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Commons Chamber

Volume 681: debated on Tuesday 6 October 2020

House of Commons

Tuesday 6 October 2020

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

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

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

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

Cancer Outcomes

The NHS’s recovery approach is restoring urgent cancer referrals and treatment to at least pre-pandemic levels and building capacity for the future. Latest data from July suggests that urgent two-week-wait GP referrals are back to over 80% of pre-pandemic levels.

I thank my right hon. Friend for that answer, but does he agree that if we are to deliver better outcomes in cancer and all areas of care, our clinicians need the best possible infrastructure? Is not that why it is so important that the Prime Minister confirmed last week that we will deliver our manifesto pledge of 40 new hospitals? Does my right hon. Friend share my delight at seeing on that list a new rebuild for West Suffolk Hospital, to deliver even better outcomes for our constituents?

Yes, I do. I share my hon. Friend and neighbour’s enthusiasm for the rebuild of the West Suffolk Hospital. For treating both patients with cancer and patients with all other conditions, the West Suffolk is a brilliant local hospital that is much loved in the community; however, its infrastructure is getting very old and it needs to be replaced. I am delighted, along with the Minister for primary care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), in whose constituency the hospital is and will be rebuilt, that we are able to make the funding commitment and get this project going.

I understand that we continue to requisition private hospitals. Given that there are patients who are nervous about attending hospitals, could those be used as covid-secure environments for cancer analysis and treatment?

Yes, absolutely. The private hospitals of this country have played a very important role in responding to covid, and we have a contract with them to be able to continue to deliver much needed services, including cancer services. Because by their nature they rarely have the pressures of emergency attendance, we can ensure that they are part of the green part of the health service—that they are as free as is feasibly possible from coronavirus—and therefore safe to carry out all sorts of cancer treatments. They are an important part of the recovery plan.

In my constituency of Stoke-on-Trent Central, patients being treated for cancer at the Royal Stoke University Hospital were relocated to Nuffield Health in Newcastle-under-Lyme. That is an example of practical measures that hospital trusts across the UK have taken to limit the spread of coronavirus since the outbreak in March. As we approach the winter pressures on the NHS, will my right hon. Friend outline the precautions the Government are taking to ensure that cancer patients’ treatments and appointments are not put to the back of the queue and do not suffer from undue delays?

My hon. Friend makes an important point. The Royal Stoke Hospital has performed brilliantly during coronavirus, and I thank everybody who works there for the efforts that they have gone to. It is critical for everybody to understand that the best way to keep cancer services running is to suppress the disease; the more the disease is under control, the more we can both recover and continue with cancer treatments. I believe that it behoves us all to make the case that controlling this virus not only reduces the number of deaths directly from coronavirus, but enables us as much as possible to recover the treatment that we need to for cancer and other killer diseases.

Following an online meeting with the manufacturer, I am excited to visit the Royal Surrey County Hospital on Friday to see up close the robotics that are used in many soft tissue cancer operations. Does my right hon. Friend agree that these clever robots, operated by talented surgeons, help to reduce the size of the incision site and therefore trauma, meaning a swift discharge and recovery for cancer patients, and that they are crucial to ongoing success in hospitals such as the Royal Surrey, which is a world leader in cancer treatments?

I know the Royal Surrey and I enjoyed visiting it, albeit in the rain, in December last year with my hon. Friend. The Royal Surrey is carrying out some of the most cutting-edge treatments for cancer. We have put extra funding in—a more than £200 million fund—for the use of advanced technology for treating diseases such as cancer, and she will have seen that I announced to the House yesterday that we are engaging with the best regulators around the world as we leave the European Union to ensure that we get cancer treatments to the frontline as fast as is safely possible.

York Hospital, like a lot of others, experienced a fall in cancer referrals at the height of the pandemic as a result of residents having stopped going to consult their GP. There is real concern among health professionals in York about the knock-on consequences of that and the rise in the backlog of cancer referrals locally. What steps can the Secretary of State bring forward to assist NHS trusts such as York’s to ensure that the backlog does not lead to late diagnosis of cases, worsening cancer outcomes?

My hon. Friend raises a very important point. As I mentioned in response to the first question, we now have referrals back up to over 80% of pre-pandemic levels, but we need to get that up further, because we all know that early diagnosis saves lives. I am also very glad to be able to report that in July, on the latest data, over 90% of patients saw a cancer specialist within two weeks of a referral from a GP, and 95% of patients receive treatment within 31 days of a decision to treat, so those referrals are leading to the action that is necessary. It is very important that the message goes out that the NHS is open, and anybody with a concern over cancer should come forward and they can get the treatment in a safe way that can help to save their lives.

In June’s departmental questions, I pressed Ministers on the cancer backlog that has grown so greatly under covid, so it was alarming that despite those ministerial assurances, between August and September, with infection rates being much lower than they are today, the waiting list to see a specialist grew by 16%. Things will only get harder now that infection rates are rising and with the NHS facing winter pressures, so will the Secretary of State give us a categorical assurance that he has a cancer recovery plan, and that it will drive down the waiting lists each month for the rest of the year?

Yes, absolutely. I think we agree right across the House on the importance of this agenda. The first and most important part of it is to bear down on the long waits, because the longer that people wait, the more dangerous cancer can become. That is happening, and we also have to make sure we bring the referrals forward, because we do not want to have fewer people referred for the diagnostics. At the same time, we are expanding the diagnostics that are available, both in hospitals and increasingly in community hubs, which are safer from a covid point of view and, for the long term, will mean that diagnostic centres for things such as cancer can perhaps be on a high street or in the places where people live, so that they do not necessarily have to go to a big, acute hospital to get the diagnostics part of the pathway done.

Non-covid Treatments

What steps he is taking to ensure that patients with illnesses other than covid-19 can access the treatments and procedures that their diagnosis requires. (907100)

It is vital that non-covid treatments are restored as quickly and safely as possible. That is what the NHS is doing. It is working to have them restored, by October, to around 90% of last year’s levels.

Thankfully, children are relatively robust in the face of coronavirus. However, children’s services, like other hospital services, were understandably reduced during the pandemic. What is my hon. Friend doing to ensure that paediatric services are now 100% up and running and will not be affected by a future wave of the pandemic? What is he doing to support NHS trusts in dealing with the backlog of appointments delayed by the coronavirus?

I pay tribute to my hon. Friend for her service to her constituents both as their MP and as a paediatric clinician. She is right to raise this important issue. Restoration guidance has already been published by NHS England and NHS Improvement, setting out a framework to fully restore services in this area, which I agree is vital. I would be very happy to meet her to discuss this further.

Mental Health Support in Schools

What recent discussions he has had with the Secretary of State for Education on allocating additional resources for mental health support in schools. (907101)

We are working closely with the Department for Education to support children and young people’s mental health, and we remain committed to implementing the proposals in the children and young people’s mental health Green Paper putting mental health support teams in schools and colleges, otherwise known as trailblazer schemes.

Schoolchildren have had their education interrupted. They have been separated from their friends and face continual threats to their daily lives. The Government knew schools were to return. Why did they not put adequate measures to provide mental health provision in schools for students and teachers?

I am afraid I have to say that, actually, the opposite is the case. We have just completed the wellbeing for education return “train the trainer” scheme. The trainers have been trained by the Anna Freud Centre and are ready to go out into schools across the country. It was always the position that schools should be open and the best place for children to receive help and support, for exactly the reasons that the hon. Member described: separation from their routine and their friends, and school being a place of safety.

Train the trainer has now completed. The Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), and I worked hard on that over the summer to ensure that the £8 million was there and the training was in place, ready to provide mental health and wellbeing support to children when they return to school. I am pleased to say that the last “train the trainer” scheme happened last week, and those involved are now ready to move into schools across the country.

It has been six months of uncertainty for our country’s children and their parents, with schooling cancelled, the exam results fiasco and now students trapped in uncertainty in their university accommodation. Despite the Education Secretary recognising that there was a serious impact on young people’s mental health, yet again it seems that the Government have no plan. Children and young people are being failed. When will the Minister finally address the pending mental health crisis in our schools, colleges and universities?

I just do not recognise the picture that the hon. Lady has presented. We are investing at least £2.3 billion in mental health support and mental health provision. That investment translates to 345,000 children and young people who will be able to access mental health support via NHS-funded health services and school-based mental health support teams. Spending on children and young people’s mental health services is growing faster than the overall spend on mental health, which itself is growing faster than the overall NHS budget. Children and young people’s mental health is our priority, and we are showing that by investing in it. The picture that she paints is, I am afraid, completely not the case.

NHS Test and Trace

NHS Test and Trace launched in May. Four months later, more than 150,000 people who have tested positive for covid-19 have been contacted, and 450,000 of their contacts have been reached so that they can self-isolate. We have tested more than 7 million people at least once and many, such as care home workers, more than once. Rapid expansion brings with it challenges. Working with local authorities, we will continue to improve test and trace, as it is an important part of our armoury to defeat this virus.

As a co-chair of the all-party parliamentary group on adult social care, I meet weekly with a working group drawn from across the care sector. Providers on that group report that they are still experiencing delays in receiving weekly test results, still have no routine access to weekly testing for domiciliary care workers or staff working in supported living environments and urgently need regular testing for family members to alleviate the terrible isolation of care home residents from their loved ones. When will the care sector have all the access to testing that it needs on a reliable basis to stop the second wave of coronavirus delivering the utter tragedy and devastation of the first to the care sector?

I thank the hon. Member for her question and for the work that she does with the APPG, which I joined recently for a very valuable conversation. Supporting care homes through the pandemic and in the months ahead is absolutely our, and my, priority. One part of that is ensuring that they have the testing that they need. We are getting regular repeat testing to care homes. I acknowledge that the turnaround times have not been what we would have liked them to be, but those turnaround times are coming down and we are seeing a rapid improvement in performance.

This week, the president of the Association of Directors of Public Health said that the funding is just not there for local authorities to effectively run local contact tracing. Where it has been done, at a cost to the local authority, evidence shows that local teams were more likely to be successful in contacting people compared with the national tiers 2 and 3. Can the Minister tell me why the Government keep insisting that the current track and trace system is working when public health professionals are telling them the opposite?

I thank the hon. Member for her question. I am sure she will know that local authorities received £400 million to support them with local outbreak management. It is really important to have this coming together of the national system and the local system, where local authorities are indeed playing an important part, using their local knowledge to follow up with contact tracing, particularly for some of the contacts that are proving harder to reach.

Schools in my constituency are having to close, disrupting children’s education and the work of their parents. Serco’s test and trace has been an unmitigated disaster. It is more than an extraordinary waste of public money; it is a public health crisis. To make matters worse, Ministers signed off on a wholly inappropriate Excel spreadsheet, blowing billions and leaving thousands of contacts untraced. When I asked the Secretary of State last week when he was going to take personal responsibility, he simply boasted that the system was working brilliantly. When does the Minister think her boss, the Secretary of State, will begin to take personal responsibility for this fiasco?

There was quite a lot in that question. One thing I will say on schools is that enabling our children to continue to go to school is very much part of the whole strategy that we are using to tackle and suppress coronavirus, because education is so important. On the specific test and trace system to which the hon. Member refers, the Secretary of State spent an hour and a half in the Chamber yesterday answering colleagues’ questions about the performance of that system.

In the light of the fact that infection levels in York have risen from 63.1 cases per 100,000 to 143.9 cases per 100,000 in just the past seven days, the local public health team is working with the university and local labs, and together they have put together a programme where they can test, process the testing and do contact tracing. This is a testing service that works for York, with test results the next day and tracers who understand local population flows. Will the Minister put the necessary resources in place to enable them to do their work and allow this to happen, because this is surely the game changer we need to beat this virus?

Well, it is very good to hear of the set-up in York that the hon. Member describes, and what I can do is take away from here and follow up to ensure that there is joint working, which we know is a really effective way to bring together national resources with the local resources, expertise and knowledge that are so important in tackling this virus.

With covid, speed is of the essence, but people are struggling to get a test due to limited capacity at the Lighthouse labs. New labs were due to open in Newport in August and in Loughborough last month, but both are delayed. As NHS labs are having to take on more testing, can the Minister say what additional funding will be provided specifically to increase NHS lab capacity?

The context is the huge increase in the testing capacity of our system that we have already seen, going from in the order of 2,000 tests a day back in March to well over 200,000 tests a day now and building up to 500,000 tests by the end of this month. I recognise also that there is both the Lighthouse labs—what is known as pillar 2 testing system—and the important part that NHS testing facilities play in the pandemic. And of course the hon. Member will know that a huge amount of money has been and is going into the NHS to support its response to covid.

Scotland’s public health-based tracing service has reached over 95% of contacts, yet four months on, the Serco system in England has still only reached 61%. As finding contacts and getting them to isolate is critical to reducing covid spread, should not tracing in England now be based more on local public health teams?

It may be helpful to say that, since the NHS Test and Trace system started, it has contacted 78.5% of those who have tested positive, and then 77% of their contacts have been reached. There is an important part of the system where the national contact tracers are handing over to local authority contact tracers who are able to access the same system and are supported in contact tracing but, critically, are also using their local knowledge of the local area to increase the success rate. It is really important that people are reached wherever possible and advised to self-isolate.

May I also say how much I appreciate and thank all those who are doing the right thing by self-isolating, both those with symptoms and those who have been contacted by contact tracers?

I am not going to ask about the current problems with test and trace, because it is clear from what we have heard already that the Government have no answers on that. Instead, I will ask about the so-called moonshot tests and Dido Harding’s comments that some people will have to pay for them. When the Prime Minister was given a chance in the Chamber, a fortnight ago, to deny that was on the table, he did not take it. We have real concerns about creating a two-tier system for tests where some people have to pay. It undermines a fundamental principle of the NHS and will do nothing to stop the spread of the virus. Will the Minister give us a definitive answer today? Are some people going to have to pay to access the moonshot tests, yes or no?

I do not recognise the hon. Gentleman’s suggestion that there could be a two-tier system. What we have in place is a universal system where everybody who has symptoms is able to access a test. As he well knows, where we know there are particular risks, such as for those in care home settings, there are also tests for those who do not have symptoms so that we can pick up outbreaks early. A huge amount of resource and investment is going into developing new technologies for testing—easier testing, quicker tests and tests that can be done at greater scale—because this is all part of building up our testing capacity, so we can suppress this horrid virus.

Education, Health and Care Plans

What discussions he has had with the Secretary of State for Education on ensuring that education, health and care plans are linked effectively with the healthcare system. (907104)

Education, health and care plans identify the support needs of children and young people across those three areas. Local authorities and health bodies are required to jointly commission the services. The Government are currently undertaking a review of the special educational needs and disability system, and I am working on this with my ministerial counterpart in the Department for Education.

I thank the Secretary of State and Ministers for their focus on Dorset County Hospital in the recent investment announcements, but in my West Dorset constituency, I have totally unacceptable waiting times of up to two years for EHCPs for children and their parents. That is totally unacceptable. They face the most difficult of situations and, I am afraid, are losing hope. Will the Minister help me in supporting these desperate children and parents who need to get their EHCPs done?

My hon. Friend makes an important point about how we need to see children and young people getting in place, as soon as possible, the support that can help them and about how there are waiting times for these plans. There are two things I can say in response. First, in the context of covid, NHS England has made it clear to NHS organisations that they must restart and restore services that support children and young people with EHC plans and in the assessments for those plans. Secondly, in the review of the SEND system, we are indeed looking at how we can address some of the problems in the system and achieve better integration across health, care and education.

Breast Screening

Women at greatest risk of breast cancer continue to be prioritised for screening. The NHS has worked hard and has significantly reduced the backlog of delayed breast screening appointments from over 468,000 in June to under 52,000 in September. All services have now been restarted and, in Breast Cancer Awareness Month, the message is clear: when you get a screening invite, please attend; if you are worried about anything, contact your general practitioner.

Breast screening appointments were paused during the height of the pandemic. Breast Cancer Now has estimated that 986,000 women across the UK missed their mammograms, and it estimates that, as a result, there could be 8,600 women living with undetected breast cancer. With this being Breast Cancer Awareness Month, what steps is the Secretary of State taking to address the gaps in specialist breast cancer nurses recently highlighted by Macmillan Cancer Support?

I thank the hon. Lady for her question. Cancer nurse specialists are a particular interest of mine, and the long-term plan identifies that everybody deserves to have personalised care from a cancer nurse specialist. We did see the rate decline from 91% in 2018 to about 89% in 2019, and we are focused on making sure that everybody has a cancer nurse specialist. We promised it in the long-term plan and it is our ambition to deliver that personalised care to every woman. As I have outlined, the backlog of breast cancer screening has gone down but, again, I urge women who are called for screening to come forward. It is safe and, as with me, it could make all the difference.

Local Restrictions: Reducing Covid-19 Transmission

What assessment he has made of the effectiveness of local restrictions on reducing the rate of transmission of covid-19. (907107)

What assessment he has made of the effectiveness of lockdown restrictions on limiting the second wave of covid-19. (907108)

What assessment he has made of the effectiveness of local restrictions on reducing the transmission of covid-19. (907115)

I chair the Government’s local action gold committee, which considers the latest data and advice from experts, including epidemiologists and the chief medical officer, and the Joint Biosecurity Centre. Through this process, we consult local leaders and directors of public health. We have seen local actions in some parts of the country bring the case rate right down and we need to make sure that we are constantly vigilant to what needs to happen to suppress this virus.

Yesterday, the Health Secretary told me:

“we have been putting the extra money into…councils”—[Official Report, 5 October 2020; Vol. 681, c. 637.]

What money is that? He announced £7 million, split between nine councils, as compared with £12 billion for Serco. That is not putting the extra money into councils, is it? So may I ask him to show respect for Members of this House and, more importantly, for our constituents, and answer the question: when is he going to stop relying on the outsourcing giants and to support local public health teams with the funds they need, because that is how he and this country are going to fix test, trace and isolate?

We are, as the hon. Gentleman said in his question, putting money into local councils in areas where local action needs to be taken. We have an open dialogue with councils and local mayors about what needs to be done. But I urge him, on behalf of all of his constituents in Sefton, that it is better to support the whole effort to control this virus, not just part of it.

The Mayor of London has warned that the virus is now spreading widely again across London, although vital knowledge is being hampered by the problems with test and trace. Are the Government now looking at introducing wider restrictions across London? As a matter of interest for this House, will the Cabinet Secretary, as a part of that, commit to reintroducing a hybrid Parliament in such a situation?

I discuss these matters with the Cabinet Secretary and other colleagues across government all the time, and I also speak regularly to the Mayor of London. We maintain vigilance over the transmission of the virus right across the country.

Can the Secretary of State answer a very simple question: what rate of infection means that a local authority needs to go into local restrictions and what rate means that it can leave them? Of course I accept that there will sometimes be very specific circumstances, such as workplace outbreaks, that would need to be considered, but surely it is not beyond his level of competence to do both, because my constituents deserve to know when they can see their families.

Of course the hon. Member’s constituents and all those who are under local action restrictions yearn to see their families. We all yearn to be able to get back to the normal socialising that makes life worth living, but I am afraid that the answer to her question is in the question: because of specific local circumstances, such as outbreaks in a workplace or a halls of residence, it is not possible to put a specific number on the point at which a judgment is made to put in place local restrictions, which we do in consultation with the council, or to take an area out of them.

Student Lockdown: Access to Care

What steps he is taking with the Secretary of State for Education to ensure that university students with (a) cystic fibrosis and (b) other long-term health conditions who are required to self-isolate on campus as a result of the covid-19 outbreak have access to essential (i) medication, (ii) dietary provision and (iii) medical care. (907109)

Universities have a duty of care to support students who are required to self-isolate. The Department for Education is working with universities to make sure that where an outbreak occurs, support is in place. That includes ensuring that students with cystic fibrosis and other long-term health conditions who are self-isolating have access to the food, medicine and medical care they may need.

Self-isolating students throughout the country, and their understandably worried parents, are reporting problems with accessing food, drinks, exercise and other support. That is completely unacceptable for any student, but for those with cystic fibrosis, who often need high calorie requirements to stay well, access to regular food supplies is absolutely essential for their health. What is the Minister doing to ensure that students with CF who are required to self-isolate at university and have previously shielded are able to access priority supermarket delivery slots? Many will have relied on their parents’ accounts when they were at home. What other action is she taking, in partnership with universities and the Department for Education, to ensure that every student with CF who finds themselves in lockdown is supported on their healthcare needs?

The hon. Lady asks a really important question. Clearly, it is a difficult time for students starting university now, but particularly for those with long-term health conditions such as cystic fibrosis. Overall, as she knows, the context is that we are prioritising education. We do not want students to put their life on hold, but we do want them to be supported by their university, particularly if it is harder for them to self-isolate because of health conditions. I am in regular contact with the Minister for Universities and will take up with her the specific questions about support for students with cystic fibrosis and access to supermarket deliveries. If the hon. Lady would like to raise any specific case with me, she should let me know and I will take that up with the Minister for Universities to address the specific issues.

Covid-19 Laboratory Testing Capacity

As part of the drive towards the capacity target of 500,000 tests a day by the end of October, we have announced additional Lighthouse labs as part of the national lab network, and work is ongoing to expand the UK’s lab capacity inside the NHS.

The Lighthouse labs do not appear to be delivering sufficient test results. Schools and care homes in my constituency are still having to wait an unacceptably long time for covid-19 test results, and the delays are making it difficult for them to operate properly. What is my right hon. Friend doing to make better use of the many life science companies in Kent, including those at Discovery Park in Sandwich and at the Kent Science Park in my constituency of Sittingbourne and Sheppey? Those companies have laboratories in which some of the tests taken in Kent could be analysed.

We are increasingly contracting with labs like the ones my hon. Friend mentions—as well as the Lighthouse labs, which have huge capacity—to make sure that we can both increase capacity and reduce the turnaround time. I am glad to say that the latest figures for the past week showed that the turnaround time is coming down, which is important in Kent and right throughout the country.

Mental Health Service Provision

What steps he is taking to equalise the provision of resources allocated to mental health services for (a) children and (b) young adults. (907112)

As I said in an answer to the hon. Member for Tooting (Dr Allin-Khan), we are committed to spending on children and young people’s mental health services, which is growing faster than the overall spend on mental health, and the overall spending itself is growing faster than the NHS budget.

See, Hear, Respond, a new service managed by Barnardo’s in response to covid-19, to provide early intervention support for families and children in crisis, has received more than 11,000 referrals since June. The majority of children and young people referred need support for their mental health and wellbeing. What early intervention measures have been introduced? Are they enough? Does the Minister agree that early intervention measures are key to tackling the increase in children and young people’s mental health and wellbeing needs?

I could not agree with the hon. Gentleman more. The Government’s £8 million Wellbeing for Education Return programme, which is to support staff to respond to the emotional, mental health and wellbeing pressures that some children have experienced during the pandemic, is in place. As I have said, the last train the trainer session took place last week and those trainers are ready to go into primary schools to assist both teachers and parents to recognise when children display early signs of emotional distress or mental health issues as a result of the pandemic. I have been working closely with the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), to ensure that this programme is in place to address exactly the needs that he has highlighted.

Long Covid

I am sure that the right hon. Gentleman would welcome yesterday’s announcement that the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network will work with the Royal College of General Practitioners to develop guidelines to support patients and practitioners in the treatment of and recovery from the disease. This follows on from the NHS launch in July of the Your COVID Recovery service, which provides personalised support for individuals. In addition, we are funding research into covid-19, including a study of 10,000 patients who were admitted to hospital with covid, building our understanding of the long-term effects and helping direct those improved treatments that are needed.

I thank the Minister for that helpful and comprehensive answer. If she has not already read it, may I commend to her the most recent edition of The Doctor, the British Medical Association magazine, which outlines several compelling case studies of GPs who are still suffering, some up to six months, after they first contracted covid? There is a growing body of evidence that a number of people continue to suffer with this months after it has been contracted, in a quite debilitating way. Will she build on the work that she is already doing and make the case to the Treasury and the Department for Work and Pensions in particular to ensure that all those who suffer from long covid get the support that is necessary for them?

I thank the right hon. Gentleman for that statement and I will read the document that he mentions with interest. It is a new disease on which we are still gathering evidence and data, so that we know how we can best support the individual in their recovery and, arguably, in their new covid-tinged life. I assure him that that is precisely what I shall be doing—looking at the evidence base and making sure we work with the colleges and general practitioners to ensure that we get the right answers.

Adult Care: Covid-19

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907119)

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907120)

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907127)

We have sweated blood and tears to support the sector through this pandemic. Last month, we launched the adult social care winter plan, with regular testing for care home staff and residents, free personal protective equipment and mandatory infection prevention and control measures for care providers, supported by £546 million of Government funding. I am enormously grateful to all those on the frontline in social care. I recognise the challenges that they have faced and how many feel daunted by the winter ahead. I say to care workers: “I cannot thank you enough for what you do and I am with you every step of the way.”

I have been contacted by Ann Penrose, who is 91, in good health and in a care home in Ashbourne, Derbyshire Dales. She asked her family to contact Boris, but sadly she got me. Does the Minister agree that the time has come to look very carefully at what is happening in care homes to review the existing measures, routines and guidelines, bearing in mind that we are testing so much now? We need to have a bit more humanity. We are in danger of throwing the baby out with the bathwater. These people need their families, yes, in a safe environment, but they do need to have access to families and, at times, to their pets.

My hon. Friend makes an important point about the importance of visiting both to the individuals living in care homes, and to their family and friends. Achieving the balance between protecting care home residents from the risk that covid might be brought into the care home, where it is so hard to control, and giving them access to visitors, has been one of the hardest areas to get right over the past few months. That is why in the summer we issued guidance on safe visiting and gave more freedom on the decisions about visiting to local authorities, with directors of public health working with care homes. I want us to continue to support and enable safe visiting for care homes.

Order. We have to get through this grouped set of questions, and it is going to take us well into topicals time; the Minister really does need to speed up on the answers.

I thank the Minister for the social care winter plan announced two weeks ago. Can she tell me when this half a billion pound infection control fund will be released to councils covering constituencies such as mine in Congleton, in order to help protect residents and staff over the winter?

The infection control fund is being distributed in two equal instalments, the first of which has already been paid to local authorities. My hon. Friend’s local authority, Cheshire East Council, will be receiving £4.7 million in total, so it should already have received £2.35 million to go towards the extra costs for care providers and others in infection prevention and control.

As always, I commend the Department and the Secretary of State on their work during the pandemic. Although not every part of the response has been perfect—and we never expected that it would be—I am convinced that the Department has done its utmost to protect the public. I do have some concerns, however, about the transmission between care homes. What measures has the Department taken to prevent cross-contamination of covid between care homes, particularly from staff who work in multiple locations?

I thank my hon. Friend for his comments, but most of the credit should go to those working in social care, who have been looking after some of the most vulnerable people in our society in such difficult circumstances. He is right that it is really important that we ensure that there is no transmission between one care home and another, which is why we are requiring care homes to make sure that their staff work in only one setting and are providing additional funding to enable them to do this.

Care homes are rightly the focus of our attention at the current time, but I know that the Minister is reviewing the future of social care. Does she agree that our focus in that regard should be on more community-based services, not solely on residential provision? Will she also set my mind at ease by ruling out the creation of a new national care service run from Whitehall?

First, may I congratulate my hon. Friend on his recent report on levelling up our communities? As he said, care homes have indeed been the focus of our social care response to the pandemic, but I would not want anyone to think that that was the limit of our support for social care during the pandemic; the winter plan also includes support for domiciliary care, supported living and others. I agree with him that as we look to the future, we should support the aspiration that most people have to live independently, with their own front door, well into their old age. There are no plans to create a national care service run from Whitehall.

Families with loved ones in care homes are desperate to start visiting again, but are banned from doing so in swathes of the country with extra restrictions. The Government’s own carers advisory group says that visits are essential for residents’ health, and that, to make them safe, relatives should be treated like key workers—with regular testing. Will the Minister now please put that testing in place and lift the blanket ban on care home visits in lockdown areas, so that we can help to bring all families back together again?

The hon. Member makes an important point, as did my hon. Friend the Member for Derbyshire Dales (Miss Dines) a moment ago, about the importance of visiting for those in care homes, and for their relatives and loved ones. We are striking the difficult balance between protecting those in care homes and ensuring that they have visits wherever possible, but these visits must be done safely. I have heard from the sector about the aspiration for some family members to be treated as care workers—for instance, if they visit the care home regularly. As we expand testing, I very much intend that we should test some visitors—and am making the case for doing so—but it is all part of how we expand and use our testing resources.

Topical Questions

On Friday we confirmed the 40 hospitals we will build by 2030 as part of a package worth £3.7 billion, with a further eight new schemes also invited to bid, all to ensure that we protect the NHS long into the future.

All I want from the Secretary of State today is a simple yes or no answer. It has come to light that the Northern Ireland authorities have taken unprecedented action and committed to pay for private prescriptions for medical cannabis for severely ill children. Will he do the right thing and follow the example set in Northern Ireland in supporting other children with intractable epilepsy by paying for their private prescriptions—yes or no?

The hon. Lady has long been a campaigner on this subject. We have made significant progress in terms of expanding access where it is clinically safe to do so. On this, as on so many things, I will make sure that I constantly follow the clinical evidence.

My right hon. Friend knows that for every person who tragically dies from coronavirus, at least one other person has long-term symptoms lasting more than three months, meaning that they have breathlessness and chronic fatigue and often cannot go back to work normally. In his letter to me of 14 September, he said that clinics were going to be set up so that they could get mental health support, face-to-face counselling and rehabilitation. Have those clinics been commissioned, and when will those long covid sufferers be able to access them throughout the country?

My right hon. Friend makes an incredibly important point. I know very well the impact of long covid; it is something that I understand deeply. We are in the process of setting up those clinics and there will be further information on this very shortly.

Given that the Office for National Statistics has said today that deaths have increased three weeks in a row, and given the rising prevalence of the virus, can the Secretary of State understand the upset and the anger over the Excel spreadsheet blunder? Can he tell us today what he could not tell us yesterday: how many of the 48,000 contacts—not the index cases, the contacts—have been traced and how many are now isolating?

We have obviously been continuing to contact both the index cases and the contacts. The total number of contacts depends on how many contacts each index case has. That information will of course be made available in the normal way when it has been completed. However, we cannot know in advance how many contacts there are because the interviews with the index cases have to be done first.

So essentially thousands of people who have been exposed to the virus could be wandering around not knowing they have been exposed and infecting people, and the Secretary of State cannot even tell us if they have been traced.

Let me move on to something else. I listened carefully to what the Secretary of State said about a vaccine yesterday in light of the news that the Government are aiming to vaccinate about 30 million people—just under 50% of the population. There has been an expectation that the whole of the population would be vaccinated, not least because he said at the Downing Street press conference that he “would hope, given the scale of the crisis, we would have the vaccine and everyone would be given the vaccine.” Those are his words. We accept the clinical guidance. However, can he tell us how long it will take, for the 50% of people who will not be vaccinated, for life to return to normal for them?

As the hon. Gentleman well knows, decisions on the distribution of any vaccine have not been taken. The Joint Committee on Vaccination and Immunisation is the body that advises the Government on the appropriate clinical prioritisation of vaccines. It has published an interim guide, which he well knows about and we have discussed. That sets out the order of priority as an interim measure, but we await the data from the clinical trials of the vaccine before we will come to a clinically validated full roll-out plan. We are putting in place the logistical plans now, but on the decisions as to the clinical order of priority, we will take the evidence from the Joint Committee.

Can I just say to those on both Front Benches that these are meant to be short and punchy topical questions, not full debates?

With many GPs surgeries adapting to coronavirus guidelines by holding surgeries outside, often in car parks, one of my constituents was left feeling embarrassed and upset by having to discuss a sensitive and personal health issue within earshot of other patients waiting in line. Does my right hon. Friend agree that in times when alternative methods are replacing the usual privacy of face-to-face appointments behind closed doors, GPs surgeries must be sensitive to the whereabouts and comfort of their patients to ensure that others do not have the same experience as my constituent? (907160)

Yes, I wholeheartedly agree with my hon. Friend, who speaks well for her constituent. I am very sorry that her constituent had that experience, and of course GPs should be sensitive, as the large majority are.

The implications of coronavirus include rising levels of loneliness, which can impact on mental health and physical wellbeing while increasing pressure on the NHS. Last Friday, I visited Henley Green community centre in my constituency of Coventry North East and saw the work it is doing with health services to combat loneliness and deliver positive health and wellbeing outcomes. What resources can the Government provide to accelerate the spread of such social prescribing schemes so that community groups can deliver tailored local support to tackle this growing problem? (907161)

I pay tribute to the group that the hon. Lady mentions. I have put a huge amount of effort into supporting social prescribing, including with funding, and I encourage her CCG to engage with such bodies to make sure that we can get funding to support them on the frontline.

At the start of this pandemic, in the first lockdown, abortion services were relaxed to allow women to enable them to access the service from home, but I am particularly worried about the effect that has had on those women who are particularly vulnerable, subject to abuse or in coercive relationships. Now that we know that the risk to women of childbearing age from attending a face-to-face appointment is extremely low, what assessment has my right hon. Friend made of the ongoing need to continue in this way? (907167)

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) has committed to consult on the subject to make sure we get to the right outcome.

This Government have repeatedly refused to meet the group representing covid-19 bereaved families. I met the group last week, and they confirmed that they are not in litigation with the Government and never have been. They simply want to put across the concerns of thousands of people who have lost loved ones to coronavirus, so will the Minister now commit to meeting the group and hearing their concerns at first hand? (907162)

Of course I have met and continue to meet the families of those bereaved through coronavirus. With this particular group, I am afraid that when I last looked into it, they were in legal action—in pre-action protocol—with the Government, so I am advised that I should not therefore meet them.

It is important that communities, such as mine in Middlesbrough, can see a way out of the tighter local restrictions that have now been imposed. Notwithstanding my right hon. Friend’s earlier, very reasonable answer to the hon. Member for Bradford South (Judith Cummins) about the impossibility of setting hard metrics for the release from lockdown, can he set out what would constitute a path out? Does it include, for example, a sustained fall in transmission rates? (907169)

The level of cases matters, but so too does the direction of travel, and when the number of cases is falling—especially if it is falling rapidly—that is the sort of indicator that we will look at. One example is the action we took in Leicester a few months ago now, where we removed some of the most restrictive measures when the numbers were coming down sharply.

Please, please, Secretary of State, my constituents need extra support. Despite the outstanding efforts of the staff at Northumberland County Council, covid-19 is running rife through our towns and villages. Since stricter local lockdown measures were introduced, we have seen a huge increase in transmission levels. Parts of Ashington, Bedlington, Morpeth and Newbiggin have seen rates of almost 500 per 100,000. Secretary of State, please help us. (907163)

I am very worried about the rates of transmission in the north-east, as I am about parts of the north-west of England. I look forward to working with the hon. Gentleman and colleagues from across the regions affected to take the action necessary to suppress this virus and to support the economy, education and the NHS right across this land.

I have first-hand experience of how effective the app has been, as it has kept my father covid-free before he goes into hospital tomorrow. Could my right hon. Friend update the House on the success of the app and advise me of what more Members can do to ensure that the covid-19 app continues to keep us all safe, including my father? (907168)

The covid-19 app has now been successfully downloaded by around 15 million people, including my hon. Friend’s father. Every extra person who downloads it helps to keep themselves safe and keep others safe. I urge everybody in this House to download it—I hope you have, Mr Speaker. It is one of the tools in the armoury, and everybody can play their part in keeping this virus under control by downloading the app.

As you can imagine, Mr Speaker, I was astounded to be told that people living in Devon were being advised to go to Inverness for a covid test. Can the Secretary of State reassure me that a truly collaborative effort is being made by Her Majesty’s Government and the Scottish Government to beat this virus? (907164)

Yes, absolutely. The testing facilities are one example of that. Testing facilities across the UK work very closely with the Scottish NHS, to ensure that people can get a test as close to them as possible. I think we have reduced the problem of people being sent to Inverness, but we continue to work to increase the capacity in Inverness and right across the country.

Partly in response to large queues and hours-long waits for tests in Canada, Health Canada has followed the US Food and Drug Administration in approving rapid testing, such as the ID NOW test, which can give a result in 15 minutes. Can the Secretary of State update us on where we are with the roll-out of rapid testing? (907171)

We are making good progress in validating the tests and in doing what needs to be done to be able to use them effectively. I have seen some of these reports from around the world, and I talk regularly to my opposite numbers about how we can get this sort of next-generation testing going.

With Spina Bifida Awareness Week coming up, can the Secretary of State say when the Government will respond to the consultation on putting folic acid into flour? It is a move that could help to reduce the number of babies born with defects of the spine, and it is important to hear when that might happen. (907165)

I am a strong supporter of the work we have done to look at that approach. The hon. Lady is right to raise it, and I will write to her with a timetable for that response.

Positive outcomes are more likely when cancer is detected early through breast screening, and evidence suggests that take-up of screening is generally higher when mobile units are used, yet women in Heald Green have missed out on local screening and been directed out of Cheadle to Macclesfield. It is the second time that their three-yearly checks have been disrupted, potentially affecting uptake and risking cancers going undetected. Will the Secretary of State agree to meet me to discuss ways to address the situation in Stockport and give women in my constituency access to the local mobile screening units they need? (907173)

Yes, of course I would. I would underline some news announced by the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), which is that the breast screening backlog from the first peak, which was 450,000, is now down to just over 50,000. I pay tribute to the NHS and all those involved in screening who have done so much work to bring that backlog down, and I am very happy to meet my hon. Friend to discuss this subject.

The pharmaceutical industry has highlighted supply difficulties due to covid-19 as a challenge to recreating stockpiles before the end of the transition period in December. How will the Secretary of State ensure that there are no drug shortages, particularly of medicines such as insulin, which is not produced in the UK? (907172)

A huge amount of work is under way to ensure that we are fully prepared for all eventualities this winter. It is an important piece of work across the Department.

I would like to thank the Secretary of State for his commitment to Northumberland hospital investment, with the Northgate Hospital investment announced last week. Does he agree that rural hospitals such as Berwick Infirmary—one of the most rural English hospitals—are places to develop the technology to enable us to reach many more patients, without them having to travel long distances to get to hospital? (907174)

We have ended where we started this questions session: with my delight at a new hospital that has been funded and announced by the Prime Minister on Friday—Newgate in Northumberland. That is a very important development. My right hon. Friend makes a wider point about the importance of community hospitals, which are local to where people live. With modern advances in technology, we can deliver more services closer to people’s homes and in people’s homes, and then in community hospitals, while of course needing to build those superb hubs of science and care that our great hospitals are.

In order to allow the safe exit of Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for a few minutes.

Sitting suspended.

Areas with Additional Public Health Restrictions: Economic Support

(Urgent Question): To ask the Chancellor of the Exchequer if he will make a statement on economic support available to individuals and businesses in areas of the country subject to additional public health restrictions.

The decision to extend tighter lockdown measures to Liverpool city region, Warrington, Hartlepool and Middlesbrough was based on the latest health evidence, including advice from the chief medical officer and local public health authorities. The resurgence of the virus has demanded further action to minimise harm to health and wellbeing, while preserving the ability of people to work and businesses to trade in the areas affected. That is why, throughout this crisis, we have sought to strike a balance between minimising the burden faced by businesses and protecting public health. To that end, we have provided one of the most generous and comprehensive packages of support for people, businesses and public services, totalling £190 billion by July.

As the path of the virus and the threat to the economy have become clearer, we have taken further decisive action. Last month, the Chancellor announced the winter economic plan—a package of targeted measures to protect jobs and businesses, including the job support scheme to support the wages of employees in viable jobs and an extension of the self-employed income support scheme to the end of April 2021. We are also continuing the temporary reduction in VAT for hospitality until the end of March 2021 and the Government-backed loan schemes until the end of November this year. We are also providing an additional £100 million in surge funding to support the hardest-hit areas in containing covid-19. That is on top of the £300 million provided through the test and trace programme. We are offering grants to businesses that have been required to shut because of the new measures, worth up to £1,500 for each three weeks of closure.

Throughout this pandemic, we have prioritised a flexible and adaptable approach to economic support. We will continue in that spirit, and we stand ready to evolve our policies as required.

Thank you, Mr Speaker, for your courteousness and patience, as always.

Seventeen million people—one in four of us—are living under additional covid-19 restrictions. That was not inevitable: experts agree that it is linked to the continuing failure to deliver a functioning test, trace and isolate system. That failure has profound economic consequences and puts businesses and jobs at risk. Today, nearly 1 million people are still on furlough in the areas of the country that are subject to local restrictions or are on the watch list.

Support for local areas has only ever come after restrictions have been imposed—for example, a month later in Leicester’s case. There are leaked suggestions that the Treasury will be involved in decision making around restrictions, potentially to prevent such delays. When will the Government finally be in a position to deliver support hand in hand with the imposition of restrictions, not trailing them?

The response has been inconsistent: £3 million for Leicester, £7 million for Liverpool city region, an undefined funding package for the north-east of England and nothing for Greater Manchester or the west midlands. What criteria determine the allocation of support to areas under local restrictions? Will they be published? If not, why not? Do they truly reflect the needs of areas subject to restrictions? I note that the Chief Secretary did not talk at any point in his statement about support for areas with economic needs, not health needs. He referred to the local restrictions support grant, but can he confirm that no area currently qualifies for that grant because of current restrictions?

The millions of people living under local restrictions deserve better. When will the Government grasp the scale of the challenge and act to recover jobs, retrain workers and rebuild businesses?

The shadow Chancellor almost implies that the resurgence of the virus is unique to the United Kingdom, yet anyone who looks across the continent will see that many other countries, as we come out of the summer period, are seeing exactly the same trend and are dealing with it in in many of the same ways as we are in the United Kingdom.

The hon. Lady says that support has not been offered to those suffering from economic harm, but that ignores, for example, the announcement that I made in the Chamber some weeks ago about the £1,500 of support for businesses for every three weeks of closure as the result of a local lockdown—[Interruption.] Hon. Members should let me answer, rather than chuntering from a sedentary position.

The hon. Lady also ignores the fact that my right hon. Friend the Chancellor has extended many of the measures that we introduced in our initial response, including the package of loans, the tax deferrals and pay as you grow. Those are universal offers to support businesses, irrespective of whether they are in areas of acute lockdown or otherwise.

As I said at the start, and as my right hon. Friend the Chancellor said yesterday, we will keep listening, and we will keep striving to be creative in response to the challenges that we face. Where we can, he will act. That shows our willingness to adapt. The package of measures that my right hon. Friend the Chancellor brought to the Chamber just a few days ago, with the winter plan, illustrates that willingness to listen, to evolve and to respond to the virus, as the economic needs of the country dictate.

Local restrictions are inevitably impairing many thousands of businesses in those areas, but some businesses are not just being impaired: because of the regulations, they are simply unable to trade. I am thinking about many companies in the hospitality sector—events companies, hotels, nightclubs and many more. Would my right hon. Friend recognise that and come forward with a specific set of support packages for those businesses, which the regulations basically stop dead in their tracks? In that way, the many thousands of jobs in those businesses, which are otherwise entirely viable, can be saved.

The Chair of the Treasury Committee raises an extremely pertinent point, which I know my right hon. Friend the Chancellor has heard loud and clear. That is why we have seen repeatedly in the measures that the Chancellor has brought forward a targeting—particularly, as the Chair of the Select Committee says, in areas such as the hospitality sector, which have been acutely hit—with a package of measures, such as the cut in VAT and the package over the summer. For specific areas such as the independent cinema sector, there has been the £30 million of funding for the British Film Institute. That is an individual measure, but it does not address the much wider part of the cinema sector and the major chains. It is about looking at targeted measures of support in response to the issue that the Select Committee Chair raises.

Local lockdown is a reality, and there is a potential for a national lockdown of some kind as we go into the months ahead. Livelihoods have been disrupted once again and the viability of businesses is being threatened by these restrictions, which are necessary to protect public health.

Kate Nicholls of UKHospitality told the Treasury Committee this morning that sector-specific restrictions require sector-specific support. What sector-specific support is the Minister going to bring forward for sectors such as hospitality, events, tourism, funfairs, culture and the arts? The Chancellor earlier seemed to suggest that people should just go and get another job, which is deeply offensive to many in those sectors.

Failing to support and sustain businesses right now risks putting those businesses over the edge so that they will not be there for a recovery in the future. The Minister must speak to the Chancellor today, extend the furlough in the self-employment support scheme and fill the gaps for those who have not had a single penny from the Government since lockdown began. People are depending on this UK Government, with the economic levers that they have. The Government are failing in their duty to protect those jobs and livelihoods right now. They are letting millions of people down and accepting the harm of mass unemployment that will follow.

The Scottish Government are limited in how much they can spend and in how much they can borrow, which is very limited. They do not even have the certainty of a UK Budget to know how much they will receive in the months ahead. If Scotland needs to lock down on public health grounds, how much money will come in support?

The hon. Lady says that she seeks targeted measures, but then seems to ignore the £1.57 billion that the Chancellor announced for the arts—exactly the sort of targeted package that she was referring to. She then says that that is not enough, but it is unclear how long the SNP would want to extend schemes such as the furlough, how targeted that would be on specific sectors and what that would mean for the supply chains for those sectors. We think that it is right to be honest with the British public and ensure that we target support beyond the eight months of the furlough, in the way that the Chancellor set out, with the job support scheme and the extension of the self-employed income support scheme.

On certainty of funding for the Scottish Government, I have had regular discussions with the Scottish Finance Secretary. I would have welcomed the hon. Lady’s acknowledgement that we had done something unprecedented in guaranteeing the Barnett consequentials in order—as the Scottish Government had requested, and responding to their wishes—to give them confidence in the funding pipeline. That had not been done before. The Government did it to give the Scottish Government confidence on the Barnett consequentials. An acknowledgement by the hon. Lady of that point would have been welcome.

Although I am clear that my right hon. Friend and his colleagues in the Treasury have done a Herculaen job in bringing forward schemes to support jobs in the economy, like the Chair of the Treasury Committee, I remain concerned about those sectors that are unable to operate because of Government restrictions. I cite particularly the events industry and our aviation sector—I think especially of the regional airports, which will be affected by regional restrictions. May I ask my right hon. Friend to look with colleagues across Government at ways in which we can get those sectors at least partially working again, with proper social distancing rules? I cannot believe that it is not possible to do that. If it is possible to go to a supermarket, surely it is possible to have airport testing, and socially distanced trade shows and similar to get some of those sectors moving again.

My right hon. Friend is right that it is important, as we live with the virus and accept that it will be with us for longer, that we constantly learn from that and see what lessons there can be, not just in terms of, for example, regional air travel, but how that reads across into other matters such as non-pharmaceutical interventions. My right hon. Friend’s point is exactly why the Chancellor said yesterday that he will keep listening and striving to be creative. His track record has demonstrated that. I look forward to working with my right hon. Friend as we learn those lessons.

Many businesses may not have to close because of local restrictions, but they have seen a drop in footfall and a decline in their business. I am thinking of many small family-run businesses that have approached me in Lancaster in Fleetwood. Will the Chief Secretary outline what support will be available for those businesses and what they can expect when local restrictions are put in place?

For exactly that reason, the Chancellor set out the package of measures in the winter plan. We recognise that there is a balance, and we have sought to strike one that enables many of those businesses still to trade—so restrictions have not led to closure of certain businesses, as full lockdown did. However, we acknowledge that there has been an impact, particularly on cash flow. That is why the Chancellor set out the furlough bonus and the job support scheme and extended what is, by international comparisons, one of the most generous self-employed income support schemes. We recognise that there is a balance between the health measures that we are taking and the hon. Lady’s legitimate concern about the impact on businesses, particularly their cash flow.

There is no crystal ball that will tell us how bad the virus will be in various areas. I thank the Chief Secretary for his assurance that the Government will be flexible and continue to offer targeted support in areas of high coronavirus rates. Will he also assure my constituents in Wolverhampton North East and people in the Black Country that the Government’s levelling up agenda will not be forgotten in the coming months?

I am happy to give my hon. Friend that assurance about levelling up. It is at the core of the Government’s mission. It is a key priority of the Prime Minister and consequentially of all Ministers. We are actively working in the Treasury to accelerate under Project Speed our infrastructure investment to ensure that it is better targeted in terms of place as well as scheme.

London, which is now on a watch list, is not only our financial centre but our cultural capital. [Interruption.] I believe so. It is the nation’s beating heart. Despite the £1.57 billion arts rescue package, freelancers and the self-employed in the sector in my constituency have not seen a penny since March. Established venues such as The Questors in Ealing face a record loss this year because the panto is off—oh yes it is! Will the Chief Secretary not be a villain and sort this out now?

I shall resist pursuing the panto theme, although I am not sure too many villains have allocated £1.57 billion to the industry in addition to the other package of support that the Chancellor has announced. The hon. Lady speaks of a real concern, which we are acutely aware of. The House has debated at length the issue of that subset of the self-employed who were beyond the date of the initial package and I do not think we need to rehearse that argument, but I recognise that it is an issue of ongoing concern. By international standards, the self-employed income support package that we have put in place is extremely generous, and my right hon. Friend the Chancellor extended it further in the winter plan.

Hyndburn and Haslingden have been in local restrictions since 31 July, and were only removed for a short period beforehand. My local authorities are playing a huge part in supporting my community, to support the most vulnerable people and keep vital services running. Will my right hon. Friend outline what steps the Government are taking to support them and what further support is being considered if further restrictions are imposed?

My hon. Friend is quite right to single out the huge amount of work being done by local authorities up and down the country to assist us in our response to the pandemic, and I am sure that I join many hon. Members in paying tribute to that work. She will be aware that my right hon Friend the Chancellor announced £3.7 billion of grant support for councils, an extra £1.1 billion of support for social care providers, and on top of that £300 million as part of our enhanced track and trace. In addition, £100 million was announced for the surge, in our response to local authorities. It is an important point; we work very closely with local authorities as part of our response.

We now have local lockdowns on top of the threat of further national restrictions, warnings daily from various sectors, and the threat of mass unemployment. Many companies are under threat because they are being responsible and following restrictions, so, bearing in mind what the Secretary of State has said about flexibility, will the Government now accept that an extension to furlough into June 2021, which experts say could protect more than 1 million jobs, is absolutely vital to those companies?

I am very proud that, as a result of our ability to act as one UK, the broad shoulders of the United Kingdom have enabled us to protect almost a million jobs in Scotland, supporting nearly half a million through the furlough scheme, and 65,000 businesses in Scotland have benefited from the UK Government loan scheme. The ability of the Treasury and the Government to act and support businesses and jobs in Scotland has been enhanced by our ability to act as one United Kingdom.

On what further measures are taken, I do not agree with the hon. Lady that the solution would be to extend the furlough scheme indefinitely, because I think that would hold out to people the expectation of a job that may never return, and do so at very significant cost. That is why we need to support those jobs that are viable, and, in addition we need a training package to enable people to get the skills to re-enter the labour market when they are needed.

Does my right hon. Friend agree that while some parts of the Labour party see this as a good crisis to exploit, we have actually managed to ensure that our response has helped the least well-off the most, proportionately?

It has been a time when most people have come together and worked together to respond to the very legitimate concerns that we all have on behalf of our constituents. The more we can work together across the United Kingdom and with local authorities and other stakeholders, the stronger the Government’s response to the pandemic.

The further restrictions announced on 1 October will have a huge impact on the Liverpool city region’s retail, hospitality and leisure sector—a sector that accounts for 20% of the city region’s economy. The end of the furlough scheme and the 20% below self-employed income support scheme will impact thousands of jobs and hundreds of businesses. The £7 million to be shared with other areas is not enough. The city region has therefore called for a support package totalling £710 million, in order to ensure that we have an economy to revive. Will the Chancellor make a statement on what financial support will be made available to the Liverpool city region?

The hon. Lady says that there should be a package for the Liverpool city region of £700 million of additional funding. That would equate to over £23 billion if applied evenly on a per head basis across England. It is important that we are proportionate. Of course, the £7 million is not in isolation; it sits alongside the many other things that have been announced, including £130 million of un-ring-fenced funding to the Liverpool city region in March; but I am happy to continue to work with colleagues across the House in considering our wider response.

May I return to the sectors that are effectively closed by the lockdown rules? Will my right hon. Friend ensure that when the Chancellor is looking at what support he can give, he thinks about companies in the supply chains to those sectors, which have lost all their orders but so far have not had the benefit of some of the help, such as the business rate reliefs?

One of the difficulties when people talk about extending the furlough is that those supplying particular sectors do not simply supply one sector; they usually supply across sectors. In the wider discussion about extending the furlough, not only is there the question of how long, because we do not know how long it will be until a vaccine arrives, but it is often unclear from those seeking an extension which sectors it would apply to and how it would apply to the supply chains of those sectors. The reality is that people do not simply supply one sector; supply chains reach across many sectors.

The Minister knows that the Rhondda has not just had to contend with coronavirus this year; we have had the worst flooding of any area in the whole of the UK—nearly a quarter of it was in one constituency—and we have had a major landslide from a coal tip. In February, the Prime Minister promised this House that the money would be “passported” from Westminster to Rhondda Cynon Taf to pay for the repair work. In June, the Prime Minister told me that the work had to be done and that he would be looking at making sure it happened. The Minister wrote to me in July to say that we should be applying to the reserve fund. I cannot underline more strongly how serious this is for the local community. We are one of the poorest communities in the whole of Europe. The local authority will be bankrupted if we do not get the money. There are families who are fearful that they are going to be flooded all over again, and many more who are even more worried that there will be another Aberfan. Please, please, please, just say the money is going to come.

The hon. Gentleman has raised this before and I discussed it with the Secretary of State for Wales. As a result of the hon. Gentleman’s question, I will ask for an urgent update to clarify with the Secretary of State what the latest is on that. Because of the emotion that I think everyone feels around the national tragedy of Aberfan, we recognise the specific issue in that regard, and I know that the Prime Minister is very sighted on it. To be fair, I think the issue has more aspects to it than simply the individual site that is of most concern; there is a wider discussion with the Welsh Government around flood protection and where that funding is, but I am very happy to follow up. Given that the hon. Gentleman has raised the issue before, let me follow it up, and I will write to him following today’s exchange.

The Welsh Government have imposed movement restrictions in four north Wales counties, an area where tourism and hospitality are the mainstay of the economy. That has had an immediate adverse effect on local businesses, some of which have closed, maybe never to open again. Can my right hon. Friend say whether the Welsh Government have been in touch with the Treasury to outline what financial measures they intend to put in place to compensate the businesses that have been so badly affected by this action?

I am not aware of any specific representations in respect of the individual case that my right hon. Friend refers to. The wider point I would make is that it is important across the United Kingdom as a whole that decisions on local lockdowns are shaped by the Joint Biosecurity Centre so that we have a consistency of approach that is led by the medical science, and then, on the basis of that, the Treasury can have discussions about any individual issues that arise from that advice from the Joint Biosecurity Centre.

Last Friday, in an interview with the BBC, the Prime Minister said that additional resources would be available for Northern Ireland in the light of restrictions due to alarming covid numbers, which are now twice the UK average. There are local restrictions in place, hundreds of students are isolating, and businesses are struggling but have to keep the doors open to pay the bills. With furlough ending and an extra 89,000 universal credit claimants just in the second quarter of this year, people cannot afford to wait and see. When asked whether extra funds would be available, the Prime Minister said, “Absolutely.” When will those funds come?

We have provided significant funds to Northern Ireland—an additional £2.2 billion—to cope with the pressures of the pandemic, and that has enabled 300,000 jobs in Northern Ireland to be protected through the furlough scheme, along with an additional 78,000 jobs through the self-employed income support scheme. Indeed, the package of measures that my right hon. Friend the Chancellor announced in his winter plan applies in terms of additional support for Northern Ireland as it shapes its response to the pandemic.

Does the Chief Secretary agree that the best way to help business is to let business get on with the job, as free as possible from Government control? Will he note that when the Treasury argues against further lockdowns for business, scores of Tory MPs and tens of thousands of businesses cheer it on? After all, to quote the Chancellor, is it not our “sacred” duty to “balance the books”? What is the point of solving this problem by borrowing money? Is that not the socialist way? What would be the point of a Conservative Government if we did that?

As a former Chair of the Public Accounts Committee, my right hon. Friend is quite right to focus on the importance of value for money and protecting the interests of the taxpayer. He knows me well enough to know that I share that sentiment. On our wider response, it is important that we get the right balance between responding to the virus and doing so in a way that is supportive to the economy. It is a false choice to see this as a choice between health and economics; they are clearly intertwined and we need to work together in shaping our response.

It is a horrific irony that while we risk 1980s levels of unemployment, the Chancellor was busy reminding his party conference that Tory values are old and timeless. I appreciate that not every job can be saved, but many more jobs can be saved by a proper extension of the furlough scheme and targeted support for aerospace, aviation, travel, tourism, hospitality, the night-time economy and those excluded to date. If the Treasury is not going to step up, does the Minister agree that the Scottish Government need borrowing powers so that they can provide targeted sector support and localised support where local restrictions might be needed for public health measures?

The slightly puzzling thing is that the hon. Gentleman does not seem to accept yes for an answer. When I was asked by the Scottish Government Finance Minister whether I would give further guarantees on Barnett consequentials, we agreed that, thereby enabling the Scottish Government to make spending commitments with that guarantee, yet that point is not recognised at all. The reality is that it is because of our broad shoulders and ability to act across the United Kingdom that we have been able to protect 930,000 jobs in Scotland at the peak in July, and 65,000 businesses in Scotland have benefited from our loan schemes. Our ability to act across the United Kingdom enables us to better protect jobs.

I urge my right hon. Friend not to forget areas like the High Peak which, although not under local restrictions themselves, are impacted economically by the local restrictions next door in Greater Manchester. I wish to highlight specifically the events industry, which, if it is allowed to trade again, could be a crucible for economic recovery. The situation is imminent—lots of fantastic events, such as Buxton International Festival, are having to make decisions now about when their event can go ahead next year—so I urge my right hon. Friend to look urgently at measures for the industry.

My hon. Friend is quite right that the impact on business is not constrained to those areas most acutely affected by the virus; there is a wider displacement effect on businesses, including in neighbouring constituencies. We very much recognise that issue, which very much shaped the approach that the Chancellor set out in the winter plan, particularly in respect of the cash-flow pressures faced by those businesses. Together with the job support that he brought forward, the package recognises the very real pressures businesses face and will provide comfort as we go through the winter period.

In his response to my hon. Friend the Member for Liverpool, Riverside (Kim Johnson), the right hon. Gentleman suggested that he would be willing to work with MPs from all parties because of our concerns about the vulnerability of the hospitality, retail and live entertainment industry. In the light of that invitation, may I suggest that he agrees to meet local MPs from our city region, together with council leaders and the Metro Mayor, for a constructive discussion about how a comprehensive package for those sectors and others can be put in place as a matter of urgency?

As I think colleagues across the House would recognise, I have always been open to meeting MPs from all parties, and I am happy to give an undertaking to the right hon. Gentleman to meet MPs to discuss these issues. On the Liverpool city region, the point I was making in response to the previous question is that the request for £700 million that has come in will equate to an additional funding commitment of £23 billion. There is a responsibility on all of us, not just on Government, to have a view of the wider value for money of schemes, because £23 billion, in addition to the other packages, is a very significant amount.

Some of those worst affected by local lockdown measures will be our young people, who are left isolated or worse still, trapped in unhealthy home environments, and there will be long-term implications for local services that stem from that. Youth groups and organisations that can offer support need help, and the youth investment fund is vital to their sustainability. Will my right hon. Friend use his influence to end the delay to that funding and get that help to the young people who need it?

My hon. Friend is right that the youth investment fund is a very important allocation—£500 million was allocated in September 2019 under the fund. However, he speaks to a more fundamental point, which is that many of those most affected by covid’s economic consequences are the young, who tend to concentrate in areas such as hospitality that are most impacted. That is why the Chancellor has set out measures such as the £2 billion for the kickstart scheme, the tripling of traineeships, the £2,000 for apprentices and the doubling of work coaches. We recognise that it is not just the number of young people whose jobs go, but the length of time that they are out of the labour market that is absolutely crucial. Both of those are key areas of focus and I look forward to working with him in our response on them.

Further to the question asked by the hon. Member for High Peak (Robert Largan), what consideration have the Government given to the impact of local lockdowns on businesses and supply chains located beyond the lockdown areas? What support will be made available to businesses that are materially impacted by restrictions imposed elsewhere?

As I said to my hon. Friend the Member for High Peak (Robert Largan), it is absolutely valid for colleagues across the House to raise the wider impact. That is partly why we gave the guarantee on Barnett consequentials, which has meant that the Welsh Government have benefited to the tune of £4 billion. It is why we are engaging very closely with the Welsh Government, among others, on shaping our response, and why the Chancellor set out, through the winter plan, the package of additional measures, building on his plan for jobs—the £30 billion that was announced in July. We recognise that it is not only the areas most affected by lockdown that have pressures in terms of retaining jobs or cash flow challenges; the winter plan spoke to the issue much more widely across all parts of the United Kingdom.

There are 660 closed and shuttered nightclubs and live entertainment venues across the west midlands. I understand that they are not eligible for any help from the local restrictions support grant. Why not?

First, all businesses are able to benefit from the universal elements of the support package put in place by the Chancellor, whether that means loans, tax referrals or schemes such as the furlough. However, the hon. Gentleman is right that the nightclub sector is affected acutely, among all businesses affected. That is not just because it has been shut down from the start of the lockdown, but because it is very unclear when the end will be in sight, in terms of that sector and our ability to reopen. That is why the Chancellor has said, extremely reluctantly, that we are not in a position to save every single job. I think that around a third of nightclubs have repurposed by becoming pubs or reshaping their offer, but I absolutely accept that not all nightclubs will be able to do that. We are trying to target the very comprehensive measures of support on areas where jobs can be saved, but we recognise that not every single job will be saved.

In my constituency of Stoke-on-Trent Central, more than 11,600 jobs have been protected so far through the furlough scheme and more than £50 million has been made available to businesses to bounce back through various loans and grants. Recently, Stoke-on-Trent was removed from the watchlist and avoided a local lockdown, thanks to prompt local action; however, we are geographically close to many local lockdown areas. I ask my right hon. Friend for reassurance that those businesses in Stoke-on-Trent most economically vulnerable to any local lockdown will continue to be able to access financial support.

I am very happy to reassure my hon. Friend that the package of support that the Chancellor set out in his winter plan will assist businesses in Stoke and elsewhere, bringing back jobs that are viable and supporting them in terms of their cash flow. Furlough has already seen more than half the jobs—from a peak of 8.9 million—come back, so it has served a key part of its purpose. I know that my hon. Friend is also a keen champion of the wider levelling up agenda, so as those businesses bounce back, it will also be important that we work together on that agenda, which I know areas such as Stoke should benefit from very strongly.

In the leisure and entertainment industry in my constituency, Cineworld shut its cinema, Hollywood Bowl has written to me about the problems that it has, wanting a further cut in VAT because of the impact of additional restrictions, Peller Agency has had virtually no work for any of its artists in live entertainment venues since March, and Central Travel and Linburg Travel were offered no help by the Government at all because, perversely, coach companies are not seen as part of the leisure industry. Those are effects on the constituency without additional restrictions; it can only get worse if additional restrictions come into play. Will the Government introduce a comprehensive range of measures to help the leisure and entertainment industry? Ultimately, if measures are not brought in, such products and offerings will not be available for all of us to enjoy once the restrictions are lifted.

I gently take issue with the point about coaches not having support. One of the areas where coach firms have been able to benefit hugely from our response, and to work with the Government, has been in school transport. We were able to secure the additional capacity that we needed in part through the willingness of coach companies to adapt as part of our response. It is not the case that coach companies have been unable to get any business during the pandemic.

On more comprehensive measures, the hon. Member is right that the cinema industry has been hit hard. We were all concerned to see the announcement from Cineworld at the weekend. Together with Odeon and Vue that is 75% of the market, but as he knows it is not simply down to one issue. With cinemas, there is the supply of films—the delay of some of the blockbuster films has had an impact—and consumer confidence. Attendance is significantly down compared with last year, and there is also the impact of the non-pharmaceutical interventions. There is not one single factor, but we continue to work with the cinema industry in shaping our response.

Dominic Harrison, the director of public health for Blackburn and Darwen said that some of the more economically challenged boroughs are

“being placed into more restrictive control measures at an earlier point in their…case rate trajectory. This has the effect of exacerbating the economic inequality impacts of the virus in those areas.”

Why are some areas being treated differently from other areas, and can the Minister not see the need to have greater transparency and equity across the board?

The pace of those medically driven decisions is more, perhaps, a matter for my right hon. Friend the Secretary of State, who I know has been to the Chamber and answered such questions. I am willing to flag the hon. Gentleman’s concern about the transparency of that process.

I thank the Minister for the generous and timely support that businesses and workers across Aberconwy have received during this pandemic. Sadly, the same businesses and workers, mainly in tourism, are struggling now under fresh local restrictions that have been brought in by the Welsh Government. I noted the Minister’s response to my right hon. Friend the Member for Clwyd West (Mr Jones). Will he press the Welsh Government, when they introduce local restrictions that are stricter than those in other parts of the UK, and do so at lower thresholds than in other parts of the UK, to also provide the funding that the businesses and workers struggling under them need?

As I said in reply to my right hon. Friend the Member for Clwyd West (Mr Jones), it is important that these decisions are shaped by the Joint Biosecurity Centre and that it takes a consistent approach throughout the United Kingdom. That helps not only with the consistency of support that can be offered to businesses across the UK, but with communication to constituents and the clarity of that message.

I welcome the Minister’s agreeing with my right hon. Friend the Member for Knowsley (Sir George Howarth) to meet local MPs, local leaders and the Mayor to talk about what is happening in the Liverpool city region. The Minister will know that £7 million between nine different local authorities as extra money for the much more severe restrictions being imposed is not nearly enough, so will he promise to keep an open mind about the extra support we need in a region where 20% of our economy is the visitor offer, hospitality and tourism, and where 50,000 jobs and 4,000 businesses are at stake?

As I said to colleagues earlier, I am happy to meet Members of Parliament across the House, and I am happy to meet the hon. Lady, who brings considerable experience to these issues from her time in government. However, as I pointed out earlier, it is not the case that it is only £7 million of support. It is important to look at the wider package of support that has been offered, but of course we can discuss that in due course.

There is no doubt that a number of businesses in Birmingham, Northfield and across Birmingham, especially in hospitality, would not exist now if it was not for the support packages put in place by the Government over the past several months. Will my right hon. Friend please commit to looking at as many ways as possible of supporting businesses, especially those affected by the local restrictions and the 10 pm curfew?

As I said in an earlier reply, the Chancellor was very clear yesterday that he continues to listen and to strive to be creative in our response. I refer my hon. Friend to the comprehensive package that has already been announced, including the winter plan that the Chancellor has announced, which provides considerable support to businesses through the furlough bonus, the jobs support scheme, the self-employed income support scheme, the tax deferrals, the loans and so on, all of which support businesses in his constituency.

The fact is that more and more people are struggling just to put food on the table, as the Trussell Trust and others have highlighted, so with furlough being wound down, will the Government end the five-week wait for universal credit? Will they also make the £20 uplift permanent and extend it to legacy benefits? These measures are desperately needed.

We always keep these things under review. That was a temporary set of measures brought in by my right hon. Friend the Chancellor, but the hon. Member is right to point to the wider package of support that the Government offer. Following the package of support that was set out in March for individuals, public services and businesses, he will recall that the Chancellor has continued to revise that, with the most recent iteration being the winter plan that he announced in the Chamber a week or so ago.

A theme of many of the questions, and of some of the Chief Secretary to the Treasury’s answers, is predicated on the assumption that some of these economic support measures will be needed only for a short period. My right hon. Friend referred to the potential for a vaccine to solve the problem. Is it the Treasury’s assumption that these measures will be needed only for a short period and that a vaccine will come along and solve everything, or is it more likely, as I believe, that we will see permanent changes to our economy that will require us to accept that a significant economic transformation is required?

The significant fiscal measures that we have put in place will clearly have longer-term consequences for the public finances. The Chancellor has been quite clear about that in terms of our response to the future fiscal event. In terms of the timing of a vaccine, as the Prime Minister and the Chancellor have set out, things have changed since March, when there was perhaps a sense initially that these measures would be needed for a shorter period, and it is now clear that we will be living with the virus for a longer period—at least for a further six months. I know, however, that through the work of the Secretary of State for Business, Energy and Industrial Strategy, a huge amount of work is going on in the vaccines taskforce, because that is clearly the best way to limit the longer-term damage. However, we cannot guarantee the timing of when any vaccine would arrive.

The Minister will no doubt appreciate just how precarious the future of many businesses is and how desperately worried they are that they could face further restrictions and more local lockdowns. Further to the question from my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith), will the Minister please outline the additional and specific support that businesses that do not have to close but are facing significantly lower demand can expect to receive?

One of most important areas of support is avoiding, if at all possible, businesses closing in the first place. That is why, in response to the measures brought forward by the Secretary of State for Health, we have drawn the balance between businesses being open for the majority of the evening and addressing the risk—outlined by the chief medical officer and others—that social distancing tends to be weaker later in the evening. This addresses the concerns of the Department of Health about the increased risk, while protecting the ability of businesses to stay open. It is important that we keep this measure under review and ensure that the modelling and the data evolve so that we get the balance right for businesses.

Many of the areas that have been hit hardest by covid are those that relate most to the Government’s levelling-up agenda and that, like Stoke-on-Trent, will be vital for unlocking productivity. Will my right hon. Friend prioritise ensuring that we continue to see a refocusing of investment into these areas as we build a stronger recovery, so that no part of our country is left behind again?

There are few stronger champions of the levelling-up agenda in this House than my hon. Friend, and rightly so. I share his determination to ensure that our levelling-up agenda speaks to the people of Stoke and to many other places across the United Kingdom. I look forward to continuing conversations with him as we take that important work forward.

From 1 November, the job support scheme will only be available to firms that can offer their staff at least a third of their usual working hours. For businesses forced to close as a result of local restrictions, that will not be possible. What do the Government suggest such businesses do in these circumstances to retain their staff who are skilled and who have been trained by these businesses?

As we covered earlier, there are specific measures for areas with local lockdowns, such as the £1,500 support for businesses that are closed for three weeks or more. The Chancellor announced a package of measures in the winter plan, including tax deferrals, loans and other cash-flow support, alongside the self-employed income support and job support that he announced in the same statement.

Thank you, ground control.

I thank my right hon. Friend for explaining the current position. He will know that we are currently experiencing an increase in the infection rate in virtually every borough in London. What we do not know is whether lockdowns or further restrictions will take place covering the whole of London or on a borough-by-borough basis. In either case, there will be a huge impact on business, so will my right hon. Friend set out what measures will be in place to support London and each London borough in the event of local lockdowns or a London-wide lockdown?

As I have said in reply to a number of colleagues, we will continue to listen and evaluate the circumstances, including as applies to London. The Chancellor has set out a comprehensive package of support that applies to businesses within the London community, assisting them in their ability to retain what is most prized within a business, which is the talent of its own staff, and in addressing particular cash-flow pressure. We responded very much to the feedback that we have received from business leaders, including business leaders in London, as the winter package was shaped.

The International Monetary Fund has encouraged Governments to spend on infrastructure. In London, the infrastructure is the west end and the suburban theatres. What urgent plan will the Government put in place to protect the workers—whether the technicians, the actors, the divas or the stars—to keep our desperately loved theatre going?

On the specific point about the theatre, it is sector championed by my right hon. Friend the Secretary of State for Culture, Media and Sport and I referred earlier to the £1.57 billion package that the Chancellor has set out. I agree with the hon. Lady about the importance of infrastructure as a whole. Theatre is one aspect, but there is a much wider piece that includes Crossrail, High Speed 2, the acceleration of our road schemes, and broadband in particular to areas of poor connectivity. There is a huge agenda for infrastructure, and delivering that at pace is a key focus of the Chancellor and the Treasury team.

The hospitality sector has benefited from an incredible and innovative package of support, and I hope that will continue in a targeted way to mitigate the impact of local lockdown. But if we do not rethink the 10 pm curfew, we could see bars, pubs, restaurants and breweries call last orders for the final time. Will the Government back Britain’s boozers and breweries and reconsider their approach to the 10 pm curfew?

My hon. Friend is absolutely right that it is important that we act in a targeted way both in terms of our economic measures and in our health response to the pandemic. It is about getting that balance right.

On the 10 pm curfew, it is worth reflecting on the fact that we are not alone in that. The Netherlands and parts of Spain, such as Madrid, have taken a similar approach, but it is all about getting the balance right and ensuring that we act in a targeted way, as my hon. Friend suggests.

Live music professionals in my constituency saw an average income drop of 97.5% during the initial lockdown. If further local restrictions come into force, the situation is likely to become even bleaker. Given that the sector employs 589,000 people nationally and that their skills are in demand worldwide, will the Chief Secretary extend the remit of the £1.57 billion arts support package to cover live music?