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Commons Chamber

Volume 679: debated on Tuesday 1 September 2020

House of Commons

Tuesday 1 September 2020

The House met at half-past Two o’clock


[Mr Speaker in the Chair]

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

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

Speaker’s Statement

The House will know that a Member has been arrested in connection with an investigation into an allegation of a very serious criminal offence. I have received assurances from the Member and from the Government Chief Whip that the Member has voluntarily agreed not to attend the House of Commons for the period of bail.

I, the House of Commons Commission and the House Service take the safety of our staff and of the parliamentary community as a whole very seriously and are ensuring that any necessary measures are taken in respect of MPs, employees and staff. All Members and staff have access to the Independent Sexual Misconduct Advisory Service by contacting the new single, independent ICGS helpline and should not hesitate to use it.

While the investigation is ongoing, I believe that it would be wholly inappropriate for any further reference to be made to this matter in the House, including any attempt to name the Member concerned. I would appreciate your co-operation on this matter.

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

NHS Test and Trace

NHS Test and Trace is consistently reaching tens of thousands of people who need to isolate each week. In the latest week’s data, 84.3% of contacts were reached and asked to self-isolate where contact details were provided. Since its launch, we have reached over 300,000 people who may have been unwittingly carrying the virus and transmitting it, to ensure that they keep themselves safe and keep their community safe.

Scientists in the Scientific Advisory Group for Emergencies have continually warned that, for the test and trace system to be successful, 80% of people in contact with those who have covid must be reached. We are well off that target, I am afraid to say. Will the Secretary of State consider seeking advice from our European partners who have had a functioning system since May, or is he going to continue to allow the private sector to do this, on which it has no proven track record, and protect the interests of particular companies that certain civil servants allegedly may have links with? Are we going to see a serious approach to this?

Unlike the question, we will have a serious approach to this. I will absolutely defend to all ends the teams who work on our NHS test and trace system, the private sector companies without which this would be impossible and the civil servants who are working day and night to make this happen. I will not have disparaging remarks about civil servants, who have done so much during this pandemic, made in this House by the hon. Gentleman. I do not think he was listening to my answer, because the latest week’s data show that 84.3% of contacts were reached and asked to self-isolate where contact details were provided.

Cheadle residents welcome the release of the intervention measures that will take place tomorrow and the more local approach to this. Effective test and trace has been a vital part of getting us to this position and keeping the rates low. To continue with that, will the Secretary of State consider devolving the testing of cases to local authorities such as Stockport, which has a 99% rate of success?

My hon. Friend has played a very important role, and I pay tribute to her and her community for playing a role in the success of the local action that we had to take in Stockport and other parts of Greater Manchester, which meant that we were able to release the measures last week. I am grateful for her work, the work of her council and other local leaders and, most importantly, the people of Stockport, who have worked hard and followed the rules, and the case rate is coming down. She is right that the integration of a national system that can move fast at scale and a local system, which can often reach more contacts because there are boots on the ground and people who know the communities inside out, is critical.

In my right hon. Friend’s assessment, how does our track and trace programme compare with those of other countries, and what lessons are we learning from countries such as Germany and South Korea, which seem to be having some success with their systems?

Of course we learn the lessons, and I talk to my international counterparts, including those in Germany and South Korea. Compared with international systems, with the figures that I just read out, we are absolutely in the top tranche, and we are constantly looking all around the world to see how we can improve the operation of test and trace.

Devon’s director of public health has confirmed that we in North Devon have had no statistically significant increase in cases as a result of the return of tourism. Can my right hon. Friend confirm that test and trace will ensure that that remains the case?

I pay tribute to my hon. Friend for everything she has done to stick up for North Devon at this difficult time. I am really pleased that there is no evident increase in covid in Devon as a result of tourism. So many people go to Devon, during the summer especially, because it is such a wonderful place. We must ensure that, through test and trace and through social distancing, which is the first line of defence against this virus, that remains the case.

Covid hit Croydon and the rest of London early and hard, but Croydon has done us proud, and the number of infections has been very low for a number of weeks, thanks to the hard work of the people in the borough. We welcome the move towards more local track and trace, where expertise and local knowledge make all the difference, but as my director of public health said to me, we have just finished the beginning of this thing and we are now starting the next chapter. One of the things that keeps her awake at night is the need for certainty about budgets for outbreak control plans beyond the end of the year. Can the Secretary of State provide some reassurance?

Absolutely. I am glad to hear what the hon. Lady says about the constantly improving integration between the national and local systems. We have worked hard to make that happen, and I am glad to hear that it is happening in Croydon, as it is in other parts of the country. The budgets in that respect are of course important, and we have been clear that financial provision will be made. I cannot make any more definitive statement than that at this stage, but it is of course an important consideration.

Since June, the Scottish public health-based tracing system has managed to trace 99.7% of positive cases and almost 99% of their contacts, yet in England the commercial Serco call centres have traced less than 60% of contacts. Will the Secretary of State clarify whether any targets are included in the £10 billion contact with Serco? If so, are they being met?

If I may correct the hon. Lady, there is no £10 billion contract with any private company. The private companies have been critical in the work to make sure that the whole testing system could be built at the scale that it has been. As I said, the improvements are continuing. We are seeing local engagement, which is critical, and we are seeing testing rolled out right across the UK. For instance, when there was a local outbreak in Aberdeen over the summer, we were able to use UK resources to get huge amounts of testing into Aberdeen, thanks to the collaborative work between the UK Government, who provided the UK testing, and the Scottish Government, who were responsible for the lockdown.

That does not address the fact that the call-centre system run by Serco has managed to contact only 60% of people’s contacts. Regional Public Health England teams have been working flat out for the past seven months and are tracing more than 95% of the cases with which they deal. Does the Secretary of State really think that the middle of a pandemic is a good time to be threatening the job security of those teams with a huge reorganisation?

The answer to the first part of the hon. Lady’s question is that when we are trying to reach scale fast, we use the national system. That then engages with the local system—for instance, in Croydon, as we just heard—so that we can get the boots on the ground to find those contacts who cannot be contacted through the national system. It is the combination of the two that works best. As for making sure that our systems are in the best possible place to tackle coronavirus going forward, I absolutely think that it is right constantly to be seeking to make improvements to how things operate, which is why I announced the changes that I did.

In some areas, the private companies involved in test and trace have been reaching less than half the contacts they are supposed to reach, not the 80% that the Secretary of State has claimed. We do not need an algorithm to work out that those companies’ performance, compared with that of local public health teams, is where test and trace is failing. Why, then, are the Government rewarding private sector failure by extending the contracts?

As I have just explained, the test and trace system at the national level makes the immediate and rapid first attempt at contact. If no contact is made, the local teams can then go in. It is the combination of the two that works best. I really think that the Opposition —especially coming from the Front-Bench team—are making a mistake in trying to divide people between public and private. Actually, everybody is working very hard together to deliver the control of this virus.

NHS and Social Care Resources: Winter 2020-21

What discussions he has had with Cabinet colleagues on ensuring that the (a) NHS and (b) social care sector are adequately resourced during winter 2020-21. (905225)

We recognise that there will be increased pressures on the NHS and social care during winter, and substantial preparations have been and are being made. The NHS has already published its winter plan, and we will shortly publish the winter plan for social care.

That is exactly why there is a need for significant additional funding to prepare for a surge this winter, and that has to include a fully funded pay rise for health and care staff. At the height of the crisis, the Secretary of State was saying, “Now is not the time to consider a pay rise.” When will the time be? Is it now or some time in the future?

As I expect the hon. Gentleman knows, we have announced £3 billion of additional NHS funding for the winter and are continually looking at additional funding needs for social care.

There is a looming mental health crisis this winter, and as such it is vital to meet with experts. I know the Secretary of State believes that that is important, so I asked him several parliamentary questions wanting to know how many mental health trusts and organisations he had met during the first three months of lockdown. I was told that he “holds these meetings regularly”, but a freedom of information request revealed that he and the Mental Health Minister organised only two meetings with mental health trusts and organisations during that entire period. Can the Secretary of State confirm that he did not attend either of those two meetings? Does he think that is an acceptable track record?

The Secretary of State has regular meetings with stakeholders about the future of mental health.

Public Health Protection

On 18 August, I announced the establishment of a brand-new organisation to provide a world-leading approach to public health protection and resilience, the National Institute for Health Protection. It will bring together the health protection expertise of Public Health England, the Joint Biosecurity Centre and NHS Test and Trace under unified leadership and will start work immediately so as to boost the UK’s ability to deal with covid-19.

Everyone accepts that my right hon. Friend’s priority at the moment is fighting the invisible enemy, but with winter approaching many people will be worried about the threat of flu, so will he tell the House if there are any special arrangements for those people who want the vaccine? Does he have any further news about the reopening of all GP surgeries?

The flu vaccination programme this year will be the biggest in history. As I was going to say in my statement—I will say it now for my hon. Friend—we will be putting before the House proposals to expand the number of NHS qualified clinicians who can administer vaccinations, whether for the flu programme, which is coming, or for a covid vaccination programme, should a covid vaccine come out.

The NHS Confederation, the British Medical Association, the British Dental Association, NHS Providers, the Royal Society for Public Health and many health charities have expressed real doubts about the Secretary of State’s plans for Public Health England. It is evident that, come what may, he will have his own organisation for tackling disease and that, come what may, he will pick which of his pals he wants to lead it, but he seems to have ignored the fact that Public Health England also leads crucial work on tackling drug and alcohol misuse, reducing smoking, promoting sexual health and much more. Six weeks ago, obesity was the Prime Minister’s priority, and now the Health Secretary wants to cut the organisation that leads our fight against it. Will he end the confusion today by committing to the remaining functions of Public Health England continuing to be led by a dedicated national organisation?

The hon. Gentleman obviously did not read the announcement, because part of the purpose of having a dedicated national institute for health protection is also to ensure that the ill health prevention agenda—the health improvement agenda—is embedded in the health system, including the NHS. This is a good day to discuss this, because just this morning the NHS set out the next steps in its diabetes prevention and remission programme. Embedding the anti-obesity drive right across the health system, including the NHS, is a critical part of its future, and we are consulting widely on making sure we have the right and best organisational structure to deliver that.

NHS Capacity: Winter 2020-21

In July this year, my right hon. Friend the Prime Minister announced £3 billion of additional funding to help the NHS to address the challenges of winter. In addition, in August this year, we set out an £300 million for the enhancement of urgent and emergency care capacity and to provide infection control measures.

I thank the Minister and the Secretary of State for the forward-thinking measures to support winter capacity in our hospitals. We should not, however, forget the work of our hospices, which have no seasons and work compassionately all year round. Will my hon. Friend and the Secretary of State join me in visiting one of the jewels in the crown of my constituency—Mary Stevens hospice, which due to covid-19 has had to delay the official opening of its day services unit?

My hon. Friend is absolutely right to pay tribute to the amazing work of hospices. She is also right to highlight the work of Mary Stevens hospice in her constituency, of which she is a great champion. I very much look forward to taking up her offer to visit.

I thank the Secretary of State for the investment into Warrington A&E announced recently. An additional £4.3 million will create a treatment plaza and, most importantly, a new paediatric A&E unit for the hospital. This investment is very welcome for the short term, but will the Minister and the Secretary of State meet me to discuss the longer-term issues for our hospital—plans for a better healthcare facility in Warrington South, better parking, and, in the long term, a new hospital?

I am grateful to my hon. Friend. He is right to highlight the investment we are making in NHS infrastructure, as he did recently in his Warrington Guardian column. He is well known for his energetic campaigning, on behalf of his constituents, for a new hospital. Although such decisions are for the spending review, I would be very happy to meet him.

I welcome the extra £1.6 million the Government are investing in Ipswich Hospital’s A&E department ahead of the crucial winter period, but will the Minister build on this work by ensuring that the new plans for a £25 million A&E department at Ipswich Hospital are accelerated? If this were to happen, it would go some way towards alleviating my constituents’ concerns about the merger with Colchester Hospital.

I am grateful to my hon. Friend. When I visited him earlier this year, he made a powerful case for the longer term for a new A&E department at his hospital—a cause that he has been a driving force behind. I know that the trust is keen to progress this, and I would hope and expect that it is engaging with him. Although the spending review will see the Chancellor’s final decision on spending on this, my hon. Friend’s voice is being heard loud and clear.

The capacity of Barnet Hospital to cope with winter pressure is being assisted by a brand-new modular ward with 35 beds. Can the Minister assure me that there will be continued investment in expanding NHS services in Barnet so that it can cope with any covid pressures this winter and also help to clear the backlog of people who have been waiting for treatment for other conditions?

As my right hon. Friend highlights, the new modular 35-bed ward at Barnet Hospital will add to its capacity to cope with winter pressures. More broadly, we have invested £2.5 million in the Royal Free London NHS Foundation Trust, of which Barnet is part. She is of course right to make the case for continued investment in the longer term, with her typical effectiveness and commitment to her constituency, and I am always happy to discuss that further with her.

Covid-19 Testing

We have developed capacity to over 200,000 antigen tests per day across the testing programme. We are planning for the next phase of testing and are committed to rapid and accessible testing at scale for everyone who needs one. Localisation of testing in accessible places is absolutely critical.

I thank the Secretary of State for his answer. He may well be aware of the outbreak in my community of Newcastle-under-Lyme centred on Silverdale working men’s club. The outbreak appears to be under control. I praise his Department for its support, and also Staffordshire County Council. Close to 2,000 tests have been carried out, a number of those at the new local centre at Ryecroft. If I could make one suggestion based on our experience of this outbreak, it is that the online booking system needs to react more quickly to make spaces available. Spaces always have been available, but not always online. Will he comment on that?

I am very grateful to my hon. Friend for the work he has put in over the summer to make sure that the challenges we have seen in Newcastle-under-Lyme are dealt with as well as possible. Of course, when we put in extra testing and extra mobile testing units, making sure that that is tied in with the online booking system is critical. I am very happy to work with him to resolve the specific issues in Newcastle.

Alongside the need to increase capacity, there is a real need to make sure that what is already there is working properly. In Chesterfield, I have had many people contact me over the summer to say they have been waiting four or five days to get a test result back. I have also had people who have applied online and been told to go for testing 20 or 30 miles away, when there is a testing centre in Chesterfield. With Chris Hopson of the NHS Providers organisation saying that the current system is not even

“fit for purpose, much less world class”,

will the Secretary of State tell us what he can do to ensure that the system is ready when we approach the potential increase in cases in the autumn and winter?

Of course, we are constantly working to improve the system, but as the statistics that I read out at the start of this Question Time show, we have made very significant progress over the summer. NHS Test and Trace is just over three months old, and is now reaching 84% of contacts when contacts are given. On testing expansion, of course when a testing site is full, people will be directed to a nearby but not immediately close testing centre. That does sometimes happen when there is an increase in demand for testing, but we try to respond by putting in more testing where it is needed and in the highest-risk areas, of which, thankfully, Chesterfield is not one.

Covid-19: Support to Scottish Government

The UK Government are supporting the covid-19 response right across the country. We have established the Joint Biosecurity Centre, ensuring decision makers in Scotland and across the UK have the best possible information when responding to outbreaks. The UK-wide test and trace programme has significantly enhanced the ability to respond to covid-19 in Scotland, notably through the six Department-funded testing sites and 18 mobile testing units, with additional ones deployed such as the one to Aberdeen during the recent outbreak there.

I thank my right hon. Friend for that answer. One of the things that has been welcomed in Scotland has been seeing both of Scotland’s Governments working together to fight this pandemic—for example, the British Army working with the Scottish Ambulance Service and local NHS boards to increase our testing capacity. Can he confirm that this one nation approach to tackling covid will continue in the future?

There is absolutely no doubt about the combination of the UK Government putting in place the capacity that we can get only because we are one united nation, working in concert with the Scottish Government and local councils, which have people on the ground who are in the communities. That combination is the strongest possible approach to responding to an emergency such as covid-19.

Cancer: Alternative Therapy Regulation

What plans he has to introduce additional regulations for practitioners of alternative therapies for cancer treatment. (905231)

The Government are clear that we will do everything we can to protect the most vulnerable. We will not tolerate the false advertising of alternative cancer treatments. It is dangerous, but it is also cruel, and we will ensure penalties are handed out for any breaches of the law. While there are no plans to bring complementary therapies into regulation at present, many are registered on voluntary registers accredited by the Professional Standards Authority for Health and Social Care, ensuring patients can access safe care.

My constituent Linda died of untreated breast cancer after she had been seduced, we believe, by advertising on the internet offering alternative therapies such as scans and pastes that were actually caustic to her body. She died alone in my constituency some months ago. Will the Minister consider bringing in tough restrictions on advertising on the internet, particularly as people are accessing internet therapies more now, and also tough restrictions on the people who practise these bogus therapies?

I thank the hon. Gentleman. I was really saddened to hear of the death of his constituent, and fully agree that we must protect people who are often so desperate to find something that will help them and give them hope of recovery. Under the Cancer Act 1939, all advertising of cancer services and treatments is prohibited wherever advertised—online or in the paper—including complementary or alternative services and treatments that purport to be able to cure cancer. We know the role that the internet can play in spreading harmful messages about alternative treatments. It is dangerous, and I have discussed the issue in its broadest sense with my Digital, Culture, Media and Sport colleagues. I give him an assurance that we are committed, across government, to taking any further action needed. He knows that my door is always open, and I would be happy to continue this conversation at any point.

Social Care: Covid-19

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (905232)

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (905237)

We know that those who receive social care are among the most vulnerable in our society. The Department of Health and Social Care has strived to support the sector throughout this pandemic, providing it with a sense of guidance, extra funding, emergency supplies of personal protective equipment and prioritising access to testing.

May I express my very sincere thanks for all the help that social care services have provided throughout this ongoing crisis, but can the Minister assure me that we have learned all the lessons from the shielding programme and that the social care sector is adequately prepared for the coming winter months?

I join my hon. Friend in thanking all those who work in social care for their commitment and compassion since the start of the pandemic. We have indeed carried out work to understand the impact of shielding on people’s health and we will shortly be publishing our winter plan for adult social care, setting out our preparations for the winter and in the event of a second wave.

Can my hon. Friend confirm that every care home in England has either received a coronavirus test or is about to receive one?

Yes, I can confirm that. Every Care Quality Commission-registered care home in England has been offered testing. Care homes for those who are over 65 and with dementia have been offered repeat testing. We have now opened up repeat testing to care homes for working age adults.

Following on from that question, Ministers initially promised weekly testing for care home staff by 6 July. They then abandoned that pledge and said that routine tests would not happen until 7 September. With more than 15,000 deaths from covid-19 in care homes so far and with winter and the flu season fast approaching, regular weekly testing of care home staff is critical. Will the Minister now guarantee that every care home will have weekly testing for their staff by Monday to help all of our loved ones in residential care keep safe?

We are indeed determined to support social care, particularly care homes, with repeat, regular testing. As the hon. Member knows, because we have spoken about it, there has been a delay with our repeat testing of care homes because of a particular issue with some of the test kits. That was communicated to her and to the sector. As I said in my previous answer, we have now been able to offer repeat testing to all care homes for older people, to open up the portal to those care homes with working-age adults as residents and to initiate our second round of repeat testing for the older sector.

Northern Lincolnshire and Goole NHS Foundation Trust

What assessment he has made of the adequacy of funding for hospitals in the Northern Lincolnshire and Goole NHS Foundation Trust. (905233)

I thank my hon. Friend for his question. He and I have had the opportunity in the past to discuss his hospital trust and I pay tribute to its work. I am conscious that his trust has faced financial challenges, running a £57 million deficit a year ago. That has now been halved, meeting the financial control total. I also understand that income levels at his trust increased by 22% from 2015-16 to last year.

I thank the Minister for replying and also for meeting me and my hon. Friend the Member for Great Grimsby (Lia Nici) before the recess. May I emphasise the importance of the Diana, Princess of Wales Hospital in Grimsby that serves my constituency as well? It needs £150 million to £200 million of major infrastructure work to avoid infrastructure failure. I urge him to consider that and bear in mind the pressures on the trust as he considers the additional resources?

My hon. Friend quite rightly raises the Diana, Princess of Wales Hospital in Grimsby. He has raised it with me before, and I give him that commitment.

Obesity Reduction

The Prime Minister is clear that we must care for the health of our population. In July, we published the ambitious strategy to empower adults and children to live healthier lives, taking forward actions from the previous three chapters of the childhood obesity plan and laying out a series of initiatives. It sets out an overarching campaign to reduce obesity and has measures to get the nation fitter—to protect, importantly, against covid-19, to protect the NHS, but most importantly, to improve individuals’ health and wellbeing and quality of life.

There is strong support for the Government’s ambition to reduce obesity among children and young people, in particular. There are many calls for advertising bans for broadcasters for high salt and sugar content, for example, but those are not as straightforward as is suggested, because there is the risk of driving advertising online, which is far more targeted and, as some believe, might be much more effective in communicating the message to attract people to buy those products. Does the Minister recognise that this is a complex picture that needs lots of analysis before clear policies are decided upon?

I thank my right hon. Friend for that question. I know that as a keen marathon runner, he has a keen interest in us all keeping fit. I could not agree with him more: our children’s online watching is considerably greater than their watching of terrestrial television, and that is precisely why we have included a consultation in the online space to ensure that we have fully considered all the impacts that he just mentioned before we move forward and any changes to advertising restrictions before they are introduced.

Nurse Recruitment

We will deliver 50,000 more nurses for our NHS. We are increasing the number of student nursing places on degree courses and improving the experience of working in the NHS so fewer nurses leave, and we will also add to our home-grown nurses through international recruitment. I am happy to report that we now have 13,840 more nurses in the NHS than a year ago.

I thank my hon. Friend for her answer. Does she agree that the changes made by Project 2000 in 1986 led to a large group of caring people being excluded from training to be nurses? If we are to recruit many more nurses, this approach should be rethought, with recruits once again being able to learn on the job, as they did prior to 1986. This would bring nurses’ education much more in line with the Government’s recognition that university is not for all children and fulfil our objective to have apprenticeships in all walks of life.

My hon. Friend makes an extremely good point. We want all those with the capability and aspiration to become nurses to be able to do so. That is why we are supporting multiple routes to becoming a nurse. While the majority of new nurses take the university route, another option is the degree apprenticeship, which enables students to earn while they learn. Last month, we announced a £172 million funding package to double the number of nursing apprenticeships.

I am delighted to hear that we are successfully recruiting into the nursing profession. Does my hon. Friend agree that it is not just school leavers, but dedicated and caring people of all ages and diverse working backgrounds who have the transferable skills needed to start nursing qualifications? Will she outline what steps her Department is taking to engage with these individuals and encourage them to consider nursing as a vocation?

I completely agree that nursing should be open to all men and women from diverse backgrounds. Our £5,000 grant to all nursing degree students, starting this autumn, will help students with the cost of that degree course. In addition to the apprenticeships route that I just mentioned, in January we are launching an online blended nursing degree to give another route into nursing.

Diabetes Screening: Covid-19

What recent assessment he has made of the effect of the covid-19 outbreak on diabetes screening. (905240)

Diabetic eye screening has continued throughout the pandemic for those at the highest risk. NHS England and NHS Improvement are working closely with service providers to ensure that where services took the decision to reschedule screening appointments during the pandemic, those services are restored as soon as it is safely possible to do so, to minimise any risk to individual patients and with appointments based on clinical need.

It is nice to see you in your place again, Mr Speaker. I thank the Minister for her response, which is, as always, comprehensive. In relation to diabetes, I wish to ask about both screening and weight loss. What funding has been set aside for those who are morbidly obese and need gastric procedures urgently to set them on the path to better health, in line with the Prime Minister’s statement and reaction to the massively increased risk of death from covid-19 for those who are obese? It is important that we address all the issues.

As well as our world-leading obesity strategy, we have today announced a targeted dietary approach to diabetes. From next week, thousands of people will be able to access a rigorous weight-loss programme to help tackle type 2 diabetes. The diet and lifestyle plans have been shown to put diabetes into remission for many people who have been recently diagnosed. This will provide 5,000 more patients with the first stage in an NHS drive to increase access to the NHS diabetes prevention programme and builds on the commitment to get another 200,000 people into the life-changing programme. We know that diabetes increases the risks of other health challenges and coronavirus, so it is vital that we take immediate action to help people.

NHS Expenditure and EU Negotiations

What recent assessment he has made of the potential effect on NHS expenditure of negotiations on the future relationship with the EU. (905242)

As the hon. Lady knows, the negotiations with the EU on our future relationship with it following the end of the transition period are ongoing. This Government are delivering on their pledge to respect democracy and the referendum result, with the UK engaging continuously and constructively in the negotiations. We must await the outcome of those negotiations, in which health-related aspects are very important, rather than prejudging what will emerge from them.

In just four months’ time, new customs bureaucracy will lead to increased drug costs for the NHS, including for insulin, which the UK does not produce. Pharmaceutical and medical supply firms report that they are struggling to rebuild last year’s stockpiles because of global shortages due to covid. How does the Minister plan to ensure that patients will not face shortages next year?

The Department is putting in place a multi-layered approach to help to ensure continuity of supply of medicines and medical products in any case that might fall out of the negotiations and the end of the transition period. We are confident that we will maintain continuity of supply.

Covid-19 Testing for GPs

What recent assessment he has made of the availability of covid-19 testing for GPs required to attend care homes. (905244)

GPs with symptoms can be tested through the self-referral portal. In addition, we are launching pilots in Northamptonshire, Peterborough and Cambridgeshire to provide regular covid-19 testing for professionals who visit care homes regularly and provide services within 1 metre of residents.

That is all in the future, of course. I was talking to GPs in Cambridge last week, and they told me about the difficulty they have with getting tested before going into care homes. Indeed, one of them told me she had to pretend to be a care worker to get a test. That cannot be right after all this time, can it?

As I said, the pilots are now being launched in Peterborough and Cambridgeshire to provide regular covid-19 testing for professionals, and I think that problem has probably been resolved.

Medicine and Medical Device Safety

What steps he is taking to implement the recommendations in the July 2020 Independent Medicines and Medical Devices Safety Review report. (905247)

The Minister is aware that the Cumberlege review has clearly set out Government failure, with Primodos not being withdrawn and thousands of babies being born with severe deformities. Does she think it is acceptable to cite legal action, which has no bearing on the report’s findings, to continue to delay justice for the families? Will she meet me and the all-party parliamentary group to discuss a road map to implement the recommendations for all the three causes without further delay?

We welcomed the Cumberlege report and we are looking into the recommendations made, but the hon. Lady knows that, as a result of live litigation, I am not able to comment further.

Face Coverings

What recent assessment he has made of the adequacy of Government guidance for people unable to wear face coverings due to medical or other reasons. (905250)

Guidance to explain the Government’s policy on face coverings continues to be updated and fully takes into account groups with protected characteristics. This guidance makes it clear that there are exemptions for people who are unable, for a variety of reasons, to wear face coverings. We have also run a proactive communications campaign to ensure that people are aware that some people are unable to wear a face covering in certain circumstances.

Georgina Fallows is a rape survivor who suffers from post-traumatic stress disorder when her mouth is covered. Georgina and others like her have been challenged for not wearing a mask in shops and on public transport, and this causes further stress and anxiety. Does the Minister support Georgina’s campaign for a badge to identify people who legitimately cannot wear a mask, and will she consider raising awareness of this issue via a public information campaign?

I was incredibly sorry to hear what Georgina has been through and fully understand that she and others who have undergone traumatic experiences cannot wear a face covering without distress. That is why our guidance and public messaging have been very clear that there may be people who should be exempt from wearing a covering for a variety of reasons. It is also clear that people do not need to prove it when challenged. We are actively engaging with stakeholders and charities to ensure that these messages sensitively get across, and we will continue to do so, but I would welcome a fuller discussion with the hon. Member about anything we can do further to help individuals such as Georgina.

Topical Questions

As well as our work to fight coronavirus, we are continuing our historic levels of investment in the NHS. Good progress is being made in the projects for 40 new hospitals. The number of NHS nurses in England has increased by more than 13,000 compared with this time last year, and the number of doctors is up by over 9,000. This landmark investment is bearing fruit.

Thank you very much for that welcome, Mr Speaker. I am one of those who most certainly owes an awful lot to the care and dedication of NHS staff. May I ask the Secretary of State a very simple question? One waiting list that is going up is the amount of time that overseas doctors offered jobs in the UK have to wait for a visa. Will he have a quiet word with Home Office Ministers to ensure that we have a joined-up Government and that these doctors, who are part of the solution, can get their visas?

May I join you, Mr Speaker, in welcoming the hon. Member back to the screens—and hopefully, one day soon, back to the House in person? The question that he raises is an important one. I am working with the Home Office to introduce the NHS visa, which will mean not only that the numbers are uncapped, but that the administration around visas is much reduced. It is not just about Home Office administration; it is also about reducing the burden of bureaucracy from the General Medical Council and others. The GMC is working incredibly hard to reduce the bureaucratic requirement while still ensuring that any doctors who come to practise in this country are fully qualified and can speak English to a high enough standard, as the people of Rochdale and the whole country would expect.

The ongoing problems in maternity units in Shrewsbury, Telford and east Kent hospitals have shown that independent, blame-free investigations into baby deaths have never been more important. Will the Secretary of State confirm that it is still the Government’s intention to put the healthcare safety investigations branch on to a statutory footing and that those plans will remain in the Queen’s Speech later this year?

Nobody has done more for the cause of patient safety in this country than my right hon. Friend. We are seeking to put the health service investigatory branch into law at the earliest legislative opportunity. He will know that, as a Minister, I could not possibly pre-empt what Her Majesty might say in a few months’ time in the other place, but I will say that, in the same way that we introduced the Health Service Safety Investigations Bill just before the election, it is our full intention to legislate for it at the earliest chance.

I listened carefully to the Secretary of State’s response to the hon. Member for Southend West (Sir David Amess). Can he guarantee that he has currently sourced enough flu vaccine to vaccinate all 50 to 64-year-olds by Christmas?

We have the biggest flu vaccination programme in history, and we set out very clearly when we announced the plans our proposals, which are that we will vaccinate those who are clinically most vulnerable—that starts with the over-65s and those with another health condition that causes them to be particularly vulnerable to flu—and then move to vaccinate the 50 to 64-year-olds. We set that out several weeks ago. It is exactly as clinically recommended, to make sure not only that we have the biggest flu vaccination in history but that we get it to the people who really need it first.

I think the Secretary of State was saying there that he cannot guarantee vaccinations for all 50 to 64-year-olds. We are heading into a difficult winter. He knows that; the whole House will know that. One area of the health service that is particularly under pressure is rehab services and community mental health services, because they often now treat people who have had covid and have long-term conditions associated with having covid, yet many local areas are currently putting local community and public health contracts out to competitive tender. That could mean staff being made redundant. It could open the door to Virgin Cares coming in. At the very least, it is distracting and wasteful. Will the Secretary of State halt all competitive tendering of community and public health contracts until the end of the pandemic?

What I will do is ensure that we put in the best possible resources to improve the public health of the nation. That is our goal; that is our policy. It of course follows on from the policy that was put in place by the Government of which the hon. Gentleman was a behind-the-scenes part. He knows very well that I admire the work that he did when he was trying to expand the provision of health services. No matter where those health services come from, what matters is the quality of the service that people get on the frontline, and that is what we on the Government Benches will be focused on.

Tomorrow, the people of Burnley will have the additional restrictions that have been in place for the last month removed. That is possible only because of the efforts and sacrifice of people across Burnley, so I want to start by putting on the record my wholehearted thanks to people in Burnley, Padiham and all our villages. These have been difficult measures, but they have been effective at driving down the virus. Can the Secretary of State reassure me, though, that as an area of enhanced support, we will still get access to Government support to ensure that we continue to make progress? (905287)

My hon. Friend has been a tireless advocate for Burnley. He is quite right to praise the people of Burnley, who have had local restrictions put in place. Because of the actions they have taken—because they have followed their duty and followed those tougher rules—and the sacrifices they have made, the case rate has come down in Burnley, and I pay tribute to my hon. Friend and to every single resident of Burnley who has played their part. Absolutely, the enhanced support will continue in Burnley, as it does across those parts of Greater Manchester, East Lancashire and West Yorkshire that we have been able to take out of the most restrictive measures, and we continue to watch with vigilance.

The Secretary of State will know that on Friday, the Royal College of Nursing launched a campaign for a 12.5% pay increase, which would do only a little more than restore real pay to the value it had in 2010 when the Conservatives were elected. There is huge public support for all who work in our health and care system, so, ahead of the Budget, will the Secretary of State commit to pressing the Chancellor for the funds necessary to pay all our health and care staff properly? (905285)

Of course we have put in over the last two and a half years some very significant pay rises for nurses, and the whole House commends the work that the nursing profession as a whole, and each individual nurse, has done during this pandemic. Of course we are putting unprecedented sums into the NHS, and we work to make sure that everybody has the best possible working conditions, both now and in the future.

LGBT so-called conversion therapy is an abhorrent and fraudulent practice, so please will my right hon. Friend confirm to me and all my Conservative colleagues across the House who care deeply about this issue that he will do all he can to end this abusive practice at the very earliest opportunity? (905289)

Yes, I will. I agree wholeheartedly with my hon. Friend that so-called conversion therapy is abhorrent. I praise her for the campaign she is running on this. I agree with the Prime Minister who, from this Dispatch Box, committed to ensuring that that practice is stamped out. We have a review under way. I will make sure that I work very closely with my hon. Friend, who has done so much to make the case.

Care homes in my constituency and right across the country are currently waiting several weeks to access coronavirus tests and those in supported living still cannot access regular testing. I wrote to the Care Minister last month about this issue, but I have yet to receive a reply. So will the Secretary of State please confirm today when regular and swift testing will be available in care homes and supported living, or will he finally admit that the so-called protective ring for social care simply does not exist? (905288)

Yes, we have been rolling out the asymptomatic testing for residents and staff in care homes. As the hon. Member will know from the statement I gave to the House in July, we had a problem with the supply of tests from one particular company, which caused some difficulties. We have spent the summer catching up on that programme.

Will my right hon. Friend join me in welcoming the appointment of Jo Whitehead as the new chief executive of the Betsi Cadwaladr University Health Board in north Wales, and wish her every success with resolving specific issues, such as the cramped doctors’ surgery premises in my constituency of Clwyd South and Hanmer, and more generally in reducing the stubbornly high waiting lists in north Wales? (905291)

Yes. The direct provision of healthcare is of course devolved, but as the UK Health Secretary, I take an interest in ensuring we have high-quality healthcare right across the country. I am very happy to work with my colleagues in the Welsh Government on improving the delivery of services in the Betsi Cadwaladr health service. I wish the new chief executive all the very best. I am sure she will take the service, improve it and work with her colleagues in this House to make sure that the people of north Wales get the very best health services that they deserve.

Having used the coronavirus testing kit produced by Randox, which was awarded a £133 million contract by the Government, care homes in Blackburn were told that the kits were unsafe and re-tests should be carried out. As the Secretary of State knows, people in Blackburn have worked extremely hard to get the virus rates down. However, when care homes asked for replacement kits, they were informed that they had already received their quota and that no kits would be available until September. On the one hand the Government are saying, “Don’t use the kits,” and on the other hand they are saying, “We have no kits to replace them with.” When will the Government reassure care homes in Blackburn that they will receive test kits regularly and, more importantly at this stage, the rapid results of those tests? (905290)

In response to the last point, the turnaround time for test results is now the next day for almost every one. However, there has been a challenge, referred to just now and in a previous question, with the Randox kits. The test results from the Randox kits that were withdrawn were accurate. The challenge was that the Randox kits did not pass our very high and stringent standards; essentially they were not as clean as we would have wanted. I am informed by the clinicians that there is no evidence of any health threat from that, but of course we have to make sure that we protect people as much as possible. Hence, we had to withdraw the kits. As I said, we have a catch-up programme that is under way.

During the pandemic, I have been volunteering at my local hospital and have seen first-hand the outstanding dedication, enthusiasm and care given by all who work at North Tees Hospital. This fantastic, award-winning workforce deserve to work in a modern, fit-for-purpose building. Will my right hon. Friend join me in visiting this ageing building to see how we can make it fit for the future? (905292)

Yes, I would love to come up to Stockton and have a look round. I have enjoyed my many visits, especially the one in December, which went particularly well, just before the House reconvened after the general election.

Yesterday, a dear friend of mine died of stage 4 pancreatic cancer. It has the lowest survival rate of all common cancers, yet it receives less than 2% of funding for cancer research. Half of all the diagnoses come about only after emergency admissions to hospital, because patients commonly visit their GPs three or four times with symptoms before being referred to a consultant. What will the Secretary of State do to improve early diagnosis of this disease, because it is killing 10,300 people a year, which is 28 people a day? (905296)

My heart goes out to the hon. Member and to the family and friends of his friend, about whom he spoke so movingly just now. He is absolutely right to raise this. The early diagnosis of cancer is a critical part of improving cancer survival rates in this country. We have talked an awful lot in this House over the last six months about the testing and diagnosis of covid, but frankly this country needs to increase its testing and diagnosis of all diseases, including cancer. For a generation, we have not had enough testing. He is quite right to raise this issue, because it is not just about people coming forward; it is also about the problems being spotted earlier. We are investing £2 million in more rapid diagnostic centres, and we are trying to get diagnostics not just in the major hospitals but out into the community so that they are closer to primary care. There is also a major piece of work under way to recover the backlog that was necessarily built up during covid—that is under way and the backlog is down by about half—and also to go further and never give up on trying to have earlier diagnosis of cancer.

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

Sitting suspended.


With your permission, and indeed your encouragement, Mr Speaker, I would like to make a statement on coronavirus. The latest figures demonstrate how much progress we are making in our fight against this invisible killer. There are currently 60 patients in mechanical ventilator beds with coronavirus—that is down from 3,300 at the peak—and the latest daily number for recorded deaths is two. However, although those figures are lower than before, we must remain vigilant. I said in July that a second wave was rolling across Europe and, sadly, we are now seeing an exponential rise in the number of cases in France and Spain—hospitalisations are rising there, too. We must do everything in our power to protect against a second wave here in the UK, so I would like to update the House on the work we are doing to that end.

To support the return of education, and to get our economy moving again, it is critical that we all play our part. The first line of defence is, and has always been, social distancing and personal hygiene. We will soon be launching a new campaign reminding people of how they can help to stop the spread of coronavirus: “Hands, face, space and get a test if you have symptoms.” Everyone has a part to play in following the social distancing rules and doing the basics. After all, this is a virus that thrives on social contact. I would like to thank the British public for everything they have done so far, but we must continue and we must maintain our resolve.

The second line of defence is testing and contact tracing. We have now processed over 16 million tests in this country, and we are investing in new testing technologies, including a rapid test for coronavirus and other winter viruses that will help to provide on-the-spot results in under 90 minutes, helping us to break chains of transmission quickly. These tests do not require a trained health professional to operate them, so they can be rolled out in more non-clinical settings. We now have one of the most comprehensive systems of testing in the world, and we want to go much, much further.

Next, we come to contact tracing. NHS Test and Trace is consistently reaching tens of thousands of people who need to isolate each week. As I mentioned in answer to a question earlier, the latest week’s data shows that 84.3% of contacts were reached and asked to self-isolate, where contact details were provided. Since its launch, we have reached over 300,000 people, who may have been unwittingly carrying the virus. Today, we also launch our new system of pay to isolate. We want to support people on low incomes in areas with a high incidence of covid-19 who need to self-isolate and are unable to work from home. Under the scheme, people who test positive for the virus will receive £130 for the 10-day period they have to stay at home. Other contacts, including, for instance, members of their household, who have to self-isolate for 14 days, will be entitled to a payment of £182. We have rolled out the scheme in Blackburn with Darwen, Pendle and Oldham, and we will look to expand it as we see how it operates on the ground.

The third line of defence is targeted local intervention. Over the summer, we have worked hard to integrate our national system with the local response, and the local action that we are taking is working. In Leicester, as the hon. Member for Leicester South (Jonathan Ashworth) knows well, as a local MP, in Luton and in parts of northern England, we have been able to release local interventions, because the case rate has come down. We also now publish significantly more local information, and I put in place a system for building local consensus with all elected officials, including colleagues across this House, wherever possible. Our goal is that local action should be as targeted as possible. This combination of social distancing, test and trace and local action is a system in which we all have a responsibility to act, and this gives us the tools to control the virus, while protecting education, the economy and the things we hold dear.

Meanwhile, work on a vaccine continues to progress. The best-case scenario remains a vaccine this year. While no vaccine technology is certain, since the House last met, vaccine trials have gone well. The Oxford vaccine continues to be the world leader, and we have now contracted with six different vaccine providers so that whichever comes off, we can get access in this country. While we give vaccine development all our support, we will insist on safety and efficacy.

I can update the House on changes to legislation that I propose to bring forward in the coming weeks to ensure that a vaccine approved by the Medicines and Healthcare Products Regulatory Agency can be deployed here, whether or not it has a European licence. The MHRA standards are equal to the highest in the world. Furthermore, on the development of the vaccine, which proceeds at pace, I will shortly ask the House to approve a broader range of qualified clinical personnel who can deploy the vaccine in order of clinical priority, as I mentioned in questions. As well as the potential vaccine, we also have a flu vaccination programme—the biggest flu vaccination programme in history—to roll out this year.

Finally, Mr Speaker, in preparation for this winter, we are expanding A&E capacity. We have allocated billions more funding to the NHS. We have retained the Nightingale hospitals to ensure that the NHS is fully prepared, and we published last month updated guidance on the protection of social care. As well as this, last month, figures showed a record number of nurses in the NHS—over 13,000 more than last year—and record numbers of both doctors and nurses going into training. We are doing all we can to prevent a second peak, to prepare the NHS for winter and to restore as much of life and the things we love as possible. As schools go back, we must all remain vigilant, and throughout the crisis we all have a role to play.

This is a war against an invisible enemy in which we are all on the same side. As we learn more and more about this unprecedented virus, so we constantly seek to improve our response to protect the health of the nation and the things we hold dear. I commend this statement to the House.

Jonathan Ashworth (Leicester South) (Lab/Co-op): We are indeed all on the same side in fighting this virus. I hope that the Secretary of State understands that when we raise issues, we do so because we urge the Government to improve their response to fighting this virus. This remains a lethal virus that leaves many with serious, debilitating sickness. Everything must be done to drive down and eliminate infections and suppress the virus completely.

With that in mind, I hope that the Secretary of State can answer a few questions today. I am grateful for advance sight of his statement. First, to avoid a second national lockdown, which we all want to avoid, an effective test and tracing regime is vital. I listened carefully to the figures that he outlined, but he did not tell the House that the numbers going into the system have actually fallen in the past week, from 79% to 72%. This system is not yet world beating.

Throughout questions, the Secretary of State has rejected criticisms of the private sector contractors who are involved in delivering the system, so there is no point in me raising them again, but would it not be better if money was spent on investing in local public health teams, particularly in those areas where restrictions are in place, so that they can do more door-to-door testing, as we have seen, for example, in Leicester? Surely that would be a better use of public funding, for example, than paying for so-called influencers on Instagram to big up test and trace.

On testing itself, the Secretary of State now supports mass testing as a policy aim. It is something I have been calling for, for some months. It is something the former Health Secretary, the Chair of the Health Select Committee, has been calling for. Indeed, we tried to persuade the Secretary of State of its merits before the summer when we asked him to introduce regular testing of NHS frontline staff. He whipped his MPs to vote against it, but will he now, given that he is in favour of mass testing, introduce regular weekly testing of all frontline NHS workers?

To move to mass testing means evolving our testing regime from one that provides antibody tests and diagnostic PCR—polymerase chain reaction—tests effectively to a system of mass screening using more rapid, on-the-spot antigen tests. The Secretary of State referred to rapid tests in his statement. Can he tell us when rapid, on-the-spot antigen tests will be rolled out across society and which sectors of the workforce will be first in the queue to access those tests?

Will the Secretary of State also look at introducing saliva testing, which is being used in Hong Kong, for example, and will he ensure the quick turnaround of tests? I wonder whether he has seen the study from Yale that suggests that saliva testing could be as sensitive as nose and throat swabs. What is his attitude towards pooled testing, which would surely increase the capacity in areas of low prevalence? Does he have a plan to introduce pooled testing? Will he allow GPs to carry out testing or, at the very least, to arrange a test for their patients directly? They currently have to ask their patients to log on to the national system, which is causing huge delays.

On local lockdowns, the Secretary of State said that he wants to involve MPs and elected officials. What process will be used to properly consult local Members of Parliament? What can MPs expect? When a decision has been made to put a local area into restriction, will he publish the specific evidence behind that decision? Why is it, for example, that our constituents in Leicester are not able to gather in private gardens? Can he publish the scientific evidence for that decision?

In Trafford, we have seen infections increase. The local authority leader and the director of public health felt that restrictions should continue, but the hon. Member for Altrincham and Sale West (Sir Graham Brady) felt that they should be lifted. Why did the Secretary of State overrule the advice of the director of public health and instead endorse the representations of the chairman of the 1922 committee? There was a similar story in Bradford, and in Bolton, where restrictions are due to be lifted tonight, infections are increasing. Is it still his plan to lift restrictions tonight in Trafford and Bolton, even though infections are increasing compared with last week, when he made his initial decision?

The Secretary of State is right: in the end, a vaccine is our best hope to stop this pandemic. Vaccines save hundreds of millions of lives every year, and I repeat my offer to work with him on a cross-party basis to promote uptake and challenge the poison of anti-vax myths, including those that we witnessed at the irresponsible and dangerous demonstration this weekend in Trafalgar Square. We will work constructively with him on the proposals he brings to the House. Does he share my concerns about those leaders, such as Putin and Trump, who are trying to short-cut testing to rush out a vaccine, undermining safety and efficacy, potentially damaging millions of lives and giving succour to the anti-vax movement?

Finally, health protection is built upon good population health. Poverty makes people sick. Ending cuts and tackling deprivation as a determinant of ill health is vital to improving and protecting people’s health. But the Secretary of State is now embarking on a risky, distracting restructuring of Public Health England in the middle of a pandemic. Tory MPs like to blame Public Health England—it is such rotten luck that these decent, hard-working, competent Ministers are always let down by the people who work for them—but is not the reality that this restructuring will sap morale and focus and should wait until the end of the pandemic? The UK has suffered the highest per capita death rate of any major world economy. To get through this winter safely, our NHS and public health services need resources, and staff need personal protective equipment, fair pay, security and support. I hope he can deliver that.

I will answer as many of the hon. Gentleman’s questions as possible. His first question about the effectiveness of NHS Test and Trace is very important. He is right that we are investing in public health teams, and so we should. As we discussed in Health questions earlier, it is important to have the combination of the national system and the local one. It is also important that we communicate to people that it is important to engage in testing and contact tracing for those who test positive and their contacts. It is important to be able to communicate to people so that they get those messages, and we will do that in whatever way is effective to get those messages across.

The hon. Gentleman asks about the importance of mass testing. I bow to no one in my enthusiasm for mass testing and am glad that he supports my drive for it. He might remember the exchanges we had some time ago when I rather stuck my neck out in pushing for mass testing when we needed to get to hundreds of thousands of tests. We now need to increase the number of tests again.

The hon. Gentleman mentions both saliva tests and pool tests; we are trialling both of those. As with vaccines, to which I shall come briefly, we will only use testing that is validated and for which the results are safe, so it is important that we use the world-class facilities that we have at Porton Down to make sure that tests are validated before we use them in public. Saliva testing and pool testing are both options that we are working on.

Local lockdowns are working. Local action, taken jointly between national and local government, is having an effect, as the hon. Gentleman knows well from Leicester, where the case rate is right down. We do publish the data on which such decisions are made. In fact, from last Thursday, we now publish data at lower-super-output-area level, which is the lowest level in terms of how local the test results can be reasonably published. We also provide extensive data to directors of public health.

It is important that all elected officials are engaged in the process of making lockdown decisions, so, as we set out the week before last, we require councils to seek consensus with local elected officials, which includes colleagues in this House. For instance, if your area, Mr Speaker, were under consideration for the need for intervention, we would require your local council to seek consensus with you—although that consensus is not always possible, and there have been a couple of examples where it has not been—and would then make as targeted an intervention as possible. We want to get to the point at which everybody is on the same side in the battle against the disease. I am glad to say that in nearly all council areas the process has worked well. I urge all council leaders to work to engage with their local MPs and with colleagues from across the House to make sure that colleagues’ views are taken into account in trying to seek consensus.

The hon. Gentleman makes the point that a vaccine must be deployed only when safe and effective, and he is completely right. He and I are as one, along with every single Member of this House, in our abhorrence at the anti-vax people who peddle lies and in our abhorrence at the anti-test people who similarly try to argue that testing is somehow wrong when it is not. In the UK, a vaccine will be deployed only when it is safe and signed off by the regulator. The UK health regulator, the MHRA, is one of the finest regulators in the world. It is robust, independent and technically brilliant. People should know that we will sign off a vaccine only when it is safe. Having said that, we will also work incredibly hard and give all the resources that the vaccine development teams need to try to get a vaccine over the line as quickly as possible.

The Secretary of State has made impressive progress in making testing available to everyone with covid symptoms, but I wish to press him on the availability of tests for people who are asymptomatic. Will he confirm that it is the Government’s intention to introduce regular weekly testing for NHS staff, teachers and other people who are in regular contact with the public and who could potentially transmit the virus? Even if it cannot be done right away, is it the intention to do that as soon as possible? Surely that is the best way to reassure patients that their hospital is safe and parents that their kids’ school is safe.

It is my intention to deploy as much testing as possible using the new testing innovations coming on stream and to do so as widely as possible following clinical advice. We have set out the process we propose to use for the current generation of testing capability, but if a new, easier type of test gets over the line, of course we will always keep that under clinical review, being guided always by clinicians.

Is the Secretary of State aware that some people are being refused home-testing kits because the credit-checking company TransUnion has not found their names on the public version of the electoral register? Can he explain why he contracted this American company to verify people’s identities and what he will do to resolve the issue? He still has not addressed the poor performance of Serco, which has failed to trace 40% of contacts and apparently did not even have contact details for over 2,500. This compares poorly with the public health-based systems of the devolved nations, which are managing to trace 90% or more. Instead of breaking up PHE, will he not provide it with the necessary resources to develop a public health-based tracing system for England, too?

Finally, Chris Whitty says it is not possible to open up everything and keep the virus under control. While it is really good to see the number of deaths from covid falling, the number of new cases in the UK is currently higher than when we had to go into lockdown in March. If getting children back to school is his Government’s priority, why are they pushing people back into offices at the same time?

I have addressed several of those points already in questions. The idea that, instead of the large-scale national system working together with local contact tracers, we should disparage one part and praise the other—this divisive approach proposed by the SNP spokesperson—is wholly wrong and would lead to things getting worse, not better. Instead, we need to work together to improve the system, in the same way the Scottish Government and the UK Government worked together to provide testing capability right across Scotland.

On the arrangements for the future of PHE, we look around the world for the best way to ensure we have systems at a national level that can respond to the virus, in the same way we put in place the Joint Biosecurity Centre, when we worked closely with the Scottish Government, the Welsh Government and the Northern Ireland Administration to ensure the best possible system—for instance, when cases move over a border. Some of the best systems in the world, such as the German system, have an institute dedicated to infectious disease control. I am convinced that the enormous amounts of extra money we are putting into health protection, along with the extra support going in and the clarity and dedication of the new National Institute for Health Protection, will be a step forward. I pay tribute to all those who have worked in PHE and right across the board to keep people safe during this crisis.

I welcome my right hon. Friend’s announcement of two groundbreaking tests that will allow people to be tested for coronavirus in less than 90 minutes. Will he aim for these tests to be rolled out as soon as possible, particularly in care homes, and may I suggest that the roll-out begin in Buckinghamshire, particularly Beaconsfield?

I will certainly look into whether the roll-out can start in Buckinghamshire. Thankfully, it has a relatively low rate of the virus, which is good news, and we are working to ensure that the testing system there is as effective as it can be. That will include using this new generation of testing when we can begin to roll it out more broadly than the current pilots.

Cancer is rapidly becoming an even bigger catastrophe than anything else. The number of new cancer patients presenting is down by more than a quarter this year. The number of appointments for cancer specialist treatment is down by more than a quarter. The amount of money available for clinical trials has completely fallen through the floor. There is a real danger that lots and lots of people are going to die of cancer this year unnecessarily, when there is treatment that could be available, and that new treatments will not come online. Will the Secretary of State please put together a single taskforce to deal with cancer during this process, increase the amount of money for new kit, in particular in radiotherapy, make sure that we have enough pathologists, histopathologists and haematologists for the future, and make up the additional money for the clinical trials?

The hon. Gentleman’s point about research is important. In the places where research has paused because of the virus, the programme of restart is well under way. I am glad to say that although the backlog of cancer cases had increased—because it is not safe to treat cancer during a pandemic and because of some of the surgery that had to be paused—we are now halfway through recovering from that backlog on the latest figures. Obviously, that recovery is incredibly important, and it is important to look at the catch-up as well as the absolute drop in overall delivery of cancer services. It is also critically important that people who fear that they may have cancer come forward to the NHS.

I thank the Secretary of State for his statement. My question today is about support for people with mental health conditions during covid-19. One of my constituents, Nicola Kulawsky, went missing just over a week ago. Thankfully, she was found within four days. During 2018 and 2019, there were approximately 176,000 reported incidents of people going missing. Charities such as Missing People have highlighted the huge strain that the covid-19 pandemic has put on people with mental health issues. Charities working in this sector have had to make budget cuts. Will the Secretary of State do everything he can to ensure that individuals who suffer from mental health conditions during covid-19 get the support they need, as part of the wider covid-19 strategy?

My hon. Friend is absolutely right to raise these issues, which are very important. I acknowledge and can see the challenges that mental health services face. Some cautiously positive news announced today by the Office for National Statistics shows that the number of suicides during the peak of the pandemic was down from 10.3 per 100,000 to 6.9 per 100,000, but of course we have to ensure that mental health services are there for people as we come out of lockdown, so that they can access them again more easily and that we do all we can to support those who need them.

Following on from the Secretary of State’s answer to the question that my hon. Friend the Member for Rhondda (Chris Bryant) asked about cancer, obviously winter is a time of huge pressures on NHS services, with pressures on acute beds in recent years. Can he tell us more about his plan to tackle the backlog and deal with cancer patientsand about the treatments they will receive in the wintertime?

Yes; the hon. Gentleman is right to raise exactly this point. Now is the time to get through as much of the backlog as possible. At the same time, we have introduced changes to the way that the NHS operates so that it is more risk-based, so that infection control procedures, which are important, can also be more risk-based, to try to increase the amount of surgery that can happen, essentially splitting the NHS into areas that are deemed “covid green”, which are secure from covid, and “covid blue”, which means the areas where there may be covid, to allow the throughput of surgery to increase. Of course, cancer services have continued all the way through, but obviously they were diminished during the peak. With winter coming, we want to put the extra funds into the NHS to try to ensure that those services can continue all the way through, as much as is possible. The flu vaccination programme is also an important part of protecting the NHS from higher demand this winter.

May I help the House by saying we are going to finish at 4.40 pm? I am sure the Secretary of State will want to help as many Back Benchers as possible to ask their questions by giving shorter replies. That would be helpful.

I thank my right hon. Friend for the announcement last month of £900,000 extra for Buckinghamshire Healthcare NHS Trust to upgrade A&E facilities in the county ahead of winter.  That will make a huge difference as we continue to battle coronavirus as well as prepare for other winter illnesses. What assurances can my right hon. Friend give me that those very welcome upgrades will be completed in time for this winter to treat Buckinghamshire patients?

It is very good that we have been able to give funds to over 100 A&Es across the country so that they can expand, both to be able to cope with infection control procedures and to ensure that there is more space. I pay tribute to the Minister for Health who has driven through this programme along with the NHS. I am confident that this can be built in time for winter to ensure that we are ready by December.

All of west London rejoiced when the Secretary of State axed the hated “Shaping a healthier future” programme, which was established by his predecessor. Will he now stave off the rumours circulating and confirm that the stopping of services at Ealing Hospital—that programme would have put an end to those services, as we know it—does not mean that the closure programme is coming in through the back door? There are a lot of rumours around. Will he start by restoring in full the CEPOD surgery and trauma services, so that we ward off the second spike that he and I do not want?

We have indeed stopped “Shaping a healthier future”, as it was called. We are continuing with the investment into primary healthcare services that was a part of that programme, but not with the rest of it. I am happy to arrange a meeting between the Minister for Health, who is brilliant on this stuff, and the hon. Lady and other west London colleagues, to ensure that that commitment is kept to.

I thank the Secretary of State and his Department for the additional funding for Milton Keynes University Hospital of £1.5 million for winter preparedness. May I stress—and hope that he agrees with me—that it is not just about the threat of covid this winter, but the dual threat with the winter flu?

Yes. Both my colleagues from Milton Keynes have been assiduous in making the case for the need for expansion at Milton Keynes Hospital. The team there have been absolutely brilliant, even while the chief executive has also been stepping up to national responsibilities in response to this crisis. I hope that the expansion of A&E will help to ensure that my hon. Friend’s constituents can access emergency services when they need them.

Given that the Secretary of State decided to announce the scrapping of Public Health England in the middle of recess, when there was no opportunity for parliamentary scrutiny, I find it astonishing that his statement did not make a single reference to the bureaucratic reorganisation in the middle of a pandemic. The King’s Fund described scrapping PHE without a full public inquiry as finding it “guilty without a trial”. The Prime Minister has committed to an inquiry. Will the Secretary of State now set out when that inquiry will happen?

This is all about ensuring that we are as well prepared as possible for tackling this virus and that the total focus of the new National Institute for Health Protection is on the prevention of infectious diseases. I have set that out very clearly, as I did in my speech. Sometimes we have to make changes to ensure that our systems are working as effectively as possible, and, critically, we had to do so to bring together the different parts of the infection response that had ended up in different places and needed to be brought under single leadership.

What work is ongoing to ensure that all the PPE needed by the NHS this winter is procured in good time, and will details of all previous PPE contracts be published immediately in order to address serious concerns about the appropriateness of some of the earlier deals?

Yes, absolutely; we are working very hard to ensure not only that we have PPE for now and for winter and that we rebuild the stockpile that we used during the peak of the pandemic, but that as much as possible of the PPE available and used in this country is made in this country, so that we are less reliant on international contracts and the international flow of PPE, which obviously became difficult at the height of the crisis. We are one United Kingdom in ensuring that we have the provision of PPE for now and in the future.

Does the Secretary of State agree that achieving the biggest ever flu vaccine programme will need local GPs and pharmacies to work together, not compete for revenue, so can he find a way of incentivising such working together, not fighting for every jab?

It is incredibly important that pharmacists as well as GPs and others are able to make the flu jab available. We have got to make sure that happens as effectively as possible, and it is a massive operation. If I may, I will talk to my hon. Friend and we can have a discussion about the specific problems he has found and try to resolve them, but it is going to be one huge national effort.

I thank the Secretary of State for all he has done: he has not been found wanting when it comes to responding in the way he should. Can the Secretary of State further outline if he has reviewed routine operations—such as for tonsillitis and hip, knee and shoulder replacement surgeries—and when will he be able to address the massive backlog, which has occurred because of coronavirus, but must now be worked on?

We are working through that backlog. I am glad that, over the summer, we were able to re-contract with private providers of healthcare to help us to get through that backlog, and on a better contract than before—better value for money. I pay tribute to the private providers of healthcare that have been there and delivering improvements for people throughout the summer and now on into winter. They play an important part in improving people’s health, and it is a big team effort.

It is very reassuring to hear how far we have come in terms of our lines of defences against this invisible killer over the past six months. May I, through the Secretary of State, thank everyone who has helped us get here? On the second line of defence, the testing, may I have an update on how the NHS is working with the private sector to make sure that all aspects of our economy can reopen safely?

If I understand the question correctly, the ability to provide tests to parts of the private sector that need to know people do not have the virus in order to be able to reopen parts of the economy or just enable things to happen is a very important part of where we would like to get to when we have the next generation of testing. At the moment, we of course have to follow a clinical protocol for the roll-out and the use of the capacity we have. We have very significant capacity, having built it up over the pandemic, but the work with the private sector is very important, and we will be publishing more details on this shortly.

I have had personal experience of track and trace over the last couple of weeks. Having filled in my initial form, I was contacted at least three times to be asked for the same information again, so it is a question not just of the contacts, but of what is being done with the data. My assessment is that there is poor management of the data and a waste of time and effort in duplication, including in contacting members of my household and telling them to isolate from the wrong date. Improvements are needed to what is done once track and trace gets in touch with people. Does the Secretary of State agree?

I am very happy to look into these individual circumstances. Of course, we are constantly seeking to improve the system. I am very glad that the hon. Gentleman was contacted so assiduously by the system, and I take the point about the need for the data to be collected as effectively and efficiently as possible. I hope that he and members of his household are following the rules and doing the isolation that is necessary.

Following the recent outbreak in Stoke-on-Trent, I would like to thank local authorities and the community for their actions, which have helped to stem the spread of the virus locally. Does my right hon. Friend agree that it is thanks to these rapid actions that we are now seeing positive covid results decline and that everyone must continue to play their part by closely following Government guidelines if we are to see cases fall further?

Yes, absolutely. Stoke-on-Trent provides another example of a local action that worked. We did not have to go to a full lockdown, which I am very glad about. The combination of enhanced support from the national system plus assiduous work locally and the responsible and strong voice of the local MPs, including my hon. Friend, has meant that the cases are coming right down. I am very grateful to the people of Stoke-on-Trent for responding as positively as they did to what were challenging circumstances. At one moment, it looked like there might be a full-blown local lockdown, but that did not happen because Stoke-on-Trent got in there fast and acted.

The Secretary of State mentioned the importance of local efforts in keeping infections down, so can he tell me what additional financial support the Government will now provide to support local test and trace efforts, specifically in those areas where the level of infection places them on the watch list or under lockdown?

We do enter into those sorts of discussions. Of course local councils have a statutory obligation as well, but what matters most is that the response is as effective as it can be. Thus far we have been able to ensure that councils have the support and the capability to be able to respond, but, with their statutory duties, it is absolutely at the top of their priority list to prevent a local outbreak as well.

The truth is that young people of working age who are fit know that there is very little chance of their becoming seriously ill from this thing. I know that the Secretary of State will say, yes, but they can pass it on to older people, but may I speak on behalf of older people? I am one. I think that, at 70, I am the oldest person here and I am still kicking—just. What I can say to him is that older people do not want to be patronised. They are very well aware of their own health needs. They can be trusted to isolate if they have to. We do not want to have this thing whereby the man from Whitehall knows best. The man from Whitehall does not know best, especially as he changes his mind every two minutes. Can we get back to being a proper Conservative Government who trust the people and who let the people decide how to look after their own health?

The challenge is that this disease passes on without people knowing. I have seen the challenge of older people trying to stay away from and stay safe from the continuing spread. In the United States of America, we saw that, at first, the increase in rates was among younger people and then it spread and the hospitalisation rate went up and then the number of deaths went up. Unfortunately, we are seeing a similar pattern on parts of the continent. I understand where my right hon. Friend is coming from. The goal is to have as little intervention, as targeted intervention, as possible, subject to keeping the virus under control. That is what we are trying to do. Essentially, we want to protect the ability of schools to go back and to make sure that we get the economy going as much as possible. These localised interventions, whether through test and trace to the individuals who have tested positive or to a local area where there is an outbreak, is the approach that we propose.

Office for National Statistics data show that 75% of disabled people are extremely worried about life post lockdown and a further 46% report that this is having a serious impact on their mental health. Will the Minister tell me what the Government are doing to support them, and will he commit to ensuring that disabled people, who have felt like an afterthought throughout this crisis, are at the heart of any recovery plan, as called for by Scope and many other charities?

Yes, absolutely. Our approach is to ensure that the support that is given, including with the vaccine if and when that comes, goes to those who are clinically most at risk. That is the answer to ensuring that disabled people get the support that they need. People who are disabled for different reasons have different needs. We must be cognisant of that and not try to treat all disabled people with different disabilities the same. Instead, we should support people according to their needs and that is at the heart of the approach that I take.

Does the Secretary of State agree that the recent coronavirus outbreak from the Crown and Anchor pub in Stone in Staffordshire next to my constituency demonstrates how vital it is that we all—including businesses—follow the track and trace guidance that has been put in place, so that we can reopen our economy safely and control this virus?

Yes, absolutely. Everybody has a role to play. Businesses have a role to play especially, including with contact tracing, so that people can safely go to the pub and know that if there is a problem they can be contacted. We all have that part to play.

Does the Secretary of State share my concern that, of the £2.5 billion of covid-related Government procurement activity, at least £1 billion has been awarded without recourse to open competitive tendering, including a contract to a close friend of the Prime Minister’s chief adviser? Why is it that, six months into this pandemic, the Government are still citing unforeseen circumstances to explain a lack of openness in the tendering process for contracts?

We need to move fast sometimes in the response to a pandemic, and we need to move fast to contract with those who are best able to provide the support that people need. The constant attempt by those on the Opposition Benches to divide people in this way runs precisely counter to what people want to see—what people want to see is people working together, instead of these divisive tactics.

I want to start by thanking my right hon. Friend and his officials for the way in which they have communicated with me and my colleagues in Sandwell, as we have seen some rather concerning figures, particularly during the summer. May I ask him for some clarification? We have had a unique situation in Sandwell, where certain parts of the borough have had an exponential rise in the number of cases, which have been very localised. The number of cases in other parts of the borough—particularly in the west, in my communities of Wednesbury, Oldbury and Tipton—has thankfully been quite low. Can he confirm that local authorities should be taking a targeted and pragmatic approach when instituting local restrictions?

That is absolutely right. From the first nationally imposed local lockdown, in Leicester, we worked with the local authorities to decide what the appropriate geography was, and it is not necessarily the entire local authority geography. In the very first of those interventions, we worked with the Leicestershire leaders to decide what areas should be in it—the Minister for Health who is one of the representatives of that area, is nodding away. Indeed, last week, in parts of West Yorkshire, we went down to a sub local authority geography. That is absolutely one of the options available. Sometimes it is at a local authority level, and sometimes it is at a sub local authority level. We are driven by the data.

The Secretary of State has always rightly claimed that he is guided by the science and data, so I welcome his decision to release Stockport from local measures. The data, the director of public health, the council and the borough’s four MPs support it, but I represent a cross-borough seat. Local measures have been tough for us, and we need confidence in them. Does he understand the interconnected nature of Greater Manchester’s boroughs? What is his message to my Tameside constituents on whether the decisions he has made to lift restrictions in Bolton and Trafford, where covid is now spiking, will keep the rest of us in lockdown for longer?

The detailed local nature of the question shows how important it is that we engage with local representatives, including colleagues in this House, so that the local intelligence that the hon. Member has can be brought to bear on this decision, for instance. The decision to take Stockport out of and leave Tameside in the measures was taken with the agreement of the leaders of both councils. I absolutely concur with the hon. Member that we should have as targeted an approach as possible, and local councils need to ensure that if it is appropriate for some of their area to come out of a local lockdown and some to stay in it, that is what we should do. We should be driven by the data.

Joint partnership working and effective test and trace have been essential in ensuring that we have reduced covid cases in Cheadle and kept the pressure off our NHS. Public Health England has indicated that the flu jab is one of the most effective measures that we can take to further reduce the pressure on intensive care units. Does my right hon. Friend agree that, to avoid a flu outbreak at the same time as we are tackling coronavirus, we need to encourage people to take up flu jabs and ensure that we get test and trace and flu jabs working in conjunction?

Over the next few weeks, hundreds of thousands of students will be returning to universities, which is very, very welcome, but what we are seeing at the moment is each institution having to make its own decisions. Universities UK tells us that most students will be getting in-person teaching, but what advice is the Secretary of State giving to those universities and what support is his Department giving?

We are working very closely with the Department for Education to have a successful and safe return of universities, just as, from today onwards, we are seeing a successful and safe return of schools.

I am really pleased to hear my right hon. Friend talk about the largest flu vaccine programme ever being put in place, particularly for those over the age of 50. In normal times, that would be a challenge and it is going to be even more difficult in the light of covid. I would be grateful if he talked about the practical steps he is taking to make sure that things are simple and secure enough to deliver it, but not too prescriptive for those delivering the vaccine; whether or not adequate funding is in place to support the flu vaccine; and any other steps he has taken to make sure we have a successful flu vaccine campaign over the winter, given the covid situation.

We are putting enormous sums into the flu vaccine programme and have released extra funds to buy more vaccine. We are deregulating and making sure that we have a wider group of people—who will all be clinically qualified—who can administer the flu vaccine; those regulations will come before the House shortly. My hon. Friend is right to say how important it is to get the communications out that everybody should get a flu jab. We will start with the free jabs for the over-65s, the frontline healthcare workers and those who are clinically vulnerable, and we will then move on to the 50 to 64-year-olds. But everybody, of every age, can get one—it is just not free to others. I encourage everybody to get one. We must tackle these online rumours that spread the pernicious anti-vax lies.

Only 40% of the 90 care homes in Enfield have had covid testing to date, so when will the Secretary of State roll out the mass testing promised to the care homes? What progress is being made to increase the use of rapid turnaround tests in care homes, in Enfield and across the country?

We are introducing more rapid turnaround tests and validating that technology. We are also rolling out asymptomatic testing to care homes. We did have a problem with the delivery of tests from Randox—these were the leading tests we were using with care homes—as I made clear to the House in July. We have spent the summer recovering that programme.

I welcome the Secretary of State’s statement, and recognise his and his Department’s herculean efforts in leading our national fight against the virus. Throughout my constituency, there exist growing concerns that the lockdown measures to tackle localised spikes of covid-19 that have been imposed on swathes of West Yorkshire, across the Pennines and beyond may well be imposed on Wakefield, thus harming livelihoods. To help to manage these fears and encourage adherence to the guidelines, will he publish the criteria that inform his decisions to impose or ease specific lockdown measures in certain areas, such as Kirklees, Greater Manchester and Leicester?

We publish the data on which the decisions are made and we have published the so-called contain framework, the one in which those decisions are taken, in consultation with the local authority and local representatives, should such an intervention be needed. What I would say to residents of Wakefield, and indeed of any other area, is that the best way to avoid local action and a local intervention is to follow the social distancing rules: “hands, face, space, and get a test if you have any symptoms”. By following social distancing we are more likely to be able to control the virus without the need then to resort to local action.

I would like to start by paying tribute to public health officials and community partners in the east end of Glasgow, who have been managing some of the local clusters. It really has been a team effort.

Part of the Secretary of State’s test, trace and isolate strategy is based on people following the advice to isolate when they show symptoms. What discussions is he having with the Department for Business, Energy and Industrial Strategy regarding the pitiful levels of statutory sick pay? Anecdotally, a lot of constituents tell me that they are worried about the financial pressure of having to isolate. So what discussions on that is he having with his colleagues in government?

I thank the Secretary of State for his statement. Research on immunity once people have had covid remains critical. What progress has been made in understanding how immunity is developed and how long it lasts? What work is being undertaken in terms of rapid testing for immunity and analysis, and the technology that sits around that?

This is a very important question. Essentially, part of the research into the vaccine is research into its efficacy, which is about research into the immune response that it provokes—the antibody response and the T cell response, both of which have an impact. We are doing a huge amount of work on that and I am very happy to write to my hon. Friend with more details.

Could the Secretary of State now answer a question that he has been asked repeatedly this afternoon about the creation of the National Institute for Health Protection? What persuaded him, in the middle of August, that it was a great idea to reorganise the structure of public health in the middle of the worst pandemic for 100 years, which is a bit analogous to reorganising the fire brigade in the middle of a blaze?

It is important to bring together the leadership on test and trace, the Joint Biosecurity Centre and the leadership from Public Health England into one place to make sure that our response is as effective as it possibly can be and that we are constantly searching to have the best possible response to the virus.

I know my right hon. Friend will share my excitement over the two new groundbreaking tests that can detect coronavirus in as little as 90 minutes. Does he agree that we should get that tech rolled out as quickly as possible, but particularly in care settings?

Yes I do, and I put everything I possibly have into driving it as fast as possible, subject to it working effectively.

Today’s Office for National Statistics suicide statistics show that middle-aged men remain at the highest risk of suicide. It is well established that recessions can lead to increases in suicides, but that is not inevitable. What will the Secretary of State do to ensure that suicide prevention is a Government priority and that this group of people is supported through the recession caused by the covid-19 pandemic?

The hon. Lady is quite right to raise this issue. It is good to see the figures showing that suicide rates have fallen, but we absolutely must and will remain vigilant.

I thank the Secretary of State for the written ministerial statement he published after my last question to him in July. May I ask a bit more about the National Institute for Health Protection? Who was consulted before the decision was made? What is the legal basis for its present operation? Does it require legislation? What kind of public body is it intended to be: a non-ministerial department, an executive agency or a part of the Department of Health and Social Care? How will it be funded? When will there be a proper White Paper or Green Paper on the subject? Will the political appointee put in as interim head be replaced by a properly appointed public appointments-approved person? I could go on—there are plenty of unanswered questions.

I counted eight questions. Let me try to answer them. The National Institute for Health Protection does not require a legal basis; these PHE duties were not done on a legal basis. It will take on some UK-wide responsibilities, but also have responsibilities for England only. It is funded from the Department of Health and Social Care. It will be an executive agency of the Department. There is a global search under way for long-term, permanent leadership. As I said in response to the previous question, it will bring together the leadership of several different parts of the response. It was imperative, as far as I could see, to try to make sure we have that single unified leadership for the next stage of our response to the crisis. I pay tribute to the work of Public Health England. It has done an enormous amount, especially through its scientific work, which has truly been among the best in the world and has helped us to respond as well as we possibly could. I think that the new National Institute for Health Protection, established on the basis that I have set out, will make sure that we are constantly learning to have the best response, in terms of both the science and the scale, and to deliver for this country.

I welcome the Secretary of State’s comments in relation to dealing with anti-vaxxers. He will recall that I asked him a question before the recess and he said he was meeting Sir Nick Clegg, formerly of this House and now of Facebook fame. I wonder whether he can update the House on that discussion. It is still a reality that Facebook takes millions of dollars from anti-vax sites, and it is still the case that an increased number of people in this country fear what the vaccination could or could not mean, so may I press him to start a campaign to tackle anti-vaxxers head-on and to ensure that all Members across the House are able to take a lead on this? It really is a cross-party issue.

That campaign is under way. We are constantly looking to strengthen it. Of course Facebook and other social media providers have an important role to play. I had that meeting with Nick Clegg, who in fact broke off his holiday to take the meeting. [Interruption.] Zoom reaches all parts. In fairness to my former coalition ministerial partner, he absolutely understands the importance of this issue, and Facebook has been doing very significant work. That does not mean that there is not more that it can and must do, but the response was positive. Further work needs to be done to make sure that we get the positive messages across.

The Secretary of State will know that, as somebody who knows PHE well and knows what it actually does, I have some concerns about the changes that he announced last month. Although I can see the arguments about future health protection and future pandemics, of which sadly there will be more, we need to know who is taking ownership of the long-term public health work on smoking, air quality, obesity and childhood vaccinations, and the inequalities work that PHE does. Is he considering bringing that experience and vast expertise, which I benefited from as a Minister, back into the Department of Health and Social Care, for instance?

My former ministerial colleague, a distinguished former Public Health Minister, raises an incredibly important point. We are undertaking consultation on precisely this question right now; in fact, I invite him to come into the Department to give his views. The critical thing is that we need to ensure that we drive the health improvement agenda, the obesity agenda and the wider health improvement agenda forward very strongly. Local councils have a huge role to play in this, and they must be bound yet further into the health improvement agenda. The NHS has a huge role to play, and that must be bound more strongly again. Today’s announcement is good progress from the NHS. This is incredibly important. We are going to get it right. It is a very high priority of the Prime Minister, and I look forward to working with him on making it happen.