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Volume 673: debated on Monday 9 March 2020

Before I call the shadow Health Secretary to ask his urgent question about the coronavirus, I draw to the House’s attention the fact that it is being streamed live with accompanying British Sign Language interpretation, which means that people will have to be very careful what they say and how they wave their hands around during this important piece of business.

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will update the House on the coronavirus outbreak.

The coronavirus outbreak continues to advance around the world. The number of cases in China and South Korea keeps rising but at a slowing rate, but the outbreak in Iran, Italy, Switzerland and now France and Germany is growing. In Italy alone, we have seen 1,492 more cases overnight and 102 more deaths. Here in the UK, as of this morning, there were 319 confirmed cases. Very sadly, this now includes four confirmed deaths. I entirely understand why people are worried and concerned, and we send our condolences to the families.

The UK response is guided by our four-point action plan: we continue to work to contain the virus, but we are also taking action to delay its impact, to fund research and to mitigate its consequences. Throughout, our approach is guided by the science; that is the bedrock on which we base all our decisions. Our plan sets out what we are prepared to do, and we will make the right choice of which action to pursue at the right moment. The scientific advice is clear that acting too early creates its own risks, so we will do what is right to keep people safe. Guided by science, we will act at the right time, and we will be clear and open about our actions and the reasons for them. These are the principles that underpin the very best response to an epidemic such as this.

On research, I can report to the House that we have made available a further £46 million to find a vaccine and develop more rapid diagnostic tests, and we will continue to support the international effort. Here at home, the NHS is well prepared, with record numbers of staff, including nurses and doctors. I thank all those involved for their work so far. The number of calls to NHS 111 has increased—we have now added an extra 700 people to support that effort—and 111 online is now dealing with more inquiries than the voice calls.

To date, Public Health England has tested nearly 25,000 people, and the time taken to test is being reduced, as we are bringing in a new system for faster results, but of course responding to coronavirus will take a national effort; everyone must play their part. Of course, that means Government, and it also means everyone washing their hands more often and following public health advice, but there is much more we can all do, through both volunteering and supporting the most vulnerable. We will shortly introduce legislative options to help people and services to tackle the outbreak. The Bill will be temporary and proportionate, with measures that will last only as long as necessary in line with clinical advice. I can also report that over the weekend, we initiated action to help 120 passengers on the Grand Princess cruise ship off the coast of California to return home.

We will stop at nothing to get our response right.

Our thoughts are naturally with the loved ones who have sadly died of covid-19. Let me also record, again, our thanks and gratitude to our hard-working NHS and Public Health England staff.

May I press the Secretary of State a little further? He will know that we have called repeatedly for an emergency funding package for our NHS, he will know that the NHS is short of 100,000 staff, and he will know that critical care beds were at 81% capacity during the week for which the latest figures are available. The Chancellor has said that the NHS will receive whatever it needs. Does the Secretary of State agree that in this Wednesday’s Budget we need to see significantly more resources for the NHS, not just rhetoric?

Scaling up and freeing up capacity in the NHS is now urgent. What is being done to scale up intensive care beds in the NHS, what is being done to expand access to the oxygen and ventilation machines that will be needed, and what is the current capacity of extra corporeal membrane oxygenation beds? We welcome the distribution of personal protective equipment to NHS staff, but does the Secretary of State agree that GPs and social care staff also need access to that equipment?

Those in receipt of social care are some of the most vulnerable, and could be affected extremely badly by this virus. Indeed, many who work in social care are low paid, and if they have to go on sick leave there are huge implications for the delivery of social care. What advice has been given to social care providers and, indeed, local authorities to ensure that the most vulnerable are protected, and what plans are in place to protect staff and increase the number in the social care sector?

Public health directors are expected to play a leading role in local preparations. They need to make decisions about deploying staff—Public Health England, for example, has asked for staff to be seconded—yet they still do not know their public health allocations for the next financial year, which will start in three weeks’ time. We are begging the Secretary of State: please tell local directors of public health what their budget is for this coming April.

We are still officially in the containment stage. At some point, we presume, we will need to move into the delay stage, when we understand that social distancing measures will be necessary. Many of our constituents are now asking—and I think it would benefit the House if the Secretary of State could explain to them—why we are not yet considering more home working, whether we should be asking those over 65 to isolate themselves, whether we should be cancelling larger events, and whether those returning from northern Italy, for instance, should be quarantined. I think it would help our constituents if the Secretary of State ran through the medical advice, although I understand why he has made the decisions that he has made.

Can the Secretary of State also confirm that once we move into the phase in which measures of this magnitude are proposed, he will come to the House, explain why that has happened, and allow Members to question him? He has hinted, or suggested, that we will need emergency legislation for the mitigation stage. As a responsible Opposition, we would like to sit down with him in order to understand the content of that legislation, because we want to work on a cross-party basis; but let me leave him in no doubt that we also want statutory sick pay for all from day one. Asking people to wait five weeks for universal credit is not a serious solution.

Will the Secretary of State update the House on food supplies and the conversations that he has had with supermarkets? Can he reassure us that our constituents do not need to be panic-buying, as we saw people doing on social media in some parts of the country over the weekend? Finally, does he agree that whatever happens, we must find a way for Parliament to continue to hold Ministers to account so that we can ask questions on behalf of our constituents? However, we continue to offer to work constructively with the Government, because the public health interest and the safety of our constituents must always come first.

Let me start by concurring with what the hon. Gentleman said about the legislation. It should be taken through on a cross-party basis. I should of course be happy to talk to him about the proposals in that legislation, and also to ensure that the clinicians are able to explain why they are necessary and proportionate. I am grateful for the tone that he has taken throughout, recognising that our responses are led and guided by the science.

The hon. Gentleman asked about the NHS and its preparedness. There are record numbers of nurses and doctors, as I said. The 8,700 increase in the number of nurses over the past year is welcome in this context. We are, as he said, scaling up intensive care beds, and making sure that we have as much availability of ventilation equipment and, crucially, the skilled and trained people to use it, because ventilation equipment, without trained people, is dangerous. On that subject, we are making sure that we have the oxygen needed to go into those ventilation kits, working with oxygen suppliers to make sure that that is available.

The hon. Gentleman also asked whether GPs would have access to the protective equipment that they need, and the answer is yes. We have stockpiles of protective equipment and, again, we will release it at the right time. I am working closely with NHS England to make sure that that happens.

The hon. Gentleman asked about social care. He is absolutely right to draw attention to the importance of making sure that the staff in social care are well enough supported, including if they are sick and, critically, because many people in residential social care are some of the most vulnerable. Those living in the community in receipt of social care are likely to be vulnerable, whether because of prior health conditions or because they are elderly, or both. That is an area of significant attention, and we will update the existing guidance this week with further information for social care providers.

The hon. Gentleman asked about public health budgets which, of course, are going up. He also asked about home working and the cancellation of large events. We are not at this stage proposing the cancellation of mass events, because we are following the scientific advice that that is not what is proposed at this stage. Home working and flexible working are things that, in many cases, are advocated anyway. People will make their own decisions as to when that is appropriate. What we are saying from the Government point of view is that people should follow the public health advice so that, for instance, if they are returning from an affected area and they have symptoms they should stay at home, and that means home working. Over the weekend we added northern Italy to the list of places to which the Foreign Office does not recommend travel except in exceptional circumstances. We recommend that people returning from northern Italy self-isolate if they are symptomatic.

The hon. Gentleman asked about the food supply. We are confident that food supply will continue, even in our reasonable worst-case scenario. We have been talking to the supermarkets for some time about this scenario. I appreciate that on Friday there was discussion about whether every single supermarket executive had been involved in those talks. If any further supermarket executive wants to be involved in those conversations they should get in contact, but those conversations have been ongoing, and it is important, especially as we ask more people to self-isolate and stay at home, that we can ensure that we get supplies that are needed to the people we are asking to stay at home.

The hon. Gentleman asked about statutory sick pay, and I can confirm that we are proposing to put changes to statutory sick pay in the legislation, and I am happy to go through the details with him in the talks that I mentioned at the beginning of my response.

Finally, on Parliament, of course, this is a matter for the whole House. I know that the Commission met this morning, and I think that parliamentary scrutiny of decisions of the magnitude that we are having to take in response to coronavirus and their novel nature is incredibly important, and I will do all that I can to ensure that Parliament remains open.

I commend the Health Secretary for the way in which he is handling the crisis and ask him to reflect on what we now feel we have learned from the situation in China, given that yesterday was the first day when reported new cases in the UK exceeded reported new cases in China. The chief medical officer told the Select Committee that he hoped that a smaller proportion of the population in the UK would get the virus, given what we can learn from what happened in China, but one of the reasons for growing concern among our constituents is that the only number out there is the 80% reasonable worst-case scenario. Is it not time for the Health Secretary to share his central estimate of what proportion of the UK population he thinks will get the virus, even though we would all understand that that estimate might change over the passage of time?

I pay tribute to the Chair of the Select Committee for the way in which he has handled this—for instance, in demonstrating the need for transparency in the questioning of the chief medical officer last week. I will take away his point on the need for a central estimate. The figures out there relating to the proportion of people who will get the virus are a reasonable worst-case scenario. On the central estimate, there are still things that we do not know about the spread of the virus through China—in particular, whether the degree to which the slowing of the increase in cases in China is because the virus has reached a large proportion of the population and there is a large proportion who are not symptomatic, which would mean that the mortality rate was lower than otherwise thought; or whether the significant measures that the Chinese have taken are having a significant effect, and that therefore, as and when they are lifted, the virus will continue to spread. Either of those options is possible, and we do not know which one it is, but whichever it is, the approach that we are taking in the UK is the right response to both of those scenarios.

There seems to have been some media confusion in reports that the move from the contain phase to the delay phase will involve an instant flick-of-the-switch moment. Will the Secretary of State assist us by confirming that that is not the case and that any move will involve a phased transition? Another area of particular vulnerability is the UK prison system, which is extremely short-staffed and stretched. What measures will he be taking following reports of riots and deaths among inmates in Italy’s prisons to ensure that our prisons remain under control during what will be a period of heightened tensions and frustrations as restrictive measures are introduced? Will he also confirm that he is aware of the latest workplace advice from Health Protection Scotland, which was published today and which urges routine cleaning of phones and keypads and says that food should not be left open for people to share? Will his Department be making a similar recommendation for England?

The hon. Member is absolutely right to suggest that the transition to the delay phase is indeed that: it is a transition. We will not give up hope of containing this disease while we can still take containment actions, and many of the actions that are needed to contain it are also effective for delaying. Of course, the primary action is that everyone should wash their hands, but there is much more than that. He asked about the advice from Health Protection Scotland. We are working very closely with HPS, and Public Health England will shortly be bringing forward further updated guidance that we have been working on over the weekend, not just on social care, as I mentioned earlier, but more broadly, including for businesses, employees and others.

I thank the Secretary of State for his statement. He will know that the number of cases in Hertfordshire is now into double figures, and that it is a county with some very large businesses with an international footprint, as well as many commuters going into London. Has the time come for discussions with those large businesses on how to reduce the number of international visits that are made, perhaps through more teleconferencing, and also on how to allow more people to work from home when possible and to reduce the number of visits backwards and forwards that might be affecting the spread?

An awful lot of companies and other employers are taking these steps. Teleconferencing is usually cheaper and also better for the environment than travel, so there are good reasons to use it anyway.

The Secretary of State made it clear in his answer to the urgent question that parliamentary accountability is fundamental—that is evidenced by so many Members on both sides of the House rising to raise myriad issues —yet despite that acknowledgment we are hearing reports that after Easter the House might be suspended until September. Will he give an undertaking that that will not be the case? Will he recognise that, as a big organisation of 650 MPs and thousands of staff, we can play our part in containment without opting for the nuclear option of closing down accountability altogether? Other measures could be considered, such as using Westminster Hall on a UQ basis, so that we have continuous accountability for what the Government are doing through Parliament, albeit in a different form.

I have not seen those specific reports, but I know that the House of Commons Commission met this morning. Parliamentary accountability is incredibly important. I will be doing all that I can to ensure that Parliament stays open through this process, and that we follow the clinical advice on how that can happen so that we keep that parliamentary accountability. It is a decision for the House, but my position and that of the Government is clear.

The Government are absolutely right to be putting a lot of public money into research on a possible vaccine, but the Secretary of State will know that research is no good unless we can produce vaccine at scale, and this country is not great at doing that. What can he do to ensure that we grow indigenous capacity very quickly so that the public, and particularly key workers in our health service, do not have to wait in line when a vaccine becomes available?

My right hon. Friend raises an important point. We do have significant vaccine capabilities, and not only in research, where we are world-class, but in some production, for instance in Hamilton in Scotland. The broader point is that investment in the whole production chain and not just research is critical.

The Government have outlined emergency legislation that will extend new powers to the Welsh Government. Council representatives I have spoken with are concerned that there are currently legal obstacles hindering the swift deployment of emergency staff, for example in relation to vehicle insurance and limits on working hours. That applies particularly to social care staff, of whom there is a shortage in Wales and, I believe, across the UK. What discussions has the Secretary of State had with the Welsh Government to ensure that there are clear guidelines for emergency implementation in the care sector?

We have ongoing discussions with the Welsh Government. For instance, the Welsh Government joined the Cobra meeting this morning—in fact, they have been present at all the Cobra meetings—and we have had very good engagement on the Bill. I will look into the two specific points that the right hon. Lady has raised and will talk to my Welsh colleagues about them.

May I thank the Health Secretary for the way he is managing this crisis, and for how frequently he has come to the House to answer questions? Pregnancy is a time of great joy, but in the context of coronavirus it can also be a time of great worry. Is there any specific advice from the chief medical officer for ladies who are expecting or who are considering starting a family?

I am glad to say that the evidence so far indicates that there is not a particularly raised concern. Nevertheless, I entirely understand the level of worry that getting coronavirus might cause somebody who is pregnant, so we are researching this very carefully.

A study of 52 critically ill patients at Jinyintan Hospital in Wuhan has found that more than two thirds required invasive breathing support, and last Monday, as the Secretary of State will know, the World Health Organisation urged all countries to stock up on ventilators. Given that around 5% of those with coronavirus might require critical care, what is his current best estimate of the number of ventilators that would be required to meet that demand, bearing in mind his earlier point about having sufficient staff to operate the ventilators?

I am very happy to write to the right hon. Gentleman with the specific answer to his question, but the general answer is more, and, frankly, as many as possible. We are buying ventilators—we have a commercial strategy on that—and, of course, we are training people to use them.

As my right hon. Friend knows, vaccines are the long-term solution to tackling the virus. Can he give the House a bit more detail on what work is being done and on the potential timings for new vaccines and home tests? More importantly, will he keep under active review the balance between the efficacy and safety of vaccines and the public health impact they could have?

The critical point about vaccine development for coronavirus is that if we cannot be sure that a vaccine is safe, we cannot put it into large numbers of people for a disease with a mortality rate of around 1%. This is different from a disease like Ebola, where the mortality rate of around 70% is so high that it is worth taking the risk.

The broader point about the response to this virus is that it is very different from Ebola. It spreads in a different way and its mortality rate is very different, so it is very important that we fight this disease rather than fighting the last war.

The other day, the Prime Minister said on morning television,

“perhaps you could take it on the chin, take it all in one go and allow the disease to move through the population without really taking as many draconian measures.”

Can the Secretary of State advise the House that that is not the Government’s official position?

No, it is not the position. The Prime Minister was explaining why we have taken the decisions that we have.

This is obviously a particularly worrying time for our elderly population who are, by all accounts, more likely to suffer badly from the disease. What advice would the Secretary of State and, indeed, the chief medical officer give to the elderly, their families and their neighbours about how best to protect them? What actions should they take to ensure they are not exposed to this disease?

That is a really important point, and the advice now is, as for everybody else, that they should wash their hands, follow the public health advice and catch sneezes and coughs. We do not rule out changing that advice to advising measures that help protect either the elderly or more vulnerable people who have pre-existing health conditions, because an approach that treats them differently is appropriate given that the disease treats them differently.

Order. A lot of people are standing, and I cannot really let this business run much past quarter past 4. People are being quite brief and the Secretary of State has been brief, but I give notice that not everybody will be called.

May I press the Secretary of State on this matter? Yes, it is very important that we follow good science, but we also need good management. It is all right having a national Cobra, but what about local Cobras? Every community and every local authority has to deliver on the ground as this gets worse, and that needs partnership across health, the police and local authorities. Is he sure that is in train?

Absolutely. This is a national effort, and a national effort involves the Government, the NHS, every single individual, local authorities, local resilience fora and local police. It is a national effort.

Can we have net figures that take account of recoveries? It is very alarming simply to be given cumulative deaths and cumulative cases.

It is not just coronavirus and dealing with it that needs parliamentary scrutiny. The Government cannot continue levying income tax unless we have another Finance Act, and they will not be able to use emergency powers under the Civil Contingencies Act 2004 for longer than 28 days, so Parliament will have to keep on sitting, won’t it? The Secretary of State is wrong, as it is not for the House authorities to decide whether this House sits. The only person who can table a suspension of Parliament is a Government Minister, so will he just rule it out now?

As I said, we see no purpose for suspending Parliament, and parliamentary accountability is very important, as is the legislative power of Parliament.

On the day Carillion collapsed, all the UK banks, through UK Finance, agreed forbearance on the loans and overdrafts of small businesses affected. Has Cobra obtained the same assurance from the banks in respect of businesses affected by the coronavirus?

Those sorts of discussions are going on, led by the Treasury and the Department for Business, Energy and Industrial Strategy.

Millions of people in this country live alone, and many elderly people rely on their relatives visiting them to keep them able to live in their own homes. This activity may well be disrupted if people get ill or have to be isolated. How then will those vulnerable people, who rely on outsiders to be able to live, get their food delivered and be looked after, possibly cope?

This is an extremely important consideration, because in keeping people safe from coronavirus we also need to support people to live their normal lives. Many people rely on support from others who come to them, whether through social care in the formal system or, as in many cases, through informal care and support. We may need to see more of that, but it will have to be done properly in order also to protect the people involved from the coronavirus.

Last week, I met officials from Durham County Council, and part of our discussion turned to council preparations for coronavirus. Will my right hon. Friend confirm that he is working with the Ministry of Housing, Communities and Local Government and with local authorities to ensure that we are fully prepared?

Yes, we are working with all the local resilience forums and the local authorities, which are crucial parts of them.

The director general of the World Health Organisation has called on all Governments to develop all-of-society and business continuity plans. What is the Minister doing in respect of two groups: the street homeless, and the staff and volunteers who work in homeless shelters; and small businesses? Specifically, in a worst-case scenario, would the Government, under contingency plans, underwrite the three biggest costs facing small businesses—staff, rent and business rates?

MHCLG is working on and leading on the first of those, which is very important, and the Treasury is leading on the second.

Does the wearing of gloves on public transport or in other public places make any difference to the dangers of acquiring or transmitting the disease?

I am tempted to give my right hon. Friend a clinical answer, but instead I will ask one of the chief medical officer’s team to write to him.

On Friday, I met the chief executive of my local council, where four cases have been identified. She told me that the council is not able to obtain information from Public Health England about where those four individuals are self-isolating, and that is a concern in managing community relations and information. Of course we appreciate the need to protect patient confidentiality, but will the Secretary of State discuss with colleagues the need for information to be shared with specific council officials, on a need-to-know basis, so that they can manage the protection of the whole public?

Yes, absolutely. There should not be data protection problems here, but sometimes there are perceived to be, so cracking through those is important as well.

May I echo the concerns about suspending Parliament? Whatever the threats and the challenges we face in this country, Parliament must continue to do its business and do its duty. The Secretary of State has a responsibility, and the Government have responsibility for the people in the UK and for those overseas. How is he working with the Ministry of Defence on the support it might provide, both domestically and internationally, in looking after our citizens abroad?

I agree with my right hon. Friend wholeheartedly on the first point. On the second, it is absolutely true that the MOD is working alongside the Department for International Development, and of course the Foreign Office, to support Brits overseas.

Returning to the issue of statutory sick pay, can the Secretary of State confirm that all the relevant Departments are in agreement that SSP should be paid to self-employed people who are told to self-isolate?

We are all in agreement that nobody, including those who are self-employed, should be penalised for doing the right thing. How we get that support to them is a different question, because SSP is paid by the employer and the self-employed do not have an employer. We will bring forward a solution to that particular policy conundrum.

The Grand Princess cruise ship will finally dock in Oakland today, allowing 140 Britons, including at least four of my constituents, to disembark. My right hon. Friend mentioned a few messages about the support that will be given. A lot of the Brits on the ship feel that the UK has not responded as strongly as the Americans. Will he use this opportunity to say a little more, or will he perhaps get the Foreign Office to contact constituents on the ship directly?

The Foreign Office will be putting out more information, because it leads in that policy area. We will be repatriating the Brits and we are working with the Americans to ensure that we can get them home safely. We have full confidence that the American public health system will be able to help those individuals off the ship and on to planes to come home.

Is the Secretary of State aware that services and advice may not be accessible to those for whom English is not their first language? Will he ensure that the Government make instructions and advice available in a range of languages, including Braille?

Members of the Procedure Committee are, like many in the House, concerned about how we make sure that we properly represent our constituents if either Members of Parliament or their staff have to self-isolate. The Committee is meeting regularly this week to discuss the changes that might be needed to our procedures in that event. Will my right hon. Friend confirm that the Government will work with us to ensure that all parliamentarians are able properly to represent their constituents?

To follow up on the question from my hon. Friend the Member for Leyton and Wanstead (John Cryer), there are 4.7 million self-employed people, and currently they will not be entitled to statutory sick pay or contributory jobseeker’s allowance. The company Hermes, working with the GMB, has already said that it will offer support to its workers who cannot come to work because they have to self-isolate; other companies have not. What pressure are the Government putting on businesses such as Uber, Deliveroo and DPD to ensure that the people who deliver their services will be able to self-isolate?

I urge all companies, especially the large companies that, as the hon. Lady said, use an awful lot of self-employed workers to deliver their services, to look at what Hermes has done and appreciate that their part of the national effort is to help everybody to make sure that they can go home and stay at home if they need to stay at home to keep themselves and others safe.

I have a practical question for the Secretary of State. Many of my colleagues who work in the health service are keen to come forward and do their best. Their big concern is: should schools close, who would care for their children when they run forward to help in the NHS? Are the Government considering any plans to support frontline workers?

We absolutely are, not only in terms of any measures that we take and how they might have to be amended for key workers, but also because, critically, when it comes to school closures, one reason why closing schools is not a cost-free option is that it takes away some of the very staff whom we need to be able to respond to the crisis.

I have been approached by some parents who want to know what option they may have to withdraw their children from school for a short period, perhaps prior to the Easter break, if they wish to do so, and agree with the school an arrangement for a period of home study. Is the Secretary of State working with his Department for Education counterparts on any contingency plan should home schooling become necessary?

The most important thing is to follow the advice from Public Health England. We now have in place well-established routes to ensure that all headteachers get the appropriate advice. Ultimately, it is headteachers who are currently responsible for such decisions.

Home working is all but impossible in the early years sector, in which employers tend to be small and medium-sized enterprises and employees tend to be women. I have been contacted by nursery owners in my constituency who are extremely concerned that the advice they are getting from Government helplines is not consistent. I urge the Secretary of State to make sure that the information provided to these essential businesses in a crisis is consistent and kept up to date.

Yes, absolutely, and if my right hon. Friend could bring the individual concerns to my attention, I would be very happy to look into them.

My constituents of Inverclyde are expecting 80 visits from cruise ships during the sailing season, which starts in April, including from the Regal Princess, which is due in on 10 May. What plans do the UK Government have in place should there be an outbreak on a cruise ship in UK waters?

We are, of course, working with Public Health England on making sure that we have the right answers should this happen. Looking into what happens on cruise ships and what advice will be given with respect to people going on future cruises is a critical piece of work that we are undertaking.

Today, we had the first acknowledgement that there was a case in Herefordshire and yet I am still waiting to hear from the Government about the 70 children who are planning to go to northern Italy to ski. Can we make sure that airlines are giving these parents their money back?

We advise against all but essential travel to northern Italy, and I do not regard skiing as essential.

The adult intensive care unit at Nottingham University Hospitals Trust was at over 100% capacity on 76 occasions in the past year. An expansion of critical care will add a further eight beds. What is the Secretary of State doing to expedite this expansion? How many additional intensive care beds does he believe can be created and how soon?

We are working very hard right across England and I know that my Scottish and Welsh counterparts are working right across Scotland and Wales to ensure that we get that expansion of critical care beds as much as is possible.

I thank the Secretary of State and his team for their help for all patients who have been diagnosed with covid-19 in the south-west, but, as he knows I have a highly rural community. Can he please just elucidate as to how he will be able to provide further action and help for those in rural communities?

This is a very important point. One thing we will be doing during this period is encouraging people who need to see their GP or to have an out-patient appointment for something that is not to do with coronavirus to do so via Telemedicine if it is both clinically and practically possible. That is even more important in rural areas, and absolutely critical for reducing the amount of infection through GPs.

Before I entered this place, I worked as an emergency planner for the NHS. I would like to pay tribute to my former colleagues and to say that I am pleased that the Secretary of State is following their expert advice. Most people will not go into hospital or go to their GPs; they will be supported in the community. Critically, they will be supported by the wider services of local government and the voluntary sector. Will the Secretary of State expand on what conversations he is having with his counterpart in the Ministry of Housing, Communities and Local Government to support the wider public health and social care provision of local government?

We have extensive work under way to provide exactly that support. It is also available through the Office for Civil Society, and through volunteers as well. It is very important that we offer the opportunity for people to volunteer in these difficult circumstances, but we have to do so in a way that the voluntary efforts can then plug in and add to the professional efforts that are, as the hon. Lady says, providing a great service to this country.

I was deeply saddened to find out that the fourth case has died in my constituency in Wolverhampton North East. I offer condolences to the victim’s family and friends. Our thoughts also have to be with the staff at New Cross Hospital. I ask my right hon. Friend whether there is any special advice for those with relatives in New Cross Hospital or the attending staff members, because I know that people are greatly concerned.

I add my condolences to the family and loved ones of the patient who has died at New Cross Hospital. I want to thank the staff at the hospital who have acted in an exemplary way and to reassure other patients at the hospital that the steps that are necessary to ensure that the hospital is safe have, of course, been taken and that my hon. Friend’s constituents can be confident that her local NHS has risen to this task.

On the point about people who have booked holidays and cruises and who are perhaps doing the right thing by considering not going on them, I have to say that, even though they are insured, they are not always covered to do so unless they have been specifically told not to travel to that country. What are the Government doing to assist people in that sort of situation?

We constantly keep travel advice under review, and have made covid-19 a notifiable disease. Both those measures will help with the circumstances outlined by the hon. Gentleman.

On behalf of those who have already been affected in West Sussex, may I thank all those who have been working extremely long hours to deal with this crisis? Will the Secretary of State remind everyone involved that this is a marathon, not a sprint, and that pacing is incredibly important in dealing with any crisis? I urge him to use the innovation, capacity and capability of business as we move through this situation.

Yes, I agree with all of that. This is a marathon, not a sprint. Critically, as the scientists have advised us, getting the timing of the interventions right is crucial for getting the best possible response as a nation.

Last week I asked the Secretary of State about the advice given about coronavirus to DWP decision makers. We were not particularly reassured by the answers given by Department for Work and Pensions Ministers this morning, and that advice has still not appeared in our inboxes. Can he please follow that up?

My local authority of Kensington and Chelsea has eight confirmed cases—the most of any local authority in London. We have a lot of international visitors. My constituents are very concerned that people are continuing to arrive from north Italy, and they are only being told to self-isolate if they have symptoms, but we all know that the symptoms can often come late. Will my right hon. Friend think about testing at airports or mandatory quarantining?

We are increasing the amount of information that is available at airports, but the evidence from other countries that have tried temperature testing at airports shows that it is not effective and can actually be counterproductive to the effort because it leads to lots of false positives.

Industries such as the hospitality industry employ people on zero-hours contracts, and I know of one major hotel that has laid off a number of people. What can the Secretary of State do to ensure that people are not left in financial difficulties due to their employers taking these decisions?

I thank my right hon. Friend and his team for the way in which they are being guided by the science and medical advice. My constituents in the Colne and Holme valleys, and Lindley, are keen to do the right thing and to do their very best to contain the outbreak. What specific advice would the Health Secretary give my constituents who are organising community events over the Easter period and over the May Day weekend, particularly events that will have large attendances from those who are most at risk—the elderly?

We are not currently advising the cancellation of mass events, but we are considering closely providing further advice and strengthening advice to those in the vulnerable and elderly groups.

King’s College Hospital in my constituency has the highest level of debt of any hospital trust in the country. It also has a new 60-bed intensive care unit, which has been much delayed in its opening. Can the Secretary of State confirm what additional resources will be made available to King’s to ensure that those beds can open—fully staffed and fully equipped—as soon as possible, and to ensure that this challenged NHS trust has all the resources necessary to deal with the additional needs presented by coronavirus?

In May and June millions of pupils, including in Eddisbury, will be sitting important public exams. Although I accept that my right hon. Friend is doing the right thing by following the scientific evidence, may I encourage him to do everything possible to ensure that those exams go ahead, and to put in place clear contingency plans in the event that they do not?

Yes, of course. This is a lead for the Education Secretary, but he and the Schools Minister are working very hard on it.

Churches in my constituency took precautions yesterday. Those who need to self-isolate are having food supplies delivered, and are receiving regular phone contact to stave off the feeling of being alone. Does the Minister accept that the ability for churches to meet for fellowship and prayer is essential for a lot of people’s mental health and spiritual welfare, and that churches remaining open for as long as possible is as essential as schools remaining open?

I emphatically agree. I should, of course, have added churches and other religious groups to the long list of organisations that can—and I hope will—participate in this national effort, so that the country can get through this situation as well as possible.

Good communication is obviously key, so, first, may I thank my right hon. Friend for his regular updates? Secondly, will he join me in praising the staff and management at Royal Stoke University Hospital, who have treated a case recently and have communicated very clearly with the local community in Stoke and in Newcastle-under-Lyme?

Yes, all the staff at the Royal Stoke have done a brilliant job. I worry that they will no doubt have more cases to deal with, but the work they have done so far is something that we should all praise.

The Secretary of State has called for a national effort on a number of occasions. What is his take on the request from the TUC, which has called for a joint emergency taskforce between trade unions and businesses to make sure, for example, that statutory sick pay issues are addressed as well as keeping public services afloat?

Of course trade unions have an important role to play in this as well, and that is something we absolutely should consider.

The Secretary of State is no doubt aware that one of the four deaths that he referred to in his statement was an elderly patient with underlying health conditions in Milton Keynes University Hospital. What steps is he taking to ensure that hospitals like Milton Keynes University Hospital and others are open, safe and clean?

All of the hospitals that have so far dealt with cases—and, indeed, the four confirmed deaths—have protocols in place to ensure that the hospital remains a safe place to treat everybody else. The evidence so far is that that has worked well, but of course we keep working at it.

Many careworkers are on zero-hours contracts and work for multiple providers. This means that they may struggle to prove that they are eligible for statutory sick pay, forcing them to choose between protecting their clients and paying their bills. The Secretary of State mentioned statutory sick pay earlier. What is he planning to do to help care staff who are not eligible for statutory sick pay or who might struggle to prove their eligibility?

Over the weekend, Leicestershire had its first confirmed case of coronavirus, while a number of European countries moved to ban large public events. Will the Secretary of State explain why the timing of such social distancing measures is so crucial, and at what point and on what basis he will decide if they are necessary?

The first question we must ask is, “How effective is this measure—is it effective?”, and the second is, “Are we going to get unintended consequences from people acting differently in a way that actually hinders the overall effort?” It is for the scientists best to explain the reason why they have scientifically come to this advice. But it is clear that there are other measures that we can take that are more effective and have fewer negative side-effects.

My constituents in Kettering are struggling to understand why we are not banning flights from quarantined areas of north Italy.

The reason is that there are many UK citizens in that area who may want to come home. Also, crucially—this is very important—the evidence shows that banning flights from affected areas does very little to protect us. Indeed, Italy was the only country in Europe that banned flights from China earlier in the progress of this disease: it did not work, and now Italy is the epicentre of the European outbreak.

We have just heard about the death in Wolverhampton. I have had a lot of constituents talk to me about safety in schools. The Secretary of State has updated the House on this, but there are hundreds of school trips planned over the next three months all over the UK and Europe, so what is the advice around that?

The advice around school trips is to follow the Foreign Office travel advice—so, as of this weekend, not to take a school trip to north Italy, and otherwise to follow the travel advice.

As a former journalist, I know the temptations of a dramatic headline, but does my right hon. Friend agree that in this case there is an onus on the media to report responsibly and not engage in scaremongering?

I strongly agree. I would say that largely the media have been responsible, but there have been a couple of exceptions. I hope that the media play their part in this national effort in reporting the facts and what the Government are thinking of doing, especially with the transparency that we are providing, but do so responsibly and thoughtfully as to the consequences of the way that this virus is portrayed.

If large numbers of elderly and vulnerable people have to self-isolate, the statutory system will simply not be able to provide them with all the support they need at home. May I urge the Government to work with not only local authorities but civil society groups, to ensure that people get the social and practical support they need?

I emphatically support the call for civil society groups to play their part in the national effort. My hon. Friend knows more than most about the work that they do and can do, and I would be grateful to work with him on how to ensure that this is best done.