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Covid-19 Update

Volume 695: debated on Monday 17 May 2021

With permission, Mr Speaker, I would like to make a statement on coronavirus. Since January last year, and especially since 8 December, when the world’s first clinically authorised coronavirus vaccine was given in Coventry Hospital, we have been engaged—all of us—in a race between the virus and the vaccine. As a nation, we have taken some huge strides forward and we can make careful further progress today, and we must remain vigilant.

I can report to the House that there are now fewer than 1,000 people in hospital in the United Kingdom with coronavirus, and the average number of daily deaths is now nine. This progress means we are able to take step 3 in our road map today, carefully easing some of the restrictions that we have all endured. People have missed the things that make life worth living, businesses have endured hardship and everybody has made sacrifices. While we can take this step today, we must be humble in the face of this virus. We have all learned over the past year that, in a pandemic, we must look not just at where we are today, but where the evidence shows we may be in weeks and months down the track. The vaccination programme can give us confidence, but we must be alert to new variants that could jeopardise the advances that we have made.

Today, I would like to update the House on the work we are doing to tackle variants of concern—in particular, variant B1617.2, which is the variant of concern first identified in India—so that we can protect the progress that we have worked so hard to achieve. There are now 2,323 confirmed cases of B1617.2 in the UK; 483 of these cases have been seen in Bolton and Blackburn with Darwen, where it is now the dominant strain. Cases there have doubled in the last week and are rising in all age groups. In Blackburn, hospitalisations are stable, with eight people currently in hospital with covid. In Bolton, 19 people are now in hospital with coronavirus, the majority of whom are eligible for a vaccine but have not yet had one. That shows that the new variant is not tending to penetrate into older vaccinated groups, and underlines again the importance of getting the jab—especially, but not only, among the vulnerable age groups.

In Bolton and Blackburn, we have taken the approach that worked in south London against the South African variant. We have surged in our rapid response team: 100 people so far, who visited approximately 35,000 people this weekend to distribute and collect tests. We have installed six new testing units, brought in more than 50 new vaccinators and set up two new vaccination centres, as well as extending opening hours and capacity at our existing sites. In Bolton, we have quadrupled the rate of vaccination. We carried out 6,200 vaccinations over this weekend, and it is brilliant to see so many people from the most vulnerable groups coming forward to get the protection, whether it is their first or second jab.

All in all, this is the biggest surge of resources into any specific local area that we have seen during the pandemic so far. It has been co-ordinated by Dr Jenny Harries, the chief executive of the new UK Health Security Agency, drawing on all the health capabilities, locally and nationally, that we have built in the past year. I thank everyone who is working so hard to make it happen, including everyone at the two local authorities; the rapid response team; all the volunteers, including those from St John Ambulance; and, most importantly, the people of Bolton and Blackburn for the community spirit that they are showing.

It has been really heartening, as I am sure the whole House will agree, to see the videos published over the weekend of people queuing up to get the jab. I say to anyone who feels hesitant about getting the vaccine, not just in Bolton or Blackburn, but right across the country: just look at what is happening at the Royal Bolton Hospital. The majority of people in hospital with coronavirus were eligible for the jab but had chosen not yet to have it, and have ended up in hospital—some of them in intensive care. Vaccines save lives. They protect you, they protect your loved ones and they will help us all get out of this pandemic.

This is not just about Bolton and Blackburn. There are now 86 local authority areas where there are five or more confirmed cases. The next biggest case of concern is Bedford, where we are surging testing. I urge everybody in Bedford to exercise caution and engage in testing where it is available.

I also want to tell the House the latest scientific assessment of this variant. The early evidence suggests that B1617.2 is more transmissible than the previously dominant B1117 variant. We do not yet know to what extent it is more transmissible. While we do not have the complete picture of the impact of the vaccine, the early laboratory data from Oxford University corroborates the provisional evidence from the Royal Bolton Hospital and the initial observational data from India that vaccines are effective against the variant. This, of course, is reassuring, but the higher transmission poses a real risk.

All this supports our overriding strategy, which is gradually and cautiously to replace the restrictions on freedom with the protections from the vaccines. The data suggests that the vaccine has already saved more than 12,000 lives and prevented more than 33,000 people from being hospitalised, and we are protecting people at a very rapid pace. Last week was the biggest week of vaccinations since the end of March. Some 36 million people have now had a first dose, and yesterday we reached the milestone of 20 million people across the UK having had their second dose.

I am delighted to see the figures released by YouGov today, which show that the UK has the highest vaccination enthusiasm in the world, with 90% of people saying that they have had or will have the jab. This was no accident. We began planning the campaign for vaccine uptake a year ago. I thank the huge range of people involved in promoting the benefits of vaccination, from Her Majesty the Queen to Sir Elton John, Harry Redknapp, Lenny Henry, Holly Willoughby, Lydia West and many, many others. Our campaign has been based on positivity and science, and I am grateful to everybody who has played their part.

I can confirm that from tomorrow we will be inviting people aged 37 to come forward, before expanding this further later in the week. It has been brilliant to see people’s enthusiasm when they have been invited to come forward, and we want to make it as easy as possible for them to show that they have had the protection the vaccine provides. I am delighted to say that, as of today, people can demonstrate whether they have had their jab, quickly and simply, through the NHS app.

Since January, we have been following a dosing interval of 12 weeks for second doses. Because of the extra protection people get from the second dose, particularly among those most likely to end up in hospital or dying, it is incredibly important that everyone comes forward for that second dose at the right moment. The approach we have taken aims to give the most vulnerable the strongest possible protection against this virus. Since January, that has meant getting the first dose to as many people as possible, as quickly as possible. The research shows that this approach has saved about 12,000 lives.

Now, it is important to accelerate the second doses for all those most vulnerable to ending up in hospital or dying. Our vaccination strategy for all parts of the UK, including the areas of surge vaccination, will therefore stick by the clinical advice set out by the Joint Committee on Vaccination and Immunisation: first, prioritise anyone over 50 who has not yet been vaccinated; next, second doses to those over 50 are vital—that will now be done on a schedule of eight weeks; and, then, follow the cohorts in priority order, and the age groups as we open them. This clinically approved approach is the best way to save the most lives, rather than jumping ahead with first doses for younger people. Although the JCVI of course keeps this under constant review, we are clear that its advice is the best way to protect those most in need of protection and so save as many lives as we can. The NHS will be reiterating this advice to all vaccination centres and all directors of public health, and I am very grateful to everyone, in the NHS, local authorities and in the whole system supporting this vaccination programme, for following it.

Today’s opening and step 3 marks an important step on our road to our recovery. We must proceed with caution and care, and bear down on the virus, in whatever form it attacks us, so that in this race between the vaccine and the virus, our humanity, science, and ingenuity will prevail. I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement. May I start by congratulating the Leicester City football team on winning the FA cup on Saturday? The winning goal from Tielemans was one of dreams. Leicester City fans boast that Foxes never give up and nor do I, so let me turn to the matters before us.

Yesterday, the Secretary of State warned on the television that the B.1617.2 variant could “spread like wildfire” among the unvaccinated, but does he accept that we could have avoided this? Our borders have been about as secure as a sieve, and the delay in adding India to the red list surely now stands as a catastrophic mis-step. One month ago in this House, I urged him to act quickly in response to this variant. The Wellcome Sanger Institute data today shows a rapid increase in this variant, to 30% of all sequenced cases in the UK, and that excludes cases from travel and surge testing. Alarm bells should be ringing, because although the Secretary of State offers reassurance that vaccines are effective, we have also heard Professor Anthony Harnden of the JCVI recently warn us that vaccines are “almost certainly less effective” at reducing the transmission of this variant.

I entirely appreciate that when questioned I suspect that the Secretary of State will not be able to give a cast-iron assurance about opening up on 21 June, and I am not going to try to push him into a corner; we all understand that we are dealing with uncertainties and we have to be grown up about these things. But we do need a plan now to contain this variant urgently. He is said to be considering local lockdowns. As he knows, I speak as a resident of long locked-down Leicester. Before he takes out his mallet to try to whack moles again, may I suggest a number of things for him to try first?

First, will he consider surge vaccination in all hotspot areas and go hell for leather to roll out vaccinations to everyone? I listened very carefully to what he said about vaccination increases in Bolton, and I hope that also includes Blackburn. Is he saying that everyone over 18 in those areas will now be eligible for vaccination? As he knows, that is something that public health directors on the ground have been calling for, and I hope we listen to them.

We have had these debates in the House before, and the Secretary of State knows that even if we drive up vaccination as high as it can possibly go among adults, there are still about 20% of the wider population—children —who remain unvaccinated, which means the virus can still spread. The Centers for Disease Control and Prevention in the US are moving to vaccinate children. Will he update us on what progress he is making on that front here? On children, the Secretary of State knows that in many secondary schools, mask wearing is no longer necessary. Will he assure us that he thinks that is the right response in the light of the data he unveiled today?

Secondly, the Secretary of State has announced extra surge testing, but he knows by now that surge testing must be backed up by proper sick pay and decent isolation support. That should have been fixed in the Queen’s Speech last week.

Thirdly, more venues are opening up today. Many will be spending a lot of time disinfecting surfaces, like we do in here, which is good and important, but we know so much more about this virus now. We know about airborne spread of the virus, so why are we not supporting venues more with ventilation? What are we doing to help supermarkets, shopping centres and larger venues where air circulates around the building to put in place covid-secure air filtration systems?

Fourthly, what the Secretary of State said about the NHS and the uptake of beds is welcome, but NHS staff, as he knows, are exhausted and fear another surge. What modelling has been shared with NHS leaders, and what are they doing to prepare for any surge in admissions?

Finally, the surge in this variant reminds us that we are not safe until everyone is safe. That is not a slogan; it is a fact. Some 3.3 million lives have been lost globally to this virus, and Dr Tedros Adhanom Ghebreyesus from the World Health Organisation warns that we are on track for the second year of this pandemic to be far more deadly than the first. Only 0.3% of vaccine supply is going to low-income countries. Trickle-down vaccination is not an effective strategy for fighting this deadly virus. Not only do we have a moral responsibility to play our part internationally, but that also reduces the risk of new variants bouncing back at us and setting us back.

At this critical time, when we need to work internationally to defeat this virus, why are we the only G7 nation cutting its aid budget? How can the Secretary of State defend cutting our contribution to vital science and research projects? Given the total silence from the Government on President Biden’s support for the temporary lifting of patent protections to increase vaccine production, should we assume that the Government do not agree with President Biden?

Let me address the hon. Gentleman’s substantive questions. The first was about the surging of vaccines and testing into hotspots. We saw in south London earlier in the month and last month that that sort of surge testing can work. We had an outbreak of the South African variant in south London. We put in more than 200,000 tests, and we effectively managed to contain that outbreak. That is the approach that we are taking in Bolton and Blackburn, and we will also take that approach if we see a further spread in other areas of the country. We have been working very hard on that to ensure we have that capacity and can do that effectively. We do that, of course, hand in glove with the local authorities in question, which know the communities on the ground.

We are also making sure we have the vaccines available, but I want to be absolutely crystal clear about the approach to vaccination. The hon. Gentleman asked about vaccinating all over-18s in Bolton and Blackburn, but that is not our approach. I have looked into it in great detail, and we have taken clinical advice. The approach is to make sure that we get done as many second vaccinations as possible, as many first vaccinations as possible among the vulnerable groups, and then as many vaccinations as possible among those aged under 50 in the eligible groups. We have taken that approach because that is what is likely to save most lives. That second jab is vital. The first jab for anybody over 50 could mean the difference between life and death. The very strong focus is to get the vaccine to all those over 50 who have not yet taken the first jab. I am glad to say that reports from both Bolton and Blackburn suggest that uptake among people who are eligible, but who have not yet taken the jab, has increased since we saw the rise of the B1617.2 variant in those areas. It is effective in proving to people that the jab really does work to protect them. That is what the data shows.

The hon. Gentleman asked about children. I have been closely following the results of the clinical studies from Pfizer that show that the vaccine is safe and effective among children between the ages of 12 and 18. We have procured enough Pfizer to be able to offer that jab to children should that be clinically approved here, but given that we are at the stage of opening tomorrow to people aged 37, there is some time to go before we get to 18-year-olds. We are on track to meet the target of offering the vaccine to all those aged 18 and above by the end of July, so we have a couple of months before we need to make and operationalise a decision. We want to be very, very careful and sensitive about whether and how we offer the vaccine to children.

The hon. Gentleman asked about important wider measures. He mentioned ventilation. We have put in place guidance for businesses in terms of strengthening the rules around ventilation, and that, too, is important. He did a bit of a Captain Hindsight act on the Indian variant. He did not seem to mention that we put India on the red list before this variant was even deemed a variant under investigation, let alone a variant of concern. Indeed, we put India on the red list before countries such as Germany and Canada stopped flights from India. We have a strong policy of restrictions at the border and we will remain vigilant.

The final point to which I wanted to respond was on the global moral responsibility to vaccinate everybody in the world. The hon. Gentleman is absolutely right that we have a global moral responsibility. I argue that, thus far, the United Kingdom has done, and will continue to do, more than any other nation. It is about not just the huge sums that we have put into COVAX, but the way that we delivered the Oxford-AstraZeneca vaccine around the world. As of this morning, 1.47 billion vaccines have been delivered globally, 400 million of which have been the Oxford-AstraZeneca vaccine. AstraZeneca has charged a profit margin and a margin for intellectual property of zero—no charge for intellectual property, no profit for AstraZeneca. Costs, of course, need to be met, but we have taken nothing for the money that we put into the vaccine’s development. This is the biggest gift that this country could give to the world. A total of 65% of those 400 million doses have been delivered into the arms of people in low and middle-income countries, including more than 150 million in India. On the COVAX facility, which is the biggest global effort to vaccinate in low and middle-income countries, it has delivered 54 million vaccines so far, 53 million of which have been done with the Oxford-AstraZeneca vaccine.

This country can be hugely proud of the contribution it has made. It is far bigger so far than that of any other country. We took the view from the start that we do not need to change our IP rules, we do not need to change the law, we just need to get on and get the vaccine out to as many people around the world as possible, at cost. Everybody in this House should be very, very proud of what AstraZeneca and Oxford University have done with the support of the UK Government. That is how we save lives around the world.

Many of the new variants come from abroad, so clarity on borders policy is essential. We now know that the first wave was largely seeded by people coming back from their spring holiday break in Italy, France and Spain, so will my right hon. Friend provide absolute clarity on the amber list? Should my constituents in Farnham, Godalming and Haslemere—indeed, all our constituents—go on holiday to countries on the amber list even when it is no longer illegal?

The answer is no. The official Government advice is very clear that people should not travel to amber or red-list countries or territories. People should not travel to amber-list countries for a holiday. What is on the amber, red and green lists is kept under review, based on the data assessed by the Joint Biosecurity Centre. Our priority is protecting the progress we have made at home. We will assess whether any new countries might go on to the green list every three weeks and, of course, we constantly monitor to check that the countries on the green list remain safe. If a country is not on the green list, people should not travel there unless they have an exceptional reason.

Covid cases in India began to soar at the start of April, so why were Pakistan and Bangladesh added to the red list at that time but not India? Was it because of the Prime Minister’s planned trade visit? After India was finally added to the red list on 19 April, the restrictions did not take effect until 23 April. How many people arrived from India in those days, trying to escape having to go into hotel quarantine? When I previously raised the issue of applying hotel quarantine to all travellers, the Secretary of State claimed that the current system was protecting the UK; does he now accept that the entry and community spread of the Indian variant shows that that simply is not the case and that having a negative test does not rule out the possibility that travellers are carrying covid?

The Scientific Advisory Group for Emergencies has stated that evidence shows that the B1617.2 Indian variant is up to 50% more infectious than the Kent variant and has advised that, as in Scotland, areas with rising numbers of cases should remain under covid restrictions. The Indian variant has been doubling every week despite lockdown, so why is the Secretary of State ignoring SAGE advice and opening up areas like Bolton that have exponential growth?

Thankfully, the Indian variant does not show significant vaccine resistance, but the Secretary of State must know that it is not possible to outrun the virus through vaccination alone. As those aged up to 35 are not eligible for surge vaccination, that leaves a large pool of unvaccinated people among whom the variant can spread. It will take two to three weeks before even those who receive a vaccine in the coming weeks are protected. Does the Secretary of State not accept that the variant is in danger of surging and that without local travel restrictions it will spread to other areas? It is good news that fully vaccinated people are not ending up in hospital, but just letting the virus spread among young adults could allow the evolution of yet another UK variant.

I answered those questions in response to the right hon. Member for Leicester South (Jonathan Ashworth). The truth is that when we put Pakistan and Bangladesh on the red list, positivity among those arriving from those countries was three times higher than it was among those arriving from India. That is why we took those decisions and, of course, they were taken before the Indian variant became a variant under investigation, let alone a variant of concern. It is striking that the Scottish Government took the decision to put India on the red list at the same time as we in the UK Government did. It is all very well to ask questions with hindsight, but we have to base decisions and policy on the evidence at the time.

When it comes to how we are tackling the virus in the UK, the hon. Lady is quite right that it is good news—albeit early news—that the vaccines do appear to be effective against the B1617.2 variant. I am obviously pleased about the evidence we have seen but we are vigilant about that. I am glad that the approach we are now taking in Bolton and Blackburn worked against the South African variant in south London. We always keep these things under review, but I think that as a first resort, surge testing, going door to door, ensuring that we find and seek out the virus wherever we can spot it, and putting in the extra resources with the armed services who are supporting us, are the right approaches while we keep this under review. The numbers thus far nationally are still relatively low and, thankfully, we have a very good surveillance operation across the UK so that we can spot these things early and take the action that we need to.

Does my right hon. Friend agree with Sir Patrick Vallance, who told my Committee that new variants will arise all the time and that border restrictions will only slow, not prevent, those variants that originate overseas? What level of vaccination protection do we need to get to in this country before my right hon. Friend is in a position to rescind the rather strange advice that he has just given to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and allow people who have been tested three times and quarantined for 10 days to travel to places such as France and Spain?

Typically my right hon. Friend asks the most pertinent question, to which we do not know the answer. The level of vaccination that we need in order to withstand the incursion of new variants, even those that the vaccine will work against, depends on their level of transmissibility, and we do not know the increased level of transmissibility over and above that of B117, the previous main variant here in the UK, which was first discovered in Kent. This is an absolutely critical question, but unfortunately we do not know the answer to it yet.

Having reached this tremendous milestone today, and given the sacrifices that the British people have made through lockdown and the fantastic successes of the vaccination programme, will the Secretary of State listen to his own colleague, the Minister for Covid Vaccine Deployment, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), who said last week that, with the new variant, we must “isolate, isolate, isolate” every single case and its contacts? Will he finally commit to paying people’s wages to stay at home to self-isolate, and provide practical support in terms of accommodation and support for dependants if necessary? Otherwise, we will only go backwards.

I am afraid I do not agree with the hon. Lady’s characterisation of the situation, not least because the approach we are taking in Bolton did work effectively in south London. We are piloting new approaches to ensuring that we can support people to isolate, and some of those pilots are taking place in areas where we can see cases of B1617.2. We keep this under close scrutiny and review to see what works effectively.

Part of our fight against covid, and indeed against future viruses, is to improve our domestic vaccine manufacturing capability. To that end, the Government are fast-tracking the Vaccines Manufacturing and Innovation Centre at Harwell in my constituency. I will be visiting it in a few weeks, but could my right hon. Friend provide an update on the progress so far?

Yes, we are making significant progress with the onshoring of vaccine capability. It is about developing the vaccine, as the team in Oxford did brilliantly, but also about manufacturing it onshore, and boy, if there is one lesson we have learned from this whole thing, it is that we cannot just not care about where manufacturing happens. Having it onshore really, really matters, for resilience but also to ensure that it is close to the NHS so that the whole supply chain can learn and constantly improve. I am delighted that we are pushing forward with the VMIC project in the same way that we have brought onshore manufacturing supply in Teesside, in Livingston in Scotland and in the fill-and-finish plants at Wockhardt in Wrexham, at Barnard Castle and elsewhere. It is a big project and, frankly, a big opportunity for life sciences in the UK to ensure that we can do all this onshore, because in my view, the pandemic has shown that we need to.

I thank the Secretary of State for his statement and for his comprehensive answers. I know that he has regular discussions with the Northern Ireland Assembly Health Minister, Robin Swann. There has been a surge in the Indian variant in Donegal in the Republic of Ireland and in the maiden city of Londonderry in Northern Ireland. Can the Northern Ireland Assembly Health Minister call upon the UK for expertise from Westminster to assist us, which I believe will show once again that we are always better together with the United Kingdom of Great Britain and Northern Ireland?

I could not agree more with the hon. Gentleman. The UK fights this together. There are outbreaks also in Moray and in Glasgow, and I have been talking to the Scottish Cabinet Secretary for Health about the action that is going on to tackle the outbreaks there. I talk frequently with Robin Swann, who is doing an absolutely brilliant job with the Health portfolio in Northern Ireland. The fundamental point is that the benefits of the United Kingdom working together are once more demonstrated by our ability to work together to tackle this variant.

More than 20 million people have now received their second dose of the vaccine, an achievement that demonstrates the phenomenal pace at which we are delivering vaccine across the UK. Does my right hon. Friend agree that this incredible milestone demonstrates what our Union can achieve when we work together?

I have just waxed lyrical about the value of Scotland working with the UK Government and of Northern Ireland working with the UK Government, and my hon. Friend almost chastises me for not mentioning Wales. Of course working with Wales is incredibly important—look at the Wockhardt fill-finish plant. The number of people who have been vaccinated in this country with a product that is manufactured in Wales measures in the tens of millions, including me. We should all be very proud of that, and I look forward to working with my new Welsh counterpart, the Minister for Health in Wales, and making sure that we use all capabilities across these islands to get us back on the road to recovery.

Today sees the long-anticipated lifting of many of the restrictions on our life and social life. At the same time, this strain of the virus reminds us that we need to be cautious in how we mix and how we hug our loved ones. It is important that we have clear messages about interaction, so will the Secretary of State ensure that Government messages are clear, unambiguous and not mixed, as at present?

It is really clear that we are removing restrictions. I am delighted that we are able to remove restrictions, such as the absolute restrictions on close physical contact, and rely more on people’s personal responsibility. In order to do that, we are providing the best possible advice that we can, such as to hug, but cautiously. Everybody knows what that means: it means outside is better than inside, it means making sure it is in ventilated spaces and it means that those who have had the vaccine, and in particular two vaccines, are safer than those who have not.

It is incumbent on us all to communicate these messages from our scientists and to make sure that people understand them. I am pretty sure that the British public get that. Given how brilliantly people have responded to requests during the pandemic, I am highly confident that this approach will be successful and that people will be cautious, but enjoy the new freedoms that we are thankfully able to give.

I listened very carefully to what the Secretary of State said in his statement about people being able to prove that they have had the vaccination through the NHS app. I also listened carefully to what he said about the importance of the Union. Can I just draw to his attention something that I hope he can look at urgently? I have thousands of constituents who live in England, but who are registered with GPs in Wales and who receive their vaccinations in Wales. At the moment, it is not proving possible for them to register with the NHS app that they have had their vaccination. Can I ask him to urgently fix that for my constituents and those across our United Kingdom?

This is another example of where we work better together as one United Kingdom; we are working to solve this problem precisely. Coming from the borders with Wales, I understand this very clearly. Work is under way to ensure that there is interoperability between the data systems in England, Wales, Scotland and Northern Ireland. This situation was not foreseen when health responsibilities were devolved. I have been working with my counterparts in the three devolved nations on fixing it, and we have agreed to fix it. Getting these data to talk to each other is technically complicated, but that work is under way.

In their decisions on easing the lockdown, the Government have rightly emphasised the importance of being driven by data, but when Pakistan and Bangladesh were added to the red list, the data showed that daily infection rates were substantially higher in India. Will the Secretary of State admit that the decision not to put India on the red list at that time was influenced by the Prime Minister’s imminent visit to Delhi and the desire to secure a trade deal? Does he now recognise that that was a mistake?

If I just explain the data to the hon. Gentleman, I am sure that he will understand. The measures of the case rate per 100,000 are influenced by the amount of testing that is done in any country, and there is not nearly as much testing in Pakistan or Bangladesh as there is in India. As I said in response to the right hon. Member for Leicester South (Jonathan Ashworth), the rate of positivity of people coming from Pakistan was three times higher than that of people coming from India, which was at that time quite low. We have to be careful with the raw data, and we have to look at the underlying positivity. One of the advantages of testing everybody at the border is that we now effectively have a global surveillance system to understand the positivity of travellers from any individual country. As I said, the decision was taken on the basis of the fact that the positivity was three times higher from Pakistan than from India.

In Bolton we are battling the Indian variant, with the rate currently standing at 274 per 100,000. The heroes of Bolton jabbed 6,200 people this weekend. Well done to the Health Secretary and his Department. Will he pay tribute to the Bolton team—Councillors Greenhalgh, Baines and Morgan, Dr Lowey and Dr Wall? Will the Government commit to first-dosing the whole of Bolton before the end of May and getting the second dose out to more vulnerable groups at a similar pace? Finally, what would the Health Secretary like to stress to Boltonians as we open up today with the rest of the country?

There is one other person who my hon. Friend did not add to the list, probably due to modesty, and that is himself. He has worked incredibly hard over the last few days to get the message out to people across Bolton, and I am very grateful. My message to everybody in Bolton and Blackburn is: take these steps, but please take them safely. Get a test and get yourself vaccinated as soon as you are in one of the eligible groups. It is incredibly important that we get vaccinations to anybody over 50 who has not had a jab yet, so please come forward now. Anybody over 50 who has had one jab eight weeks ago or more should come forward for their second. Crucially, get a test.

I pay tribute to all those my hon. Friend mentioned. Councillor David Greenhalgh, the leader of Bolton Council, has worked incredibly hard, as have his whole team. We are working cohesively together, and I very much hope that with that effort, we can get this sorted.

Obviously vaccines are important, but so is testing. Six months ago to the day, the Health Secretary told us that the UK would open two new mega laboratories in early 2021 to double the country’s capacity for carrying out covid-19 tests. We were then advised that they would open in early spring. The one in Scotland was cancelled. The one here in Leamington remains surrounded in secrecy, non-disclosure agreements and private contracts for staff employed by private companies, some linked to Conservative donors. The Health Secretary will be concerned by the delay, I am sure, even if he does not have a financial concern in this project himself. Can he tell us what is going on, and can he confirm when the place will open and that staff will be employed directly by the NHS?

We have a PCR testing capacity in this country of many hundreds of thousands more than we use each day. The Leamington Spa project is incredibly important and the people working there are doing a magnificent job. Frankly, I do not think that the rest of the hon. Gentleman’s question deserves an answer.

I strongly share my right hon. Friend’s sentiment, which he expressed earlier, about his pride in the role that the United Kingdom has played in the global vaccine effort, through the Oxford-AstraZeneca vaccine. Of course, the Indian variant shows that we remain vulnerable while the virus is rampant abroad, so what further steps can we take in the global fight against covid?

My hon. Friend makes an incredibly important point that we cannot stress enough. We all, especially developed countries, have a role to play in making sure that we get the vaccines around the world. The UK approach is focused on outcomes and on getting as many people as possible vaccinated globally. The best way to do that is to allow the work that we have done here—the research and the proving of the Oxford-AstraZeneca vaccine—to be replicated and manufactured everywhere at cost. That is a better approach because it protects future intellectual property values and allows for the research money to go into new vaccines and variant vaccines. It does not undermine the system of intellectual property, which is the underpinning concept of all pharmaceutical development, yet at the same time it makes sure that we get people vaccinated around the world. This country should be incredibly proud that we have helped vaccinate over 400 million people, with many hundreds of millions more to come.

On Saturday, my friends and I put on our trainers and walked 26 miles in Gower to raise a bucketload of cash for the fantastic breast cancer charity Walk the Walk. As chair of the all-party parliamentary group on cancer, I know only too well the devastating impact that the pandemic has had on cancer services. One of the key ways in which the Secretary of State can help with the Government’s goals to recover from the pandemic is by ensuring that we have enough well-trained and motivated NHS staff now and into the future. What discussions has he had with the Treasury to ensure a comprehensive, multi-year funding settlement for the NHS in the autumn spending review? Will he meet me and Macmillan Cancer Support to discuss this urgent matter?

I am always very happy to meet the hon. Lady, who works incredibly hard on this topic. I am delighted to say that the recovery of cancer services is going well and that in many of the centres, the rate of diagnosis, testing and surgery is above 100% of 2019 levels. That is very important. Of course, we are working towards the spending review. The NHS has a long-term baseline settlement, but on top of that we are putting extra money into the recovery that she rightly champions. I would be delighted to talk to her more about it.

The message today is all about the balance between celebrating the return of more freedoms today and in the future, and the need for caution, depending on the good sense of my constituents in Gloucester and those elsewhere. Will my right hon. Friend tell us how many of those recently hospitalised in Bolton as a result of the new variant had already been vaccinated; what more we can do to help spread the word to those who have not yet agreed to be vaccinated; and what role he expects pharmacies to play in testing as we go forward?

The best understanding that we have is that five of the 18 who were in hospital yesterday had been vaccinated once, and one had been vaccinated twice but it is not clear how recently. Therefore, the majority have not been vaccinated, but most of them could have been vaccinated. That is frustrating to see, but it is also a message to everyone. We monitor this closely and the latest information on those who have been admitted to hospital in Bolton over the weekend is similar: the majority are unvaccinated. It reinforces the message that people should come forward and get vaccinated, because that is best way to protect everybody.

Before Christmas, it was the mutation—the Kent variant—mixed with the opening of the economy in York that caused a rapid spike of covid-19 infection, as people came to visit our city en masse and spread the virus through the hospitality sector, where still many workers are yet to be vaccinated. Here we are again, and who knows what will come next? A different variant—the Indian variant—with high transmissibility is about to be spread in a city that many people are already visiting, with more to come. We feel vulnerable. What proactive, preventive steps will the Secretary of State take so that we do not pay that heavy price again for the Government not acting fast enough?

The most important difference between now and then is, of course, that the vast majority of those who are vulnerable to ending up in hospital or dying of covid have had two vaccines. The vaccination uptake rates have been spectacularly high and the uptake rate of the second vaccine has also been incredibly high. That means that the protection afforded to those who have chosen to take up the vaccine is very high. The latest estimates show that having two jabs and waiting a fortnight or so after the second jab leads to around a 97% reduction in mortality. Of course, we will continue to drive and to open up access in order to find the final few per cent. of people, but the lesson of the last few days is that people who have not taken up the opportunity to be vaccinated should do so, because it is those people who have sadly ended up in hospital, and we do not want that.

The Health Secretary can be proud of his role in the vaccination programme, and I welcome the further reduction in the age of eligibility. It may surprise my right hon. Friend, and indeed the House, that despite my appearance and general manner, there are still a few years yet to go, but I will be there, seized of the importance of taking up my vaccine. May I urge him to favour a surge in vaccination, rather than to flirt even momentarily with the idea of imposing local restrictions, which are not helpful and create a great deal of resentment?

I am glad to say that we will get to my hon. Friend before the end of July, no matter how young he is. I am pretty sure he is an adult in both actuality and attitude—crikey, I am getting myself into more trouble than I anticipated.

I understand my hon. Friend’s broader point, which is a call against local lockdowns, and we have had differences of view on that in the past. It is not where we want to go, though of course we do not rule it out. We have seen our approach work—it worked in south London —and we have this huge testing capacity, which we did not have in the autumn, of hundreds of thousands of tests a day. That capacity is expanding, as the hon. Member for Warwick and Leamington (Matt Western) articulated. We also have millions of lateral flow tests, which are simple and easy to use, and people get the result fast. With surge testing plus the vaccine, we have many more tools in our armoury than we did before.

I am very grateful in advance to the NHS Fife staff who will give me my second dose of the vaccine exactly 10 weeks to the day after my first one.

The Secretary of State indicated that probably a significant factor in the spread of the highly transmissible new variant is that people who could have been vaccinated by now chose, for whatever reason, not to accept the vaccine. In a number of cases, people have genuine concerns, but a major issue must be that people are declining the vaccine because they believe the lies deliberately and maliciously spread by anti-vax campaigners on social media. What further action do the Government wish to take against those who deliberately spread those lies for no other purpose than to put the lives of others at risk?

The anti-vaxxers have not had a very good time of it recently, and I am absolutely delighted that take-up is as high as it is. One of the reasons we have been able to take on the anti-vaxxers so effectively is that we have not danced to their tune. Instead, Members right across the House—I am looking around now and I see people in all parts of the House who have played their part in this—have put across the positive, science-based, objective, enlightenment values, if you like, of why the vaccine is the right thing. We as a House, as leaders of our national debate, have done that with one voice, based on the scientific advice. We have done it across the four nations of the United Kingdom with one voice. We have done it with scientists, with clinicians, with religious leaders—with all those who have a strong voice in this debate. Telling the positive story is the vital thing that we can do. Of course there may be those who do otherwise, but that is not for us—it is for us to tell the positive story.

I am very grateful to the hon. Gentleman for playing his part in that by celebrating having his second jab. I am thrilled that he will have, in just a couple of weeks’ time, the maximum protection that one can get. He is helping not only himself and his loved ones, but all of us together to get through this.

I was going to ask the Secretary of State to confirm whether, for those vaccinated, there is effectiveness against the B16172 variant, and how many deaths in the UK from that strain have been recorded among the vaccinated. However, given that he has just effectively turned the amber list red, can I ask him what is the point of me having my passport anymore? Covid will always mutate and the vaccine will always have to keep up. We have managed to vaccinate 99% of the mortality risk cohort. When will this Government actually take a little bit of risk and allow people to get on with their lives again?

The red, amber and green lists reflect the risks that there are in other places around the world. The amber list means that people need to quarantine at home, the red list means that they need to quarantine in a hotel, and the green list means that we think it is safe to travel. My hon. Friend should get his passport out—he can get on a plane to Portugal or one of the other countries. The system allows for some careful foreign travel. However, my first duty is to protect the lives of people here in the UK, and the best way to do that right now is to make sure that we are cautious on international travel to protect the opening up here at home.

The Secretary of State will know that analysis of the data published by Public Health England shows that the spike in cases in Bolton so far is mostly confined to schoolchildren and young adults who are socially mobile and have not yet been vaccinated. There are valid concerns, therefore, that as lockdown eases today, it might lead to a rise in cases within unvaccinated cohorts across Salford, which borders Bolton. Can he confirm that he will act now to protect people in Salford by curbing any spread beyond surge hotspots and accelerating the vaccine roll-out programme in Salford not just for second doses, but for first doses for young, unvaccinated cohorts?

Yes, we are opening up vaccinations for those aged 37 tomorrow, and anybody in Salford who is in one of the eligible groups and has not been vaccinated should come forward. If you are in Salford and you were vaccinated more than eight weeks ago but have not yet had your second jab, please come forward. We now have a very good surveillance system in this country and we publish all the data from it so that we can all see the cases day by day. We can also see the impact on hospitalisations. I am glad to say that, thankfully, the almost inexorable link from cases through to hospitalisation and death that we saw in the past is now broken. The link is not completely severed, but it is much, much weaker because of the protection of the vaccine. Those are the things that people can do in Salford, and I look forward to working with the hon. Lady to get those messages out to everybody.

The Secretary of State will know that my constituency of Hyndburn and Haslingden borders Blackburn with Darwen, and I thank the Department for having listened to colleagues’ call for extra support and resources through additional vaccines and surge testing. On a call this morning, Amanda Doyle, the integrated care system lead for Lancashire and South Cumbria, told us that one of the main concerns today is not a shortage of supply but the uptake of vaccines, so will my right hon. Friend join me in encouraging residents across Lancashire to come forward for their jab when eligible, and reiterate how important this is in protecting our local communities?

Yes, 100%. Just like people across Salford and Greater Manchester, people across Lancashire should come forward to get the jab if they are eligible. In some areas, such as parts of Bolton, we are going door to door with the jab; in the wider area, we are saying to people, “Come forward and get your jab. That is the best protection you can have.” Twice-weekly testing is also available to everybody now, so people should come forward and get their tests. The more regularly they get tested, the more they can help break the chains of transmission, and when they get their chance, they should get the jab.

Thanks to the Prime Minister’s delaying travel restrictions, an estimated 20,000 people arrived in the UK from India before restrictions were put in place. Can the Secretary of State inform the House how many of those arrivals were covid positive and were subsequently quarantined, and if not, why not?

The vaccination programme is one of the biggest and most successful civilian logistical exercises in our country’s history, and I thank the Secretary of State for his role in delivering it. It should open the way for our hospitality businesses to start operating at full capacity in due course, and for events, festivals and conferences to start, but there is still a lot of uncertainty about when this will happen. Will the Secretary of State publish a plan so that those two crucial sectors of our economy can reopen? It may take a while, but they need a plan and a timetable.

We are working on a plan for that with my right hon. Friend the Secretary of State for Digital, Culture, Media and Sport, and of course on the social distancing review that the Prime Minister is leading on. We are committed to making sure that we publish that well in advance of the decision on 14 June as to what the data show about step 4, which is currently planned for 21 June. Of course, we have set out four parameters for taking that step on 21 June, and the first three are currently in good shape. The challenge is the new variant, but it is far too early to be able to say anything about that specifically. We will look at the data up to 14 June and make an announcement on that date.

Covid restrictions are easing, but almost 5 million people are waiting to start NHS treatment, so now is not the time for a major reorganisation of the national health service. However, the Government’s plans for the future of the NHS and social care would embed a postcode lottery, allow for the deregulation of NHS professions and allow the discharge of vulnerable patients from hospital before they have been assessed for continuing healthcare. Public consultation on this has been woefully inadequate, so will the Secretary of State pause the entire process until after all covid restrictions have been lifted, and then carry out a full public consultation so that patients, NHS staff, care workers and unpaid carers can have their say?

On the contrary, the proposed reforms set out in the White Paper, which have come from the NHS itself, will help to deal with the backlog. They will help to make sure that the NHS is ready for the rest of the 21st century. They have been welcomed by the Health and Social Care Committee, and I am grateful to that Committee for its report last week, which welcomed those reforms while asking for further detail on a couple of other areas, which we will work with the Committee on.

I urge the hon. Lady to speak to her colleagues in the local NHS, and ask them whether they think that collaboration is the way forward; whether we should have greater interoperability; and whether we should have greater integration on the ground, and get rid of a load of the bureaucracy that is currently there in law. If she is not persuaded by her local NHS, by me or by the Select Committee, perhaps she should speak to her own Front Benchers, who also welcomed the reforms.

As of last week, over 82,000 doses of the covid vaccine have been administered across the High Peak. It is an amazing achievement and I put on my record my thanks again to everyone who has made that possible. I urge the Health Secretary to focus on doing surge vaccinations and surge testing in those areas with growing numbers of new cases to put us in the best possible position, so that we can get rid of any remaining restrictions as soon as possible.

Yes, this is our planned approach. I am glad to say that the number of cases across the High Peak is very, very low. I am also glad to see that the vaccination rates across the whole of Derbyshire are really high—I was in Derbyshire just before the elections, and the rates are high and there is huge enthusiasm behind the project. I pay tribute to my hon. Friend’s work in making sure that that is what has happened.

Given that the so-called Indian variant is now a variant of concern and is linked to several outbreaks in schools, why have the Government just abandoned the requirement to wear face masks in secondary school classrooms? The Secretary of State is fond of claiming that he is following the science, but this flies in the face of scientific advice from SAGE, public health experts and teaching unions. It begs the question as to why he is getting rid of one of the few mitigation measures in schools that we know actually works when we have such a transmissible variant. No one wants to see face masks in schools for longer than necessary, but neither do they want children to lose out on face-to-face education because of virus outbreaks. Once community rates go up, school rates go up, so why is he needlessly putting education at risk?

The hon. Lady kind of answered the question in the question, when she said that everybody wants to see face-to-face education. The thing is that in a classroom setting, being able to see somebody’s face does have a material impact and, therefore, we do not want to have face coverings in school settings for longer than they are necessary, but we are prepared to have them in place where they are necessary. There is discretion for local directors of public health where there are significant challenges. It is something that we discussed, for instance, with the director of public health in Bolton and in Blackburn. That has been part of the discussions over the last few days. What the hon. Lady is asking for is a blanket approach, including in areas where the number of cases is incredibly low. The decision that we have taken, on balance—taking into account the education risks and the advice from SAGE and public health experts—

The hon. Lady shakes her head. We listen to the scientists and, crucially, balance both the public health advice and the impact on education. Therefore, we have a more localised approach, without the blanket approach that she recommends.

Today’s measures are very welcome in Aylesbury, with local pubs, restaurants, the museum and the cinema all eager to welcome back customers. Will my right hon. Friend reassure local residents that, as business and culture return to normality, so too will our health services, and that, over time, it will become easier once again to have face-to-face appointments with GPs?

Yes. My hon. Friend will no doubt have seen the letter sent out from Dr Nikki Kanani, who is the medical director of primary care for NHS England, reiterating the point that it is important to offer a face-to-face consultation for a patient who really wants one while also using technology where that is the most clinically appropriate thing to do. These decisions should be taken between doctor and patient together. There is no greater supporter than me of the use of technology in healthcare. I think it improves access no end. People do need to be able to go to the surgery if they so choose and see the right person—the clinically appropriate person. That is the approach that we are taking while making sure that we can use a system that allows people to access the right services in the right settings as much as possible.

People will understandably feel angry that all the progress that everyone has worked so hard for by supporting the vaccines and following restrictions is now being slowed or potentially put at risk because the Government’s border measures have failed to prevent the spread of a new variant. Can the Secretary of State tell me whether it is true, as reported, that even by 7 April, 5% of people arriving from India had covid, apparently 50 times higher than the rate here; what that figure had risen to by 19 April; and how many of the 2,323 already identified new variant cases are people who travelled directly from India, and how many are people who caught it through onward transmission that was not prevented by the border measures?

As I said, the positivity rate for people travelling from India was relatively low at the start of April. We published the data of the positivity rates from the managed quarantine service. However, by the end of April, the positivity rate from India had risen, so we took the precautionary decision, even before this variant was deemed a variant under investigation, to put India on the red list. We did that before other similar countries, such as Germany and Canada, banned their flights. I understand the enthusiasm of the Chair of the Home Affairs Committee for pursuing this line of questioning, but we have to take decisions based on the evidence; we cannot take decisions based on evidence that arrives afterwards, which is what she seems to think we should have done.

More than 70,000 people in Redcar and Cleveland have now had at least one jab, which is an amazing achievement so far. It is great to hear that the vaccines seem to be protecting against the Indian variant too. Can my right hon. Friend confirm that the Novavax vaccine, which is made in Teesside, will also be tested against the Indian variant and other variants of concern, and will he update us on when it will be made available as another great Teesside export?

Yes, Teesside is playing it part. In fact, earlier today I met Ben Houchen, the newly re-elected Mayor of Teesside, to talk about what more we can do to invest in Teesside—in the NHS in Teesside, and in life sciences, such as vaccine production, on Teesside. He is doing a fantastic job of taking the voice of Teesside right into the heart of Whitehall—as is my hon. Friend, of course.

My hon. Friend is quite right to raise this point about the Novavax vaccine, which is going to be manufactured on Teesside. Of course, we will study its impact against the new variants, but we have a high degree of confidence that the Novavax vaccine has a broad coverage. In fact, one of its attractions is that it has that broad coverage, not just against the variant that it was precisely designed to deal with but against a wide range of variants. That is part of the theory of the technology that underpins that particular vaccine. It is a very modern vaccine, it is very exciting, and it is terrific that it is being made on Teesside.

We are not safe until everyone is safe. Following President Biden’s announcement that the US Government will support an intellectual property waiver to help scale up the volume of safe and effective covid-19 vaccines globally, can the Secretary of State explain why the British Government are still blocking the agreement on trade-related aspects of intellectual property rights—TRIPS—waiver at the World Trade Organisation?

Because we have a better approach. Our UK approach has led to the vaccination of 400 million people. The hon. Gentleman should take enormous pride in that. We have been able to do that while protecting the intellectual property rights that will lead to the development, for instance, of the new vaccines, the new technologies and the variant vaccines that are going to be necessary in the future. It is that combination of the protection of intellectual property rights plus the giving away of this vaccine at cost to the developing world—to lower and middle-income countries.

I reiterate the point I made earlier, which I hope the hon. Gentleman will take pride in: of the 54 million vaccine doses delivered through the COVAX facility, of which we are a major funder, 53 million have been of the Oxford-AstraZeneca vaccine, delivered with no charge for the intellectual property. That is the approach we should be taking. That is what we will do, and I urge everybody around the world to follow.

I do aim to try to take everybody, so can we have concise questions—and concise answers, Secretary of State?

My right hon. Friend will be aware that London has a younger cohort and is full of communities from across the world, but many are hesitant because of the activities of pharmaceutical companies in the countries of their origin. Will he look at aspects of control to ensure that those communities can get the vaccine they choose to take, rather than attempting to force them to take vaccines they are extremely reluctant to take?

We have had a principle of saying that they come forward for the vaccine and get the vaccine that is there on the day, but of course we have nuanced that because of the changes in the clinical advice on the AstraZeneca vaccine. As we reach further and further into those who need encouragement to come forward, so we are willing to look at more and more creative solutions to tackle people’s hesitancy. As it happens, I was in Brent central mosque last week at Eid. It was absolutely wonderful to see the work they have done to make sure that people of all faiths and none can come forward. For many Muslim people it means that in Brent they can go forward to somewhere where they are very comfortable being vaccinated. It was brilliant, frankly, to see teams working in the mosque to vaccinate people of all backgrounds. The imam was vaccinated by someone with the support of a member of the Jewish community with me looking on, all organised by a Hindu administrator. It was modern Britain at its best. They have done thousands of vaccines and they have done great work. I know it is that sort of approach that my hon. Friend is looking for. If we can do more on the specifics of which vaccine, I am very happy to look at that. [Interruption.]

Hull Royal Infirmary is a tower block and the geography of the building has resulted in a higher number of covid transmissions in hospital, despite the excellent work being done by all NHS staff. I fear that covid cases caught in hospital will only increase with a more transmissible strain of the virus. Will the Secretary of State look urgently at providing Hull Royal Infirmary with the funding it needs to improve its building as we all learn to live with the virus?

As the hon. Lady knows, we are building 48 new hospitals over this decade. Forty of those have been set out, but there are a further eight slots, so she may want to work with Hull Royal Infirmary to bring forward a proposal. Of course, tackling infection within hospital is incredibly important work and always has been since the time of Florence Nightingale. It is even more important right now and I think it will be a higher priority over the years ahead. I am always very happy to look at all proposals.

Today’s relaxation of restrictions is so welcome for all those who work in the hospitality industry. Pubs, restaurants and leisure facilities are all making huge changes to operations to welcome back customers, while also ensuring they keep everyone safe. Does my right hon. Friend agree that we should support those local businesses, while ensuring that we play our part in abiding by the safety measures and exercising caution as we gradually return to a normal way of life?

Yes, of course. My hon. Friend puts it very wisely. As the Member of Parliament for Burton, which is famous for its beer and its pubs, she no doubt speaks for her whole constituency when she says that she welcomes the measures we are taking and the steps we are able to take today. People should take those steps with caution. Outside remains better than inside. It is harder in the rain, Mr Deputy Speaker, but it is still better to be outside if you can. Putting more down to personal responsibility is the right approach at this stage, with the low level of virus and the huge scope of the vaccination project. I am very grateful to her for her support in pushing that agenda.

The Secretary of State will be aware that in Glasgow we have seen an increase in the virus due to the so-called Indian variant. That means that although everybody in this House is celebrating the return to indoor hospitality, many Glaswegians have not been able to experience it today, which we bitterly regret.

Up until 6 o’clock yesterday, flights were still coming into the UK from India, and 20,000 people have arrived in the UK since the alarm was raised about that variant. Does the Secretary of State really want to look Glaswegians in the eye and say that that was decisive action that has led to their staying in tier 3?

The history as the hon. Gentleman describes it is, in fact, wrong. We put India on the red list and therefore required hotel quarantine before the variant was designated even as under investigation, let alone as a variant of concern. So yes, we did take pre-emptive action. Anybody arriving now who has been in India in the past 10 days must go to a hotel to quarantine.

Although the incredible success of our world-leading vaccination programme has reduced the number of people in hospital with covid substantially, thereby relieving much of the pressure on the NHS, many of my constituents are still waiting longer for non-urgent NHS care. I am delighted that Blackpool Victoria Hospital is included in the pilot project looking at innovative ways to deliver services and reduce the backlog. Can my right hon. Friend reassure me that it will get all the resources it needs to remove the backlog as quickly as it possibly can?

Yes. Blackpool Victoria is a fantastic hospital and the team there has worked incredibly hard, especially over the past year and a half. I am delighted that it is part of the plan to work out how we can go even faster to get not just to the baseline 100% levels of activity in the equivalent month in 2019, but far higher than that, because we have to get through the backlog. The backlog is not just those who are currently on the waiting list, although too many are waiting more than a year and the waiting list is too long; there are also people who have not yet presented, but who we know are likely to have a problem. This is a huge challenge and I am very grateful to colleagues in Blackpool, who are working so hard not just to get through the backlog, but learn how best to get through it so that others can learn from them.

The staggering success of the covid vaccination programme means that on current trends, sadly, non-covid viruses may well kill more people this winter than the coronavirus. Is my right hon. Friend confident that an effective flu jab will be available to address this year’s emergent strains of flu? What will he do to maximise uptake of the flu vaccine by vulnerable groups? What is the latest on a covid booster dose this autumn? Would the flu jab be given at the same time?

My right hon. Friend is quite right to ask all those questions. In fact, I met Simon Stevens and the Minister for Covid Vaccine Deployment about the matter this morning, because we want to ensure that the flu vaccine programme this winter is a success. We had the biggest flu vaccination programme in history last winter. We are currently trialling the co-administration of flu and covid vaccines—I am waving my hands because one goes in each arm. We are looking at that for the autumn as part of a booster programme for covid. A lot of work is under way in this space; I suggest that my right hon. Friend discusses it with the Minister for Covid Vaccine Deployment, who is now responsible both for the covid programme and for the flu programme, in order to better tie them together.

I heard what the Secretary of State had to say about testing rates in Pakistan and Bangladesh, but according to Johns Hopkins University, the daily infection rate in Pakistan back in April was 4,500; in Bangladesh it was 7,000 and in India it was 100,000. Surely, if he were taking a precautionary approach, he should have placed India on the red list much sooner.

No. The statistic that is missing from that analysis, which was also missing from that of the hon. Member for Sheffield Central (Paul Blomfield), is the amount of testing that is done in each country. We have to look at the positivity when an appropriate selected sample is tested. It is not possible to do that in many low and middle-income countries, so the best way is to look at the positivity rate of people who are travelling to the UK, because we test everybody. That is the most statistically appropriate way to assess the question that the hon. Member for Eltham (Clive Efford) rightly tries to assess, and it showed that positivity rates were three times higher in India.

The time limit in the Queen’s Speech debate following this statement will start at five minutes, but I am sure it will go down thereafter.

I look forward to welcoming my right hon. Friend the Secretary of State when he visits the vaccination hub in Bournemouth. Today’s partial liberation of covid restrictions will be welcome up and down the country, and not least in Bournemouth where hospitality and tourism are so important, but the development of yet another mutation in the Indian variant illustrates that until this pandemic is brought under control globally, other more deadly mutations may develop. Does my right hon. Friend agree that this is a shared global adversary? Will it be raised at the G7 summit, and when does he think our spare vaccine capacity can start to be directed abroad?

My right hon. Friend is right to praise the incredible efforts in Bournemouth, which I know he has played a very direct and personal part in delivering, and I look forward very much to visiting as soon as I can get down there—and, by the way, I agree with Sir John Bell that Bournemouth is a great place to go on holiday and I am sure my right hon. Friend agrees about that too.

On global support, of course as and when we have excess doses we will look to support countries around the world with those doses, but the number of doses that we can support around the world from our excess purchases is small compared with the spectacular support we have already given the whole world with the more than 400 million doses of Oxford-AstraZeneca vaccine that have been delivered at cost. The majority of Oxford-AstraZeneca doses have been injected in low and middle-income countries, and 98% of all COVAX jabs given so far have been that vaccine delivered on the back of British science, supported by the UK Government, Oxford university and AstraZeneca, doing this all without taking a profit. We should be very proud of that.

The wider the gap between the rich and poor, the bigger the difference in our life expectancy and healthy life expectancy. That has been laid bare over the last year: the UK’s high and unequal covid death toll has been driven by the rampant poverty and inequality that successive Conservative Governments have allowed to go unchecked. In January, the Prime Minister promised to implement Professor Sir Michael Marmot’s recommendations to address that and to build back fairer, so what discussions has the Health Secretary had with the Prime Minister on that, and will investigating the UK’s structural poverty and inequality be part of a covid inquiry?

I discussed this issue with the Prime Minister. The office for health promotion is intended to be able to tackle some of those issues, led clinically by the chief medical officer, to make sure we can strengthen the public health case around Government, because so many policies of Departments outwith the Health Department are critical in addressing the question the hon. Lady raises.

I thank the Secretary of State for yet again coming to the House to update us on the covid situation. The Prime Minister, the Secretary of State and the whole Government must take great credit for the vaccination programme. The Secretary of State is surely right when he says we can defeat covid only if we have vaccinations, and we have been tremendously successful at that; I think we did 800,000 in one day last week. However, is it possible for us to increase that vaccination rate even more so we can defeat this terrible pandemic even earlier?

I hope so. The great limiting factor remains supply. We get them out as fast as we get them in; there is not a stockpile waiting. My hon. Friend is absolutely right about the importance of the programme: trusting the vaccine science and offering everybody a vaccine is the way out for all of us. If the Bolton example demonstrates that it is the unvaccinated who end up in hospital, we need to get that message to everyone. I would far rather be getting the vaccines out than having to undertake the sorts of local lockdown we had in the autumn; it is a far, far better approach, because we have these capabilities—the vaccines and the mass testing. That is the approach we are taking; my hon. Friend is right to highlight it, and he was very kind to say what he said about me.

People are really grateful to GP surgeries for their role in the vaccine roll-out, but are very keen to be seen face to face by a doctor, where that is appropriate, and in a timely manner. What is the Department doing to make that increasingly possible, please?

My hon. Friend will no doubt have seen the note that went out last week from Dr Nikki Kanani about ensuring that face-to-face access is available to the appropriate clinician, and that the use of technology should be encouraged but should be a matter for a discussion between the clinician and the patient. For many people, it is more of an advantage. Personally, I use telemedicine, and it is much more convenient for me, as a healthy and busy 42-year-old, but for some people it is right to see their clinician face to face. That letter went out last week, and we obviously constantly keep this issue under review and monitor it carefully.

Last week, I met the Taskforce for Lung Health, which raised a concern about an increased occurrence of lung scarring in long covid sufferers. What assessment has the Secretary of State made of the impact of this on potential resources for the health service?

We are of course worried about the impact of long covid, and the evidence is growing about the different impacts. The clinical advice is that there are a number of different syndromes that are, together, badged as long covid. For some people it has an impact, as the hon. Member says, on lung scarring; for some people the impact is more neurological. So we have to make sure that the services, the response and, indeed, the research are targeted at the different types of long covid. I am very happy to arrange a discussion between him and our clinical leaders on long covid, because it is a very important topic.

The Health Secretary may be forgiven, as he is one of the busiest people in the country at the moment, if he missed Tielemans’s strike from 30 yards and the VAR decision late on in the game, but 21,000 fans saw it live, and many of them were my constituents who were there to celebrate Leicester City winning the cup. Wembley of course holds 90,000 people and it was a test event, so when will we find out the results of the test event and the outcome for things such as the Euros in the future?

We will find out the results in the next few weeks. Of course, the right hon. Member for Leicester South (Jonathan Ashworth) may have been so cheerful in his opening remarks because he was there, and he saw Leicester triumph. I watched it, and I just thought how brilliant it was to see a live crowd again. It was not full— that is true—and no doubt it could have been filled, but it was not full because we are taking it carefully. I am working with my right hon Friend the Culture Secretary and the Minister for Sport—the Under-Secretary of State for Digital, Culture, Media and Sport, my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) —who I know found it extremely enjoyable to be able to go to a sports event as the Minister for Sport, which he has missed. We will assess the data that come out of it. Everybody who went is part of a testing regime. We will look at the results, as we will look at the results of the other pilots, such as the Brits and the snooker at the Crucible, and then make an assessment.

The UK’s defences against incoming covid infections are only as strong as the weakest point. I am still awaiting a response from the Health Secretary about the Hounslow director of public health’s concerns about covid-infected seafarers being transported to Hounslow hotels by the shipping companies, with no quarantine, no prompt notification to local public health teams and no consistent infection control at the hotels. Travellers and staff at Heathrow are also raising concerns about weaknesses in the arrivals process. When will the Health Secretary convince this House that the UK’s covid defences are fit for purpose?

I pay tribute to the team who have put together the managed quarantine service, which has run remarkably smoothly for such a complicated operation. They are always very happy to hear feedback, and are constantly improving the system. I work very closely with the Home Secretary and the Transport Secretary on this. There have been remarkably few complaints about a system that has had to be put in place for significant numbers of people.

I thank the Health Secretary for his constant support in ensuring continuous vaccine supplies to the Baths Hall. We have, of course, been following the Prime Minister’s announcements closely in Scunthorpe. Will my right hon. Friend set out more detail on how the move toward some second doses after eight weeks will be implemented, especially for those who have already booked their 12-week appointment?

I am delighted that we managed to sort out the wrinkle that we had with the supplies of vaccine to Scunthorpe. It was a really good example of how this should work: my hon. Friend spoke up for Scunthorpe, and then the Minister got it fixed. I am very glad that we managed to sort that, and if there are any further problems, please do let me know.

We are inviting people who are over 50 and have a second jab booked 12 weeks after their first to rebook their vaccination from eight weeks after—not before eight weeks, because the effectiveness of the second jab strengthens for those first eight weeks. They can do that on the national booking system or through calling 119. We are texting those whose numbers we have to communicate with them. There is a whole process in place to get people rebooked wherever possible.

People in Chesterfield are looking forward to getting back to the football stadium this weekend. I am not sure we will enjoy it quite as much as my right hon. Friend the Member for Leicester South (Jonathan Ashworth) did this weekend; none the less, it is incredibly important to everyone. For that reason, they are understandably worried by the increase of the Indian variant, so it is important that we understand the decisions. I heard what the Health Secretary had to say about the reasons why he thought it was appropriate for India to be put on the list later than Pakistan and Bangladesh, but there will be those who think that the Prime Minister’s impending trip to India was a factor. We know there is an inquiry coming down the track. Will the Health Secretary confirm and clarify that there were no discussions, when the decision was made to put India on the red list later than Pakistan and Bangladesh, about the economic consequences, the Prime Minister’s trip or anything like that, and that it was purely health considerations that were in play?

These decisions are based on the evidence, and the Joint Biosecurity Centre puts forward the evidence for red-listing. In the first instance, the red list is there to stop new variants, but this variant was not a known variant under investigation. Because of the increase in the overall rates—the overall positivity—of people coming to this country, first from Pakistan and Bangladesh at the start of April, and then towards the end of April from India, we took the precautionary decision to put them on the red list. That is a matter of fact; I am happy to state that. The job now is to make sure we keep this all under control.

The success of the vaccination programme has surpassed expectations, in part because of the very effective work that was done in tackling vaccine hesitancy at the start, but it is implicit in my right hon. Friend’s statement that, in Bolton and Blackburn particularly, there has been less success with persuading some people. What does he consider to be the model of good practice in persuading hard-to-reach groups? Where does he think that has taken place, and how will he roll it out in other areas?

I am incredibly proud that the UK has the highest measured rate of enthusiasm for taking the vaccine in the world, and especially that such a diverse nation has been able to achieve that record by taking this positive attitude and having people from Her Majesty down setting out the value of being vaccinated. I pay tribute to the comms team at NHS England and my communications team from across Whitehall, which have taken the lessons for how to get a positive narrative, especially on social media, and made sure we fought lies with objective truth. That has been fantastic.

On the ground, there are some really good examples. I mentioned my visit to Brent central mosque and I pay tribute to the people there. Some brilliant work has happened in Leicester; for instance, there was a vaccination centre right next to an area heavily populated by those of Somali background, but they were not going to the vaccination centre despite the fact that it was next door and so we set up a vaccination centre almost next door but where the doctors and clinicians are themselves Somalis. We then we saw a very sharp rate in the Somali vaccination rate. That is one example that I can immediately add to the elucidation of the answer to this question, but there are legion. People from around the world have been coming, via Zoom, to talk to some of our more innovative vaccination centres, be it at the mosque, at the Hindu temple in Neasden, which is doing brilliant work, in Leicester or, now, in Bolton and Blackburn, where I hope we can make some really significant progress. Frankly, this country should be proud of how people have pulled together to make this vaccination programme work.

Unbelievably, I am older than Will Wragg, marginally, so I have had my first jab. The second jab is a week Saturday—bring it on! Secretary of State, thank you for your statement today. We will suspend for two minutes.

Sitting suspended.