changes can be made in Leicester. The process is that we will look at 14 days of data, and today it is 14 days since the measures were introduced. We will look at that on Thursday this week, and will make a public announcement as soon as is reasonably possible about whether any changes can be made to the situation in Leicester.

Thankfully, the numbers have been coming down in Leicester and we have put in that extra testing, but the number of positive cases is still well above the number in the rest of the country. I will not prejudge the decision that we will take on Thursday, and we will take into account all the data. The hon. Gentleman asks for specific metrics. We will not set out specific thresholds. Instead, we will look at all the data—both the level and the rate of change—and make the appropriate decision in consultation with the local authorities.

The hon. Gentleman asks about health and safety inspections. There are risk-based health and safety inspections on all the types of facility that he mentioned, and that absolutely needs to be based on risk. For instance, we have seen across the world that meat-packing factories have a much higher risk of outbreak, so we have targeted inspections on them.

The hon. Gentleman asks about data. Patient-identifiable data is available to local authorities when they sign a data protection agreement. Of course, there has to be a data protection agreement, and, as he knows, we plan to publish more and more of that as open data.

We will continue the work to control the virus. We will continue to bring in measures as they are appropriate, and I look forward to a return to the spirit of constructive engagement for which the hon. Gentleman is so well known.

I congratulate the Health Secretary on the impressive resilience that he has shown throughout the coronavirus crisis, but as we both know, the joy of his job is that winter is always around the corner. One of the most sobering statistics in this morning’s report from the Academy of Medical Sciences is that the number of people every day over winter who have covid symptoms will increase from 100,000 to 360,000. It is obviously vital to know which of them have coronavirus and which just have regular winter flu. The report states that it is essential to have a massive ramp-up of testing and tracing capability before then, so what are my right hon. Friend’s plans to do that, and when he does it, will he be able to do what not just Sir John Bell but Sir Paul Nurse and many other distinguished scientists are calling for, and provide routine testing for NHS frontline staff?

I take very seriously the royal colleges report. We are engaged in a massive ramp-up of testing and of the contact tracing that my right hon. Friend has long championed. The scale of the ramp-up of testing will be big enough to cope with the sorts of figures that are described in the royal colleges report—that is even on the current testing technology. If there is a breakthrough so that we can get testing technology that is even easier to roll out, where it can be done at the bedside in the community rather than having to be sent to a lab, we will be able to have an even bigger roll-out.

As for my right hon. Friend’s final point, as he and I have discussed in this Chamber, we have put in place a programme of regular testing of NHS staff that is advised by clinicians. That insists on regular testing that is, again, risk-based, and as we further ramp up testing above and beyond the current 300,000-a-day capacity that we have now achieved, which is one of the highest in the whole world, we will of course continue to expand that effort.

I thank the Secretary of State for his statement; it represents a welcome step towards preparing for any potential new second wave of coronavirus infections this winter. The virus has not been eliminated, so as we lift lockdown and people increasingly interact with one another, we need to use every tool we have to reduce the risk of a second wave.

A report commissioned by the UK chief scientific adviser, Sir Patrick Vallance, has concluded that July and August must be a period of intense preparation for a potential winter resurgence of the virus, with R potentially rising to 1.7 by September. The report’s worst-case scenario forewarns of an estimated 119,000 associated hospital deaths between September and June—more than double the deaths we saw during the spring wave. This outcome, of course, does not take any account of likely actions that the Government may take. I sincerely hope that an elimination strategy is adopted as part of that.

The move to compulsory face coverings is a welcome and helpful intervention, but I am in no doubt that effective uptake will require consistent and effective public messaging. So far, we have had the Chancellor of the Duchy of Lancaster saying on Sunday that face coverings should not be mandatory, the Justice Secretary saying that perhaps they should be, the Prime Minister saying that he is looking at the evidence, and, thankfully, the Health Secretary saying today they will be mandatory. Will he confirm the implementation date? Press speculation has suggested 24 July. When the head of the World Health Organisation said yesterday that mixed messaging from leaders is one of the worst challenges in tackling covid-19, who do we think he had in mind?

The chair of the British Medical Association has said that

“each day that goes by adds to the risk of spread and endangers lives.”

While I welcome the UK Government’s falling into line with Scotland and 120 other countries worldwide on mandatory face coverings, they need to be one component of a wider elimination strategy, not just about keeping the virus down. I hope the Secretary of State will take this opportunity to commit himself to an elimination strategy.

I certainly agree that the UK has throughout the virus moved largely in lockstep but for a few days in some cases, owing to the implementation and timings of these sorts of decision. That is a good thing, because we are far stronger when we work together as one single United Kingdom. I welcome the Scottish Government’s support for the decision we have taken.

I add only that suppressing the virus is absolutely critical. As all countries around the world have discovered, elimination is extremely difficult. Those countries that thought elimination was achievable are finding that cases pop up again. The correct approach, which we are following right across the United Kingdom, is local action whenever we see cases, clamping down on them as much as possible in order to suppress the virus, while lifting those national measures.

I praise my right hon. Friend. It is great that this is the third week of a lower than average number of deaths across the country, which shows that we are really getting a grip on the virus. We have seen real reductions in rates in the north-east as well.

However, as the economy opens back up, confidence is absolutely key for my local community and the local economy, particularly for those coming back from shielding in August. Also key is the confidence that, when there are local outbreaks—there has been one in my constituency in the last 48 hours—track and trace is there for people. Will my right hon. Friend tell the House how many people have already been tracked and traced across the country, to help give people confidence that the system is working?

There are 144,000 people who have been asked to isolate who simply would not have known that they were at risk before the large-scale track and trace programme was put in place. It is vital that we have the resources to act and that we have plenty of resources for testing and tracing. For a while, we faced criticism that we had too many people with not enough to do, but, as was shown by the royal colleges report released this morning, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt)—the Chair of the Health and Social Care Committee—said, and as my hon. Friend just mentioned, it is vital that we have that capacity, so that whenever we need to trace an outbreak of the virus, we can get right in there and take the action that we need to take.

Every covid-19 death is a tragedy—a family changed forever. The tragic but inescapable truth is that the UK Government’s response to this pandemic resulted in one of the worst death tolls in the world. However, adjusted for age, the death toll in England is 81.9 people per 100,000, compared with 67.6 in Wales. Commons Library research indicates that excess deaths across the pandemic period have been 15% higher in England than in Wales, despite a significantly greater proportion of the Welsh population living with long-term limiting illnesses. What does the Secretary of State believe explains that disparity, and what lessons can his Department learn from the Welsh Government’s response in preparation for further local outbreaks and a potential second wave?

I have been engaged positively with the Welsh Government throughout, and when we have had concerns—for instance, about the outbreaks the Welsh Government were handling in Wrexham or on Anglesey —we have been in communication about them, especially when there has been an issue on the border. I would caution slightly against the sorts of comparisons the hon. Lady draws, but what I will say is that this exercise is best conducted together, and that is why our approach is to tackle this virus together across the whole United Kingdom.

The Academy of Medical Sciences is very clear: prepare now for a winter covid-19 peak. We must grasp this chance to learn from past mistakes such as PPE shortages and a Welsh Government gazumped by the British Government on testing equipment. Will the Secretary of State commit himself to a rapid review, not to point the finger of blame, but to stand ready to implement what we have learned before winter is upon us?

This attempt to divide us is very unfortunate. The UK Government have put testing capacity into Wales that is bigger than NHS Wales’s own capacity, and we do that in Scotland as well with the same effect. We are working together in partnership across the United Kingdom, and, absolutely, we are making the preparations for winter, as the right hon. Lady and every other Member of this House would expect.

If test and trace is to work effectively and people take the advice they are given via that service, some of them will find it difficult, because they will be earning no money; there is a choice to be made between self-isolating and being able to pay their bills. So will the Secretary of State look once more at the issue of sick pay for those, especially in local lockdowns, who are asked to self-isolate on behalf of all of us?

Yes, of course we keep this under review. The evidence shows that the most important difference that we can make to get yet more people into the test and trace system is for everybody who has any symptoms at all to get a test if in doubt. That is where the biggest gap is, and that is partly due to the number of cases where people have no symptoms, when of course they would not know that they need to get a test; finding them is incredibly important and is done through contact tracing. We must make sure that if anybody has coronavirus symptoms, and therefore needs a test, they come forward and get a test: if in doubt, get a test. It is of course an important consideration to make sure that people are supported if they need to isolate, and we are working closely with business to ensure that happens.

The experience of this virus in Barrow and Furness is that it has hit most those with underlying health conditions or who live in areas of deprivation. Surely a lasting legacy from coronavirus should be a move towards early intervention, so we can lift people out of health inequalities and deal with issues before they become intractable problems. Will my right hon. Friend share his views on this approach?

I strongly agree with the point of view so eloquently expressed by my hon. Friend. It is critical that, as well as tackling coronavirus and the economic consequences of the action that we have had to take, we tackle the deep-rooted health inequalities that have exacerbated this disease and its impact on many people. This is a critical part of the levelling-up agenda. Issues such as obesity in particular clearly have an impact on how badly people are affected by coronavirus, and we need to take action in order to ensure that people have more equal life chances across this country.

Transparency and trust are crucial in any public health crisis, but public health directors still need household data on infections, not just postcode data. Wakefield Council told me this afternoon that it is still not getting the household data on positive tests, even though we have had outbreaks at Forza meat processing factory and at Urban House asylum accommodation. The public also need proper weekly cases information, not just at local authority level, which itself is hard to get hold of, but at town level and constituency level. Will the Secretary of State now publish—for everybody across the country—that more local data, at constituency or town level, on the weekly cases each week?

The information that the right hon. Lady has requested is available to directors of public health in upper-tier local authorities, and we are extending that further. In addition, I want to see much more data published as open data, and I have requested that that happens. I am sure it will happen soon, but the truth is that, following a request from directors of public health right across the country, we have extended a huge amount of data to them. Those who have signed data protection agreements in upper-tier local authorities and who have the statutory responsibilities for dealing with this have got the data down to the personal details that she requests.

On a conference call with the North Yorkshire resilience forum yesterday, I discovered that while the borough of Scarborough had experienced 561 cases in total, apart from one isolated case on 3 July we have not had an infection since 23 June. Will the Secretary of State join me in paying tribute to the people of Scarborough and Whitby not only for so assiduously following the Government guidelines, but for applying liberal quantities of Yorkshire common sense?

Absolutely. The people of Scarborough have been well represented and well led by my right hon. Friend. They are doing a great job in following the social distancing rules and making sure that they take appropriate precautions, and as a result, the disease has been suppressed in Scarborough. I am sure that the people of Scarborough will be able to enjoy summer safely.

Will the Secretary of State please outline what is being done to enhance procurement resilience within the NHS? Also, what is being done to ensure that British companies get orders for PPE, not just those in China?

I am absolutely determined to see that happen. Many British companies have stepped up to the plate to deliver PPE, and a very significant proportion of our PPE will be manufactured in the UK by the end of the year. It is a very important part of our global resilience.

The much-loved author of “Don’t Put Mustard in the Custard”, Mr Michael Rosen, has broadcast very eloquently on the BBC about his experience of excellent healthcare in his local Whittington Hospital. However, what he has also described very eloquently on Twitter are the sequelae or after-effects of covid. What urgent steps is the Minister taking to address the need for tailor-made, experienced, proper healthcare in the community for those who are still suffering months after they have had covid?

The hon. Lady raises an incredibly important question for the small but significant proportion of people who have long-term detrimental effects from coronavirus. I am glad that Michael Rosen got such excellent care at the Whittington, and I can assure him and the hon. Lady that we are putting in place NHS treatment for people with long-term impacts and research to make sure we understand as much as possible about those long-term impacts, because they are still little understood.

Thank you, Mr Deputy Speaker. As chair of the all-party parliamentary group for disability, I have been hearing concerns from those who may be exempt from wearing face masks but are fearful of being confronted because not all disabilities are visible. Will the Secretary of State join me in congratulating East Kilbride’s Hannah Kelsall on developing free “chase the rainbow” carry cards that explain this exemption? Ultimately, no one should ever be challenging vulnerable people outside. It takes a lot of courage for many to leave their homes, but these innovative cards are providing reassurance for many across my constituency and beyond.

It is very important that, as a society, we look out for the most vulnerable, especially during this epidemic. The initiative that the hon. Lady describes is just one way in which we can all support people who have particular circumstances, and it relates directly to the introduction of the mandatory use of face coverings in shops, because there are important exemptions. It is important that people are able to express the fact that they have an exemption because of their medical condition requiring them not to wear a mask, so that they can still shop.

Will my right hon. Friend update the House on the “NHS is open” campaign, to make sure that members of the public in Dudley, Gornal, Upper Gornal and Woodsetton, Sedgley and beyond know that if they need to seek medical help, they can do so?

Yes. I want to reassure people in Dudley and beyond that the NHS is open. If people need NHS treatment, they should go to the NHS. In the first instance, they should contact their GP by phone or telemedicine, or call 111 or go to NHS 111 online. If people are asked to go to hospital or into a surgery, they absolutely should, and it is safe for them to do so.

The only way that directors of public health can properly tackle covid-19 is through an integrated approach to testing, tracing and outbreak management. Currently, the Government are treating each of those separately, with little regard to how they are interconnected. Does the Secretary of State accept the limitations of this system, and will he reallocate resources so that regions can develop integrated approaches for coronavirus test, trace and management?

It is vital that all those things are brought together at both a national and a local level, and they are. The actions that have been taken under the NHS test and trace programme, whether national or local, and the interaction of the two, are testament to the fact that we are increasingly integrating national and local work and ensuring that the best high-quality data available is shared.

In the unlikely event of a local outbreak in a town or village in Cornwall in the summer, could the Secretary of State outline what a local lockdown might look like for local people and anyone holidaying in Cornwall?

Yes. Local action can be anything from action in an individual business premises, an individual farm, as we saw in Herefordshire over the weekend, or an individual GP surgery, up to a group of organisations or, if necessary, a whole city. The approach we take is that, for an individual premises, that is largely a decision for the local director of public health to take, but of course, once we get up to the level of a whole city, that has to be a decision taken nationally by the Government. We will publish more details of this escalation procedure in due course.

A report from the Academy of Medical Sciences states today that July and August are critical months for “intense preparations” for a possible second surge. What specific measures is the Health Secretary taking to stress-test the PPE supply chain during that period, as the report recommends, given that recent improvements in supply have not taken place in worst-case scenario conditions? Furthermore, will he be responding to calls from Care England and the Relatives & Residents Association to provide PPE to adult social care, free of charge, as an important public health intervention ahead of a second wave?

Of course we are doing that work to stress-test the delivery of PPE and to rebuild the stockpile. We had a huge stockpile at the start, but the distribution of that stockpile was extremely difficult for a couple of weeks while we fully sorted it out, got the supplies flowing back in from abroad and built up domestic supplies. Lord—Paul—Deighton has done a remarkable job in putting together the logistical effort. It is exactly as the hon. Lady says. Over the summer, we are doing the work to ensure we are ready for winter.

I welcome the Government’s announcement of an exeption from the immigration health surcharge for health and social care staff. As set out by the Home Secretary just this week, we will launch a health and care visa, providing an exemption from the health surcharge upfront for either themselves or their dependants. There are, however, some in social care who will not be caught by that exemption. Can my right hon. Friend therefore please update the House on how he plans to ensure that those social care workers will be exempt from paying the surcharge?

Yes, I can. I can announce today that all employees working in health and social care will be exempt from the immigration health surcharge, and that all employees in health and social care who have paid the immigration health surcharge on or after 31 March will be eligible for a reimbursement. We value enormously the work that people do right across the NHS and all across social care, and I am glad that we have been able to make this announcement.

I thank the Secretary of State for his update. The media have highlighted the role of carers and those they look after, and inquiries to my constituency office reflect that. Has he considered allocating additional funding to respite services for carers, bearing in mind that many carers have been caring intensively for their loved ones without a break for 15 weeks? Many of them are on the brink, and I sincerely believe they need time to rest.

Yes. That is a really important subject and I am very happy to talk to the hon. Gentleman about it to ensure we provide the best possible support. It is obviously very difficult and I pay tribute to all those who have been caring for loved ones in difficult circumstances. When we clap for our carers, we clap, too, for those unpaid carers who give so much.

I thank my right hon. Friend for his statement. Will he join me in reiterating that, while face coverings can help to reduce transmission in some circumstances, face masks worn as part of PPE for healthcare and other workers should be reserved for those who need them? Will he also confirm that wearing a face covering is not a substitute for social distancing, and that we should do both?

This point is incredibly important. A face mask can reduce the risk of transmission, and in particular, it protects others should someone be positive and transmitting the virus, especially when they are asymptomatic and do not know it. However, it can only be effective as part of a broad range of social distancing measures, and it is not a substitute for social distancing and washing hands. It is easy to forget that washing our hands, as well as keeping surfaces clean, is one of the most effective protections against the transmission of the disease.

Nightingales sat empty while the Secretary of State’s Government’s guidance allowed people to die needlessly in care homes. With 120,000 extra deaths predicted this winter, when will he be making changes to that guidance?

The Nightingales project was one of the most successful projects in the history of the NHS—building the Nightingales in nine days was something that many people in this country thought would be impossible—but the Nightingales were designed very specifically for intubated patients who were not conscious. They were not built to be effective and usable for people who are, and there are some very practical reasons for that. I understand the hon. Lady’s call for us to use the Nightingales for other reasons, but they were built with a specific intention in mind; they met that intention, and they were a great success.

The pandemic has inevitably led to a backlog in other treatments, which is causing anxiety among my constituents. Can my right hon. Friend give an assurance that the Northern Lincolnshire and Goole NHS Foundation Trust and the two clinical commissioning groups that serve my constituency will have the additional resources that they need to meet the backlog?

It is vital that we deal with the back- log of cases that is building up because of the absolutely necessary requirement, in the peak of the crisis, to pause a lot of activity. I can absolutely assure my hon. Friend that we will continue to support and protect the NHS, including with increased resources.

That point brings me back to something that the hon. Member for Leicester South (Jonathan Ashworth) said at the start and that I should have responded to. He seemed to complain about the £1.5 billion of capital funding that we have put into the NHS recently, but of course it is also very important that we take forward measures to ensure that there is capacity there, too.

Of course the whole House hopes that in the coming months a vaccine will be developed that can be rolled out, possibly early in the new year, but in the meantime—I know that this issue is close to the Secretary of State’s heart—there are 58 million people across the UK and the US, up 7.7 million since the outbreak, who have joined anti-vax Facebook pages. Tech companies, mainly Facebook, have made more than $1 billion from supporting and advertising anti-vax sites, including those that sell fake cures and discourage the public from seeking any medical support when showing signs of covid. As we move towards finding a vaccine, may I press the Secretary of State to look into putting more investment in ensuring that we tackle those anti-vax sites? As they have been described by many, they are simply an ideological dirt bomb waiting to go off.

The hon. Gentleman is absolutely right. He and I are passionately of one voice on this—as, I think, is the whole House. The Government will recommend a vaccine only when it is known to be safe and effective. We will then need to administer that vaccine, and will people need to have confidence in it. People who propagate untrue myths about vaccines are putting lives at risk—that is true of the measles jab and other jabs, and it is true in this case too.

The social media companies have an important responsibility. They have taken some action already, and I pay tribute to them for that; in fact, I have a meeting later this week with a Mr Nick Clegg, who is in a position of responsibility at Facebook, but it is not only Facebook and Instagram that have taken action. We will be discussing what more action can be taken to make sure that people who are propagating lies about vaccines do not manage to spread those lies.

Nobody has worked harder than my right hon. Friend to try to save lives and protect people throughout this pandemic, but I know that he, like me, would like a safe and fast economic recovery, so can he please clarify something for my constituents? I have wedding events organisers and business meeting organisers who are genuinely asking what the difference is between a restaurant, which can safely socially distance with perhaps 60 covers, and a wedding, which is allowed only 30 people, who are also socially distancing with all the motivation to do so. Is there some health reason for that, or is it simply a straightforward matter of trying to reduce the return to economic activity?

No. This is essentially a judgment about ensuring that people have the appropriate social distancing, with, of course, the maximum possible return to economic and social life. There is a judgment to be made about where such restrictions are put; they are the sort of restrictions that nobody would ever want to put in place, but the problem is that the virus thrives on exactly the sort of social contact that people want to undertake when they are celebrating something like a wedding.

We cannot negotiate with the virus; all we can do is try to have the right balance of measures to keep the spread of the virus down while allowing the restoration of economic and social life. Ultimately, the rules we put in place are judgments, and they are the best judgments we can make with the information available. We keep them under constant review—as I hope my right hon. Friend has seen, for instance, with the reopening of nail bars and beauty salons this week—just as we keep the data on the spread of the virus under review.

The Secretary of State gave a statistic in his statement that retail workers have a far higher than average chance of being infected with covid-19. If that is the case, and if mandatory face masks are about saving lives, why has it taken so long to take action to make them mandatory, and why is the reported implementation date 24 July?

The implementation of this will be on 24 July to ensure that shops and businesses have time to put it in place and to ensure that the implementation can be done in an orderly way.

Nothing would make me less likely to go shopping than the thought of having to mask up. Was there consultation with the police force, and particularly the chief constable of Hampshire? For it is she who will have to enforce this monstrous imposition against me and a number of outraged and reluctant constituents.

The need to restrict the spread of the virus while allowing the ancient liberty of a gentleman to go shopping is a difficult balance to strike. We have made the judgment that the best way to strike it is to allow a gentleman to go shopping but require him to wear a face mask. Of course, enforcement is for the police, but I think enforcement will largely be undertaken by the British people, who have been remarkable in their fortitude, sticking with the rules even while they may be a frustrating imposition.

Wirral Council has led the way in recognising the importance of the work that care workers do by making funding available for providers to pay them the real living wage for this financial year. However, the scheme is not mandatory and not all care homes currently pay it. The Government have taken £7.7 billion out of adult social care budgets since 2010, and the care sector faces real challenges. When will the Government step up and fund social care properly to ensure that all care workers earn at least the real living wage?

I am incredibly proud to have supported the introduction of the living wage. We brought that in, and it has had a bigger impact on care workers’ salaries than on pay in almost any other sector. The introduction of the living wage is a real testament to the fact that the Government support the lowest-paid workers to get the support they need. That is true in social care across the board. The hon. Member says it is not mandatory. It absolutely is mandatory, it is in force, and we are putting the living wage up.

I, like many colleagues across the House, pay tribute to my right hon. Friend and his team for driving down infections across the country. One of the lessons we have learned in the pandemic is that, while it is easy to impose restrictions, it is much more difficult to lift them. Could he therefore explain the criteria that will be used for lifting the restriction of mandatory face masks while people go shopping?

In the same way that these are judgments on the way in, they are judgments on the way out. We will have to make that judgment according to the spread of the virus and, in particular, the risk level imposed by people catching the virus. We will keep all these things under review.

The data currently has an in-built delay, but the ability to do test, track and trace effectively and with the greatest success requires the shortest time between testing and local action. Put simply, the more local control, the more quickly things will happen. The more handovers there are, and the more time it takes, the less successful it is. So I would like to ask the Secretary of State why he does not trust local systems, including the NHS. There are those who think that this is an attempt to discredit NHS labs.

On the contrary, NHS labs have done an incredibly important job. We have expanded the NHS labs enormously, and we have brought in the drive-through centres. This is a massive team effort, and trust among the team is an incredibly important part of getting it right.

The hon. Member is absolutely right about concatenating the time taken from the suspicion of someone having covid through not only to getting the test and the result—those times are all coming down—but to the action being taken based on the result, whether that is isolating the contacts of the individual or taking wider action if it is part of a cluster or there are indications that there might have been an outbreak. I entirely agree with the premise of that part of her question. That is a huge and important piece of the work of NHS Test and Trace at the moment. As for the second part of her question, all I would say is that we are doing everything we can to bring the system together, with the support of all those involved.

Most covid deaths in hospitals are now understood to be due to sepsis as a complication. In the light of the former CMO’s concerns about increased antibiotic use during the pandemic, can my right hon. Friend reassure me, first, that the data on covid-90 is granular enough to identify the mode of death of patients in hospitals and, secondly, that the Government will support the NHS if it is challenged when making prescribing decisions in these unimaginably difficult times?

My hon. Friend asks an important medical question, and we know that he has a deep personal interest in sepsis. All I can say is that we are constantly learning, all the time. I will not try to answer the clinical part of his question—I will leave that to more qualified clinical and medical colleagues—but it is an incredibly important question, and my view is that as much data as possible should be available for research. I have put in place the regulations—and, indeed, a direction —necessary to allow for the research to be done in a much more effective way than was available in the past.

Italian doctors are once again warning us, this time of the threat of coronavirus resulting in a series of life-limiting illnesses that can affect anyone who has had even the mildest infection, including the Secretary of State and other Members of this House. Sometimes the illness returns many months later. The advice from Italy is that everyone who catches the virus faces a long-term threat to their health. Can we listen to their advice this time? This is about so much more than masks in shops and the completely inadequate test and trace system.

The hon. Gentleman makes a really important point and it is a shame that he uses such adversarial language. The test and trace system is getting better and better, and masks in shops are important, but the underlying point that he makes is absolutely right. The long-term impact of this on some people can be very significant; there is growing evidence of that. I have put in almost £10 million of research funding to try to understand that better, and the NHS has built an NHS service for people in those circumstances.

The hon. Gentleman is quite right to say that the long-term impacts can affect anyone, no matter how mild the initial illness. Thankfully, I do not appear to have any long-term effects that I know about. So far as I can tell, I am fine, but I am grateful for his interest. What I would like to do is work alongside him to try to understand this as well as possible. We are absolutely listening to the evidence from right around the world on this vital question.

In a short space of time, King’s Mill Hospital in Ashfield has gone from an inadequate rating to an outstanding rating from the Care Quality Commission. During the pandemic, the hospital has been fantastic in providing brilliant care in Ashfield and in supplying PPE to care homes, funeral directors, chemists and anyone else who needs it.

Would my right hon. Friend please say a big thank you to all staff, including the chief executive, Richard Mitchell, hospital cleaner Paula Whetton, porters Michael Thorpe and Colin Ford, Scott Cairns in mattress decontamination and critical care nurse Tracy Hague, who represent the very best of Ashfield, and will he please come to visit the hospital the next time he is in Nottinghamshire?

I would love to visit Ashfield Hospital in person and to be able to thank every single person who is there and has worked so hard during this pandemic, from the chief executive to the porters and the nurses: all those who have played their part as part of the team. The hospital in Ashfield does not regard itself as separate from the rest of the community. It is deeply embedded in the community and works across primary care with the community trust and with the mental health trust, too. It is part of a system. That is the future of the NHS: people working together, rather than in the silos of the past.

Unfortunately, my written parliamentary question dated 5 June regarding PPE for urgent dental care centres in my constituency of Stockport, Greater Manchester remains unanswered, but I will try my luck with another question, if that’s okay.

It seems likely that we will have to live with covid-19 for a long time. Data from care homes shows that the rate of infection is higher when staff do not receive occupational sick pay. When will the Secretary of State ensure that social care staff receive a proper pay rise—at least the living wage set by the Living Wage Foundation—to reflect the unbelievable work they have done during the pandemic, and when will the Government legislate for occupational sick pay for all social care workers?

Can I, through you, Mr Deputy Speaker, note to the House that we have been incredibly busy in the Department of Health and Social Care? We will get back to the hon. Member’s written question as soon as we possibly can, but we have been inundated with questions and it has been all hands to the pump to try to respond to the virus, so I hope he will understand why sometimes our responses have been a bit slower than they would be in normal times. I will get right across that. I take it very seriously—it is very important—but we do, if I may, pray in aid mitigating circumstances. We will get back on top of it.

On the hon. Member’s substantive point, the increases in the living wage are very important for social care staff, and as I said in response to an earlier question, I am very proud that we introduced it.

My constituents will be keen to know what progress has been made with the vaccine trials. Can my right hon. Friend update the House on the progress of vaccine and treatment testing in the UK?

The vaccine programme is getting all the possible support we can give it, including attention right across the top of Government. It is being led by Kate Bingham, who is doing the job brilliantly as chair of the vaccines taskforce. The best answer I can give is that no news is good news. We are trying to prove a negative: that if someone has the vaccine, they do not get the virus. So the longer we go on without hearing there is a problem, the better. We are working to a reasonable best-case scenario of getting the vaccine in at some point this year, but I stress that that is the best-case scenario. The central scenario is somewhat later, and there is a chance that no vaccine will ever work. We need to work for the best and give our vaccine programmes the best possible support, but we should also be cautious about whether one will ever come off.

A former director of public health who lives in my constituency has been in touch to express serious concerns about the real possibility of a second wave of coronavirus and his fear that lessons have not been learnt from the Government’s response to the pandemic. What plan does the Secretary of State have to get an independent body to conduct an accelerated review of the Government’s response to covid-19 so far, so that we do not make the same mistakes again?

We are looking at all the evidence and take very seriously all the academic, professional and medical studies of the pandemic and the response to it, both here and around the world.

Further to today’s announcement regarding the mandatory wearing of face masks in shops, is it anticipated that something similar may yet need to apply in pubs and bars?

We do not anticipate that at this point. We of course keep all things under review, but, in the first instance, the proposal is—in the same way that we brought it in on public transport and in the NHS last month—to bring this in in chunks.

I am going to be cheeky, Mr Deputy Speaker. I think I can help the right hon. Member for New Forest West (Sir Desmond Swayne) with his problem about wearing a mask. He is a knight of the realm, so he should just consider it a visor.

But to the serious question that I want to ask. It is very clear from the way covid has rolled out that lots of people are going to have brain injury-like conditions and there is going to be a substantial need for long-term rehabilitation. This mirrors the work that needs to be done for those who have had traumatic brain injuries and stroke, many of whom have not had the necessary support this year, for obvious reasons, but are desperate for it. I understand that the Chancellor of the Duchy of Lancaster is setting up a cross-departmental ministerial group, which will meet before the end of this month. Will the Secretary of State make sure that the rehab for people with brain injury, whether from covid or from anything else, is in place?

We are working on exactly that. This is one of a number of questions that have rightly been asked about the long-term impact of covid and making sure we have the NHS treatment available for it.

Asymptomatic workers in care homes are now tested every week. Asymptomatic workers in hospitals are not. Why not?

The programme that we have in hospitals is a risk-based one, according to the risk of the individual. It is much harder to put that risk base in place in care homes. Both these proposals, while seemingly different, are based on the same clinical advice.