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Volume 680: debated on Tuesday 15 September 2020

(Urgent Question): To ask the Secretary of State for Health and Social Care to update the House on his response to coronavirus.

Coronavirus exists only to spread, and yesterday the World Health Organisation once again announced a record number of cases globally. France and Spain have both reported daily figures of over 10,000 positive cases and increasing hospitalisations. Here in the UK, we saw around 2,600 new cases yesterday, and last week medical advisers advised that R is above 1. The epidemic is growing.

There are signs that the number of cases in care homes and the number of hospitalisations are starting to rise again, so last week we acted quickly, putting in place new measures. The rule of six came into force yesterday. We do not do this lightly, but the cost of doing nothing is much greater.

Testing also has a vital part to play. Everyone in the House knows that we are doing more testing per head of population than almost any other major nation, and I can tell the House that we have now carried out over 20 million tests for coronavirus in this country. As we expand capacity further, we are working round the clock to make sure that everyone who needs a test can get a test. The vast majority of people who use our testing service get a test that is close to home, and the average distance travelled to a test site is now just 5.8 miles —down from 6.4 miles last week; but the whole House knows that there are operational challenges, and we are working hard to fix them.

We have seen a sharp rise in people coming forward for a test, including those who are not eligible. Throughout this pandemic, we have prioritised testing according to need. Over the summer when demand was low, we were able to meet all requirements for testing, whether priorities or not, but as demand has risen we are having to prioritise once again. I do not shirk from decisions about prioritisation. They are not always comfortable, but they are important. The top priority is, and always has been, acute clinical care. The next priority is social care, where we are now sending more than 100,000 tests a day, because we have all seen the risks this virus poses in care homes. We will set out in full an updated prioritisation, and I do not rule out further steps to ensure that our tests are used according to those priorities. It is a choice that we must make.

Finally, to defeat this virus in the long term needs effective vaccines and treatments. I am delighted to say that over the weekend the trial of the Oxford vaccine restarted, and I can tell the House that we will now be trialling a promising new antibody treatment on coronavirus patients in the UK. The challenges are serious. We must work to overcome them, optimistic in the face even of these huge challenges, and to keep this deadly virus under control.

I am grateful for advance sight of the Secretary of State’s answer. That was decent of him.

Yesterday LBC revealed that there were no tests available in covid hotspots, including Rochdale, Pendle and Bradford. Over the weekend in Bolton, where infections are the highest in the country, a mobile testing centre failed to turn up. Meanwhile, in Bury hundreds queued for five hours for a test. In Walsall, a father with his sick child travelled 76 miles to an appointment in Wales, only to find on arrival that tests had run out. Increasing numbers of teachers and pupils are not in school. In hospitals, operations are cancelled while NHS staff are stuck in limbo, waiting for tests.

The Secretary of State blames increased demand, but when tracing consistently fails to reach 80% of contacts, when fewer than 20% of those with symptoms self-isolate properly and when there is a lack of financial security, infections rise. When schools reopen and people return to workplaces and social distancing becomes harder, infections rise. Extra demand on the system was inevitable. Why did the Secretary of State not use the summer to significantly expand NHS lab capacity and fix contact tracing?

Just as demand is increasing, the ability to process tests is diminishing. Postgraduate students working in the Lighthouse labs are returning to university, so why did the Secretary of State not plan for the inevitable staff shortages in the Lighthouse labs? Those commercial pillar 2 labs, The Sunday Times revealed at the weekend, have a huge backlog of 185,000 tests. Thursday’s data revealed that 65,709 test results were not returned by the end of the week. Care home residents now wait an average of 83 hours for their results. The Prime Minister promised us a 24-hour turnaround for results, so what is going on? What is the current backlog and what is the timeframe for clearing it? We were promised a world-beating system, so why are we sending tests to Germany and Italy for processing?

But, most important, people want to know when they will get a test and when this mess will be fixed. Today there will be thousands of ill people trying to book a test, only to be told none is available. When will people be able to book a test online again, or has the online booking system been deliberately disabled? When will ill people no longer have to travel hundreds of miles for a test that should be available on their doorstep? When will pupils and teachers out of school get access to testing, so they can get back to school? When will NHS staff have access to regular testing, so they can focus on their patients and not be sitting at home?

We are at a perilous moment. Imperial College estimates that the virus is doubling every seven to eight days. We all want to avoid further restrictions or another national lockdown, but when testing and contact tracing break down, the growth of the virus cannot be tracked. The Prime Minister promised us whack-a-mole, but his mallet is broken. The Secretary of State is losing control of the virus; he needs to fix testing now.

Well, the good news, in response to that, is that capacity for testing is at a record high. The hon. Gentleman raised the issue of testing in the top 10 local authorities—well, I have got the figures here. Yesterday, we processed 9,278 tests just in pillar 2—so outside the NHS testing capacity—in just those top 10 local authority areas. Just yesterday, we processed 1,428 tests in his own local authority area.

The good news is that capacity is at record levels and that a record number of people are able to get tests. I do not deny that it is an enormous challenge. When a service is free, it is inevitable that demand will rise. The challenge is to make sure that we prioritise the tests that we have as a nation for those who most need them, as I set out in my answer.

The hon. Gentleman asks about the backlog, which is actually falling and is less than one day’s processing capacity. He also asked about our being able to have testing capacity so that we can re-enable the economy and get things going. As he well knows, there is a huge effort to expand—using the next generation of technologies —the tests that we need to deliver to reopen parts of the economy, and we will deliver on that.

We will deliver on the challenges of today. I do not deny those challenges, but I face the facts in order to deliver on those challenges, rather than simply complaining. The hon. Gentleman should welcome the record capacity and the contact tracing, which are playing their part in responding to the virus.

A week ago today, the Secretary of State told the Health and Social Care Committee that he expected to have this problem solved in two weeks. Since then, in my constituency, two Farnham residents have been sent to Bristol for their tests, a councillor has been sent to the Isle of Wight for her test, and a teacher who tested positive had to wait a week for her results. Is the Secretary of State, given the efforts that his Department is making, still confident that in a week’s time we will have this problem solved?

I think that we will be able to solve this problem in a matter of weeks. In my right hon. Friend’s constituency yesterday, 194 people got their tests. We are managing to deliver record capacity, but as he well knows, demand is also high, and the response to that is to make sure we have prioritisation, so that the people who most need them can get the tests that they need.

With covid cases doubling every week, it is clear that laboratory capacity for diagnostic testing is not keeping pace with demand, leading to testing slots being cut. For example, only 70 new covid cases were reported in Scotland yesterday, yet 267 were reported today, many from tests carried out over the weekend. With a reported backlog of 185,000 tests, is the Secretary of State not concerned that results will not be received quickly enough to allow timely contact tracing, and that the delay in data means that new outbreaks will not be identified until they are out of control? Last week, the Secretary of State appeared to accept that additional NHS funding could allow hospital laboratories across the UK to rapidly increase their testing capacity, so can he confirm whether he plans such an approach, and on what timescale?

Yes, I think it is important that we expand the NHS labs, and that we work across the whole of the UK to get the testing capacity needed. For instance, in Scotland, when there was a surge in demand for tests last month, we diverted more of the UK’s capacity to support people in Scotland, and we currently deliver more tests per head of population in Scotland than in the UK as a whole. In the tone of the hon. Lady’s question, it is absolutely necessary to work together across party lines, between the Scottish devolved Government and the UK Government—for work to take place to make sure that we get the support to the people of Scotland as to every other part of this country.

May I ask the Secretary of State about the rule of six? Many of my constituents struggle to understand why they can play five-a-side football but two connected families of five each cannot meet. Will the Secretary of State look at flexibility when local rates permit, and also at excluding under-12s from the rule? Christmas is just around the corner. I know he has to think of the health of the nation, but I really urge some flexibility on the part of the Government.

Of course, I do worry first and foremost about the health of the nation, and we need a rule that is super-simple. Children do transmit this virus, and we have made the decision to keep the rule as simple as possible considering all those risks. I understand where my hon. Friend is coming from. We take a different approach in different areas according to the extent of cases locally, and that is an important tool in our armoury.

Like many other Members, I have been inundated with emails from doctors, teachers and parents unable to access the tests that they desperately need. Several of them have been advised that if they put an Aberdeen postcode into the system, they can get a test in Twickenham—and they have succeeded. How on earth is a world-beating test and trace system functioning like this, and what is the Secretary of State doing to fix it? In the meantime, does he recommend that I tell constituents who desperately need a test to game the system in that way?

No; in fact, it is incumbent on us all to take a responsible approach and tell our constituents that tests are available in large numbers, that the average distance travelled is 5.8 miles, and that people should take this seriously and not game the system.

I am grateful to the Government for all that they are doing to fight covid-19 and keep the population safe. May I ask my right hon. Friend if there is a formal trigger for easing the rule of six and measures like it?

My hon. Friend makes an important point, and it comes to the point that was previously made about Christmas. Of course, we will keep the rule of six in place only for as long as is absolutely necessary for health reasons. The vaccines and treatments that I spoke about and the mass testing regime are all important in trying to find a way through this virus with a minimal impact on the economy, education and people’s social lives. There is not a formal rate at which we will make that review; we keep everything under control, and I have no doubt that we will constantly debate the matter in the House in order to ensure that we come to the right decision.

The Secretary of State is in danger of believing the global figures without looking at the reality on the ground. In my borough, which has been working hard with the Government to keep an outbreak down, we have two walk-in test centres, which have been advertised as such to reach the digitally divided and make sure that people can get tests quickly. Over the weekend, staff from Deloitte—a private company running this public service—told people that they could no longer walk in. That was not communicated to the local authority, so the service was still being advertised as walk-in, and more than 90 people were turned away from one test centre alone. This is a fiasco of the Government’s making, and the Secretary of State could intervene now to make sure that, at the very least, there is communication. I hope he will release the correspondence between Deloitte and the Department of Health and Social Care so that we can see exactly what has happened.

I will happily look at that individual case. Of course, there are many hundreds of tests being done in the hon. Lady’s constituency, as well as across London. I can look at the individual point and make sure that communications occur as necessary.

We have heard about case after case of failure when it comes to testing. I have heard from parents, teachers and a vicar in Luton North, all saying that there are no walk-in tests, no drive-through tests and no home kits available when they need them. The Secretary of State talks about capacity, but what we need is access to testing. Capacity is nothing without access to testing. When can people with symptoms expect to be able to get tests when and where they need them?

The vast majority of people do. In Luton yesterday, 484 people got tests. I agree with the hon. Member for Hackney South and Shoreditch (Meg Hillier) that we should follow the data.

I congratulate the Government on their efforts to increase testing capacity and on working with local authorities to do so. As a result of the soaring number of covid cases in Manchester, however, some people are still unable to get the testing they need. We know that children are back in schools now and that schools are natural incubators of colds and tummy bugs, which mimic some of the covid symptoms. As the flu season gets going, will the Government look at the guidance they are giving to schools and people about how to access those tests?

Yes, absolutely; of course I will do that. We have put significantly more testing into Stockport and my hon. Friend’s constituency: 720 tests just yesterday. One reason for that is the higher rate in Greater Manchester. She makes an important point about ensuring the capacity so that tests can be there when someone has the symptoms of coronavirus, but it is also incumbent on schools to send pupils for testing only when they have the symptoms of coronavirus, to make sure we can prioritise the testing for the symptomatic people who really need it.

I am enormously grateful to the Secretary of State and the Minister for the help he provided over the weekend with Vaughan Gething, trying to get the mobile testing centre in Porth, which has now moved to Clydach, fully functioning in the Rhondda, not least because we have a very high number of infections at the moment and are trying to work out what the specifics look like in terms of a potential lockdown.

Today, however, the best part of 60 people turned up for a test, having made an appointment in Abercynon, only to be told there were no test kits but that there might be some available that afternoon, so to try again later that day. Still people are being told to go to Aberdeen. I do not know if it is just the alphabet—people think that Aberdeen is near Abercynon—but it is a very long way away. I also gently say to the Secretary of State: I know that he knows there is a problem here, but trying to rebut every argument with, “Honestly, we’ve got more people doing more stuff and people need to get with the programme”, and all that, just does not wash with the public. There is a danger, if he does too much of it, that people will simply say, “We can’t trust you any more.”

The hon. Gentleman is right: we spoke over the weekend and worked hard to get those mobile testing units into the Rhondda, where there is a significant outbreak. That showed the effectiveness of people working together to deliver solutions. I do absolutely acknowledge the challenge, but I also urge everybody to ensure that the message gets through to people in the Rhondda and across the country that tests are available. I use these figures to demonstrate that hundreds of people in every constituency are getting tests. I want people across the country to know that we understand there are challenges and are working incredibly hard to fix them, but that tests are available.

My disabled constituent Ian Kenny has been trying to get a home test since 8 September. He cannot drive so he cannot get to a test centre. He has symptoms but has been told there are no home tests available. Until he can prove he does not have covid, he cannot access the hydrotherapy he needs or go back to work. What reassurance can my right hon. Friend give Dr Kenny that he will be able to get a test? He speaks today of prioritisation and difficult choices, but disabled people living in their own homes must be a priority and must not be forgotten.

Absolutely, and I will of course be happy to look into the case in detail. Such cases, where there is a clinical need, should be at the top of the prioritisation. We have set out the prioritisation and will continue to update it to make sure that it matches the latest science. My right hon. Friend has made her point, and I will make sure the matter is looked into.

The Secretary of State is certainly a very busy person. Will he outline what steps have been taken, in co-operation with the Department for Education, to see that school bubbles that have a positive case are returned to school as a matter of urgency? The reason I bring this to his attention is simply that if one child in a household has a classmate with covid-19, and they are tested and are proven not to have it, they are sent home with their mother, but other children in the same households go to different classes in the school. It seems a bit absurd, does it not?

If somebody tests negative in a school environment, as in the example the hon. Gentleman gives, the school can of course carry on as normal because there is no sign of covid. I will double check that the guidelines around exactly that circumstance are clear and will speak to the Department for Education.

To what extent is there a possibility that it is the exponential increase in testing itself, in identifying genuine new cases, and the very significant possibility of false positives, that is giving a distorted impression of the trajectory of the disease?

I like my right hon. Friend very much and wish that that were true. The reason why the Office for National Statistics does the surveillance testing is to ensure that we are constantly looking, on a national representative sample, at what the case rate is, as well as, of course, using the tests, and as we increase the testing numbers, we will inevitably find more of the cases that are there. The ONS survey published on Friday shows a rise in the numbers commensurate with the rise in the numbers of tests that have come back positive, and that does take into account the point about false positives, which is an important one.

Work is under way to set up a walk-through testing centre at Glasgow Caledonian University in my constituency, but with universities now returning, what additional capacity is being put in place to deal with what could be an additional surge of tests that need to be processed?

We are working with universities to try to ensure that testing is available as appropriate. Of course, that has to follow the wider prioritisation, but it is very important that universities right across the UK are ready for the return of students, including with testing, where that is appropriate, and we are working on that right now.

My constituents are sharing the same experiences as those of my right hon. Friend the Member for South West Surrey (Jeremy Hunt), so I encourage my right hon. Friend the Secretary of State to do everything he can on testing capacity.

May I ask him about the rule of six? If someone is lucky—or unlucky—enough to have four very young children, under the rules they are not allowed to meet another household at all. I do hope that the Government will keep the rules under careful review and look at every possible way to make them as fair as possible for every family.

I understand my right hon. Friend’s point. We do understand the impact of the rules that we have to put in place. It is the same around the world: the rules that need to be put in place to deal with a pandemic are not pleasant ones or ones that anybody would want to have in force, but unfortunately they are necessary to save lives. Sadly, we are seeing the consequences, including in some of our closest neighbours, of what happens if we do not take the action that is needed.

Although I am sure that many ordinary people were thrilled to learn that the Government’s rule of six does not apply to so-called sports such as grouse shooting, for which up to 29 people can mingle, expectant mothers in my constituency and throughout the country are unable to take their partners for crucial checks during pregnancy. Currently, individual health trusts are left to make decisions on this issue, which is leading to a postcode lottery. Is it not time that the Government stopped passing the buck, as they did to school leaders, and instead provided national leadership across the country on matters as vital as maternity care?

I have a huge amount of sympathy with the case that the hon. Lady makes. In fact, last week we changed the guidance on this issue to allow partners to go with pregnant women for these sorts of test and, of course, the whole of the birth. The Minister for Patient Safety, Mental Health and Suicide Prevention, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), is responsible for this issue and leading on it, and we have made some significant progress in the past week. I commend the campaigners who are pushing so hard to make sure that each hospital follows the new guidance so that people can have a loving partner with them during these very special moments.

On the rule of six, I completely agree with my right hon. Friend about the importance of clarity and simplicity. Early in the pandemic, we saw some of the problems that arise when different rules kick in in different parts of the United Kingdom. On that point, is there not a strong case for having one simple, understandable rule of six that applies right across the country and has high levels of public support? To that end, I encourage my right hon. Friend to keep an open mind about the rule of six that is in place in Wales and Scotland and the exemption of small children.

I absolutely keep an open mind on all these things. We are constantly looking at the evidence and data, and updating policy accordingly. We have made the decision on the basis that I explained. Of course, I understand the other point of view, but the cause of simplicity and clarity of explanation won the day.

My constituent in Barnsley has been trying for seven days to get a test for her teenage son after he was sent home from school with a temperature. She has been offered a test in Bolton, Edgbaston and Oldham, and nearly 400 miles away, in Inverness. When will the Secretary of State stop denying that there is a problem, apologise to my constituent and sort out access to testing, once and for all?

I ask the hon. Lady to get in contact with me about that individual case; 686 people in Barnsley got tests yesterday, and I am sure we can ensure that her constituent gets that test.

As demand for testing increases, some of my constituents are struggling to get slots, are having to travel significant distances, or are even being turned away from mobile test centres. So will my right hon. Friend confirm whether the Government’s plans to increase capacity are aiming for 10 million tests a day or the 2 million to 3 million that Sir John Bell talked about this morning? As part of that welcome boost, will my right hon. Friend look carefully at my request for a public testing site in King’s Lynn?

I will absolutely look at my hon. Friend’s request on King’s Lynn. Thankfully, after an outbreak a couple of weeks ago, the number of positive test results in Norfolk has come right down. I commend the work of Norfolk County Council, my hon. Friend and colleagues from across Norfolk, who have done so much to ensure that the public messages get through. On the “moonshot”, we do not have and have not had any plans for 10 million tests a day, but we do have a goal to get to the millions of tests a day when we can. That is dependent on new technology, so that is what we need to drive forward. It is vital for this country, for the resolution of exactly the problems we are talking about today, and then for expanding testing availability more widely that we really embrace those new technologies.

Yesterday, I was contacted by an NHS nurse who had spent the weekend unsuccessfully trying to get a test for her symptomatic seven-year-old. On Friday, I visited the new Brinnington test centre in my constituency. It was very quiet, yet it seems to have been unable to offer a test to a nurse, who, it seems, will now need to take time off work. Is that what world-beating looks like? What is going on?

Again, I am happy to try to solve the individual issue for the nurse, not least because the figures that I read out for Stockport do not include the NHS capacity, which is there for NHS staff in order to resolve exactly the sort of issue that the hon. Gentleman talks about.

Cancer Research UK estimates that the screening backlog because of covid-19 might mean that as many as 3 million people are waiting. Will the Secretary of State update us on the work he is doing to ensure that all areas of the NHS are able to carry out screening programmes and on the work he is doing to reassure people that it is safe to attend these screening tests?

That is an incredibly important subject, as we need to make sure we get the screening available. It ties into the questions on testing, because prioritising testing for those about to have NHS procedures, be they diagnostic, such as screening, or an operation of some sort, is so important, for instance, in making sure that we tackle the backlog in cancer cases that inevitably built up. We are tackling that backlog and it is down by about half. I am happy to work with my hon. Friend and all others in this House to make sure that people get the early diagnosis of cancer that can so often be lifesaving.

The Secretary of State will be aware of a recent survey which found that one third of children feel more anxious, sad and stressed now than before lockdown. The charity Action for Children has therefore asked the Government to prioritise children’s mental health in covid-19 recovery planning and provide adequate funding to meet this demand. Could he tell the House exactly what he has done about that and when we can expect him to announce a covid recovery mental health strategy?

This is an incredibly important subject, and I commend the hon. Lady for raising it and for her work on it, along with many Members across the House. We are putting more funding into mental health, and paediatric mental health in particular, to ensure that we tackle the inevitable consequences of the pandemic.

“Hands, face, space” has been the public safety message for weeks now. However, I feel that the public are not as safe as they could be. What thought has my right hon. Friend given to ensuring that face masks and hand sanitiser offer the fullest protection by regulating for the need to meet set safety criteria, whether that be the British Standards Institution standard or the World Health Organisation formula for hand sanitiser, so that we are all as safe as possible using these mitigating factors?

We do have a standard for clinical masks, but for the widespread use of face coverings, we do not set a standard, because the evidence is that for the general public, using a face covering can make a big difference without drawing on the supply of clinical masks for personal protective equipment. Standards are set by the European Union that define what can be put into a hand sanitiser, but I am happy to work with my hon. Friend on the details if that needs to be strengthened.

A world-beating app that is nowhere to be seen, the national R rate rocketing and local testing all but impossible— in Ealing, we would be lucky to get offered a test in Aberdeen—all bode ill for the start of the educational year. With press reports swirling around that there are hundreds of school outbreaks already, can the Secretary of State tell us exactly how many of those there are? Can he up the number of testing kits that schools are supplied with from 10 apiece? As universities go back, which means that people will be moving around bits of the country with different infection rates, can he ensure that everyone on campus gets a test, whether they have symptoms or not? We cannot let education be the next care homes crisis.

The hon. Lady raises important points. It is important to note that in Ealing, 462 people got a test yesterday, so tests are widely available there. The other issue she raises about ensuring that schools and universities have access to testing is important within the prioritisation. As she knows, we have sent tests to every school for use in exceptional circumstances when they need them. It is very important that those tests are used when people are symptomatic, rather than asymptomatic.

Last week, a mobile covid testing centre was set up in Ashfield, which helped hundreds of my constituents to get a test, but over the weekend, several constituents said that they struggled to book online owing to the demand. Will my right hon. Friend advise the people of Ashfield what more can be done to ensure that everyone in my constituency who needs a test gets a test?

We have put the extra capacity into Ashfield that my hon. Friend talks about, and I am delighted that the number of people in Ashfield who are getting a test has therefore increased. We have to get to a position where everybody who needs a test can get a test, ensuring that we follow the prioritisation. I look forward to working with him to fix the problem in Ashfield and across the country.

In Warrington we have seen spiking numbers, with over 200 confirmed cases in the most recent weekly figures. Our rate is now the sixth highest in England, and we have real issues with demand for testing far outstripping local capacity. Can the Secretary of State outline what additional support he will give to Warrington Borough Council to increase our testing capacity, so that we do not have to go back into lockdown like our Greater Manchester neighbours?

Yes, absolutely. The hon. Lady is right to raise the concerns in Warrington about the increase in the number of people testing positive. I am happy to work with her, Warrington Borough Council and my hon. Friend the Member for Warrington South (Andy Carter) to ensure that we get the best possible response, including putting in that extra testing.

Traditionally, the start of the autumn term is the peak for returning schoolchildren showing signs of colds and sniffles. I am now increasingly getting reports from my constituency of young children being turned away or returned from nurseries and primary schools if they display any cold symptoms. I am afraid that I have to tell the Secretary of State that testing is not at a record high in my constituency, because of capacity being moved up north and to hotspots, despite Worthing now being on the watch list because of a single outbreak of 23 people not abiding by the regulations. I heard yesterday from a constituent who had been referred from the Sussex coast all the way to Aberdeen. Can he not forget those very young children and the huge impact that they can have on families and schools if testing is not properly available for them?

Yes, of course. It is so important in Worthing, as it is across the rest of the country, that we prioritise the testing that we have. My hon. Friend is quite right that, when schools go back, children often do get a cold, a non-coronavirus illness—a normal illness if you like. Obviously, that is contributing to the increase in demand, as well as people who are not eligible coming forward. That is one reason why we have been building capacity throughout the summer, and I look forward to working with him to make sure that we solve the problems in Worthing.

Greater Manchester is a covid hotspot. The nearest testing centres to me are Hyde, one and a half miles; Ashton, three miles; Brinnington, three miles; Belle Vue, four miles; Etihad Campus, five miles; Oldham, nine miles; and Manchester Airport, 11 miles. They might be testing there, but local people cannot get slots. Instead, too many of my constituents have been allocated Telford, a 152-mile round trip; Llandudno, 174 miles; Leicester, 216 miles; Glasgow, 450 miles; and Aberdeen, a 716-mile round trip. My constituents do not want to become superspreaders, so why is this world-beating system going so spectacularly wrong for them?

As the hon. Gentleman outlined in his question, we have put an enormous amount of testing into Manchester. There is availability in Manchester because there is a prioritisation on testing. Because it is such an outbreak area, we have put in a huge quantity of tests. As I have said repeatedly, there are operational challenges, but thousands of people are being tested in Manchester every day, to get a grip of the outbreak there.

My right hon. Friend has my sympathy and support as he discharges his duties. He is well aware of the position across the west midlands and, in particular, in the royal town of Sutton Coldfield, where we do have testing difficulties. I am very concerned to hear today that Ley Hill Surgery has no fewer than four GPs who are having to self-isolate and cannot get a test. May I make two points to him? First, I join those who want an exemption for informal childcare, so that parents in certain circumstances can still go to work. Secondly, may I ask him to look at a system whereby all Members of Parliament get access to regular infection rate details both by local government wards and by postcodes?

I am very grateful for my right hon. Friend’s support. I am working very closely with him and with the other Birmingham MPs, because there is a serious challenge in Birmingham and in other parts of the west midlands. On the point about getting the data down to a ward level, I will absolutely ensure that he gets that data. We look at it down to a lower super-output area level, and we publish the data weekly. I will ensure that it gets to him and that we get the full details of exactly how many cases there are in each part of Birmingham. I recognise that, while Sutton Coldfield is in the Birmingham local authority, it has a distinct geography within that area. As he knows, both from our discussions and from how we have acted in other parts of the country, we will take action on a sub-local authority area where that is supported by the data. Unfortunately, for now, we do have that local action in Sutton Coldfield, but we keep it constantly under review.

Has the Secretary of State seen today’s analysis revealing the terrifying scale of the backlog in cancer treatment and diagnostics? It is now clear that it would take the system operating at 135% capacity for six whole months just to catch up with where we were in March. Until then, the tragic reality is that people in my constituency and around the country will be unnecessarily losing their lives. I beg him to urgently meet the clinician-led Catch Up With Cancer campaign so that we can give him the solutions to boost cancer services and save tens of thousands of lives.

I am very happy to meet the campaign. Of course I have seen the reports. I feel very strongly about this. We have worked very hard to get through the backlog, and we are making progress against that backlog. Nevertheless, I am happy to look at anything we can do to speed that up, so I look forward to listening to the details of what we can do.

As my right hon. Friend knows, sporting venues are suffering financially because of the restrictions, and it does not help when planned pilot events are cancelled at the last minute. Who takes the decisions on whether to allow pilot events to carry on—is it done centrally, locally or a combination of both? There is a feeling that there is some confusion.

My colleague the Culture Secretary is responsible for the programme of pilot events. For a pilot event to go ahead, it needs both the support of the local council and to have been advised as covid-secure by Public Health England. The Department for Digital, Culture, Media and Sport takes the lead. As the MP for Newmarket—one of the four towns in my constituency relies on sport, as do the livelihoods of thousands of my constituents—of course I understand the impact, in exactly the same way that my hon. Friend does, as the MP for Cheltenham racecourse. I speak a lot to the Culture Secretary and the Prime Minister about this subject. I hope that we can get as much going as possible as fast as possible, but safely.

I understand that it is not dead easy, but rather than coming here and giving us big numbers about tests completed or the average journey, why does the Secretary of State not listen to what people in all parts of the House are telling him today? Why does he not try to understand what it is like to be a parent in special-measures Birmingham who is directed to Oldham for a test when there is a walk-in centre two miles down the road and virtually empty? Will he just recognise that there is a problem and tell us what he is going to do to try to put it right?

Yes, I absolutely recognise that there are challenges: I set them out in my initial answer and have done repeatedly. I urge colleagues in all parts of the House—including the hon. Gentleman, for whom I have huge respect—to accept that we are only going to solve these problems if we use the data as our guide.

I have constituents in Scunthorpe who have struggled to access a face-to-face GP appointment. Can my right hon. Friend reassure those constituents that, should they need one, they will be able to have one?

Yes. There is no greater supporter than me of the ability to access medicine by telemedicine. It is an incredibly important option that is available and should be a choice for our constituents. We have made access by telemedicine the default method unless there is a good clinical reason not to use it. It is, however, as I have always set out, critical that there is face-to-face access as well. The NHS has written to all GPs to explain that while telemedicine should always be available, and that option should be available where it is clinically right, face-to-face appointments should also always be available and are absolutely necessary. The combination of the two is the future of the NHS.

People in Sandwell and Birmingham certainly want to know why their whole boroughs are being suddenly locked down and not just the currently affected areas within them, but they also need a plan on how we are going to contain the virus without paralysing society and the economy. We may have to coexist for years with the virus, as countless societies and countries have had to live with many awful diseases over millennia—and even now, today—so when are we going to transit from reactive risk avoidance to prudent risk management?

We absolutely need to control this virus. I very much hope that we will make very significant progress, through treatments and vaccines, within the sorts of times that I set out previously—definitely in less than a millennium. I think that we will make significant progress in the coming months. However, in that time, we do have to control the virus.

We took the action in Sandwell having looked carefully at the data. Working with the right hon. Gentleman’s local authority, we also looked carefully at whether we should only put some parts of Sandwell under local measures—in particular, the Smethwick area was much more significantly affected earlier on—but it was clear that the virus was spreading throughout Sandwell, so working with the local authority, we decided to take local action across the whole district. That is the sort of action that we have to take.

The strategy that I have set out many times at this Dispatch Box is that social distancing is the first line of defence: the rule of six, and hands, face and space. The next line of defence is testing and tracing, which is why it is so important that we have record testing capacity and are trying to boost that further. The next line of defence is local action and ensuring that we do take that local action where necessary, even though it is uncomfortable to do so.

I thank the Secretary of State for his visit to Shotley Bridge in my constituency yesterday and look forward to working with him on the campaign for a new community hospital in the coming months. I welcome the massive increase in testing, including the mobile testing unit that has been at Consett AFC over the past few days. Across the north-east more broadly, we are seeing an uptick in the virus. The Secretary of State has now had meetings with various north-east councils on this issue, and I encourage him to give local authorities the powers they need to enable targeted local action in the north-east if necessary.

It was a real pleasure to be in Shotley Bridge yesterday, to meet my hon. Friend there and to visit Shotley Bridge Hospital. He and the whole House know that we will build 40 new hospitals, so it was interesting to see the plans that are in place. I will absolutely take away his point about the rise in cases in the north-east. The seven north-east councils have written to me with a proposal for tackling that increase. I have been studying their proposal and will make an announcement as soon as a decision has been made.

We have heard about people in England registering as coming from Aberdeen and perhaps other places. Is the Secretary of State not concerned, as I am, that this may completely undermine the data and any resultant decision that is taken to act on and manage what might appear to be a Scottish outbreak?

Obviously, I talk to the Scottish Government, who are responsible for local action in Scotland. We work as closely as we can to try to bring both the UK capacity and the local capacity to bear. We have put much more testing in Aberdeen, which is right, and I support the Scottish Government in the action that they take to bring down the number of cases there.

May I congratulate the Secretary of State on the biggest testing regime in this nation’s history? Twenty million tests is a monumental feat. That said, it would be wrong of me not to highlight the calls that my office received at the tail end of last week and yesterday, with people in Cornwall unable to access tests. What progress is he making on expanding the number of tests in Cornwall so that my constituents can access them?

There have been more than 600 tests a day in Cornwall over the past couple of days, so people in Cornwall can access tests—and it is very important, if they have symptoms, that they continue to do so—but of course I acknowledge the challenges that have been faced as well. We want to increase testing capacity right across the board.

Sometimes we have to discuss difficult issues in this House, but I am pleased to say—especially with so many people having gone to Cornwall over the summer, because, as I can personally attest, it is such a wonderful place to have a summer holiday—that the case rate in Cornwall has stayed really low. I pay tribute to everyone in Cornwall for the work that they are doing on social distancing, on hands, face and space, and on being cautious and careful to stop the spread of the virus. Let us hope that that remains the case.

There are three testing centres in Coventry, but constituents have told me of their distress and despair that they cannot access a test. Some cannot book a test anywhere, while others have booked only to be turned away at the centres. There are also cases of people in Coventry being directed as far away as Inverness. The Government have had six months to get testing sorted, and this is a complete and utter farce. The Secretary of State’s quoting figures is not good enough, so when will this mess be fixed and when will my constituents be able to access the tests that they need?

Of course, as the hon. Lady well knows, we are working both to increase capacity and to ensure that we have prioritisation so that the people who need a test most can get access to those tests. I am sure she will agree that it is important not only to listen to voices and the stories of those people who have had difficult experiences, but to ensure that we look at the facts on the ground. There were 762 people yesterday who got a test in Coventry, and that is an increase over the previous week. I am really pleased that we are able to do hundreds of tests a day in Coventry, but I appreciate that we need to keep expanding capacity.

I am really keen that we proceed on the basis of reliable and agreed evidence, so what would the Secretary of State say to people who point to Sweden as an example of how we can control the virus and minimise the impact on the economy and our social lives?

I have looked very closely at the situation in Sweden, and the challenge is that Sweden brought in significant laws curtailing social activity and that the population in Sweden followed more closely, more than in almost any other country in the world, a lot of guidance that was not enforced by law. The case rate in Sweden was also higher than in other geographically comparable countries.

The conclusion I have come to is that the approach we are taking, where we look around the world, learn from similar countries and take action where necessary, is the best way to control the virus and protect the economy. The rule of six is designed to try to restrict the transmission where we see it happening most, which is in social circumstances, and to protect the economy as much as possible by keeping the economy open within those social constraints. We are constantly vigilant and we are looking around the world for other examples of where we might be able to make changes. As my hon. Friend knows, we have made changes to our approach as we have learned throughout this unprecedented pandemic.

My constituent Rachel has an 11-year-old daughter who came down with covid symptoms on Sunday. All her family have spent days self-isolating and desperately trying to book a test. At one point, they were directed to Wales, which is a six-hour round trip. At the same time, Rachel has seen private tests for £140, and often much more, that seem to be easily available. Does the Health Secretary think that this disparity is acceptable?

We do not recommend any private tests that are not signed off and verified. Therefore we are providing as many tests as we possibly can with a growing capacity. If the hon. Gentleman writes to me with the details of that individual case, I will absolutely look into it and make sure that one of the hundreds of tests that are being done in Ealing today is available for his constituent.

Having raised the issue of testing capacity in Buckinghamshire last week, I am enormously grateful to my right hon. Friend for the supply of two mobile testing units this week, in the town of Buckingham and in neighbouring Aylesbury, but like many Members I also continue to receive a lot of emails every day from constituents unable to access testing, so will he update the House on progress for a permanent uplift in the capacity for Buckinghamshire residents?

Yes, of course. My hon. Friend is right to raise the issue, and we have put more testing into Buckingham. There are hundreds of tests available across Buckinghamshire for his constituents and others, and we are working hard to ensure that the overall capacity has increased as well. Our constituents want to get access to a test whenever they want one, and I understand that yearning, but we have to prioritise and, as I said in my opening answer, we have to put NHS and social care needs at the top of the list. I make no bones about that prioritisation, but at the same time we need to get overall capacity up, which is what we are working incredibly hard to do.

As elsewhere, the numbers in Harrow with covid are on the rise. Tests are available for key workers, but I am told that parents and their children cannot get a covid test “for love nor money” in Harrow or near Harrow. I say gently to the Secretary of State that that does not yet feel like a world-leading test and trace system. Will he take a specific look at the circumstances in Harrow, and in particular at why the nearby test centre at Heathrow is so unused at the moment?

The hon. Gentleman makes an important case for Harrow, and I am very happy to take a look at Harrow specifically. The capacity constraint is in the labs, rather than the centres. We have the centres available to be able to process a huge number of tests. We have record capacity in the labs, but it is in the labs where there is the constraint. We are bringing in more machines. More are being installed all the time, which is why capacity is constantly going up. Nevertheless, we clearly need to keep driving at that, because demand is going up as well.

We need to use every tool at our disposal to stop the spread of coronavirus. I welcome the news that the NHS contact-tracing app will be available by the end of the month, and I welcome the news that it will be available throughout England and Wales. Will my right hon. Friend join me in urging businesses in Bridgend to get prepared with the NHS QR code scan poster?

Yes. The NHS covid-19 app, which will be available this month, will, as one of its features, ensure that people can go to a pub, restaurant or hospitality venue and scan the QR code quickly. Contact details will then be safely collected in case they are needed for contact tracing purposes. We are making the scheme mandatory. It has been very successful voluntarily and we are going to roll it out mandatorily, so I urge hospitality businesses in Bridgend, and right across England and Wales, to download a QR code for themselves and put it where it is very easy to use and obvious, so that all of us, when we go to the pub in Bridgend or anywhere else, can very easily scan in. If there is an outbreak, we can then contact trace that outbreak and keep the virus under control.

I do not underestimate the challenges the Health Secretary has faced over the past few months, but six months on, after many, many warnings of the likelihood of a second wave and of what would happen without a fully operational test, track and isolate system in place before lifting the lockdown, unfortunately the Government are still not getting the basics right. That is happening in my constituency in Oldham. We did not have a mobile testing unit turn up and we are still not getting the data we need to trace covid-positive cases.

For starters, will the Secretary of State sort out the private contractors for the national test and trace system; make sure that public health directors are getting timely, high-quality data on covid cases, including occupational workplace details; and, fundamentally, make sure that our local authorities have the resources they need to trace all contacts, and ensure that restrictions are understood and observed?

The answer is yes. In Oldham in particular, where there has been a very serious outbreak, making sure we have that connection between the national system and the data flowing through to local contract tracers is incredibly important. We are working on some innovative solutions proposed by the local authority and others in Manchester to enhance that system as much as we possibly can to keep control of the virus.

Lots of my constituents in Winchester have had tests, and the Government deserve credit for that, because we as a country started from a position where we did not have a system in place. The Health Secretary had to create a system from scratch, and he had great help with that from the private sector. We certainly should not be denigrating that; we should be thanking it and expanding on that help. Given the operational challenges that the Secretary of State spoke about, I wonder whether GP surgeries, or even our wonderful community pharmacists, could be part of the solution for front-door testing. What is the cross-Government superhuman effort part 2 to increase lab capacity—AstraZeneca was very helpful in part 1 —as that seems to be the challenge outlined by my right hon. Friend?

We are increasing that capacity, and we are bringing new technologies to those labs to expand on that. My hon. Friend is a great expert on this issue, and makes a really important point. The current technology works best in labs—people send a swab to the lab and get the result back—but there is a huge amount of logistics around that. We want technologies that can be in a pharmacy or a GP service, so that people get the test result back straight away. When such technologies come on stream—I am optimistic about this, as I am about a lot of things; I do not think I could do this job at the moment without being optimistic—that will give us a chance to get testing out into the community at every level.

We need to tackle problems such as the challenges you have in Chorley, Mr Speaker—you rightly brought them to my attention in your role as a local MP, as we all are—not by having a big national system, but through solutions that are deeply embedded in the community. When we have the technology to do that, we will be in a stronger place, and we are putting every possible effort and support behind people to try to make that happen.

I am pleased you are bringing me back into it. We still have a lab at Chorley Hospital that you can use if you get on to it.

We have had a spike in cases in Redbridge, yet in recent days the Mildmay Road walk-in centre closed for walk-in appointments, without notifying the council or either of Ilford’s MPs. People have been struggling to get access to tests. A local secondary school says that it will close within two weeks unless staff get access to tests, and the local walk-in centre will not even share testing data, which the Secretary of State says is so important, with public health officials at the local council. It is an utter shambles. Can the Secretary of State reassure us that he will help us get a grip in Redbridge? Does he recognise from the voices we have heard across the Chamber that these problems are not only in Ilford? There are problems right across the country, and the only way that this system is world-beating is through world-beating incompetence. When will he get a grip?

I am happy to consider the specific issues that the hon. Gentleman raises about Ilford. We have an extremely good working relationship with the London group, which is cross-party and includes health professionals. I am happy to take that point offline and work on a solution specifically for Ilford with the hon. Gentleman. As he knows, nationally we are seeing an increase in overall capacity, but because of the increase in demand we have to prioritise. Having said that, in Ilford, as everywhere, I want to ensure that we have access to tests for the people who need them, and that is the job, day and night.

Pregnancy can be one of the most surprising, exciting, but traumatic experiences of a woman’s life. That is why this week I launched a campaign with The Mail on Sunday, calling for all NHS trusts to ensure that partners support pregnant women during all scans and all stages of labour. Will my right hon. Friend confirm that women across the country have the Government’s support, and will he push NHS trusts to stand by pregnant women?

Yes, 100%. I strongly support my hon. Friend, and I congratulate her on—[Interruption.] Somebody says, “Her pregnancy.” I hope it is public knowledge—well, it is now. I congratulate her on her pregnancy, and I know she has a strong interest in our getting this sorted. We put out extra guidance last week, and it has been a pleasure to work with her on the campaign to ensure that all hospitals follow that new guidance. We must ensure that partners can be there throughout each stage of pregnancy, in a covid-secure way, and that people get the support they need.

Coronavirus cases are on the rise in Hertfordshire, and yet in St Albans key workers, teachers, doctors and parents cannot access tests. They are frustrated for two reasons, first because they cannot get a test, but secondly because this was utterly predictable. We knew there would be a surge in symptomatic cases and we knew there would be a surge in demand from key workers. Was any modelling actually done, and, if so, will the Secretary of State publish it?

Of course, we have been increasing capacity all the time, and working throughout the summer to do that, to make sure that there is as much capacity as there is. The big change in capacity will come when one of the new technologies comes off, and that is why I am so passionate about them—because that is what is going to be able to get us out of the situation of having to have prioritisation and instead getting a test to everybody who wants one, not just those who need them according to the clinical prioritisation.

A local high school student tested positive for covid late last week, so when parents had children from that school displaying symptoms over the weekend, they quite rightly tried to book a test but none was available on the portal. On Sunday morning, I directed one set of parents to a local walk-in centre a 45-minute drive away. The first centre had actually run out of tests, but after a drive to another walk-in centre, they eventually got one. Secretary of State, please, please, please, before we talk about the moon, can we just focus on local community testing in Marsden, Meltham, Mount and other communities in my constituency?

We have put a huge amount of testing into Kirklees, and it is very important because of the levels of coronavirus there. I am very glad that my hon. Friend’s constituents did manage to get a test, and I know that there is huge demand. But I would also say that getting the new technologies on board is another part of solving the problem that we have right now. We absolutely have to push on existing capacity, but we have also got to make sure that we invest in that new technology to solve this problem once and for all.

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