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Covid-19 Response

Volume 676: debated on Monday 18 May 2020

We now come to the statement by the Secretary of State for Health and Social Care. In order to allow more Back Benchers to participate during the limited time available, I have asked the Secretary of State to keep his initial statement to eight minutes, with matching reductions for other Front Benchers.

With permission, Mr Speaker, I will make a statement on coronavirus.

This is the most serious public health emergency in 100 years, but through the combined efforts of the whole nation, we have got through the peak. Let us not forget what, together, has been achieved. We flattened the curve, and now the number of people in hospital with coronavirus is half what it was at the peak. We protected the NHS, and the number of patients in critical care is down by two thirds. Mercifully, the number of deaths across all settings is falling.

This Mental Health Awareness Week is an important reminder that we need to look after ourselves, as well as each other. If someone needs support with their mental health, the NHS is there for them. This is particularly important for frontline staff, and we have supported all NHS trusts to develop 24/7 mental health helplines.

Our plan throughout this crisis has been to slow the spread and protect the NHS. Thanks to the resolve of the British people, the plan is working, and we are now in the second phase of this fight. I will update the House on the next steps that we are taking as part of that plan. First, we are protecting the nation’s care homes, with a further £600 million available directly to care homes in England. We have prioritised testing for care homes throughout, we made sure that every care home has a named NHS clinical lead and we are requiring local authorities to conduct daily reviews of the situation on the ground, so that every care home gets the support it needs each and every day. All this amounts to an unprecedented level of scrutiny and support for the social care system, and a level of integration with the NHS that is long overdue.

Secondly, the four UK chief medical officers have today updated the case definition to include a new symptom. Throughout this pandemic, we have said that someone who develops a new continuous cough or fever should immediately self-isolate. From today, we are including anosmia—losing one’s sense of smell, or experiencing a change in the normal sense of smell or taste—which can be a symptom of coronavirus, even where the other symptoms are not present. So from today, anyone who develops a continuous cough or fever or anosmia should immediately self-isolate for at least seven days, in line with the guidelines. Members of their household should self-isolate for 14 days. By updating the case definition in line with the latest science, we can more easily recognise the presence of the virus and more effectively fight it.

Thirdly, we are expanding eligibility for testing further than ever before. Over the past six weeks, this country has taken a small, specialised diagnostics industry and scaled it at breathtaking pace into a global champion. Yesterday, we conducted 100,678 tests. Every day, we create more capacity, which means that more people can be tested and the virus has fewer places to hide.

Today, I can announce to the House that everyone aged five and over with symptoms is now eligible for a test. That applies right across the UK, in all four nations, from now. Anyone with a new continuous cough, a high temperature or a loss of, or change in, their sense of taste or smell can book a test by visiting Anyone who is eligible for a test but does not have internet access can call 119 in England and Wales or, in Scotland and Northern Ireland, 0300 303 2713. We will continue to prioritise access to tests for NHS and social care, patients, residents and staff, and as testing ramps up towards our new goal of a total capacity of 200,000 tests a day, ever more people will have the confidence and certainty that comes with an accurate test result.

Fourthly, I want to update the House on building our army of contact tracers. I can confirm that we have recruited more than 21,000 contact tracers in England. That includes 7,500 healthcare professionals who will provide our call handlers with expert clinical advice. They will help to manually trace the contacts of anyone who has had a positive test, and advise them on whether they need to isolate. They have rigorous training, with detailed procedures designed by our experts at Public Health England. They have stepped up to serve their country in its hour of need and I thank them in advance for the life-saving work that they are about to do.

The work of those 21,000 people will be supported by the NHS covid-19 app, which we are piloting on the Isle of Wight at the moment and will then roll out across the rest of the country. Taken together, that means that we now have the elements that we need to roll out our national test and trace service: the testing capacity, the tracing capability and the technology.

Building that system is incredibly important, but so too are the basics. We need everyone to self-isolate if they or someone in their household has symptoms. We need everyone to keep washing their hands and following the social distancing rules. We need everyone to stay alert, because this is a national effort and everyone has a part to play. The goal is to protect life and allow us, carefully and cautiously, to get back to doing more of the things that make life worth living. That is our goal and we are making progress towards it. I commend this statement to the House.

On symptoms, the right hon. Gentleman will know that many healthcare specialists were making these warnings eight weeks ago, so can he explain why there has been a time lag in updating the case definition?

I note what the right hon. Gentleman said about social care, but he will be aware that more than 12,500 people have sadly died in care homes because of covid-19. Last week, he said that he had put a protective ring around care homes from February, but yesterday a care home provider wrote in The Sunday Times:

“Elderly people weren’t a priority”

They also wrote:

“The government was asleep at the wheel.”

Is the reality not that there was no early lockdown of care homes when needed, and there was no testing of people transferred from hospital to care homes until mid-April, seeding the virus? Personal protective equipment was requisitioned from care home staff and given to the NHS because of wider shortages. There was guidance suggesting that infection was unlikely, and that guidance was still in place when there was community transmission.

We still do not have full testing of all residents and care home staff 12 weeks later. No wonder Age UK has said that this is “too little, too late”. I note that the right hon. Gentleman said that testing will be expanded. Can he bring forward the date by which all care home residents and staff will be routinely tested? The document last week says that it will be by 6 June. Why can the date not be sooner?

Has this crisis not shown that our care sector is staffed by exceptional, dedicated people, and that migrant care workers are not low skilled but immensely able? Does the right hon. Gentleman agree that the Home Office should acknowledge that, and praise such potential workers, not penalise them?

I welcome the wider roll-out of testing. The right hon. Gentleman did not mention the antibody test. Could he update the House on that front? It has also been reported today that 20% of hospital patients got covid while in for another illness. Two weeks ago, he suggested to me in the House that he planned to roll out screening of all healthcare workers, whether symptomatic or not. Can he update us on that front?

On tracing, I have long argued that the safe way to transition out of the lockdown is by having a test, trace and isolation strategy in place, but it depends on a quick turnaround of test results. Can the right hon. Gentleman tell us the current median time for test results to be received by someone when carried out by the Deloitte and other private sector testing facilities, and how soon do directors of public health and GPs receive those results?

The right hon. Gentleman knows that I believe he should be making better use of local public health services. None the less, he is pressing ahead with the national call centre delivered by Serco. Can he tell us by what date that tracing service will be operational? Will it be operational by 1 June?

The right hon. Gentleman did not talk about isolation as one of his key elements of the test-trace strategy. Many poorer people will not be able to self-isolate. Will he look at providing facilities for such people, such as empty hotel rooms so they can quarantine? Will those in insecure work be guaranteed sick pay if they are asked to isolate for seven or 14 days?

On the R number, will the right hon. Gentleman guarantee that every easing of restriction, such as asking children to return to school, is accompanied by a Government statement on the expected impact on the R number and the underlying prevalence of infection? If R rises to be greater than one in a region or local area, how will the Government respond?

As the right hon. Gentleman says, this is Mental Health Awareness Week. We are very fearful of a growing burden of mental health issues, especially in children, as a result of the lockdown. What extra investment is he putting into mental health services, particularly children’s health services? NHS staff, who are threatened not only by exposure to the virus, but the trauma, emotional distress and burnout associated with working on the frontline, need support as well. They need PPE, they need fair pay, they need mental health support. Those care workers who are caring for us need us to care for them and we should thank them again in Mental Health Awareness Week.

I will keep it concise, Mr Speaker—your instruction.

The hon. Gentleman is right to ask detailed questions about care homes, because making sure that we have that ring of protection around care homes is important. Of course, the majority of care homes have not had an outbreak at all. We should thank those running care homes for the incredible hard work and infection control they put in place, meaning that in 62% of all care homes there has not been an outbreak. Where there has been an outbreak, there has been rigorous infection control and a huge amount of work has gone into that. We have, as he said, now got testing for all. That started with testing throughout for people who had the first symptoms in a care home. Now, it is for all staff and all residents, whether symptomatic or not.

There was no large-scale removal of people from hospital into care homes towards the start of the crisis, as has been implied by some. In fact, the number of people moving from hospital into care homes has fallen throughout the crisis and those movements have been done with care. But I agree with the hon. Gentleman that the crisis has shown that there are many lessons for reform in the social care sector, not least the much closer integrated working with the NHS that we have seen in these crisis days.

The hon. Gentleman asked about the roll-out of contact tracing. We now have the people in place. The app is successfully being piloted, and we are ready and preparing for rolling out that system.

The hon. Gentleman asked for the median time for a test to get back. The median time is, as far as I understand it, under 48 hours. He made a rather uncharacteristic dig at private sector businesses which are helping us to deliver that. None of the testing capability—not a single test—would be possible without the private sector. His attempt to divide people between private and public sector is entirely wrong. I think he should remember that that bit of the Labour party left the shadow Cabinet a couple of months ago. I thought good sense had returned.

The hon. Gentleman asked about local public health services. It is incredibly important that local public health services are involved. We have brought in Tom Riordan, chief executive of Leeds City Council and a brilliant public servant, to lead the work on engagement with local public health services, which the hon. Gentleman rightly—I totally agree with him—says are an incredibly important part of getting this right.

We of course keep R under review. We keep watching it and we keep surveying to find out what it is. We have said that, if it rises above one and we see an outbreak in an area, we will be perfectly prepared to take action in that area. Indeed, if it goes dangerously high nationally, we would be prepared, as we were before, to take the necessary action.

Finally, the hon. Gentleman talked about the importance of mental health services across the board. The support is there in the NHS for all NHS staff—in fact, it is there across the board. One of the interesting things in this crisis is that paediatric mental health services have discovered that many services are better received, especially by children, via computer than face to face. In some cases, therefore, the service is better provided at a distance, over a screen, than face to face, but he is absolutely right to highlight the importance of mental health services in this crisis and beyond.

We now go across to the Chair of the Select Committee on Health, who I understand is audio only.

Thank you, Mr Speaker. I would like to ask the Secretary of State for three pieces of data, all of which are essential for this strategy. First, what level of new daily infections do we need to be down to before contact tracing happens for all new infections? Secondly, how many daily tests will the test and trace system need? Thirdly, if we are going to introduce weekly testing for all NHS and care-home frontline staff, when will our testing capacity be sufficient to deliver that on top of test and trace?

With 21,000 contact tracers now employed, we think that that is capacity for the current level of new cases that have been demonstrated by the Office for National Statistics surveys, but I am perfectly prepared to hire more to make sure that we have spare capacity within contact tracing.

On the number of tests needed daily to service test and trace, it depends on exactly how many new cases there are. It depends on the relationship between the symptoms and the number of positive cases. There are many more people with symptoms than there are positive coronavirus cases, but the number is falling because we are moving away—well away now—from the flu season, and at this time of year the number of positive symptoms, including coughs and fever, tends to fall, because other non-coronavirus communicable diseases such as flu are falling. There is not a specific answer to that question, because it changes over time. On weekly tests, we are looking to put together a plan to ensure that we cut in-hospital transmission, which will include appropriate, regular testing of the right staff in the NHS. I shall write to my right hon. Friend with more details as and when that policy is fully announceable.

We have a technical problem with Dr Philippa Whitford, whom we will return to shortly. We will go to Sir Desmond Swayne.

The regional dental hubs offer little more than extractions —but I want to keep my teeth. When will dentists be able to treat their own patients?

My right hon. Friend rightly points out that we have urgent dental hubs, so anyone who needs urgent dentistry can get a dentist’s appointment through their GP. Many people have asked how, in an emergency, they can see a dentist. Dentistry is there and available—it is an important message for all our constituents. However, we are also working on the restart of dentistry more broadly. I understand the challenges, especially for those who want to see their own dentist and for dental practices. With NHS contracts, we continue to keep the funds flowing, but of course many dentists rely on their private income as well, and we support the mixed market in dentistry. What we need to do is get dentistry up and running when we can, but it has to be safe.

I am pleased to say that we have reconnected with the SNP spokesperson, Dr Philippa Whitford, who has 90 seconds.

I welcome that eligibility for testing is being widened to all symptomatic cases as the first step towards a test, trace and isolate approach, but does the Secretary of State agree that the system should have been in place before lockdown was eased? Without it, how can he know that the crowded public transport systems that we saw last week are not already leading to a rise in infections? The Secretary of State prides himself on having ramped up testing, but we know that many thousands of those are just in the post, so will he clarify whether those tests are counted again when they are actually carried out?

The Royal College of GPs has highlighted the difficulty in getting test results back from the Deloitte regional test centres. As it is contact tracing and isolation that stop the spread of the virus, how will the Secretary of State speed up results and ensure that they are fed back to GPs and public health teams, who are critical to detecting and controlling local outbreaks? The UK still has more than six times the number of new cases per day than when the lockdown was brought in. Does he not think that that is still too high to be sending people back to work and school?

We have been working very closely with the SNP Scottish Government on testing, so I am slightly surprised at some of the questions from the SNP spokeswoman. Of course the tests are not double-counted. There has been a ramp up in testing capacity. I am very glad to see in Scotland that testing capacity is now starting to rise—in the latest figures, it was up to around 5,000. I work very closely with my SNP opposite number on making sure that everybody has the very best capacity. The contact tracing system was also stopped in Scotland. The reason was that the number of cases right across the UK became very high. We needed social distancing to bring that number down. Now that that number is coming down right across the UK, contact tracing is once again effective. That is the reason we are bringing it in now, and I am pleased that we have hired 21,000 contact tracers in England to ensure that we can get it going. Therefore we are on track for the current proposed 1 June changes. That date is dependent on making sure that everything is right, and that it is safe to make the changes then.

The Minister has just confirmed that there will be thousands of contact tracers who are not medically trained, but who will be handling highly sensitive patient information and issuing clinical advice given to them. Will he bring forward primary legislation to govern the collection and any potential misuse of data, whether that is via an app, by qualified health professionals or by the non-medical call handlers, so that members of the public can have confidence that all strands of his data collection plans are effective and safe?

I have looked at this proposal and it is clear that primary legislation is not needed, because the Data Protection Act will do the job.

I thank the Secretary of State for his unstinting dedication to protecting the health of our nation during this crisis. First, will he update the House on when the roll-out for antibody tests will be revealed, so that we can start to get back to normality? Secondly, in last Friday’s statement, he spoke about the reform of health and social care. When will the Government bring forward a lasting care funding solution to stop people in constituencies such as Romford from being forced to sell their family homes to fund long-term care?

I think the whole country celebrated when there was the announcement last week that antibody testing that fits the bill and does the job had been approved by our Porton Down labs. We are in the closing stages of commercial negotiations to ensure that those tests are widely available, and I will let my hon. Friend know just as soon as I can when that roll-out will be, but I do not want to prejudice the commercial negotiations, which I am sure he will understand.

On the second point, I strongly agree with my hon. Friend that this crisis has demonstrated just how important social care reform is, just how important social care is and how we must maintain the benefits and improvements in delivery and working practice that happened because of the crisis and happened through the heat of the crisis. We must maintain and strengthen that close working relationship. The financial changes that we put through have proved very effective at bringing the two systems closer together, but there is much, much more to do.

A recent survey by Unison North West found that eight out of 10 care workers would not receive full pay if they were ill, self-isolating or shielding because of covid-19, receiving at most £95 per week statutory sick pay, with workers putting their lives on the line to look after us. Will the Government provide increased funding and direction to ensure that all care workers receive full pay when absent due to covid-19?

In addition, given the current failings of our fractured—

That is an incredibly important question, and one of the purposes of the £600 million extra that we are putting into the social care system and that will go direct to the frontline—local authorities are not allowed to use it for other purposes—is to ensure that when social care staff need to be away from work for infection control purposes, they are not penalised for doing so.

I join my hon. Friend the Member for Romford (Andrew Rosindell) and my right hon. Friend in welcoming approval of an antibody test for use in the UK. I understand my right hon. Friend cannot elaborate on the timetable for its introduction, but can he tell us whether he is preparing for individuals to be able to input the results of an antibody test into the NHS covid app to help demonstrate their immunity and improve our understanding of the prevalence of this wretched virus?

It is not through the covid app, but we have a process for people inputting whether they think they have had the virus. As and when we manage to land an agreement on antibody testing the proposition my right hon. Friend makes is a very good one. After all, at the moment the science is not clear as to the level of immunity and the risk that we pose of transmitting to others if we have antibodies, as many of us who have had the virus hope that we have, but as the science becomes clearer, so we will also be able to be clearer with our guidance to people who have a degree of immunity on what they can do.

Two weeks ago, 1.8 million people in this country who are currently shielding were told that they would have to shield for an extra two weeks until 30 June. Can the Secretary of State confirm what protection there will be for them and their families, so that they do not face the threat of redundancy or sanction for not going to work or not going to school in order to follow that medical advice?

We have put in place extensive protections for people who are shielded, and those protections will of course continue to apply until 30 June. Shielding is not something that we do lightly, because we understand the very significant impact it has on those concerned and their families, but it is necessary in a pandemic like this.

Lincolnshire is fortunate to have good supplies of PPE, a relatively low infection rate and excellent capacity in our hospitals at this time. Will the Secretary of State join me in thanking our NHS staff across Lincolnshire, who have been intensely dedicated to treating covid-19 patients, but who are also increasingly aware of the needs of non-covid patients?

Yes, I will. The NHS restart is incredibly important in Lincolnshire and across the country. I know Lincolnshire well, and it is very important that we restart other services that have had to be paused for understandable reasons. Not only is Lincolnshire the home to many dedicated health and social care staff—I pay tribute to all those who work in the NHS in Lincolnshire—but my grandmother was a nurse at the Pilgrim Hospital in Boston and our great deputy chief medical officer, Professor Jonathan Van-Tam, is himself a resident of Lincolnshire. Lincolnshire has many great things to offer in the sphere of health, and we must ensure that that is about not just covid but health services across the board.

The Office for National Statistics has reported that covid-19 mortality rates in the most deprived areas of England are twice those in the least deprived. Once again, this virus has reminded us of the extreme health and social inequalities in our society; although it can affect anyone, from any background, those from the poorest communities have the highest risk of severe illness and death. Here in the north-east, we have some of the highest levels of deprivation in the country, as well as the highest rates of infection. What do the Government intend to do to reduce health inequalities, both during the covid-19 lockdown and as part of our recovery from the impact of the virus?

The hon. Lady is absolutely right; this is an incredibly important subject, both, as she says, during the crisis and thereafter. We have a study under way, which Public Health England is conducting, on the impact of all sorts of different conditions on the likelihood that covid-19 will hit someone hard. It is true that there is a link to levels of deprivation, in the same way as one of the strongest factors, other than age, is obesity—that needs to be investigated. We have also seen a bigger impact on people from minority ethnic backgrounds. All these things need to be studied. Levelling up and closing that health inequality gap is an incredibly important part of the Government’s agenda for recovering from this terrible disease.

As my right hon. Friend has said, due to the hard work of the entire health and social care system we can now look beyond this crisis. As we do that, may I ask him to say more today, and in the coming days, about how we intend to balance the need to address a substantial backlog of more routine and elective work, which, as he says, has been understandably pushed aside by covid-19, with the need to make sure that NHS staff, who have been through an extremely stressful period, have the time to recover?

That is one of the many balances we will have to strike in the months and years to come as we recover from covid-19. There are, immediately, three things we are doing on that. The first is that we have brought in more staff, especially retired staff, and we want to keep them. They have been absolutely brilliant and a huge help to the NHS during the crisis. The second is providing more support to staff. I mentioned the mental health support, but this involves all sorts of other, wider support to staff right across health and social care. The third thing is making sure that we rebuild the NHS, gaining from the improvements that have been made in the eye of this storm, because there have been improvements to ways of working. Huge strides forward have been taken on the use of technology, and we have found areas where that has made a very big positive impact. Although there are, of course, parts of this crisis response that we want to roll back, there are other parts we want to pick up and take forward.

My constituent Rebecca’s mother tragically died from coronavirus while working as a nurse in a Rotherham care home. The care home did not have access to the personal protective equipment she needed to keep safe. Rebecca wants to know: how will the PPE available to health and care professionals who have died in service be recorded and considered? Will accepting the £60,000 death-in-service payment prevent her family from making a negligence claim? And who signed off on the Government’s strategy of sending untested patients to care homes?

As I have said, in care homes we put in place infection control procedures as much as was possible at the start of this crisis, and there was not an increase in the number of people going back to care homes. But my heart goes out to the family of the hon. Lady’s constituent, who died working in social care, joining, I am afraid to say, many others who gave service during this crisis and died as a result of it. I am very happy to look specifically into her constituent’s case. We do look into the death of any health or social care worker and make sure we get to the bottom of all the lessons that can be learned, and I am very happy personally to do that in the case of the constituent that the hon. Lady has rightly raised.

Care homes in Ashfield such as Wren Hall, with an outstanding rating, and Sutton Manor, which is in the top 20 care homes in the east midlands, face a difficult future. With empty beds due to covid-19 comes a dramatic loss of income, which has a significant impact on their business. Could my right hon. Friend advise me what safeguards are in place to ensure that our care homes are supported to keep their doors open and continue to provide this exceptional level of care?

I want to congratulate Wren Hall, because getting an outstanding rating is not easy, and it has done that. I congratulate every single member of staff, and I thank my hon. Friend for being a champion for them and bringing to my attention Wren Hall’s outstanding rating when it was received. The funding, of course, is a critical part of this. We put in £600 million extra on Friday, and as I said, that will all go direct to care homes—it is not to go into local authority budgets for onward consideration of passing to care homes; it is to get to the care homes. That will help with infection control, but we also have to ensure that funding is sustainable for the future.

Yesterday, the British Government announced in their daily briefing that they hope to have 30 million vaccines ready for use by September, yet on the same day, the Prime Minister wrote in The Mail on Sunday that there may never be a vaccine. Considering the way that Wales has been undermined by the British Government over the distribution of PPE and testing, what confidence can the people of Wales have that we will have our fair share of vaccines if one is developed?

It is not quite fair to say that Wales has not been served on PPE or testing. I have worked very closely with the Welsh Labour Government, and although the number of tests declared per day in Wales is low—it is only just over 1,000—there is access to UK-wide testing capabilities, such as home testing and the drive-through centres.

On the hon. Gentleman’s substantive point about the vaccine, I am delighted that we have been able to come to an agreement with AstraZeneca. If the science behind the Oxford vaccine works, it is likely to be one of the first available in the world, and we then have an agreement to ensure that 100 million doses are available for the UK, the first 30 million of which will be right at the start for the most vulnerable. That is a UK-wide policy—we will deliver it right across these islands. We should pay tribute to the work and the ingenuity of our scientists in Oxford and to the industrial might of AstraZeneca, who together, should they manage to pull off the science, will be able to deliver this vaccine to our population as we need it. Vaccine science is an uncertain business. That is why we cannot ever be 100% sure that there will be a safe and effective vaccine, but we are putting everything we can into making sure that we give them the best possible chance for every citizen of the whole United Kingdom.

Can my right hon. Friend confirm that, thanks to the actions that this Government have taken and the brilliant response of the British people, we have prevented the NHS from being overwhelmed at any point during the current crisis, which has meant that ordinary people have been able to receive a fantastic standard of care when they needed it?

Yes, that is absolutely right. Two months ago, the people of Blackpool were told that it would be difficult to get through this without the NHS being overwhelmed across the country. Through the hard work of people who have done their bit by staying at home and staying alert, and through the NHS expansion, we have managed to ensure that every single person with coronavirus could get access to NHS treatment. I think the whole country should be proud of that.

As a co-chair of the all-party parliamentary group on adult social care, I have been speaking with social care providers across the country every single week since the start of this crisis. Not a single one would recognise the Secretary of State’s description last week of a “protective ring” having been thrown around them. They had no access to PPE, no access to testing and, in some cases, were told that ambulances would not take their residents to hospital. Now the sector is clear that they need access to testing on a weekly basis for all staff and residents, with prompt access to results, so that they can act to maintain infection control. Can the Secretary of State say when that essential measure will be in place?

We absolutely did a throw a protective ring around social care, not least with the £3.2 billion-worth of funding we put in right at the start, topped up with £600 million-worth of funding on Friday. Further to that, the hon. Lady does know, I think, that testing has been carried out in care homes throughout. Of course there is always more that we should and will do, but we have been working very hard and closely with the adult social care sector. Towards the start of this crisis, I was meeting the leaders of adult social care in Downing Street with the Prime Minister. We have been working very hard to tie together our response in what is a very diverse sector.

Will my right hon. Friend join me in praising the work of local initiatives such as Makers 4 the NHS in Beaconsfield, who have volunteered their time and money to help to contribute and deliver PPE to the NHS and care homes? Following the announcement of the new guidelines surrounding PPE production, will my right hon. Friend ensure that local groups like Makers 4 the NHS are not excluded from delivery of PPE, and will he meet me to discuss how we can support local businesses who are already supporting the NHS and local covid-19 responses?

Yes, I would be very happy to meet my hon. Friend, possibly via Zoom—other videoconferencing services are available—to discuss what Makers 4 the NHS and other voluntary organisations and groups of volunteers have come together to deliver with regard to PPE: it is absolutely fantastic. I pay tribute, too, to the Daily Mail’s PPE campaign, which has raised an enormous amount to bring in PPE from China. But those who are making it here in Britain I salute and I thank.

Does the Secretary of State remember that about a month ago I upset him by telling him that his Government’s policy during this crisis was a shambles? I thought they were actually getting a grip on this crisis until last Sunday’s disastrous performance by his Prime Minister. Now we have relaxed the advice to the country at a time when Yorkshire and the north-east is doubling its R rate. What is he going to do about that? Can he not get a grip? Can he not stand up to the Prime Minister?

The R rate has not doubled in Yorkshire or indeed anywhere else in the country. By contrast, as I said at the start of my statement, the good news is that things are progressing: the number of people in hospital is significantly down, and the number of people in critical care is down by two thirds. I think we should be thanking and supporting our NHS staff and others, and working together to get to the best possible outcome.

I acknowledge that no Health Secretary has faced the scale of challenges that my right hon. Friend has. Will he join me in thanking all the staff at Southend University Hospital, and those who provide associated healthcare, for their heroic efforts during this time of national crisis, and will he reassure them all that we do have plans to deliver this vaccine?

Yes, absolutely. To deliver the vaccine, if the science comes off—and we hope as much as we possibly can that it will—we will have the plans in place to ensure that it can safely be delivered to those who will benefit from it. We have the agreement with AstraZeneca for the production of 100 million doses—30 million right at the start of the programme. I join my hon. Friend in thanking the staff of Southend University Hospital, who have done so much in such difficult times to make sure that all the community can get access to the support they need if they have got coronavirus, and who I know are working now on the restoration of other services so that people with any health need can get the support they need.

When it comes to “test, trace, isolate”, the Scottish Government are expanding the resilience of the public health system. The UK Government are expanding outsourcing. While the private sector is part of an overall solution, surely the Secretary of State should be doing more to limit the profits of the likes of Serco and Deloitte.

On the contrary, one of things that we have learned in this crisis, as a nation, is that things are best delivered with people working together in the public and private sectors. I think this crisis has ended for good the idea that the public sector alone should deliver certain services. Actually, teamwork is the best option.

We are rightly tackling the global pandemic, covid-19, but there is a danger that the totally preventable diseases of measles, mumps and rubella will re-emerge if vaccinations are missed. Will my right hon. Friend reassure me and the parents in Broxtowe that it is safe and vital that scheduled vaccinations continue?

Yes, it is very important that the scheduled vaccination programme continues wherever possible, and we have protected it as much as possible. We must remember that, with the hope of a vaccine for coronavirus, so, too, will we have to redouble efforts to vaccinate children for MMR and for flu this autumn. Everybody will need to get a flu jab if they possibly can, and we will have more to say on that soon. It is really important that people vaccinate and that anybody who hears messages from anti-vaxxers stands up to them and says that what they say is wrong and harmful.

There are reports that covid-19 test results are coming in some 96 hours after testing. In that time, health workers and their families are at risk of catching the virus. Will the Health Secretary confirm whether there are enough reagents, specifically in acute settings, to perform all covid-19 tests within 24 hours?

Obviously, being able to perform all tests within 24 hours would be a great success. We are trying, as much as possible, to shorten the amount of time it takes. The average time is much, much shorter than 96 hours, and I will write to the hon. Lady with an exact figure of the time that it takes in acute settings. It is much shorter than the time that she mentions. All test results under 24 hours would be great. Sometimes it is just a matter of minutes or hours depending on how busy the test centre is.

May I return to the question asked by my hon. Friend the Member for Ashfield (Lee Anderson) and ask my right hon. Friend whether it is possible to give any specific support to care homes facing financial difficulties due to unusually high vacancy rates?

The answer that I tried to give at the end of my answer—perhaps too long an answer—to my hon. Friend the Member for Ashfield (Lee Anderson) is that, yes, that is something on which I am working. It is not something that I am able to announce today, but I do recognise the concerns and the challenges that the social care sector faces.

The number of daily new cases of coronavirus remains above 3,000 and the daily death rate higher than that of other countries, including Italy and Spain. We were slow to go into lockdown, but we now seem to be in a rush to come out, with restrictions relaxed before the test, track and trace system is fully in place, which may well be putting those numbers back on the rise. Does the Secretary of State understand why the public are anxious about the relaxation and the plans to reopen schools given the lack of systems in place now to minimise the risk of adding to the already devastating death toll?

We have set out the five tests that need to be met before relaxation. We will only do that cautiously and carefully. I would sign up to it only if it were safe to do so. The hon. Lady raises the issue of schools. It is very clear that the number of children who are badly affected by this disease is very, very, very small. It is a tiny proportion of the overall total. This disease reserves its power and its risk mostly for the elderly. The proposals that we have made for schools are safe and they are sensible. There clearly needs to be collaborative work to ensure that they can happen, because there are also risks to children, especially some of the most vulnerable children, of not going to school.

I thank my right hon. Friend for his incredible hard work and determination to get us through this crisis and for helping to save many lives in my constituency. Will he join me in thanking some of the amazing groups and organisations in my constituency of Stourbridge, such as staff at Russells Hall hospital, Mary Stevens hospice and our care homes, community pharmacists, volunteers, and all those unsung heroes who continue to work day in, day out, saving lives and supporting the most vulnerable?

I would be very happy and honoured to join my hon. Friend in thanking the staff at Russells Hall hospital and at Mary Stevens hospice, at the care homes and the community pharmacists, and indeed the volunteers of Stourbridge, who have come together. There have been many terrible things about this disease, but there have also been some heartwarming things. The dedication of staff and volunteers alike to coming to the aid of others is one of the things that the whole nation has been proud to see.

The Secretary of State will know the concerns across northern England about the Government’s approach to easing lockdown, specifically those raised by the Greater Manchester Mayor and the combined authority about the risk of a second wave of coronavirus owing to different R values across our city region. What measures is he putting in place to ensure that, as lockdown is lifted across England, those areas behind London in the curve do not see all their hard work undone?

Of course we take the decision after looking at the information for the whole country, and we take into account the R rate and the level of new cases and all other data from right across the land when deciding what is the appropriate step to recommend and to take. We do this cautiously and carefully, and we make sure that everyone is taken into consideration. The safety of the whole population is right at the front of our mind.

Wolverhampton has united throughout the coronavirus crisis and we have been testing for the virus at a rapid pace. Supplies of the reagent chemicals and swabs we have been using have reduced in the last week, which affects testing in care homes. Will my right hon. Friend address that as a matter of urgency, so that we can continue to test at the pace we need to?

Yes. This weekend, I was looking at how to make sure that there is enough testing capacity specifically in Wolverhampton. We are acting to ensure that everybody, right across Wolverhampton and the whole country, can benefit from the hugely expanding testing capability.

In south Wales and industrial towns, former miners with severe breathing issues are extremely vulnerable to covid-19. Those miners deserve recompense for years of dangerous work, but this is only possible after death if industrial disease is also noted on the death certificate. Will the Secretary of State please ask his officials to work with the mineworkers union to ensure that industrial diseases as well as covid-19 are considered as causes of death, so that grieving families can access the support they need?

Yes. I am from mining stock myself—in Nottinghamshire rather than south Wales—so I entirely understand the impact mining has on breathing and respiratory disease, and of course I understand the impact in turn of respiratory disease on the likelihood of having a bad response to coronavirus. I am happy to take up the point the hon. Gentleman makes, to contact those in the Department for Business, Energy and Industrial Strategy who I believe are specifically responsible for redress for miners, and to write to him.

In April, 16 residents of a care home in Fylde died. They represent about half of those in the home. Six of the remaining residents are displaying symptoms, but they are being told that they will have to wait until mid-June for further tests, following errors made by Randox a few weeks ago. Can the Secretary of State please investigate and work with me to resolve this important issue?

Yes, of course I can. I will take that up immediately and we will try to get a resolution. Thankfully, we have the testing capacity to be able to resolve such problems.

One of my constituents has written to me as a worried grandmother and the mother of a teacher. When scientists are divided over the coronavirus risk for children and how they might spread the virus, is this grandmother not right to ask me why Parliament is virtually empty due to social distancing measures, but her grandchild, who is least able to socially distance, is expected to return to school?

We have taken a cautious, balanced and safety-first approach to restarting schools. That is why we have taken the approach of just three years being proposed for return in the first instance, to ensure that there can be more social distancing at schools. Of course, as the father of three small children I get that that is more challenging than among adults, but it is necessary. The approach that we propose is safe and is signed off by medical advisers as safe. Of course, because there is hardly any impact on children of this disease—a very small number of children are badly affected—that means that parents can be confident that if they send their child to school, it is a safe environment for them.

During Mental Health Awareness Week, will the Secretary of State agree with me that local volunteer-led mental health groups meeting regularly on Zoom here in Warrington South, such as Offload Rugby League Cares and Man Talk, are providing an absolutely vital service for men during these unprecedented times, and that they really should continue to receive the Government’s full backing?

I pay tribute to Man Talk, to Offload Rugby League Cares and to all those who are working to support the mental health of others during this difficult crisis.

Many teachers and school staff are anxious about a return to class, especially those who have medical conditions or who are living with someone who is shielding. I understand that it will not be a requirement, but can the Secretary of State clarify whether if, for reassurance, staff at times want to wear face coverings and/or visors, they are perfectly free to do so?

May I please ask the Secretary of State whether the NHS is taking full advantage of the military logistics expertise currently available, and is there greater value to be had?

And some! The military have been unbelievably helpful in this crisis, right across the extraordinary things that my teams and the whole NHS have had to do in terms of logistics and delivery on the ground—literally boots on the ground. The military, just like the private sector that we were discussing earlier, have made the testing capability possible. They have supported care homes and they have done an amazing thing. They have really risen to the challenge.

Most countries have imposed some form of public health measures on international travellers in order to limit imported cases of the virus. The United Kingdom has been out of step on that since the middle of March, and today we heard that details of a quarantine scheme will not be published until next month. As Health Secretary, will he publish the detailed scientific advice on which the United Kingdom’s approach has been based in this matter since the middle of March?

We are working on a four nations approach, and trying to make sure that the approach that we have to international travel is aligned across all four nations, including with the Assembly Government in Edinburgh. We have, of course, based those decisions on scientific advice, and we will make sure that, as and when that advice is updated as we move through this pandemic, so the decisions continue to be based on that advice.

Fortunately, coronavirus presents an extremely low risk to children, and I am delighted that schools are able to plan to reopen from 1 June. We will need to monitor closely the effects of that on numbers of covid-19 infections. Can my right hon. Friend reassure parents and teachers that every effort is being made to ensure test, track and trace will be available in time for schools reopening?

That is right, and my hon. Friend makes an incredibly important point. The number of children who have died is sadly more than none, but very, very low compared to adults, and it is absolutely right that getting test and trace up and running is important. I am delighted that today we have recruited 21,000 contact tracers, ahead of the goal I set that by today we would recruit 18,000—7,500 of them medical professionals—to make sure that we can deliver safely on the opening of schools, which is so important to so many.

On the subject of those 21,000 contact tracers, what is being done to support, supervise and train them in what will be an incredibly sensitive job, dealing with not only the individuals affected but their data and other privileged information?

I have a big BAME community in my constituency of Kensington; will the Secretary of State assure me that Public Health England will look into the effect of ethnicity on outcomes?

Yes. Kevin Fenton, who is the London lead for public health in Public Health England, is undertaking exactly the review for which my hon. Friend asks. We propose to publish it in the coming weeks.

The Government have promised to carry out routine testing in care homes, yet my local authority tells me that there is a shortage of the home-test kits needed to do that and fears that such kits will be diverted to fulfil another of the Government’s pledges on tracking and tracing as more become available. Yet again, the Government have made a claim that is not borne out by the situation in our care homes. By what date will we have enough home-test kits to carry out routine testing in care homes?

I am happy to ensure that my team contacts the hon. Gentleman’s local authority, not least to explain that home testing is only one of the avenues available. In fact, much more testing in care homes is done through the mobile testing units, with the mobile unit going to the care home, or by the satellite units, from which a whole batch is taken to the care home, than through the home-testing channel, which is designed for sending an individual test or a small number of tests to an individual house.

An unheralded aspect of the comfort that has been brought to patients in the coronavirus crisis has come from hospital radio stations, such as the one at Stoke Mandeville. Will my right hon. Friend join me in thanking the volunteers who have provided the only company available to covid patients when they have not been allowed to have visitors? Will he do all he can to support hospital radio stations in the months and years ahead?

My hon. Friend should be proud to represent Stoke Mandeville hospital and Stoke Mandeville hospital radio. He is right: hospital radio is always important, but at times like this, when visitors have not been able to go into hospitals, it is even more important. I am pleased that he raised it.

The Secretary of State has mentioned that both the R rate and the level of new cases are important factors in determining the Government’s decision making, but will he clarify whether the way in which those factors differ throughout the UK will be considered in future planning, including in respect of financial-assistance programmes?

Thank you, Mr Speaker. Inequality is nothing new—[Inaudible.] The mortality rate for the poorest 10% is around double that of the most affluent. Does the Secretary of State agree that we must tackle this disparity? Will he commit to building a healthier country as we emerge from this crisis?

It is widely believed that the impact of covid-19 in the UK has been greater because of high levels of obesity. Does my right hon. Friend agree that we must do more to tackle the causes of obesity in our society?

Yes. It is true that the early evidence shows that obesity is a major factor in covid-19’s impact on an individual. One early study by Dr Ben Goldacre implied that serious obesity is one of the greatest factors, after age. We must make sure that we tackle obesity across the nation, and I very much look forward to working with the Prime Minister to bring forward plans to tackle obesity.

If I may, cheekily, Mr Speaker, I wish to thank all community first responders for the work that they are doing, because I know that my hon. Friend the Member for Brigg and Goole (Andrew Percy) wanted to ask about them.

Sitting suspended.

On resuming, the House entered into hybrid substantive proceedings (Order, 22 April).