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Covid-19 Update

Volume 706: debated on Thursday 13 January 2022

Let me start by paying tribute to Professor Sir Jonathan Van-Tam, who, after four years as deputy chief medical officer, will be returning to his role at the University of Nottingham at the end of March.

There are not many clinical advisers who can be recognised solely by three letters, but JVT’s unique and straightforward approach to communication has seen him rapidly become a national hero. I will use some words that I think he might particularly like. We are grateful for having had him on loan for so many years. He has been a top signing, and he has blown the whistle on time. I am sure the whole House will want to join me in wishing Jonathan Van-Tam—Professor Sir Jonathan Van-Tam—all the very best.

With permission, Mr Speaker. I will now make a statement on the covid-19 pandemic. We have started this year as the freest country in Europe, thanks to the decision we made to open up in the summer and the defences that we have built, but we must not lose sight of the fact that the virus is still with us, and that there are still likely to be difficult weeks ahead. According to data published yesterday by the Office for National Statistics, there are encouraging signs that infections are falling in London and the east of England, but they are still rising in other parts of the country, and the data does not yet reflect the impact of people returning to work and school; so we must proceed with caution.

Omicron’s far greater transmissibility still has the potential to lead to a significant number of hospitalisations. There are already nearly 17,000 covid-19 patients in hospital in England, and, owing to the lag between infections and hospitalisations, the NHS will remain under significant pressure over the next few weeks. It is encouraging, however, that during this wave we have seen no increase in the number of covid-19 intensive care patients, and there are early signs that the rate of hospitalisation is starting to slow.

We know that omicron is less severe, but no one should be under any illusions: it is severe for those who end up in hospital, and that is far more likely if they have not had the jab. In many major cities in the United States where the levels of booster vaccination are comparatively lower than the UK, pressures on intensive care are approaching the levels of last winter, and in Chicago they have already exceeded the peak from last January. So we must stay vigilant, and keep fortifying the pharmaceutical defences that we have built—some of the strongest in the world.

Let me now update the House on how we are making those pharmaceutical defences even stronger, and how we are giving the NHS and the country what they need to withstand this omicron wave. Our primary defence is, of course, the vaccination programme. Some 79% of eligible adults in England have now had a booster, including more than 91% of over-50s, who we know are more vulnerable to the virus. Per capita, we are the most boosted large country in the world. Data published on Friday by the UK Health Security Agency shows that about three months after those aged 65 and over received their booster, their protection against hospitalisation remains at about 90%. These vaccines do not just protect ourselves and our loved ones; they protect the country’s progress too. The reason we have been able to start the year with much greater freedom than last year, with children back at school, shops opening their doors and this Chamber bustling with activity, is that so many people have made the positive choice to be vaccinated.

There are, of course, a small minority of people who could get the jab if they wanted to, but have chosen not to. Let us be clear: those people have been able to enjoy the freedoms that they enjoy today because they are standing on the shoulders of the nine out of 10 people across the UK who have stepped forward to get the jab. If we are to maintain the collective protection that we have built, we need everyone to choose responsibly and take the simple step that will help to secure greater freedom for us all.

People working in health and care look after some of the most vulnerable in our society, so they carry a unique responsibility. Last month, this House approved our plans that anyone working in health or wider social care activities regulated by the Care Quality Commission will need to be vaccinated against covid-19 if their role involves direct contact with patients, unless of course they are medically exempt. That includes NHS hospitals, the independent sector, and GP and dental practices regardless of whether they are working in the public or private sector. Uptake over the past few months has been very promising: since the Government consulted on the policy in September, the proportion of NHS trust healthcare workers vaccinated with at least a first dose has increased from 92% to 94%, and we remain committed to putting these measures into force on 1 April.

Our next line of defence is testing. We are doing more tests than any other country in Europe. We raised the distribution of free lateral flow tests from 120 million in November to 300 million in December to meet the demands of the omicron wave, and we expect to make approximately 400 million tests available over the course of this month—four times the pre-omicron plan.

Our third line of defence is antivirals and treatments, for which we have built the most advanced programme in Europe. We have now secured almost 5 million courses of oral antivirals and are leading the whole continent in the number that we have procured per person. We are already making these cutting-edge antivirals and treatments available directly to patients. Last month, we contacted 1.3 million of those at the highest risk from covid-19, such as people who might sadly be suffering with cancer or people with Down’s syndrome, and sent them a PCR test kit that they can keep at home. If they test positive, they can access either a monoclonal antibody or an antiviral; either it can be sent to those patients at home or they can access it through a clinician at one of the 96 covid medicine delivery units that now exist across England.

We are also making oral antiviral treatments available more widely through a national study. If any of our constituents who are over 50, or are between 18 and 49 with an underlying health condition, get covid-19 symptoms and test positive, they are eligible. They can sign up for the trial, if they are interested, by visiting The more people who sign up, the more widely we can deploy these treatments.

With those three defences—the most boosted, the most tested and the most antivirals—it is no wonder that we are the freest country in Europe. This country is leading the world in learning to live with covid.

Just as we have strengthened these defences to keep people out of hospital, we are taking measures to ensure that the health service has what it needs. As part of that work, we have looked at every available route to secure the maximum capacity possible across the NHS. We have been working with the latest technology to create virtual wards where patients can be monitored by clinicians remotely in their own home. We are bringing on stream extra beds in hotels and hospices, where people can be safely discharged once they are ready to leave hospital. We are putting in place new Nightingale surge hubs within hospital grounds to provide extra resilience should we need it. We are also making use of the independent sector: this week, we announced a new three-month agreement that will allow NHS trusts to send a wider range of patients, for example those in need of cancer care, to the independent sector for treatment.

These measures, taken together, are our insurance policy, helping us to plan for the worst while we hope for the best. As with any insurance policy, we hope that we will not need to use it, but it is the role of any responsible Government to prepare for all reasonable outcomes so that we can keep this country safe and protect the progress that we have made.

Finally, I have always said to the House that any curbs on our freedoms must be an absolute last resort and we should not keep them in place for a day longer than absolutely necessary. With that in mind, we have been reviewing the isolation period for positive cases to make sure that the measures we have in place maximise activity in the economy and education, and minimise the risk of infectious people leaving isolation. UKHSA data shows that about two thirds of positive cases are no longer infectious by the end of day five, and we want to use the testing capacity we have built up to help these people leave isolation safely. After reviewing all the evidence, we have made the decision to reduce the minimum self-isolation period to five full days in England. From Monday, people can test twice before they go, leaving isolation at the start of day six. Those two tests are critical to these balanced and proportionate plans, and I urge everyone to take advantage of the capacity we have built up in tests so that we can restore the freedoms to this country, while we are keeping everyone safe.

We have now entered the third year of this country’s fight against covid-19. Thanks to an incredible national endeavour, we are now better protected than ever before. But this virus is not going away; there will be more variants, and no one can be sure what threat they might pose. But we can be sure that our pharmaceutical defences—vaccines, testing and antivirals—are the best way to protect our health and our freedoms as we learn to live with covid. I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement. I also pay tribute to Professor Sir Jonathan Van-Tam, who has provided outstanding public service throughout the pandemic. It was not the government resignation we were looking for, but the timing brought to mind the now infamous and deleted tweet from the UK Civil Service:

“Can you imagine having to work with these truth twisters?”

JVT already has a knighthood, but working with the Prime Minister he must have the patience of a saint. On behalf of the whole Labour party, we thank him for his service and wish him well for the future. He is truly a national treasure.

We welcome the announcement the Secretary of State has made on the reduction of the covid isolation period to five days, on condition that two negative tests are produced. So let us hope that he sorts out testing. Before Christmas, he told us that there were no issues with supply, but over Christmas NHS staff and other key workers were unable to access tests because the Government had not noticed that the deliverers had shut up shop for Christmas. Workforce shortages are one of the biggest challenges facing the NHS and the wider economy during the current wave of the omicron variant. This measure will help people get back to work faster and safely, which is great news for the Prime Minister, who, through a terribly unfortunate coincidence of timing, is isolating today, unable to face the cameras or the public. How good of the Secretary of State to help the Prime Minister back to work in time to face the music again at Prime Minister’s questions next week—the Leader of the Opposition looks forward to seeing him.

But what took the Secretary of State so long? Is it really because the Government had misread the policy of the Biden Administration? How many days does the Secretary of State think the NHS has lost and the economy has lost because they could not read the policy being used in the US? The Secretary of State has been briefing that it is UKHSA’s fault—how brave of him to blame officials. But the CDC—Centres for Disease Control and Prevention—advice to the Biden Administration is open access and available on its website. Did he not read it? Doesn’t anyone in this Government take responsibility any more—or is “blame the staff” now the essence of the ministerial code?

We are not out of the woods with covid-19 yet. We hope that the omicron variant has passed its peak in London, but we know it is yet to peak across vast swathes of England and that NHS services are under enormous pressure. Today, we learned that NHS waiting lists were at an historic 6 million before the omicron wave arrived. Twenty-four hours in A&E is not just a television programme; it is the grim experience of patients in too many cases. Week after week, we see more evidence of unacceptable delays for patients.

Now we know that the Government are lowering standards and normalising longer waits in the NHS: 12 hours to be seen in A&E, two years for referral to treatment and an hour just to be transferred from an ambulance into hospital—assuming someone can get an ambulance and has not been told to phone a friend or call a cab if they are suffering from a stroke or suspected heart attack, as has happened in at least one trust in the north-east of England. Does the Secretary of State really believe those waits are acceptable, or is it just the case with this Government that when they break the rules, they change the rules?

The Secretary of State will want to blame pandemic pressures alone, but we went into the pandemic with NHS waiting lists already at a record high of 4.5 million, staff shortages at 100,000 and social care vacancies at 112,000. Patients are paying a heavy price with delays, and the country has paid a greater price with lockdowns, because a decade of Tory policies left the NHS without the capacity and resilience to withstand the annual pressures of winter, let alone the unique pressures of a global pandemic. Where is the workforce strategy for the recovery? Where is the elective care recovery plan? Where is the sign that this Government have any understanding of the responsibility they bear for the crisis, let alone a plan to fix it for the future?

Finally, can I ask what on earth the Secretary of State thought he was doing yesterday when he leapt to the Prime Minister’s defence? His first duty is to public health. He also has a duty to the health and social care workforce. If doctors and nurses had brought their own booze to work, they would have been fired. The Prime Minister has undermined trust and confidence at a critical moment in the pandemic. Who is he to ask others to do the right thing when he does not practise what he preaches?

In conclusion, the Secretary of State has a duty to inoculate the Government’s pandemic response from a toxic, radioactive Prime Minister. The public have concluded that the Prime Minister is unfit for office. The Secretary of State needs to be careful in his defence that they do not draw the same conclusion about him.

First, I notice that the hon. Gentleman did not mention the huge increase in booster vaccinations in this country since he last stood at the Dispatch Box facing me. He just heard me say it, so he knows we are the most boosted country in Europe and the most boosted of any large country. He knows how much that has helped, yet there was not one word of thanks from him to the NHS, the volunteers, the military and everyone who helped to do that. There was not one word of thanks from the hon. Gentleman. It will be noted by the British public. I did notice, though—[Interruption.] Would the hon. Gentleman like to return to the Dispatch Box? I will sit down.

I am not sure that is in order, but what I said from a sedentary position is that the Prime Minister is not fit to lick the boots of NHS staff in this country.

Again, the hon. Gentleman had another fresh opportunity to thank the NHS staff for the enormous work they have been doing not just throughout the pandemic but in December, and especially for everything they have done to boost so many people, but there was not one word of thanks from him.

I was pleased to hear the hon. Gentleman welcome the new self-isolation policy. He asked whether enough tests are available. He might have heard me say earlier that we have quadrupled the number of lateral flow tests available this month to approximately 400 million, which is more than four times the original pre-omicron plan. I was confused by his response to that, because he seemed to be suggesting that we should be subcontracting our covid policy to the US Centres for Disease Control and Prevention. If I heard him correctly, he was suggesting that just because another country—in this case, the US—has changed its policy, we should automatically follow suit and do what it does.

We have just taken back control from the EU. We have just left the European Medicines Agency, and here the hon. Gentleman is, just months later, suggesting we subcontract our policy to another state. That tells us all we need to know about the Labour party’s approach. He suggests we take the same approach as the US, and he of all people should know that while the US might have an isolation period of five days, they have no testing. I do not know whether the hon. Gentleman heard me earlier, but let me remind him: the UK Health Security Agency data shows that approximately 30% of people are still infectious at the end of day 5. That is why we require two tests.

The hon. Gentleman was suggesting that we should have the same policy as the US, which requires no testing, and for everyone to leave isolation at day 5, regardless of whether they have tested or not, and wear a face mask for the last five days. The hon. Gentleman has to decide whether he wants these decisions to be made here in the UK, based on expert UK advice from some of the best advisers anywhere across the world, or to subcontract them to another state.

Finally, the hon. Gentleman talked about the NHS and capacity. He will know that as a result of the omicron emergency, it has sadly been necessary for the NHS to make changes. Of course that has had an impact on electives. The most urgent electives such as cancer care will be protected, and he heard me talk earlier about the deal that has been done at least for the next three months with the independent sector. I hope he supports that and the measures that the NHS is taking to protect capacity.

I welcome today’s announcement. We have one of the best vaccine programmes in the world and as a result we can look forward to a time of living with covid with justified confidence. This is a very important step forward.

As the Secretary of State knows, last week the Health and Social Care Committee published a report on what is going to happen now that the NHS is starting to think about tackling the covid backlog. We said that we were worried that that would be derailed by a workforce crisis, with shortages in nearly every speciality throughout the NHS. When is the covid backlog plan going to be published? Will it have details about what is going to happen in areas such as emergency care and general practice social care, all of which have a direct impact on the ability of the elective care programme to deliver? Will it deal with what the Health Foundation says is a shortage of 4,000 doctors and nearly 19,000 nurses who will be necessary for that elective recovery programme? Finally, when is he going to publish the workforce strategy? Will that have independently verified assurance that we are training enough doctors and nurses for the future?

First, I thank my right hon. Friend for his support for the changes that the Government have announced today. He is right to raise the importance of the workforce, especially when it comes to dealing with the backlog. He may know that since September 2020, 20,000 more clinicians have been working throughout the NHS, but we do need to plan properly for the NHS workforce in the long term. The Government are working on a workforce strategy and I look forward to discussing that with him and the members of the Committee that he so expertly chairs in due course.

In response to the news that all Tory MSPs and the leader of the Tories in Scotland have called for the Prime Minister’s resignation following his covid-rule-breaking party, the Tory Leader of the House resorted to personal attacks. Does the Secretary of State for Health think that attacks from members of his Government on those who criticise covid lockdown regulation violations is conducive to encouraging public compliance with covid restrictions—with all the implications that that has for the NHS and staff, who are already under enormous pressure?

If the Prime Minister cannot or will not follow his own rules, why does the Health Secretary think he can possibly continue to argue that the public should follow them? Is not the Prime Minister’s credibility on regulating and issuing public health instructions, as we continue to face covid restrictions, in tatters? The longer the Secretary of State supports the Prime Minister’s breach of these regulations, the longer his own credibility will suffer. Does he truly and sincerely think that the Prime Minister is the best person within his party’s ranks to lead the UK Government’s ongoing battle with covid?

The Prime Minister stood at the Dispatch Box yesterday and apologised; he set that out very clearly from this Dispatch Box. As he said, and as I think most people have accepted, it is right to wait for the completion of the investigation by Sue Gray.

I join the Secretary of State in his tribute to Professor Jonathan Van-Tam for his remarkable public service, and I welcome the announcements that he has made today. Restrictions have an impact beyond covid, and we should be as responsive in lifting them as we are in imposing them. Given the news he has given us today that over 91% of over-50s have been boosted, can he confirm that we are on track to lift the plan B restrictions when they expire on 26 January, and will he include in that the advice on face masks in classrooms, for which a particularly weak evidence base was published?

I thank my right hon. Friend for his support for these new measures. He speaks with considerable experience. He is absolutely right to talk about the impact of restrictions beyond health. He has heard me, and other members of the Government, say before that no restrictions—none at all—should be in place for a moment longer than is absolutely necessary. He will know that the plan B restrictions, unless this House were to decide otherwise, will sunset on 26 January. On what happens next in terms of the Government’s own view, we will set that out as soon as we can.

The Secretary of State talks about the importance of having insurance policies, and in managing risk as he is, that is of course the proper thing to do. However, on Friday, he issued a ministerial direction to the NHS England chief executive, Amanda Pritchard, to authorise the use, as he touched on his statement, of private sector providers, and this is at a very high cost. It requires a minimum income guarantee for those private hospitals of between £75 million and £90 million a month, and if the surge requirement is used, that could rise to £175 million a month, as the chief executive sets out in her letter requesting the direction. Where is that money going to come from, and why, at this stage of the pandemic, are we still being held over a barrel, as the taxpayer, by the private sector? Could not the Secretary of State at least have negotiated a better deal?

The deal that the hon. Lady refers to was negotiated by the NHS, and I think it has done an excellent job in its negotiations. It is also absolutely right for the chief executive of the NHS to write to the Government—to write to me—to request such a direction, because the NHS’s job is obviously running the NHS, but the Government’s job is to think beyond the NHS and the impact of covid beyond just health. The hon. Lady should know by now that the more capacity we have in the NHS, the less need there is for restrictions. What I can say for sure is that had we not taken out this insurance policy with the independent sector and got this extra capacity, she would be one of the first to stand up in this House asking us why we did not work with the independent sector.

I welcome my right hon. Friend’s statement about reducing the self-isolation period. I have a number of constituents who have not seen their relatives in care homes for a considerable time. A member of my own family can have one visitor but has been confined to her small room for coming up to five weeks now because every time there is a case anywhere, everybody is kept in their rooms and cannot go in the garden or the communal areas. Will my right hon. Friend look at these guidelines again, because of course we want to protect care home residents, but the way they are being implemented is having a considerable impact on those people’s physical and mental health?

My hon. Friend is absolutely right to raise this most important of issues. In the way he phrased his question, he reflects just how difficult it is to strike the right balance in care homes between protecting the residents but also making sure that they can get the visits that are so important for them. The approach that we have taken in England is different from that in other parts of the country. We do allow more visitors. We are supplying a record number of tests to care homes, not only for the residents but for the staff. For the reasons that he has so clearly laid out, we keep this under review and will remove restrictions as soon as it is safe to do so.

I welcome the Secretary of State’s statement, particularly his reference to cancer patients and his commitment to apply the latest technology. May I respectfully draw his attention to yesterday’s excellent debate in Westminster Hall about access to radiotherapy services? In particular, I draw his attention to the fact that modern radiotherapy is extremely precise, cost-effective and non-invasive, and it does not affect the immune system. Can I urge the Secretary of State to provide the required additional resources needed to modernise radiotherapy services throughout the UK and to catch up with cancer?

I very much agree with what the hon. Gentleman has shared with the House. Unfortunately, I was not able to attend that debate, but the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield) did, and she will also be meeting the all-party parliamentary group on radiotherapy and listening more. I know the hon. Gentleman agrees with me that it has been absolutely right during this very difficult time for the NHS to direct more resources especially to looking after more covid patients and to the booster programme, but it has also been right to protect cancer care.

As the world improves with the vaccine programme that we have had and continue to have, which has been brilliant in this country, could I ask the Secretary of State to urge doctors who are not on the covid frontline to actually see their patients face to face again, because doctors in hospitals and GPs are still not doing this fully and people’s problems are being missed?

There is also a problem as the world opens up that if someone who has had covid needs to travel, they cannot take a PCR test because that shows they are positive even though they may have long since had it—they are not positive for covid any more, but it still shows positive on a PCR test—and they cannot prove to the country they are going to, and many people are wanting to travel more now, that they do not have covid, so people can actually be stuck for 90 days during which they cannot go out of this country to any country that requires a negative PCR test because they cannot get one.

First, I agree with my hon. Friend about the points she has made on these issues. On her final point about travelling, as she has seen just in the last few days, the UK Government keep our travel rules under constant review. The moment we have been able to safely remove any of those rules based on the evidence, we have done so, and I know my hon. Friend has respected that. When it comes to the rules of other countries for British citizens wishing to travel for holiday, business or otherwise, those are of course their rules. However, we are working at many levels—in my Department, the Department for Transport, the Foreign Office and others—with those countries to see how we can best co-ordinate on such rules.

I am delighted that JVT is returning to the University of Nottingham, but I am worried about what he will hear from local clinicians. This week, I received an email from a doctor working in our local NHS. She says:

“I am crying as I write this. For years now the talk has been that the NHS is ‘at breaking point’. Well that point has passed. We are broken. We are on our knees.”

Of course, covid has taken a huge toll on staff, but we went into the pandemic with huge waiting lists and chronic staff shortages as a direct result of under-investment and mismanagement over the previous decade. Has not the right hon. Gentleman’s party failed my constituent and her NHS colleagues?

As I have mentioned, JVT’s move is the country’s loss, but Nottingham’s gain, and I am glad that the hon. Lady is delighted. On investment in the NHS, she will know that, even before covid-19, the Government had already set out, in the long-term plan for investment in the NHS, the extra £30 billion going into the NHS by the end of that period, with huge investment in areas such as cancer care, mental health care and electives. Then during the crisis, which has of course been very challenging for our health and care services, as it has been across the world, we have set out over £40 billion of extra investment, including this year, to help us get through this crisis.

I welcome the change in the self-isolation rules that the Secretary of State set out. It is a good indication that the Government can be flexible on policy, so let me have another go on the subject I raised yesterday. My right hon. Friend heard the exchange I had with the Vaccines Minister. She agreed with me from the Dispatch Box that persuasion was the best and right way to get health and social care workers to be vaccinated. However, telling a health and social care worker that they will be sacked if they do not get vaccinated is not persuasion, but coercion. Will my right hon. Friend reflect on whether it is sensible on 1 April to continue to try to implement a policy that, according to the Government’s estimates, will mean 73,000 NHS staff and 38,000 domiciliary care workers losing their jobs? When a policy is not working, it is right to ditch it, isn’t it?

First, I commend my right hon. Friend for the scrutiny that he has constantly provided of the Government’s covid policy. He did that long before I was Secretary of State and I am pleased that he has continued to provide that scrutiny, which is very valuable. It is most valuable to me when he supports the policy, as he did on self-isolation today, but it is still valuable when he challenges the Government to think again about policy. That is very important. I addressed the policy he raised of the vaccine as a condition of deployment in the health and social care sector a bit in my statement. He will have heard that we are committed to it, but that is because it is right that, in those settings where there are people who are more vulnerable than others, they are put first. We know that vaccines limit transmission and that as a result it is safer for patients if the individuals who provide that care—the health and care workers—are vaccinated. The policy is about putting patients first, was voted for by the House with an overwhelming majority, and the Government intend to implement it.

The Secretary of State put a lot of emphasis on testing in his statement. Inspired Outsourcing in my constituency would agree with him. It provides contact centre services, and some of its workers are key workers so cannot work from home. It has been using twice-weekly testing to keep its workers safe, but has run out of tests. It cannot get hold of any tests apart from by paying what would effectively be £2,000 a month to a private provider recommended on the Government’s website. Does the Secretary of State believe that small businesses such as Inspired Outsourcing should have access to free lateral flow tests? How can it get hold of those tests today in Newcastle, because that is what it needs to keep its workers safe and provide protection to us all?

That is an important point. When the country first discovered omicron, the tests that were in stock were not designed for another huge wave. However, the people who run testing at UKHSA responded very quickly by ordering almost any lateral flow tests that meet our standards that they could find. As I said in my statement, in December, we had 300 million as opposed to the 100 million that was originally planned and, in January, there will be four times the pre-plan amount. In answer to the hon. Lady’s specific question, whether for a workplace, for visiting a care home or other reasons, people will be able to get access to the lateral flow tests now that millions more have arrived in the country. They have been distributed and people can get them online or from pharmacies.

I am very grateful to the excellent Secretary of State for coming to the Dispatch Box yet again to update the House and particularly for making an announcement first in the House rather than to the media.

I wonder whether my right hon. Friend agrees with Lord Frost, who said:

“I would like to see the Government ruling out lockdowns for the future, repealing the legislation, ending them…We can’t afford it, it doesn’t work, stop doing Covid theatre—vaccine passports, masks, stuff that doesn’t work”.

I have huge respect for Lord Frost and for my hon. Friend, who has just shared some important points. No one wants to see this country go back into anything resembling a lockdown. As he will have heard earlier, while we have had to put some restrictions—the so-called plan B—in place over the past few weeks, I hope he will agree that, when we reflect on those restrictions and compare them with other countries in Europe, large or small, we are the freest country in Europe. The reason for that is the pharmaceutical defences that I talked about earlier: we are the most boosted large country in Europe, with the most antivirals per head and the most testing. That is what we should focus on for the future as we learn to live with covid.

I want to press the Secretary of State on the morale of our NHS and social care workforce. He will know that, between March 2020 and May 2021, 1,561 NHS and social care staff died from covid while working on the frontline. That is part of the reason I am campaigning for an NHS and social care covenant, just as we have for the armed forces and the police. What does he have to say to those key workers who saw colleagues die while the Prime Minister was at the law-breaking works party on 20 May?

The right hon. Lady is right to raise the importance of morale in the NHS. I know that, as I do and every Member of this House does, she will know full well the huge debt this country owes to everyone who has worked in the NHS and the care sector, especially over the past two years. She has talked about campaigning for an NHS covenant; I am not sure how much longer she needs to campaign, because I have already announced we are going to have one. I will be happy to work with her on how we could do that, but she can desist from her campaign and put her efforts into working with me to help to introduce one. She will know that as Home Secretary I decided the police should have a covenant, so it is right that we recognise the NHS in that way too. As for the points she made about the Prime Minister, I refer her to the answer I gave a moment ago.

As my right hon. Friend knows, despite my enormous respect for him, I voted against the introduction of covid passports before Christmas. I maintain my view that they are not effective. Will he please commit to dropping domestic certification at the earliest possible opportunity? Will he also make clear today from the Dispatch Box to NHS trusts up and down this country that he will not stand for the pandemic of arbitrary discrimination we are seeing against pregnant women and their partners, and parents who want to be with their children on paediatric wards but are being prevented by trusts in an illogical and unscientific manner from being with them to look after and advocate for them?

First, I agree with every word my hon. Friend says about pregnant women. That is a message that has been reinforced to every NHS trust. I thank her for how she has campaigned on this issue and brought it to light, because that is making a difference. On the issue she raised about domestic certification, I share her instinctive discomfort, and I assure her and the House that as far as I am concerned we will not be keeping domestic certification in place a moment longer than absolutely necessary.

May I, from the Liberal Democrat Benches, also pay tribute to the services of Professor Sir Jonathan Van-Tam? The Government are still ignoring people who are clinically extremely vulnerable, and their concerns at the lack of guidance and support. I raised this with the Secretary of State before Christmas and I still have many of my Bath constituents writing in about it. Two thirds of housebound people have not received the booster. What are the Government doing to ensure that the vaccines are accessible to everybody, including the housebound?

The hon. Lady talks about ensuring everyone gets access to the booster. The people at the top of the list should be those who are clinically extremely vulnerable, as long as the vaccine is something that can work for them. That is why, during the month of December, especially when we accelerated the booster programme, working mainly with GPs but also with others, those who are housebound or are in care homes were a priority and we saw the booster rate rise substantially.

I also point the hon. Lady to what I said in my statement about the 1.3 million clinically extremely vulnerable. The NHS has contacted them directly to ensure that they have access to the new antivirals that we have procured. I am sure that she would welcome that.

I thank the Secretary of State for his statement, which brings such positive news that will give confidence to individuals and businesses as they return to a more normal life as we learn to live with covid. My constituency has many, perhaps a higher proportion of, small self-employed businesses and they were absolutely terrified in the run-up to Christmas that we were looking at lockdowns and severe restrictions. I therefore thank him and the Prime Minister for the balanced, proportionate approach that the Government have taken in looking at how we move forward and for the steps they took during the Christmas period. May I seek assurances that that will continue to be the way?

I thank my hon. Friend for his comments and support for the changes that I have announced today. He is right to point to a key difference in our approach during the omicron wave compared with any other country in Europe—and, I think, any other large country. It is not by accident that we have been the most open and freest country in Europe; it is by design. It is because we have rightly focused on the booster programme, with 79% of eligible adults boosted—the most boosted country in Europe. We have more antivirals per head than any other country in Europe. We are testing more than any other country in Europe. It is those pharmaceutical defences that will allow us to live with covid, to keep businesses open, to protect the life chances of our young people and to keep our country open and free, just as he wants to see.

I am sure that the Secretary of State will want to join me in paying tribute to the staff at Cardiff and Vale University Health Board for their work on the booster programme. He will know that statistics show that Wales is joint first in Europe—we are actually ahead of the UK average—on delivery of boosters, which can only be a good thing for our population. Will he say a little about what the JCVI is discussing and what his view is on further boosters for people who are older and more vulnerable and the immunosuppressed, and the use of polyvalent vaccines going forward? As we open up further, people will be deeply worried about that, particularly with waning boosters. Will he talk a little about the plans for further jabs for the most vulnerable?

I join the hon. Gentleman in commending Wales for the roll-out of its booster programme. In fact, in Scotland, Northern Ireland and every part of the UK we have seen a very good, positive approach that is protecting more and more people. In terms of the JCVI, I point him to two recent announcements that he may be aware of. First, just before the Christmas break, the JCVI recommended to the Government that at-risk five to 11-year-olds be offered the paediatric vaccine. I have accepted that and that will start this month; I believe that that will start across the UK, including Wales. Secondly, we received another recommendation, I think at the end of last week. After looking carefully at the very latest evidence—some of the evidence from the UKHSA that I referenced in my statement—the JCVI decided that we should not offer a fourth dose to over-85s, or others at risk at this point. It was comfortable that the protection that is provided—it looked at waning protection—was still incredibly strong for older people.

I add to the chorus of approval for the decision to reduce self-isolation to five days. But can my right hon. Friend ensure that the NHS covid-19 app and the Government website are updated as soon as possible to avoid the confusion that seemed to exist around the reduction to seven-day isolation, so that people fully understand their obligations, when their isolation starts and when it can finish?

I thank my hon. Friend for his support. I will ensure that the website is updated in the way he suggests as soon as possible.

Recent data suggest that just 4% of teachers say that readings on classroom carbon dioxide monitors are above the safe threshold set by the Department for Education. The Secretary of State will be aware that ventilation is becoming a massive challenge in schools, and in primary schools in particular. What conversations is he having with his colleagues at the Department for Education to ensure that children can continue to learn in classrooms, but can do so as safely as possible, protecting them and the wider community?

The hon. Lady raises an important issue: ensuring we do all we can as a Government to work with schools to protect schoolchildren so they can stay in school. No one wants to see what happened before with the lockdowns and children not being able to attend school in the usual way. That is why I hope she welcomes the recent announcement by my right hon. Friend the Education Secretary on a huge new investment in ventilation. My right hon. Friend takes this issue incredibly seriously, working with schools up and down the country, and seeing what more can be done.

Implicit in my right hon. Friend’s statement was the concept that we will all be held back by the decisions of the unvaccinated. If I may say so, he used some quite heavy language to bring pressure to bear on the unvaccinated, talking about standing on people’s shoulders and so on. Would it not be better, rather than creating what seem to me to be the conditions for coercion and division, to say to the unvaccinated, “You’ve made your choice to take a greater risk and we are not going to be held back as a society by your choices. You will have to bear the consequences”? Would that not be a more consistent and humane way to deal with them, and to deal with us all, without creating division?

First, may I take this opportunity to thank my hon. Friend for the scrutiny he provides? As always, he makes important points that are worth discussing. He is right about the language I used earlier, because it is factually correct to say that. The reason this country is as free as it is now is the decision that nine out of 10 people have made to get vaccinated. Those people who decided not to be vaccinated when they could have been, because they are not medically exempt, for example, made a choice and that has consequences. It does not just have consequences for them; it has consequences for all of us.

My hon. Friend might be interested to know that when I visited the ICU ward looking after covid patients in King’s College Hospital in London last week, I was told by the consultant in charge that they estimate that 70% of patients in the ICU ward are unvaccinated. If those people had got vaccinated, they would not only have been safer, but space in hospitals, and not just in ICU wards, could have been used for others. There are 17,000 covid-positive patients in our hospitals. That could have been prevented if those who were unvaccinated or who decided not to take their booster shot had actually bothered to have their vaccination. Yes, getting vaccinated needs to be a positive choice: we need to encourage people and, with the exception of the health and social care high-risk settings, it should not be done by compulsion. I do not believe in that. I do not think it would work and I think it is unethical, but the people who have chosen not to get vaccinated should understand the consequences of their decision for the rest of society.

Following on from that, I pay tribute to all NHS and care staff. We are 17 days away from the first deadline, when NHS and care staff will need to get their first vaccine if they are to be fully vaccinated by the deadline of 1 April. What we did not hear in the Secretary of State’s statement is anything about a long-term strategy for staffing in our NHS to deal with the current vacancies and, unfortunately, those that will come about as a result of the 1 April deadline. Where is the long-term plan that NHS managers are crying out for, and where are we going to get qualified staff from in future?

I hope that the hon. Gentleman heard my earlier comments about the importance of making sure that patients are as safe as possible in health and care settings; I hope that he agrees and therefore understands the new vaccination rules to whose importance he refers.

The hon. Gentleman is right to ask about the planning necessary to cope with the changes. I can reassure him that even before Parliament voted on them, the NHS had started planning in anticipation of its decision. It is working with each and every trust, but is rightly putting in most effort into convincing the 6% of people in NHS trusts who have not yet had a first dose of the covid-19 vaccine to do so. It is working to convince them in a positive way to make that positive choice, with all the information that they need about the vaccines being safe and effective. It is offering them meetings with clinicians, including one-on-one meetings. I hope that the hon. Gentleman supports that approach.

I very much welcome the reduction of the self-isolation time to five days, which will be appreciated by the hospitality industry, particularly in Bournemouth. I am proud to say that I am a vaccinator in Bournemouth and that tomorrow I will be doing my duty along with thousands of others across the country. It is a critical job if we are to tackle covid-19 and a rewarding one.

The Secretary of State will be aware from his visits that the atmosphere in the temporary hubs is extremely professional but can also be quite quiet and sombre. Will he look at whether the licensing conditions for radio can be lifted? Maybe he could speak to the BBC, Classic FM or Virgin Radio—Chris Evans might even be listening to our debate today. I hope the Secretary of State agrees that radio would help to lift spirits as we go about this important national effort.

I thank my right hon. Friend for his support for today’s measures and for being a volunteer vaccinator. People like him up and down the country have come forward in their thousands, especially in the past few weeks as we have made the call for the booster programme. Those volunteers are working alongside the NHS, helped by the soldiers and the military, with whom my right hon. Friend also has direct experience.

I listened carefully to my right hon. Friend’s suggestion, which I think is a very good one. It is not something that I had given any thought to, but I think it is absolutely right that we contact those organisations and see whether they would like to be helpful to our army of vaccinators across the country. It is a very good suggestion; I thank him for it, and we shall try our best to act on it.

I add my voice to the congratulations to Jonathan Van-Tam and all those across our universities and science sectors who have contributed so much. I hope that others will be similarly rewarded.

The Secretary of State is aware of the shortage of testing kits. He mentioned in his statement that the 120 million have now increased to 300 million. As my right hon. Friend the Member for Leicester South (Jonathan Ashworth) said, the Opposition are desperately keen for businesses to stay open and for young people to remain in education. I am aware that there are separate supply lines to universities for testing, but there is concern about supply in future weeks. Can the Secretary of State confirm—guarantee, perhaps—that in the coming weeks there will be no issue with the supply of testing kits to our higher education sector?

The hon. Gentleman is absolutely right to thank not just JVT for his service, but those across our academic sector who have supported the Government, people and the NHS throughout the pandemic. I am privileged to work not just with JVT, but with so many of them, and I see every day the value they add and how they are helping us all to get through the pandemic.

The hon. Gentleman is right to raise the issue of testing. It is not 300 million; the 300 million lateral flow tests were in December, but for the month of January we have planned at least 400 million, which is four times as many as in the original pre-omicron plan. That makes us confident that we have the lateral flow tests we need. The university sector and the education sector more broadly, including schools and colleges, rightly have a separate supply line. It is still run through my Department, but we work very closely with the Department for Education to make sure that the sector has the supply that it needs.