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Covid-19 Update

Volume 680: debated on Monday 21 September 2020

With permission, Mr Speaker, I would like to make a statement on coronavirus. This deadly virus continues to advance across the world. The World Health Organisation has confirmed that the number of new cases in Europe is now higher than during the peak in March. Here, the latest Office for National Statistics figures indicate 6,000 new infections a day—almost double the previous week.

As the chief medical officer and the chief scientific adviser said earlier today, we are seeing a rise in cases across all age groups. That pattern is emerging across the entirety of our United Kingdom. Earlier this afternoon, the Prime Minister held discussions with the First Ministers of the devolved Administrations and the Deputy First Minister of Northern Ireland to make sure that, wherever possible, we are united in our efforts to drive this virus down.

We know that the epidemic is currently doubling around every seven days and that, if we continue on that trajectory, we could see 50,000 cases a day by mid-October, so there can be no doubt that this virus is accelerating. We must all play our part in stopping the spread.

I would like to update the House on decisions the Government have taken so far. The first line of defence is, of course, the social distancing that every single one of us has a responsibility to follow. That includes the basics—hands, face and space, and the rule of six—and a crucial part of that is people self-isolating if they are at risk of passing on the virus. People who have tested positive and their close contacts must self-isolate. That is the primary way that we, together, break the chains of transmission.

I know that self-isolation can be tough for many people, especially if they are not in a position to work from home. I do not want anyone having to worry about their finances while they are doing the right thing, so we will introduce a new £500 isolation support payment for people on low incomes who cannot work because they have tested positive or who are asked to self-isolate by NHS Test and Trace. It will start next Monday. It will apply directly in England. The UK Government will be providing funding through the Barnett formula to the devolved Administrations so that similar support can be offered to people in Scotland, Wales and Northern Ireland.

As we are strengthening our support for those who self-isolate, we propose to strengthen the sanctions for those who do not. The vast majority of people who are asked to self-isolate do, but the rules are so important that we must ensure that nobody breaks them. We are therefore proposing a new legal duty to self-isolate, again for people who test positive or who are asked to do so by NHS Test and Trace. That is backed by fines of up to £10,000 for repeat offences and serious breaches.

We will step up enforcement too. NHS Test and Trace will make regular checks on those who are self-isolating, and we will crack down on employers who try to prevent staff from following the rules. Over the past few months, self-isolation has been instrumental in breaking the chain and blunting the force of this virus. We know that it works. With winter ahead, we will support everyone to do what is right to help stop the spread of the virus.

The next line of defence is testing and contact tracing. We are doing more testing per head than almost any other major nation. Our daily testing capacity is now at a record high of 253,521, and it continues to grow. On Thursday, we announced that two new Lighthouse labs will be set up in Newcastle and Bracknell, increasing capacity further. As the House knows, alongside that record expansion, demand has gone up too, so we need to prioritise the tests for those who need them most to save lives, to protect the most vulnerable and to make sure that our health and care services and our schools can operate safely.

Today, we have published our list of where tests are being prioritised, setting out how we will make sure they are allocated where they are needed most: first, to support acute clinical care; second, to support and protect people in care homes; third, for NHS staff, including GPs and pharmacists; fourth, targeted testing for outbreak management and surveillance studies; fifth, testing for teaching staff with symptoms, so we can keep schools and classes open; and then for the general public when they have symptoms, prioritising those in areas of high incidence. I want to reinforce this important point: the system relies on people coming forward for tests if—and only if—they have symptoms of coronavirus or have been specifically advised to by a health professional. The testing capacity we have is valuable and we must together prioritise it for the people who need it the most.

The next part of our defence is local action. We have been vigilant in monitoring the data and putting in place targeted local measures so that we can come down hard on the virus wherever we see it emerging. In the summer, when the virus was in retreat, we were able to relax some of the measures that we had put in place, but now that it is spreading once more we have had to act.

On Thursday, I updated the House on the changes we are making in parts of the north-east, and on Friday we introduced new rules for parts of the north-west, West Yorkshire and the midlands. We have seen some concerning rates of infection in those areas. Liverpool, for instance, now has more than 120 cases per 100,000 population, and in Warrington it is about 100. As a result, working with local councils, we are putting in place stronger restrictions to protect local people. In parts of Lancashire, Merseyside, Warrington and Halton, we are putting in place new measures from tomorrow. As with our strategy overall, our goal is to protect education and employment as much as possible, while bearing down on the virus. Residents should not socialise with people outside their own households or support bubble. Hospitality will be restricted to table service only and operating hours will be restricted, so venues must close between 10 pm and 5 am. From tomorrow in Wolverhampton, Oadby and Wigston and the whole of Bradford, Kirklees and Calderdale, people should not socialise outside their household or support bubble.

We know from experience that local action can work when local communities come together to follow the rules, to tackle the virus and to keep themselves safe. I know how hard that is. We are constantly looking to how we can ensure measures bear down on the virus as much as possible, while protecting lives and livelihoods.

I have heard the concerns about the impact of local action on childcare arrangements. For many, informal childcare arrangements are a lifeline, without which they could not do their jobs. Today, I am able to announce a new exemption for looking after children under the age of 14 or vulnerable adults where that is necessary for caring purposes. That covers both formal and informal arrangements. It does not allow for playdates or parties, but it does mean that a consistent childcare relationship that is vital for somebody to get to work is allowed.

I would like to thank colleagues from across the House, including my right hon. Friend the Member for Berwick-upon-Tweed (Anne-Marie Trevelyan), the hon. Member for Sunderland Central (Julie Elliott) and my hon. Friend the Member for North West Durham (Mr Holden), for working with us on this important issue. I hope the change will provide clarity and comfort for many people who are living with these local restrictions. It shows the benefit of cross-party working across the House and listening to concerns as we all do our best to tackle this dreadful disease together.

The virus is spreading. We are at a tipping point. I set out today the measures the Government are taking so far. We are working right now on what further measures may be necessary, and the Prime Minister will update the House tomorrow with any more action that we need to take. This is a moment when we, once again, must come together to tackle this deadly disease. I commend this statement to the House.

I welcome advance sight of the Secretary of State’s statement, and we particularly welcome the action that he has taken on childcare. There can be no doubt that the presentations that we saw today from the chief medical officer and the chief scientific adviser were stark and deeply concerning. The Secretary of State described this yesterday, and he repeated it today, as a tipping point. I agree that we are at a perilous moment.

The exponential growth in the virus cannot be ignored. This virus takes lives, and it leaves many with long-term debilitating conditions. Every reasonable action must be taken to save lives, minimise harm and keep our children in school. That means a suppression strategy to drive infections down, so will the Secretary of State reject those siren voices telling him that the virus has lost potency or that we should let it rip through the herd while the vulnerable shield?

We support the local restrictions that the Secretary of State has had to impose—including in Chorley, Mr Speaker—and we understand why he has made that decision. Neither he nor I came into politics to place upon individuals a heavy burden of curtailments on our freedoms, and while we, as the official Opposition, would always welcome greater parliamentary scrutiny of the restrictions, we will continue to work constructively on a cross-party basis where restrictions are necessary to arrest the spread of this virus.

May I also say to the Secretary of State, ever so politely of course, that the tone of his remarks yesterday rather gave the impression that he was blaming people for breaking the rules and allowing the virus to grow? The reality is that people have done everything that they were asked to do. They have missed birthday celebrations, weddings and funerals. They have sent their children back to school, quite rightly. They have gone back to work. They have done what they were asked to do; in return, Ministers were supposed to fix test, trace and isolate, so that we could, in the words of his own Government adverts,

“get back to the things we love.”

Before the summer, the Government commissioned the Academy of Medical Sciences to scenario-plan. It modelled that the R value could rise to 1.7 in September—that is what Imperial College currently estimates it to be—and it recommended significantly expanding the capacity of the test, trace and isolate programme to cope with increasing demands over the winter. Ministers were warned, but pillar 1 and pillar 2 testing capacity did not increase significantly over the summer.

In recent weeks, only half of all tests have been received in less than 24 hours. The Secretary of State has repeated his point about asymptomatic people asking for tests. Will he publish the pillar 2 data, which breaks down how many of the people asking for those tests were symptomatic and how many were asymptomatic? Many parents report going to walk-in centres with their sick children when they themselves had no symptoms and being given a test. Was that a national policy and has that national policy been abandoned?

We welcome the recognition that people need financial support to isolate. We have been saying that for months, but, as I understand it, it is available only to those low-paid workers who are also on benefits and not to all low-paid workers, so will the Secretary of State consider expanding the eligibility criteria?

We have always said that when testing breaks down, tracing breaks down and the virus gets out of control. We are now facing a second wave of infection. We do not want a second wave of ministerial mistakes. All of us want to avoid a further national lockdown. Lockdowns or circuit breaks exact a heavy social and economic price, especially on the poorest and more vulnerable, but controlling the virus and protecting the economy are linked objectives, not in conflict with one another.

I understand that the Secretary of State will tell us that we have to anticipate the Prime Minister’s statement, but can he confirm that during a lockdown, if we have one, he will use the time wisely, expand NHS lab capacity, put public health teams in the lead on contact tracing, quickly assess the university pilots on saliva testing, and validate polymerase chain reaction pool testing, so that when those lockdown restrictions are lifted we can contain the virus in the future?

I welcome what the Secretary of State said about prioritising NHS staff, care workers and teachers, but can he clarify why he has issued guidance to hospital trusts placing restrictions on the numbers of tests that they can carry out, and how he will protect care homes? According to reports today, many care homes have had to wait over two weeks for their test results, and data from Public Health England shows that more than 200 care homes have had an outbreak of covid in the last two weeks. Will he ensure that no one is discharged into a care home without having a covid test? Given where the virus is, what is his advice to the shielding community? What protections is he putting in place for those from black, Asian and minority ethnic communities, given that there are disproportionate numbers from those communities in intensive care units today?

None of us wants to see another lockdown or circuit breaker, although we will of course understand if one becomes necessary, but test, trace and isolate should have been fixed. That failure has left us vulnerable and exposed. Now we must act with speed to save lives and minimise harm.

I am grateful to the hon. Gentleman for his constructive approach in these difficult times. He and I agree that the strategy of suppressing the virus while protecting the economy and education is the right one. In so doing, it is important to act fast so as not to have to act bigger later. I also agree that no one in this House came into office to put in place restrictions like these. The hon. Gentleman asked about the importance of people following the rules that we have put in place. It is vital that all people follow the rules. The vast majority have done so throughout but, critically, enough have not, meaning that in many cases we have had to make the rules mandatory, rather than relying on people’s sense of civic duty. That is the fundamental judgment behind making self-isolation mandatory, as I announced in the statement.

The hon. Gentleman asked about testing. Of course, we have record testing capacity right now—a record 233,000 tests were done on Friday—and lab capacity will continue to grow. He also asked about the NHS testing capacity, which will also continue to grow. In fact, I had a meeting about that earlier today with Simon Stevens, the head of NHS England. The hon. Gentleman asked about pool testing and saliva testing, which are just two of the many new testing capabilities that we are bringing to bear. He also asked me to ensure that there will be no admissions to care homes without a test. That is our policy: not just no discharges from hospital into care homes without a test, but no admission from anywhere into care homes without a test. That was reiterated in the social care winter plan that we set out on Friday.

I suppose that at the heart of the official Opposition’s response, and at the heart of my response to the hon. Gentleman, is the fact that we are united in wanting to tackle this virus, and in sending the message to everyone across the country that it is critical that we all follow the rules and play our part so that we can suppress the virus while protecting, as much as possible, the things that we love.

I support the measures outlined by the Health Secretary, which regrettably are both necessary and proportionate. Last week, on World Patient Safety Day, the World Health Organisation announced a charter for health worker protection, which asks all WHO member states to commit not only to having adequate supplies of personal protective equipment and mental health support, but to ensuring that there is zero tolerance of violence against health workers. Will the Health Secretary commit the Government to signing up to the charter so that, as we go into a second wave, all our brave frontline workers know that this Government and this House stand four-square behind them?

Yes, I will happily sign up to the proposals that my right hon. Friend has set out. As the House well knows, his long-standing and international work on patient safety is very impressive. We must ensure that in these difficult times we protect our care workers and frontline staff—including, if I may say so, the staff at the testing centres—and that we reiterate once again our commitment to patient safety.

Thank you, Mr Speaker.

As the chief medical officer and chief scientific advisers said this morning, the UK is in danger of losing control, which we have seen happen in many countries in Europe. As the Secretary of State has said, we could be facing 50,000 new cases a day by mid-October, leading to about 200 deaths a day by mid-November. No one should be in any doubt that it is a mistake to think that the virus has changed and that it will not kill people if we get back to where we were in April.

I agree utterly with the Secretary of State that we need to take action now, and that action is personal; every single person has the responsibility to stick to the rules—to wear a face covering, wash their hands and keep their distance. I remind Members in this House, because I have been watching it from outside, that that is not always what is on show in this Chamber, and we all have a responsibility to set an example. That responsibility extends to self-isolating, whether we have symptoms, we are proven, we are a contact or we have returned from a high-risk country. If we are meant to be isolating, we need to do it. I really welcome the fact that the Government are finally putting in place financial support for people on low incomes, who might be tempted not to isolate because they simply do not have any other opportunities to feed their family.

However, it is crucial that we have a fast and responsive test and trace system, so I have a couple of questions for the Secretary of State. In recent weeks, he has talked about aiming to have 500,000 tests a day by the end of October. Given the surge we are facing, does he envisage being able to accelerate that and bring it forward? Secondly, on 8 and 15 September he committed to me that he would be increasing funding to expand NHS testing, but, as we heard from the shadow Secretary of State, NHS trusts in England have been told that funding is capped and they are not to expand covid testing. Surely this is resource that we want to use and make available.

I wholeheartedly agree with the hon. Lady’s comments about the need for action across the UK. We have seen in Scotland, as in England, Wales and Northern Ireland, that the number of cases has, sadly, risen sharply. I welcome her physically back to the Chamber, in demonstrating this unity of purpose across the four nations of the UK. If we can bring forward the goal of 500,000 tests per day from the end of October, of course we will do so; we are pushing that as hard as we can and are on track to meet that commitment. As she says, that is for across the UK, so it includes the tests done by the Scottish NHS. I know that conversations have taken place between the NHS in Scotland and the NHS in England to work on making that happen. We are expanding NHS testing, including the funding. In the funding letter that went out to the NHS for the second half of the financial year—for the cover in winter—we set out that that includes the commitment to support financially the testing done in the NHS in England.

I welcome the measures my right hon. Friend has announced today, as he seems to be getting the balance absolutely right, and I praise him for the job he is doing. However, we have to remember that there are huge regional variations in the impact of the virus at the moment and many parts of the country have much lower infection rates. There are huge consequences of this virus for people in our communities, including on their mental health, and, in particular, for the younger generation, who are paying a very heavy price. Given those regional variations, may I say, in the full knowledge of the pressures he is facing, that I do not believe the case for further national measures has yet been made?

There is an important balance between the measures we need to take across the country as a whole, and the further and stronger measures in local areas. My right hon. Friend will have seen, particularly in the past week, that we have expanded some of those local interventions to cover bigger geographies, but he is right to say that there are some parts of the country where, thankfully, the number of cases is still very low. So the balance between what we do nationally and what we do locally is as important as the balance in terms of what we do overall.

I am sure the Secretary of State will agree that one of the greatest tragedies of the first wave of this dreadful virus was the loss of life in and the impact on our social care sector, and we must learn the lessons from that as we head into a second wave. Given that he has emphasised in the media and in his statement the prioritisation of testing in care homes, could he explain why a number of care homes are still reporting a two-week delay in receiving test results? Will he clarify whether the prioritisation also includes staff providing care in people’s homes?

Care home testing is incredibly important. We have brought down some of the response times, and I am glad to report to the House that since last week, when we debated the very sharp rise in demand, including among asymptomatic people, the demand has come down somewhat, and the pressures are a little lower on the testing system as a whole. That does not mean that we do not want to increase capacity further—of course we do. It is very important that we have tests available for all vulnerable people, whether they live at home or in a care home.

The scientific evidence is that covid is detectable by test within seven days of someone being infected, so why should people who have been made to self-isolate not be tested seven days after a possible infection and released if they test negative?

The incubation period before which the virus can present itself is still estimated to require 14 days of self-isolation. If we could bring that figure down, I would be the first to be pleased to do so. As with our decision to take to 10 days the period for which somebody who has tested positive must self-isolate, this is a critical point, and we must rely on the scientific evidence. If my right hon. Friend has further scientific evidence, I would be happy to look at it.

Does the Secretary of State think that a £10,000 fine will act as a disincentive to poorer people getting a test?

We have put in place the extra £500, in addition to other income that people are getting, to support people on low incomes to self-isolate. If someone who is on a low income has symptoms and wants to know whether they have the virus, the result of having a positive test is that they will get the extra £500, and then of course they have to self-isolate. I am confident that people will come forward and do not only the right thing for society but the right thing for them, to find out the cause of their illness if they have symptoms.

I thank the Secretary of State for the extra £2.5 million for Worcestershire Acute Hospitals NHS Trust and the extra money for the social care system in Worcestershire. Will he clarify what the advice is these days for people who would normally have fetched up at A&E? Is it to call 111 in every instance?

Yes. We are moving to a system where the advice is to call 111 First and then go to A&E, or call 999 if it is an emergency and you need an ambulance. That system will not only help people to be triaged for the right treatment, which may be to see a GP, go to an urgent treatment centre or go to A&E; it will also help the emergency department to know that people are coming. The combination of the two is critical. We are rolling this out over the next couple of months, and we aim to have it in place across the country by 1 December.

Despite what the Secretary of State has said today, we are still hearing myriad stories of people—our constituents—being unable to get tested. The worst story I have heard is from a constituent who was told to travel 600 miles to Aberdeen to get a test. Why is that the case, when we are constantly told by Ministers that there is no problem?

Nobody has addressed the problems and challenges in the testing system more than me. We need to resolve those problems, as we have in very large part resolved the problem of people being sent long distances. I would love to know about the example that the hon. Gentleman cites, because I am told that that problem in the system was fixed last week, and if there is a more recent example, I want to know about it.

I welcome my right hon. Friend’s commitment to the expanding of testing, which is clearly key to identifying the virus and stopping its spread. I direct him to an article in The Times today about private businesses expanding testing capacity. BAE in my constituency is testing almost 6,000 employees on a weekly basis and is keen to expand that into the community. I know that my right hon. Friend has already started to engage on this issue, but I urge him to do everything he can to cut through any red tape, expand such testing as quickly as possible and use every tool at our disposal.

Of course we support businesses and others who want to get tests outside the NHS Test and Trace system; last week we published a paper on how they can go about doing that, and we encourage businesses to do that for their employees. The critical thing is that if people test positive, that data must, by law, flow to Public Health England so that we can do the necessary contact tracing and enforce the isolation that is going to be mandatory from next Monday. We strongly support that sort of action, whether it is taken by employers or, indeed, the University of Cambridge, which proposes to do the same for its students.

Liverpool incidence rates have increased quickly and we are now on the precipice of local lockdown. There has been an increase of 247 cases on the previous week’s figures and the latest weekly rate in Liverpool is now 120 per 100,000, as the Secretary of State mentioned. What additional resources does the Secretary of State plan to provide to Liverpool and other local authorities to assist them in dealing with further localised outbreaks?

The hon. Lady asks an important question. We are putting more testing into Liverpool, notwithstanding the challenges in testing capacity, because it is exactly the sort of place where we need to put that testing. We are also bringing in £500 of support for everybody on a low income who has to self-isolate, whether they have tested positive themselves or are a contact of somebody who has tested positive and have been contacted through NHS Test and Trace. I support the hon. Lady in her work as the local representative to explain to her constituents in Liverpool, Riverside how important it is to follow the rules.

The whole country will recognise the unenviable choices that the Government face at this time. Whatever further measures are in contemplation for the days ahead, may I issue a plea for proportionality? Does the Secretary of State agree that human beings in a free society must have a right to some social contact as they go about their daily lives, even at this difficult time?

I agree with that 100%. We put in place support bubbles for single households—those who live alone—during the lockdown precisely for that reason. I remember having a Zoom with a whole load of people and somebody said, “I haven’t seen anybody in person for four months,” and I thought that could not be good or right. We have put in place support bubbles for single households for that purpose and of course bear such impacts in mind when we take the decisions we take.

I am sure the Secretary of State will agree that we in Kirklees and West Yorkshire are working hard as a team to meet the crisis in these uncertain times, with tens of thousands of students now moving across the country. Will he bear in mind the fact that our system relies on fit and healthy NHS staff? The crisis we are in is getting worse, and if we get a virulent flu virus this winter, which is coming soon, and that knocks out a large percentage of NHS staff, we are going to be in serious trouble. A significant percentage of NHS workers are refusing to get a flu jab; what can we do about that?

The hon. Gentleman and I have occasionally tangled across these Dispatch Boxes, but I wholeheartedly support what he has said and agree with him entirely. It is policy that everybody in the NHS should get a flu jab. The NHS flu programme has already started to roll out and will shortly roll out more broadly. Although it is not mandated this year, I can see no good reason why somebody in the NHS should not get a flu jab, unless they have a very specific clinical condition. We look to all NHS staff to provide leadership in their communities by getting the flu jab. It is free for everybody who works in health and social care and they should get it.

It was brought to my attention by parents this weekend that some Leeds City Council schools in my constituency are telling parents that if their child has an upset stomach or general malaise they need to go home, isolate and not come back to school until they have had a negative test. Does my right hon. Friend agree that that is not NHS England advice, and puts unwarranted pressure on the test and trace system? Does he agree that Leeds City Council should get a grip on this immediately?

I am afraid I do agree. All councils, including Leeds City Council, should make it clear that if students have coronavirus symptoms—and we all know what they are: a new continuous cough, a temperature or a loss of taste and smell—they should come forward for a test. If they have symptoms of another illness—not coronavirus symptoms—they should not come forward for a test. We have set this out very clearly once again in the prioritisation document that we have published today, and I hope that everyone will follow it.

Schools that become aware of a covid-19 case have been encouraged to take swift action and contact the dedicated advice service introduced by Public Health England. However, several primary school heads in my constituency have reported that the service appears to be overwhelmed, with significant delays in Public Health England getting back to schools with advice. Can the Secretary of State tell me what the average waiting time is between a school’s contacting Public Health England and its receiving the advice that it needs?

I do not have those figures, but I would be very happy to look into specific cases, because the speed of turnaround in the instance that the hon. Gentleman describes is very important.

My right hon. Friend and his scientific advisers are absolutely right—the virus is not getting any weaker—but doctors, including many in my constituency of South Cambridgeshire, have made great progress in the treatment of coronavirus, and social distancing means that viral loads are less, making cases less severe for many people. Can he tell me what estimate he has made of the impact of these developments on the fatality rates for those who are affected?

Yes, of course. My hon. Friend represents one of the finest hospitals not just in the country but in the world. The clinicians who work at Addenbrooke’s and across the country have improved the treatment of coronavirus. We know that treatment with dexamethasone has reduced the death rate. We know that, because of earlier oxygenation and later intubation, that has reduced the death rate. There is also progress with remdesivir. Nevertheless, while that has reduced mortality for those going into hospital, the virus remains deadly, so unfortunately we have to take measures to stop its spread, not least because we can either take measures now or we will end up with a much bigger problem, still having to take measures later.

Top-rated medical research has continuously linked vitamin D levels with covid incidence. In Norway, where people have high amounts, cases are rare, whereas here, most Brits are deficient. It is rarely found in food, and the main source—sunlight—is about to disappear, with a possible winter NHS crisis on the way. Will the Secretary of State follow the science, as there is no vaccine in sight, and seek to prescribe supplements on the NHS, or at least run a public information campaign? People need something positive now that the nights are drawing in.

Vitamin D is one of the many things that we have looked into, to see whether it reduces the incidence or impact of coronavirus. I have seen reports that it does, so we put it into a trial. Unfortunately, the results were that it does not appear to have any impact. That is the latest clinical advice, which is always kept under review.

Does my right hon. Friend agree that balancing the measures to tackle covid with the other health consequences, such as cancer patients going undiagnosed or not being treated in time, and the economic and social consequences is a political judgment, and does he further agree that political judgments are improved by debate and scrutiny?

Yes, I do. I come to this Dispatch Box as often as possible. I am very sorry that I was unable to come on Friday to discuss Friday’s decision, but the House was not sitting. I agree with my hon. Friend that, essentially, the more scrutiny, the better; that is my attitude. I am very happy to continue to work with him and with you, Mr Speaker, to ensure that that scrutiny can be done at the speed that is sometimes required for these decisions to be made.

Finally, on my hon. Friend’s substantive point, of course minimising the impact on the economy and on education is critical, but there are impacts on the NHS of covid cases going up—not just the need to try to minimise the negative impact that comes from restricting other treatments, such as treatments for cancer, that happened in the first peak, but the problem of the NHS operating with high levels of covid cases. Within the NHS, a higher number of cases itself has an impact on the care available for all the other conditions that we need to treat, but I look forward to working with you, Mr Speaker, to make sure that we have continued scrutiny.

I am delighted to have just heard the Secretary of State’s previous answer, because, in a former life, he and I both served on the Public Accounts Committee, so I know that he will understand that every taxpayer living in a community facing a lockdown or unable to get a test deserves a straight answer on whether his Department has imposed a financial penalty or withheld payments for the many voided tests undertaken by Randox. Will he give an answer to that question today?

Randox delivers a very significant number of tests every single day—it is a growing number. In fact, it is currently outperforming the allocation that we have asked it to deliver, and I pay tribute to every single person who works at Randox for the work that they have done and the part that they have played in keeping people safe. Everybody who gets a Randox test result, just like every other test result, has more information that they can use to keep themselves safe, and we have more information that we can use to try to keep the whole of society safe.

I thank the Secretary of State for his Department’s allocation to Scunthorpe General Hospital last week. I also wish him well with the ongoing work for some extra funding for Goole and District Hospital. On tests for schools, the feedback I have had from schools in my constituency has been very positive about the 10 tests with which they have been issued. Will he continue to seek to grow that number and look in particular at a lot of the rural schools where getting access to a test is particularly difficult due to transport issues?

Yes, giving 10 tests to all schools across the country has proved very popular, according to the feedback that I have had. I am very glad to hear that that is true in my hon. Friend’s part of the world as well. Of course we will continue that, with the right level of tests being sent out to the right types of schools in the right places, and I will make sure that we take into account rurality as one of those factors.

On Friday afternoon, the Department for Work and Pensions informed Jobcentre staff that, from today, they have to reintroduce face-to-face 10-minute work search interviews with customers. So, Secretary of State, in the light of the rising number of cases and with everyone meant to be playing their part, is this really a sensible approach to be taking?

One of the good things about where we are now compared with where we were in March is that, in many areas, we are better prepared. We are better prepared in the NHS. We are better prepared in social care with the winter plan that we put out last week, and many employers and services, such as jobcentres, have been able to develop covid-secure approaches, which means that they can get on with the things that they need to do. The specifics of the question, of course, are for my right hon. Friend the Work and Pensions Secretary, but the principle of how we, as a society, manage to do more things while keeping ourselves covid secure is one that, thankfully, we have been able to develop over the past six months.

I very much welcome the Health Secretary’s approach not only to save lives, but to protect livelihoods. I acknowledge and welcome his announcement on the new exemption for childcare. Can he confirm what those new arrangements are, and confirm that grandparents and others in my Colne Valley constituency—part of Kirklees, which goes back into local restrictions tomorrow—will be part of that exemption?

Yes, I can confirm that. The exemption means that, for instance, if grandparents look after children to provide childcare, where that is a continuous childcare relationship—that is the legal definition—it will be exempt, in the same way that paid-for childcare will be exempt. This therefore does not allow for people to have children staying with others and, as I said in my statement, parties and play dates. It allows, where a family member or other undertakes unpaid childcare that is akin to paid childcare, that they can be exempted. I know how much many people rely on this to be able to get to work, and I am really glad we have been able to make this progress.

Those of us who represent areas that face additional restrictions as of tomorrow are happy to reinforce the messages, but we need the Secretary of State’s help, don’t we, Mr Speaker? The difference between the instruction of households that they “must not go and visit each other” as opposed to saying they “should not go to the pub together” is one of the ambiguities that my hon. Friend the Member for Leicester South (Jonathan Ashworth) has highlighted right from the start of this crisis. It is an ambiguity that is exploited by the virus, but it is also exploited, sadly, by a small but important minority of people in this country. Will he clear up these ambiguities and improve the chances that everybody will comply with these necessary new restrictions?

The message that the hon. Member should be putting out and that I will set out is that, where we say that people should not socialise outside their household, that is the approach that people should take. He makes a detailed point underneath that, but the top-line message to all his constituents is, no, they should not be socialising with people outside their household.

I have been contacted by a large number of constituents over the weekend who are concerned about the fact that a large minority of people in retail settings are still not wearing face coverings. Most retailers are making sure that they follow the rules and they enforce them, but what support can the Department give, across Government and at local level, to ensure that when it comes to the small minority, we can enforce these rules and ensure, as the Secretary of State quite rightly said, that we are all in this together and we will stop the spread together?

I agree with my hon. Friend that more enforcement is, sadly, necessary to ensure that these rules are followed across the board, because if people follow the rules across the board, it will be easier to get a grip on the virus and the overall impact on the economy and on education, for instance, will be lower. So that is the approach that we are taking both in the example he cites and more broadly.

The Secretary of State spoke about a four-nation approach, but in reality there has not been a Cobra meeting since 10 May. It has taken the First Minister of Scotland to push for this to get a UK-wide Cobra meeting set up, and that undermines the four-nation approach. Does the Secretary of State agree that if we have a four-nation partnership, Scotland needs the powers and the financial levers to be able to implement its own local decisions, such as targeted furlough support for the hospitality and aviation industries, and perhaps help for the areas under local lockdown?

I urge the hon. Gentleman to take a lead from the SNP Front-Bench spokesman, the hon. Member for Central Ayrshire (Dr Whitford). These are very serious times, and since the Prime Minister had a conversation with the First Ministers of all the devolved Administrations this morning, as I set out, and I have regular and frequent engagement with all the other Health Ministers—in fact, I was having a text exchange with my Scottish opposite number just before coming into the Chamber—I think the most important thing is that we take as united an approach as possible. That is the approach that the Scottish Government are taking, and we are working closely with them.

I also welcome the statement that the Secretary of State has brought to the House today, particularly the emphasis he places on fighting this common enemy as one united front. What assurances can he give the House that our care homes will protected, with lessons learned from the first wave of covid-19?

I entirely agree with my hon. Friend. Right across the board, it is critical that we are constantly learning about both what went well and what did not go well. The social care winter plan that was published last week has been developed with the sector. I visited a care home on Friday and heard from the people there about what they have learned about how policy is developed to make sure that we protect people in care homes as much as possible.

Last year, I was faced with every parent’s nightmare as I rushed my small baby to the children’s A&E at the Royal Free Hospital in my constituency because he was not breathing. The doctors and nurses saved his life. The same children’s A&E will now be closed temporarily from next month because of the pressure that covid-19 will put on the NHS over winter. Will the Secretary of State give me a cast-iron guarantee that our local NHS will be given all the resources it needs so that this closure is strictly temporary and the children’s A&E service can be restored as soon as possible?

Of course I would be very happy to work with the hon. Lady on this question. We do have to make sure that our hospitals are covid secure. I would be happy to meet her to discuss the specifics at the Royal Free.

The trouble with authoritarianism is that it is profoundly inimical to civil liberties. It is also increasingly incompetent. It relies on acquiescence, and acquiescence to lockdowns, particularly national ones, is draining away. For instance, if students are told not to go to pubs, they will simply congregate in rooms, which is even worse. If the Secretary of State will not listen to me, will he at least listen to Professor Mark Woolhouse, a professor of infectious diseases? He wrote in The Sunday Telegraph:

“It is profoundly disappointing that six months into this pandemic, having rejected every alternative proposed, we keep coming back to lockdown”.

He suggests—[Interruption.] I am trying to be constructive. He suggests that we rely on encouraging people to look after themselves, to protect the vulnerable and to take responsibility for their own lives. That is the Conservative way.

As a Conservative, I believe in as much freedom as possible consistent with not harming others. One of the sad things about this virus is that because of asymptomatic transmission, if people put themselves at risk of catching coronavirus and get ill, they are not only putting themselves at risk but putting others at risk as well. That is the Conservative principle behind protecting the health of the nation in the face of this pandemic.

The Secretary of State will accept that a near-one-week turnaround for tests for people working in our care homes is not looking after our elderly. Can he be precise: when will we get the 24-hour turnaround that we must have if we are to keep the elderly safe in those homes?

We have protected the number of tests in care homes. The challenge is that when the system is running hot and the number of tests going through is very close to capacity, that can have an impact on turnaround times. We have seen that in the past couple of weeks. Thankfully, those turnaround times are coming down again, as well as our managing to protect the over 100,000 tests a day that go to social care. While some people may call for other areas to be prioritised—for instance, the testing of children—the most important thing is that we protect those who are most vulnerable to this virus, and the most vulnerable live in our care homes.

I know the Secretary of State is very keen to get more tests. SureScreen in my constituency has developed an antigen test that is ready in 15 minutes. It will be able to ramp up its production to 1 million by November, rising to 2 million a week. Will he please look at its test and make use of this expertise? I think that he will be going to a Cobra meeting tomorrow, so will he explain to the Prime Minister that we live in a democracy, not a dictatorship, and we would like a debate on this in this House?

There absolutely will be a debate in this House on the measures that we have to use. We have to move very fast, and I am very happy to talk to my hon. Friend about SureScreen in her constituency.

In south Wales, Caerphilly and Rhondda Cynon Taf are in local lockdown, and people in those boroughs cannot leave to go on holiday. Those areas will be joined by four others tomorrow evening. The Welsh Government have said that those would-be holidaymakers should have a full refund if they are prevented from going on holiday. Will the Secretary of State say emphatically that those people must have a full refund of the cost of their holidays, as a policy of central Government?

I am very happy to work with the hon. Gentleman and others to make sure people get the fair treatment they deserve.

At a time when we do not yet have the world-beating track and trace system or enough tests because of logistical problems, why are the Government excluding senior military commanders from key decision making and preventing them from bringing to bear their logistical capabilities?

On the contrary, the military’s support has been absolutely brilliant in expanding the testing system—test and trace—and it is engaged in the development of our vaccine roll-out plans. The work that senior military personnel have done is absolutely first rate.

My constituency of North Norfolk, and Norfolk more widely, have seen some of the lowest infection rates in the entire country thanks to the dedication and sacrifice that many people have made in my area. Can the Secretary of State assure me that any further major national restrictions will reflect the low levels of infection in constituencies such as mine?

My hon. Friend makes an important point. He represents the oldest constituency in the country, so this is an important matter for him and his constituents. It comes back to the central point that it is critical to get the right balance between the measures we take nationally and those we take locally, according to local rates of infection.

There will be a number of relieved parents in my constituency because of the change in informal childcare arrangements. I have spoken to primary and secondary headteachers across Gateshead, and it is clear that their difficulty in obtaining tests and getting results quickly is causing real disruption for schools and not allowing them to take swift action to stop onward transmission. I note that the Secretary of State listed teachers in his statement, but will he do more to ensure that tests are available for teaching staff and that results are available more quickly?

Of course I am working to exactly that end. If somebody has the symptoms of coronavirus, they should self-isolate even if they cannot get a test. I understand how frustrating that is, and I am working as hard as I can to try to get those turnaround times as fast as possible.

The self-isolation support payment of £500 comes into force next Monday for those on lower incomes who cannot work from home and stand to lose income. Of course, it is being distributed through local councils in England. Given that local government is a devolved matter, has my right hon. Friend had conversations with the Welsh Government about replicating the policy in Wales?

Yes, the UK Government will be providing the funding so that the devolved Administrations are able to put similar support in place. My right hon. Friend the Chancellor of the Duchy of Lancaster spoke to the First Minister of Wales over the weekend to ensure that in Wales people can get the level of support that we are introducing in England.

The Secretary of State is quite right: these are serious times, and we require serious answers, so can he answer the following? It has prioritised VIPs over the public; it has a failure rate of over 90% on testing targets; it has the highest voided tests of any lab, including 12,401 in a single day; it has Conservative MPs on the payroll; and it was found by the National Police Chiefs’ Council to have committed the most serious breach of standards by manipulating forensic tests. Why, then, was Randox Laboratories judged an appropriate company to be handed a £133 million contract to the exclusion of all others—or will the Secretary of State again resort to a churlish response, proving that the rules do not apply to this increasingly lawless Government?

I implore the hon. Gentleman to support all those who are working so hard to deliver the tests that people need. Every other question on testing is, “Can we have more tests, please?” and we hear stories about just how much these tests are needed. I think we should be there supporting the people who are doing the testing.

My right hon. Friend has many invidious choices to continue to make, but, further to the question from my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), let me say that the wider health implications of covid-19 cannot be overstated. They include delayed cancer diagnosis, missed stroke and heart attack treatments, and the cancellation of elective surgery. Will my right hon. Friend therefore confirm that the Nightingale hospitals will be brought back online to minimise impacts on wider healthcare?

The Nightingale hospitals are there, ready to go if they are needed. They are currently mothballed and can be reopened very rapidly. We are working incredibly hard with the NHS to ensure that, this time around, there is the absolute minimum disruption to other treatments, but of course the first, best minimisation of impacts on other treatments is not to have a sharp rise in the number of people going to hospital with covid. Our plan learns from what happened before. Of course there is the much more widespread capability for testing, both in the NHS and outside, thanks to the hard work of companies such as Randox and others. That means that we will be better placed than last time to keep the rest of the NHS running, but it does not mean that we can rest easy in terms of rising cases, because of course the easiest way for the NHS to operate is to keep covid cases low.

Over the weekend I have been listening to headteachers from around the south Lakes, who tell me that they are under increasing pressure, with teaching staff, teaching assistants and others off work, struggling to book a test slot. Some have been advised to travel as far as Brighton, a 10-hour round trip, and some pupils are off school for 10 days waiting for a test of their own. Our teachers are doing their job brilliantly. Is it not time that the Government did theirs and provided a testing scheme that works?

I would be very interested in the examples, especially of people being sent long distances, because, as I said earlier, the information I have been given is that that problem has been resolved. I am working incredibly hard to resolve all the other problems and to bring to bear the record testing capacity that we have.

Again, I support my right hon. Friend and his statement today, but I echo calls for what comes next to reflect the reality on the ground in areas such as mine, where rates are way down on the England average. Linked to that, as we move into what is clearly the next phase of this battle, will he look at a much more devolved and decentralised test, track and trace system? I think “keep Winchester safe” will have much more cut-through with my constituents, and that is surely better managed in Hampshire.

Yes. We need the scale of the national system and the resonance of the local system and the local knowledge. We are increasingly driving things in that direction, and I would love to talk to my hon. Friend, who is incredibly knowledgeable in these matters, to see what more we can do.

I thank the Secretary of State for his and his officials’ incredible efforts over the last few days that have meant he was able to make the statement today that informal childcare will sit alongside formal childcare to allow those selfless grandparents across the north-east and elsewhere where local restrictions have to be brought in to make sure, out of the goodness of their hearts and the love of their families, that their sons and daughters can go to work—often low-paid, seasonal work with difficult hours. I thank him for that. Does he also agree that it is for all of us to be selfless, not selfish, as we try to get to grips with the second wave?

That is a good point on which to end, because my right hon. Friend has worked incredibly hard over the last four or five days to try to ensure that we find a way to protect people who use informal childcare without unnecessarily harming others by widening the exemption beyond what is needed. It is important to control the virus and keep listening to people as to how best to do that, and she has helped enormously. Her final point is critical, which is that we all have a role to play in taking seriously the rise in cases and hospitalisations that we have seen and making sure that we are all doing our bit to control coronavirus.