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Covid-19 Update

Volume 692: debated on Monday 19 April 2021

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

This virus is diminished, but not defeated. Cases, hospitalisations and deaths are back to the levels we saw in September. Throughout the crisis, we have protected the NHS, and there are now 2,186 people in hospital with covid across the UK—down 94% from the peak. The average number of daily deaths is 25—down 98%. Because of this brighter picture, we have been able to take step 2 on our road map, and it is brilliant to see the high streets bustling with life once again and to hear a real-life crowd back in Wembley this weekend—especially if one is a Leicester City supporter.

Now, with fewer covid patients in hospital, the NHS is already turning to focus on the work to tackle the covid backlog. Step by step, we are returning this country towards normal life, and we are on track to meet the road map set out by the Prime Minister. Last week, we hit our target to offer a vaccine to priority groups 1 to 9, and we are on track to offer a vaccine to all adults by the end of July. However, we must be vigilant, cautious and careful throughout, because we want this road to be a one-way street.

The vaccine uptake has been astonishingly high. For all over-50s, uptake is 94%. Enthusiasm among those in their late 40s was so high that they briefly overloaded the website when we opened up the booking system last week. We can see the result of that uptake in the real world. The latest data show that 98% of people aged between 70 and 84 now have covid-19 antibodies, which are crucial to the body’s ability to fight the disease—98%. That is the protection our vaccination programme is spreading across the whole United Kingdom. Uptake among all ethnic minority groups continues to increase. Public Health England estimates that the vaccination programme prevented over 10,000 deaths up to the end of March, and it will protect many more as the roll-out continues.

We know that the first dose gives significant protection, but the second dose is crucial to make people as safe as possible. On Friday and Saturday, we saw record numbers of second doses—over 499,000 on each day—and I am delighted to tell the House that, as of midnight last night, we have now given second doses to over 10 million people across the United Kingdom. Three quarters of over-75s have now had both jabs, rising to four fifths of over-80s. The vaccine is our way out of this pandemic, and I am delighted that it is being taken up in such huge numbers.

We will do everything in our power to drive uptake, especially when it comes to protecting the most vulnerable. The vaccination rate among care home staff is currently below 80% in over half of all local authority areas. Many care homes have called for vaccinations to be required for those who work in such settings. We have therefore launched a consultation into whether we should require care home providers that care for older adults to deploy only workers who have received their covid-19 vaccination, unless they have a medical exemption. We all know that older people living in care homes are at the greatest risk from this virus, and we have a duty of care to protect the most vulnerable, so we will consider all options to keep people safe.

As we deliver on stage 2 of the vaccination programme—to vaccinate all remaining adults in the UK—we must also turn our attention to what comes next. The biggest risk to our progress here in the UK is a new variant that the vaccine does not work as well against. We know from our response to other viruses, such as flu, that we need updated vaccines to tackle mutated viruses. I can tell the House that as we complete the programme for first and second jabs, we are ramping up plans for a booster shot to make sure that our vaccines stay ahead of the virus. We have already procured enough vaccine doses to begin the booster shots later this year. We will be working with our current vaccine suppliers and new suppliers such as the CureVac partnership to work out which vaccines will be effective as a booster shot and to design new vaccines specifically targeted at the variants of concern, such as the variant first found in South Africa.

Our goal is to ensure that the vaccine protects against this dreadful disease whatever it throws at us, to keep us safe and protect our much cherished return to a normal way of life. The booster shot is important because it will help protect against new variants, but until then we must remain vigilant in case a new variant renders the vaccines less protective. New variants can jeopardise the progress that we have made here in the UK.

Thanks to our early investment in covid genomic sequencing, we have in this country one of the best systems to spot and supress new variants wherever we find them through a combination of tough measures at the border, our genomic sequencing capability and a massive testing system. I would like to inform the House of another new development in our testing system. We have been piloting Pharmacy Collect, a system in which people can go and pick up tests for free from a pharmacy. I am delighted to tell the House that following the successful pilot, we have now rolled out Pharmacy Collect to over nine in 10 pharmacies, meaning that the universal testing offer, through which everyone can get tested up to twice a week, is now freely and easily accessible to anyone who wants it. You just have to go to your local pharmacy, Mr Speaker.

I would also like to update the House on our response to two new variants. One is the variant of concern first identified in South Africa. We have now detected a total of 557 cases of this variant since it was first identified in December. We have seen a cluster of cases in south London, predominantly in the London Boroughs of Wandsworth, Lambeth and Southwark, and identified single cases over the last week in Barnet, Birmingham and Sandwell. Around two thirds of these cases are related to international travel and have been picked up by the day two and day eight testing for international arrivals. However, we have seen a small amount of community transmission, too.

As soon as those cases were discovered, we acted quickly to put in place enhanced testing, tracing and sequencing in Lambeth and Wandsworth. We have brought in 19 mobile testing units in our largest surge-testing operation to date, and we are distributing test kits to housing estates, secondary schools, places of worship and workplaces. I would urge everyone who lives in these areas, whether they have symptoms or not, to get tested regularly and help us keep the variant under control.

Secondly, we have recently seen a new variant, first identified in India. We have now detected 103 cases of this variant, of which, again, the vast majority have links to international travel and have been picked up by our testing at the border. We have been analysing samples from those cases to see whether the variant has any concerning characteristics such as greater transmissibility or resistance to treatments and vaccines, meaning that it needs to be listed as a variant of concern.

After studying the data and on a precautionary basis, we have made the difficult but vital decision to add India to the red list. That means that anyone who is not a UK or Irish resident or a British citizen cannot enter the UK if they have been in India in the previous 10 days. UK and Irish residents and British citizens who have been in India in the 10 days before their arrival will need to complete hotel quarantine for 10 days from the time of arrival. These rules will come into force at 4 am on Friday. India is a country I know well and love. Between our two countries we have ties of friendship and family. I understand the impact of this decision, but I hope that the House will concur that we must act, because we must protect the progress that we have made in this country in tackling this awful disease.

Another way that we have kept the country safe is through maintaining a strong supply of personal protective equipment. At a time of massive global demand, we secured supply lines, created a stockpile to see us through the winter and created onshore manufacturing capacity here in the UK. I am pleased to inform the House that since February last year, we have distributed more than 10 billion items of PPE to protect people working in the NHS, social care and public services right across the country. Delivering so much PPE at such speed and scale has been an extraordinary effort that has not only helped us through the crisis, but provided a lasting legacy for the future.

Let me make two further points. I would like to inform the House that today we have appointed Professor Lucy Chappell as the chief scientific adviser to the Department of Health and Social Care. Professor Chappell has a stellar track record in science and research, including leading on the work on vaccinations in pregnancy. She has worked closely with our National Institute for Health Research, for which she will now be responsible. I am sure that the whole House will join me in congratulating Professor Chappell on her appointment.

Finally, last month we laid before the House our one-year status report on the Coronavirus Act 2020. I am sorry to say that the report contains an error relating to section 24 of the Act, which concerns Home Office measures on data held for national security purposes. Full details are set out in a written ministerial statement being laid today. The error does not change the substance of the report, as we will be laying the regulations to expire section 24 alongside other provisions as soon as parliamentary time allows.

In summary, we are moving down our road to recovery, vaccinations are rising and the pressure on our NHS is falling. As we enjoy the freedoms that are returning, let us take each step safely. We must hold our nerve and follow the rules while the vaccinators do their vital work. I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement. Let me start by saying that I have no doubt that Downing Street was reluctant to cancel the Prime Minister’s trip to India. As a Member of Parliament for Leicester, I am immensely proud of our deep ties and bonds with India, but it was the correct thing to do in the circumstances, because we must always be vigilant and driven by the data, and variants are the biggest threat to our progress.

Tackling the variants demands that vaccination continues to be rolled out successfully; I again pay tribute to all involved. Uptake levels are improving, as the Secretary of State said, but they are still too low in some minority ethnic communities. Will he provide extra resources to the local communities that need them to drive up vaccination rates?

We will look carefully at the details for vaccinating social care staff, but the Secretary of State will know that every attempt throughout history to force mandatory vaccination has proved counterproductive. Why does he think this attempt will be any different?

Even with high levels of vaccination across the population, there will be significant groups who are unvaccinated—children, for example. The virus will be endemic, as the chief medical officer has recently confirmed. Papers from the Scientific Advisory Group for Emergencies model a third wave this summer. How do we avoid that? May I suggest to the Secretary of State that one way that we could do that would be to pay higher sick pay and expand its scope? Some of the poorest and the lowest paid will continue to suffer and be left exposed to the virus unless we fix that. We should not just glibly accept these health inequities; it could mean that urban areas are left behind, remaining under restrictions with higher infection rates. For the millionth time of asking, will he please fix sick pay?

Let me turn to India, which has the most cases in the world at the moment—more than 250,000 confirmed cases a day, I think, and going up. That is one of the world’s steepest surges, right now. Uploads of Indian sequencing to the global open access database show that the new double mutant B1617 variant has become dominant in India in the past few weeks, out-competing our home-grown Kent strain. As of today, COVID-19 Genomics UK reports 135 cases of B1617 in the UK and 115 in the last 28 days. It has been the fastest growing variant in the UK in the last three weeks. Most of those variants are imported, so we welcome the Secretary of State’s announcement about adding India to the red list, although I hope that there will be support and help in place for constituents such as mine who are legally in India and want to return.

We also now have cases in the community that are not linked to international travel. I understand that the Secretary of State is carrying out analysis of those samples, but surely we now need to start surge testing and designate B1617 as a variant of concern. How long will it take before we have more definitive evidence that it is more infectious or immune-escape? We already know that this variant carries mutations of concern in other variants. If we have learnt anything in the past 12 months, it is that this virus ruthlessly exploits ambiguity and that we must act fast when the situation is controllable, because in a few weeks’ time, it might not be.

The Secretary of State did not mention vaccine passports in his statement. Does he anticipate that vaccine passports will soon be needed for football games or concerts? As he said, Leicester City have made it to the FA cup final, and they are a team challenging for Europe on merit who always put fans first. Many who are anticipating going to a football match later this year will be wondering this: if they need a vaccine passport, will it be based on one dose or two? He may have seen data from Israel or the Centres for Disease Control and Prevention in the US which suggests that people are still infectious after one vaccine dose, so can he update us on that front?

Finally, I turn to the latest Sunday Times revelations about the lobbying by Greensill and Cameron of the Secretary of State and the very highest NHS officials about the payday financing scheme. This was not an act of altruism to staff in a pandemic but an investment plan to package up loans to sell to investors, with the former Prime Minister, not nurses, in line for a payday windfall. Cameron wrote in one of his emails:

“As you can imagine, Matt Hancock”


“extremely positive about this innovative offer.”

They sought a partnership with NHS Shared Business Services, which is jointly owned by the Department. They sought access to the personal and financial data of thousands of NHS staff. They wanted their electronic records for their own commercial gain. Their plan was to expand into the social care sector, where staff are on low pay or zero-hours contracts, and because the market is fragmented and made up of private providers, the supposed non-profit offer would presumably not apply.

There were meetings and communications with a parade of the most senior NHS officials, including former Health Minister Lord Prior and Baroness Harding. At least 30 trusts may have spent valuable time considering the adoption of this untested payday lending scheme, and it is all because the Secretary of State succumbed to the lobbying of his old boss Cameron. So again I ask him, will he publish all the text messages, all the emails and all the correspondence with David Cameron? Can he tell us how many NHS leaders and officials Cameron and Greensill lobbied and met? How many NHS trusts in total were approached about this expensive, unneeded scheme?

While we are on the issue of NHS Shared Business Services, can the Secretary of State also tell us why he never declared his own links to Topwood, the confidential document shredding firm which was still on Friday night, until it was curiously taken down, using the NHS logo on its website to promote itself? With so many accusations and allegations of sleaze and cronyism, these are basic questions that deserve clear answers. NHS staff deserve a pay rise and support, not these payday loan apps forced on the NHS by speculators trying to make money out of the pandemic. How can he possibly defend it?

Let me address the final point first. As I said to the House last week, my approach was and is that local NHS employers are best placed to decide whether to take up offers of pay flexibilities, and Ministers are not involved in decision taking in NHS Shared Business Services. When it comes to the other matter that the right hon. Gentleman raised in terms of my declarations—which are known to him and to everybody else only because I have followed the rules in letter and spirit and made that declaration—I agree with the Leader of the Opposition, rather than him, who said that he was not suggesting that any rules were broken.

I turn to the covid-related matters. I welcome the right hon. Gentleman’s support of the decision to put India on the red list, which is not one that we take lightly. He is right to ask about surge testing, to make sure that we limit the spread as much as possible of the variant first found in India, and I can confirm that we will be doing that.

I welcome the right hon. Gentleman’s support for vaccinations, which he has demonstrated at all turns. It is partly because of the unanimity across the House among all parties on the importance of vaccination that we have this absolutely spectacular level of uptake. He says that every attempt at mandatory vaccination is counterproductive. I gently point him to the fact that surgeons needs to have a vaccine against hepatitis B. Vaccination that is tied to work in fact has a longstanding precedent in this country.

The right hon. Gentleman asks many questions about certification, but he knows that a review of it is under way at the moment, being led by my right hon. Friend the Chancellor of the Duchy of Lancaster, who I am sure will have heard his representations and questions, and will be able to address them in the review.

Finally, the right hon. Gentleman says that we must avoid a third wave by sticking to the rules, and he is right. We should avoid a third wave if we can, and the way that we can do it is by sticking to the rules and getting the jab. That is why the vaccination programme is so important. It is why the road map is cautious and, we hope, irreversible. That is the plan, and with the 10 million second vaccines and the progress in the vaccination programme that we have seen in the last few days, weeks and months, I am very pleased to say that we are on track.

It is a pleasure to see you face to face, Mr Speaker, after some time.

The Health Secretary is absolutely right to put India on the red list and to explore mandatory vaccination of certain frontline workers, however difficult and sensitive that decision may be, but he will know that in the last week NHS waiting lists have risen to nearly 5 million people, which is nearly one in 12 of the population of England—the true cost of the pandemic. It is equally true that we have had capacity problems in the NHS for some time. That is partly why we have opened five new medical schools.

Does my right hon. Friend agree with the letter that he recently received from the three main health think-tanks, which says that Health Education England should be given a statutory duty to publish regular, transparent, independent, objective workforce projections, so that we can ensure that we really are training enough doctors and nurses? That approach is strongly supported by the Health and Social Care Committee and the Academy of Medical Royal Colleges. I hope that he will support it too.

We will certainly consider that. I have seen the letter. We have discussed the question. I would add that we have a record number of doctors in this country, in part thanks to the work that my right hon. Friend put in place when he was in my shoes. We have a record number of nurses—more than 300,000 for the first time in the history of the NHS. We do need, of course, to look to the future and ensure that we are preparing for it, as the letter suggests. We also need to ensure that we keep driving the project of delivering 50,000 more nurses in the NHS over this Parliament. I look forward to giving him a more substantive response, but I hear his encouragement to ensure that we take steps in that direction.

While the vaccine programmes across the UK are going well, vaccine-resistant variants remain a major threat. I welcome that the Prime Minister has now called off his visit to India due to its devastating surge in covid. Cases of the B1617 Indian variant in the UK are still very low, but they have been doubling every week, despite lockdown, suggesting that like the Kent variant it is much more infectious than the original virus. I therefore welcome India’s being added to the red list to reduce further importation.

Will the Secretary of State not now consider extending hotel quarantine to all arrivals, as travellers from red list countries can currently avoid it by coming via a third country? We have already seen increased numbers of the South African and Brazilian variants in European countries, from where travellers are not placed in hotel quarantine, and more infectious or vaccine-resistant variants could emerge in any country. We simply would not know about it until it was too late.

The pandemic is still accelerating, and as well as causing appalling suffering and death in other countries it clearly poses a threat to the people of the UK. Does the Secretary of State not recognise the need for a more co-operative, global response to covid if we are to bring the pandemic under control and allow a safer return to international travel and commerce?

I certainly agree with the hon. Lady on her final point, on international collaboration and working together, which, along with the Foreign Secretary and the Prime Minister, we are working incredibly hard on. We are using the UK’s presidency of the G7 and the enthusiasm of the new Administration in Washington to try to drive international collaboration, in particular collaboration among like-minded democracies in favour of an open and transparent, science-led response to pandemics. I hope that she will concur with that approach.

On the new variants of concern, it is important when looking at the numbers to distinguish between community spread and spread connected to travel. By taking the action that I have just announced to put India on the red list, we are restricting yet further the likelihood of incursion from India of somebody with a new variant. However, the majority of the cases that we have seen already in this country have been picked up by the testing that we have in place now for every single passenger entering this country. That is a sign of the system working, and it is now being strengthened.

I am delighted to say that I have had my second dose of the Oxford AstraZeneca vaccine and, so far, no ill effects. In Harrow, we have had surge testing because we have had a relatively small number of cases of the South African variant discovered. Literally thousands of people have been tested, but one of the most frustrating things is that these tests then have to be sent off and there appears to be an extremely long turnaround time before we get the results. What can the Secretary of State do to speed up getting the results of these tests? Otherwise, people will not be aware of whether they have the variant or whether they should take particular actions.

My hon. Friend is absolutely right to raise this important issue. I know that this is an important announcement for him and his constituents, representing as he does a significant number of constituents from the Indian diaspora. We have managed to reduce somewhat the turnaround time for the sequencing of positive tests, but we are also introducing a new type of test that can detect not just whether someone is positive but whether they have one of the known variants without having to go through a full sequence. That can give us a snapshot much, much faster—within a matter of hours—of whether a positive result has one of the known variants, before sending it off to sequencing so that we can see any new variant that we do not know about. We are introducing that technology. It is starting in the Lighthouse lab testing facility in Glasgow and we are rolling it out across the system. It is an important tool to make sure that we can get the turnaround time of spotting the variants down faster.

It is quite astonishing that the Secretary of State’s statement had absolutely nothing to say about the Government’s plans for vaccine ID cards—something that has apparently been trialled. Only last week, the Equality and Human Rights Commission told us that vaccine ID cards, and possibly even the mandatory vaccination scheme that he is trumpeting today, could be unlawful, yet this House has had no opportunity to express a view on them at all. When are the Government going to come clean and share their plans for vaccine ID cards with this House?

I refer the right hon. Gentleman to my previous answer, which is that the Chancellor of the Duchy of Lancaster is leading a review on this area that will report in due course.

I congratulate my right hon. Friend on the phenomenal roll-out of the vaccine programme, which has been astonishing. I, too, have had my second vaccine, which makes me feel much happier.

We have been told regularly that we are following the data, not the dates, but sadly it seems to be the other way round—that we are following the dates, not the data. We know that in Derbyshire, for instance, there are huge swathes of villages and towns with no covid whatsoever, and that is repeated over all sorts of areas of the country. Last week I managed to go out on several nights because I could—which was great, and the atmosphere was fantastic—but we need to start getting businesses back to normal. We need to get hospitality businesses operating, fully functioning, and using their indoor spaces. Some of the outdoor spaces I have been in are quite enclosed, so can we not go indoors as well now?

I am delighted that my hon. Friend, along with my hon. Friend the Member for Harrow East (Bob Blackman), is among the 10 million who have had their second jab; that is really good to see. The hope and cheer that the vaccine brings links to the second part of her question, about the speed of the road map. The reason for the timing set out in the road map is that we want to see the impact of one step before we take the next step. We are but one week on since we took step 2. That is a significant reopening, as we have no doubt all seen in our constituencies and around the country. We want to see the impact of that on the data before taking the next step, so we can have confidence that this is an irreversible path—a one-way street, as I put it. That is the reason for the way that we have set this out, and that is how we are planning to proceed.

Along with others, I welcome the roll-out of the vaccine, as that is very important, but few would deny that it is now time to look at waiting lists, and I shall put one on record. What steps have been taken to get routine operations such as hip replacements and tonsil operations back on the table to address the eye-wateringly long waiting lists? That is vastly concerning, especially when we hear, for instance, of children who were on waiting lists for tonsils and adenoids to be removed last year; due to dips in oxygen levels they were considered urgent at that time, but that now appears to be okay. That is very worrying.

The hon. Gentleman raises a very important point. The waiting list issue is very significant; it has built up because of covid, but we must tackle it and we are absolutely determined to do so. He, like me, will have seen the figures last week on the increase in the waiting list in England, but the waiting list has increased in all parts of the UK. We have put in extra funding, an extra £7 billion in total for next year in England and, through the Barnett consequentials, to the three devolved Administrations. That is there to make sure we can get through this backlog while also of course dealing with covid and the infection prevention and control needed to tackle covid. This is a vital task, the hon. Gentleman is right to raise it, and we are working very hard to address it.

My right hon. Friend is rightly proud of the stunning performance of the vaccination teams across the country, and of course I pay tribute to those who have been engaged in that in and around Ashford. I am sure he agrees that it is particularly important for care workers to be vaccinated, and not just care home workers but domiciliary care workers who go from house to house providing essential care. What is he doing to encourage take-up among care workers, to get as close to 100% as possible?

It is incredibly important that all care workers take up the jab if they possibly can, unless they have a vital medical reason not to, because the jab of course not only protects us, but protects people we are close to, and care workers are close to people who are vulnerable—that is in the nature of the job. That is why I think it is right to consider saying that people can be deployed in a care home only if they have had the jab, and we are looking into that. We have not said that for those who work in domiciliary care—caring for people in their own homes, rather than in a care home—because those in care homes are at the highest risk of all, but I would absolutely urge anybody who is a carer, whether they work in social care or are an unpaid carer, who has not already got the jab to please do get it, to protect not just them, but those to whom they have a duty of care.

As the UK rolls back lockdown restrictions, the global death toll has reached 3 million, and the World Health Organisation is warning that the world is approaching the highest rate of infection so far. With three new variants in three continents, all these variants now in the UK and the reduced efficacy of the different covid vaccinations against these variants, it is clear that the UK’s success in fully emerging from this pandemic is co-dependent on how well the rest of the world is doing. I asked the Health Secretary about global co-ordination of surveillance of new variants back in February, and the World Health Organisation is now consulting on this, so can he update the House on our response to this consultation?

This is an incredibly important subject. I agree with the substance of what the hon. Lady asked in the question, and she is quite right to raise this. We have put in place the new variant assessment platform, allowing any country around the world to use our enormous genomic sequencing capability if they want to sequence positive cases to discover what is happening in their countries, but our borders testing system, in which all positives are sequenced, also means that we in fact get a survey from around the world through those who have travelled to the UK, and we can relay that data back to individual countries so that they understand that better. Of course, it would be far better if something like the new variant assessment platform was run on a multilateral basis globally—for instance, by an organisation such as the WHO. We are engaged with the WHO on making sure that it is available, but my view was that we needed to get on and offer this to everybody and then build a network of labs around the world that can make such an offer so that sequencing can be available in every country, because it is currently far too patchy.

May I add my congratulations to the team that has managed to give two vaccinations to over 10 million people? That is fantastic news. Given the risk of variants, I welcome the difficult decision that the Secretary of State has made to add India to the red list. What research he has commissioned on those, such as my hon. Friends the Members for Mid Derbyshire (Mrs Latham) and for Harrow East (Bob Blackman), who have had two vaccinations, and what possibility there might be that people who have had two vaccinations are able to go about their daily lives with fewer restrictions than those who have not?

The latter question is really a question tied to the certification work. We have not hitherto, as my hon. Friend well knows, said that the rules for people who are vaccinated should be different from those for people who are non-vaccinated, but we know that some other countries are proposing to say that that will be case for international travel, so we do need to have a way of showing or proving it. However, we have not yet come to any conclusions about how we should do that and whether we should do that domestically. That is a matter for the Chancellor of the Duchy of Lancaster.

On measuring how effective a second dose is, we have tests in the field right now to follow a sample of people who have had both tests, having them tested regularly—weekly, typically—to check whether they test positive, and therefore testing the effectiveness of both of the vaccines in the field. So far, we have published the results of that after one jab. Very early results are coming through after two jabs, and in the next couple of weeks we will have some really rich data on that, I should hope, because we have now seen a significant number of second jabs—10 million as of midnight last night.

The vaccination roll-out for the majority of the country has been nothing short of amazing, and I would like to thank the local NHS providers in Enfield and across the country for their herculean efforts. Sadly, for some parts of the country, including many parts of my constituency of Enfield North, a postcode lottery appears to be emerging, whereby vaccination rates are stubbornly low and falling behind the rest of the country. What is being done to combat this, and what additional support will the Department be providing to areas with consistently low vaccine rates?

We have a huge amount of work on to tackle exactly the phenomenon that the hon. Lady describes. I thank people in Enfield who have been working on the vaccination programme, because they have done incredibly well, but there is much more to do. We have to ensure that we make the vaccine more accessible—that it is easy to access—and that people have reassurances if they are hesitant. The Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), is leading on these efforts, including with innovative approaches that we are currently trialling, such as allowing multigenerational households to be vaccinated at once, to see how we can drive up uptake in those groups in which we have not seen such high uptake. As I said, overall uptake among over-50s is 94%, which is far higher than my best possible hopes just a couple of months ago, but if we can reduce that final 6%, for every percentage point that comes off it, the safer we all get.

I refer the House to my entry in the Register of Members’ Financial Interests. I thank my right hon. Friend for his statement and for the extraordinary roll-out, which is still continuing, and I thank all the health workers across Wimbledon and south-west London.

In his statement, my right hon. Friend was right to identify the risk of new variants and to mention genomic sequencing and boosters. Will he confirm that there will be availability of rapid testing, with tests that provide results quickly and identify new variants, and that the booster programme will be rolled out on a similar basis to the vaccine programme, which has been so successfully rolled out?

Yes, absolutely. The booster shot programme will be rolled out in a similar way to the first two jabs. There will of course be some differences, not least because of the interaction of an autumn covid vaccination programme with the autumn-winter flu vaccination programme. We still need the final clinical results on their interaction to see whether someone can have both at the same time, which would obviously be logistically easier. Those matters need to be resolved. The reason for the announcement today is that we want to be absolutely clear that a booster shot programme will happen this autumn—later this year—and we are determined to make it as efficacious as possible, because, ultimately, dealing with these new variants will require booster shots, especially for the most vulnerable.

Over the last week, several serious concerns have been raised with me about the managed quarantine hotel system, with harrowing stories of families with young children stranded in airports because they cannot contact the booking provider to arrange accommodation, and others in quarantine hotels left without food for days on end. Will the Health Secretary tell me just what he is doing to urgently resolve the frankly shambolic situation with the booking system, and what he is doing to end the inhumane treatment of quarantine hotel guests by ensuring that food is not only provided on time but meets the faith and dietary requirements of travellers, particularly those fasting during Ramadan?

I am afraid I do not agree with the prognosis. We are, of course, very careful to ensure that the vast majority of people who go through the managed quarantine service—hotel quarantine—have a good experience. Of course, they have to be in a hotel when often they would rather not be, so it is an unusual situation, but it has been put in place with great sensitivity and I am very grateful to all those who have worked so hard on it, not just in my Department but among the hotels, the airports and the carriers. However, the hon. Gentleman clearly has some significant individual concerns, and I would be very happy to ensure that the Minister for Public Health, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), meets him to hear those individual concerns and to try to make sure that they are resolved—in particular the point about ensuring that food provision is appropriate for those fasting at Ramadan, which of course is very important.

Given that the seven-day rolling average of covid deaths is now 24.9, with just 10 yesterday, and that in normal times the daily cancer death toll averages over 450—a figure sadly likely to rise due to delayed treatment and the disruption of the pandemic—what are the Government doing to catch up with the cancer screening and operations backlog and get the health service back towards other medical conditions so that the death toll from non-covid cases does not become the worst legacy of this emergency?

My hon. Friend is quite right to ask about that; it is an incredibly important topic. I am pleased to say that, over the second peak this winter, the amount of cancer work—surgery and treatment—continued much closer to normal. He is quite right that, in the first peak, it was reduced significantly. We are very focused on the backlog that has been created by the pandemic, but I am pleased that the death toll from covid is coming down. In fact, the very latest data, published today, shows that the number of deaths recorded with covid after 28 days is four. Those numbers tend to be lower at the weekend, and we mourn each of them, but that nevertheless reinforces his point that it is vital that we get on with getting through the backlog that has been created by the pandemic.

I want to challenge the Secretary of State about the inexplicable delay in adding India to the red list of countries. I welcome the announcement that it will now be included on that list, and I hope very sincerely that this will not be another stable door moment in the Government’s response to the coronavirus pandemic. The Secretary of State knows that the SNP has committed to increase NHS funding in Scotland by 20%. Will he commit to a similar uplift for NHS England in order to help drive the recovery of the NHS after coronavirus and truly build back better?

I recently saw the figures for the proposed increase for NHS spending in Scotland. The proposed increase is lower than in England; it is lower than the money that has been passed over to the Scottish Government from UK taxpayers to spend on the NHS in Scotland. My question is: what has happened to the money for the NHS in Scotland that was given to the SNP Government in Holyrood? They have not spent it on the NHS. We know that they have many wasteful projects. Thankfully, we work very closely together on important things such as the vaccination effort, which has been a true UK success story, but this question of the missing millions for the NHS in Scotland is one that we need answers to from the Government in Holyrood.

I thank my right hon. Friend for the foresight and the early investment decisions made on vaccines 12 months ago. Here in Aberconwy, the result is falling infection rates and a tangible sense of hope, albeit one coloured with frustration as we watch businesses in England open ahead of us. We have the second-oldest demographic in Wales, and it is right that their environment is protected to ensure their wellbeing. That is properly a priority. However, can my right hon. Friend give the elderly and the vulnerable, and their loved ones, assurances that they will one day be able to leave their accommodation to visit family, resume employment and otherwise pick up their old routines?

Yes, of course. We want to get back to normal for care home residents—of course we do. We are taking steps in the right direction in England. I cannot comment on the situation in Wales; that is rightly a responsibility for the Cardiff Administration. As we progress down the road map, I hope we will be able to make further progress.

At today’s meeting of the all-party group on myalgic encephalomyelitis, we discussed the overlaps between ME and chronic fatigue syndrome and long covid. Obviously, there are some striking similarities. What assessment has the Secretary of State made of the impact that contracting covid can have on people with ME/CFS? Given their vulnerability, will he now do a bit of a U-turn and make them a priority for vaccination?

Of course, the prioritisation for vaccination when it comes to those who are vulnerable is clinically determined. I know that this question has been looked into. We are also looking into work on the links between ME and long covid, which share some similarities but are different conditions. It is an area that needs further work and further research—there is no doubt about that. If there is an update to the clinical advice on prioritisation and whether those with ME need to be in category 6 or category 4, I will update the hon. Lady. Thus far, however, we are following the clinical advice and that is the approach we have taken overall.

I was really pleased to hear my right hon. Friend reference the appointment of Professor Lucy Chappell and the work on vaccines in pregnancy. Will he please update the House on what is being done to reassure young women that there is no plausible way that vaccination can affect fertility? Will he also let us know how quickly he expects pregnant women, who we know might be immunosuppressed, to be called forward for their vaccination, or will they have to wait for the age band that is appropriate?

I was absolutely delighted that on Friday, following the work of Professor Chappell and others, we were able to make the announcement with respect to the vaccination for those who are pregnant. The prioritisation remains as with people who are not pregnant, so it will essentially be by age unless there is another reason that one might be in a higher group, for instance if you are a social care worker. It does not affect the prioritisation. Hitherto the advice had been understandably cautious, because clinical trials are not done on people who are pregnant. However, there is now very clear advice for those who are pregnant: when it is your turn, come forward and take advice. Have a discussion about your individual circumstances with your clinician. They can then, subject to that individual circumstance, which is of course appropriate in pregnancy, be vaccinated. I am grateful to my right hon. Friend for raising this issue. It was a really important announcement on Friday. Mr Speaker, I probably should have included it in my original statement, but unfortunately it was already rather long. I am absolutely delighted that Professor Chappell and the whole team—it was a big team effort—were able to ensure we made this progress.

Scott Morrison, the Australian Prime Minister, has just announced that he has no plans to open up his borders. Of course, he is absolutely right. I am speaking—I apologise—completely with the benefit of hindsight, but I am sure everybody would agree that if we had done what Australia had done, we could have opened up our economy months ago. It has had only 910 deaths and only 29,000 infections. What I want to hear from the Secretary of State is that he will resist the very powerful lobbyists from the travel and airline industries and from airports, and that he will be absolutely determined to follow the evidence, not allow unnecessary travel—we do not know what variants are out there in the world—and be really tough with the red list.

That is the approach we have taken so far since the introduction of the red list and the hotel quarantine. Through the testing of every single passenger who comes here, we essentially now have a survey of the world. We can see where the new variants are from the people coming through the testing regime. I am grateful for my right hon. Friend’s wise counsel.

The Health Secretary is clearly right to put India on the red list and to safeguard the vaccine programme from new variants. However, the India variant has been under investigation for three weeks, and other neighbouring countries with lower and slower covid rates were put on the red list 10 days ago. This week, Hong Kong identified 47 covid cases on a single Delhi flight. Before Friday, we still had 16 direct flights from India and many more indirect ones. Can he explain, contrary to his previous answer, why India was not put on a red list 10 days ago, when other countries were? Can he publish the Joint Biosecurity Centre’s assessments, recommendations and criteria and also publish a full genomic analysis of which countries all the new variant cases are arriving from, so that we can see where the border gaps still are in the measures that he has in place and make sure that we do not keep having these delays?

We keep all these decisions for each country under constant review. The challenge of the genomic data is that some countries have excellent coverage of genomic sequencing and others do not. Actually, that is not particularly correlated with their income. For instance, South Africa, a middle-income country, has excellent genomic sequencing. We take the decisions very rapidly when we need to. We keep all this under constant review and I am glad that she welcomes the decision to put India on the red list today.

May I add my congratulations to all those who have been involved in the fantastic vaccine roll-out that the Secretary of State set out in his statement? It is obviously breaking the link between cases, hospitalisations and deaths, as we are seeing dramatically from the figures. Many members of the public and businesses, having looked at the road map, which he also mentioned, will have seen that as of 21 June, the Government and the public are expecting the country to be broadly back to normal, but, of course, there is the small print about the reviews on social distancing. Will he confirm to the House and the public that as of 21 June, he expects us to be broadly back to normal, without social distancing? If that is not the case, will he set out what the evidence base will be for that decision?

Any decisions like that would be based on the evidence, and we have far more evidence now than we did when making these decisions previously. I fully expect that there will be some areas of life, without the need for laws in this place, where people will behave more cautiously than previously. The wearing of masks is one—before this pandemic, wearing a mask in public in this country was extremely unusual. I imagine that some people will wear masks, and choose to wear masks, for some time to come. Our goal is to manage this virus and the pandemic that it has caused more like flu—in fact, like flu. Flu comes through each year. We do take action to deal with flu—we take action on nosocomial infection in hospitals and through the flu vaccine programme—but we do not stop normal life as we know it. That is the overall attitude and approach. My right hon. Friend mentions that four reviews were set out as part of the road map and they will, of course, have to conclude. But that is my hope because, as he knows, I very firmly believe that this vaccine is breaking that link. We can see it in the data every single day and in the way that the country is responding. It is uplifting.

I add my praise to the team rolling out vaccines in Salford, led by Salford Primary Care Together, which is doing a remarkable job. The current guidance on visits out from care homes says that any resident who makes a visit outside a care home must self-isolate for 14 days on their return, even if all they have done on their visit is to sit outside with a family member. This is longer than people have to quarantine when returning from red list countries, including India, which has the most cases in the world. This is clearly disproportionate, so will the Secretary of State set out what he is doing to enable regular testing to be used to cut this self-isolation requirement for care home residents?

The hon. Lady raises an important point on a subject that she knows extremely well. If I may, could I give her the respect of considering the question and writing to her with a full reply, because it is a very important question and I want to make sure that we get it right? Maybe we can then have a correspondence to make sure that we get to the right result.

The UK’s vaccination programme has been an international trailblazer, the strategic aim of preventing the NHS from being overwhelmed has clearly been met, and I am delighted that my right hon. Friend, who has done a tremendous job as Secretary of State throughout the pandemic, appears determined not to allow a shift in the goalposts and to follow the cautious pathway out of lockdown. But can we please, and can he please, ensure that we have a rational and balanced discussion about viral variants? Viruses always mutate and there will be an unavoidable level of risk that we will have to get used to post pandemic, unless we are to become a perpetually frightened, introspective nation—the opposite of global Britain?

My right hon. Friend has deep experience in this area, and I am very grateful for what he said—that was very kind. He is absolutely right about the fact that viruses always mutate, and we can rise to that—we can respond to that—as we do with flu. This is another area in which the parallel with how we manage flu as a country is the right one, because the flu virus mutates most years. We work out, observing the Australian winter, what is the most likely variant we will get in our winter, we adjust the vaccines to that variant and then we roll them out over the autumn. That sort of programme is likely to be needed in this country for some time to come. We will start later this year with the booster shots, and we will make progress after that according to the evidence as we see it. I hope he was not trying to make a point of something; I always try to be rational, but it is sometimes hard.

I hope I do not still sound like a robot, Madam Deputy Speaker. The gradual easing of restrictions in recent weeks has come as a great relief and is very welcome, but we know that the pandemic has caused a colossal backlog of unmet healthcare need, including dental care. Many people have been unable to access any treatment for dental problems, and check-ups have simply not been happening for more than a year now. Will the Secretary of State set out the steps he is taking to enable dentists to begin to clear that backlog of treatment? When there is already huge inequality in oral health and so many people are facing financial hardship, what is he doing to ensure that people do not miss out on vital preventive check-ups because they cannot afford them?

The hon. Lady is right to raise this issue. We have maintained access to urgent dental treatment throughout the pandemic. We put in place dental centres to be able to do that in the first peak and dentistry was not closed in the second peak—indeed, we have put in place an incentive to get dental practices really motoring. Of course there is infection prevention and control that needs to be updated as the prevalence of the disease comes down, but making sure that we have those check-ups is incredibly important, because it is one of the most important preventive measures there is, especially for children. Given her interest in and enthusiasm for this subject, I hope she will support the proposals for much more widespread fluoridation of water, which we are proposing to put into legislation when parliamentary time allows and which was part of the White Paper we published in February, because that is one of the biggest steps we can take to protect dental health.

The NHS has had its busiest and most crucial year ever, fighting the pandemic and delivering the vaccine roll-out, and all while continuing to provide routine care and treatment. We owe our NHS workers so much, yet this Government are proposing just a 1% pay increase, not even the 2.1% previously promised. Can the Secretary of State not see that after the year we have had, this is an insult to their heroic efforts? Will he commit to getting a pay rise for staff that truly reflects the value of their work?

The admiration in which I hold NHS staff holds no bounds. The question of pay is rightly one for the independent pay review body, and I look forward to its publication.

On Friday I visited the vaccination centre at the Harlow Leisurezone to see the extraordinary work it is doing. Will my right hon. Friend thank the remarkable NHS staff and volunteers at the Harlow Leisurezone and at Lister House for vaccinating 40,000 residents in Harlow with their first jab? Given what he has said previously about Public Health England and the move to Harlow, will he meet me and colleagues to discuss the move and the exciting proposals for Public Health England, to ensure that Harlow and the surrounding area of west Essex becomes the public health science capital of England?

May I add my praise for those at the vaccination centre at Harlow Leisurezone? They have been working incredibly hard and we are all very grateful. I would add Essex County Council to my right hon. Friend’s long list, which I fully endorse. The council has leaned into the vaccination effort right across Essex. I am always happy to meet him, and with the recent announcement on the UK Health Security Agency, I think now is a good time to have a discussion on this topic.

I have been contacted by several constituents who ordered very expensive tests from companies recommended on the Government’s website as part of the test to release scheme. Some never received their tests, some never received their results, and some received their tests late and feared being in breach of the rules. They have had to battle for refunds, and we have heard of others having to leave home to get their tests, which undermines the whole scheme. What vetting, if any, does the Department undertake before listing these companies, especially as demand will no doubt increase, given that the Government are so keen to open up international travel again?

The hon. Lady is quite right to raise this. We have kicked two suppliers off the list of approved suppliers for testing for international travel, and we are quite prepared to do more if suppliers do not meet the service obligations that they sign up to. If she wants to send in the individual evidence, we will absolutely look at it. We keep this constantly and vigilantly under review. The companies that provide tests must meet their obligations in terms of timeliness and of treating their customers fairly and reasonably. As I say, two of them did not continue to meet those specifications, so we took them off the list of available testing suppliers. We are quite prepared to do more if that is what it takes.

This session is supposed to finish in three minutes’ time, but we have 12 more questioners. I would like to be able to get everybody in, and a fair number are in the Chamber. I am sure that everyone will be co-operative in keeping their questions very short, and I ask the Secretary of State to be equally brief with his responses.

Following the important announcement last week, I know that many expectant mothers in Guildford and around the country will welcome the certainty that they can safely come forward for a vaccine when it is offered. Can my right hon. Friend confirm that he will continue to take every precaution to ensure that pregnant women have the support that they need to make an informed decision about what is right for them and their health?

Absolutely. This decision was taken on the basis of the best possible science and significant amounts of data from pregnant women who have already been vaccinated, so people can have the confidence to come forward and get the advice that they need for their specific circumstances and then get the protection of the jab.

The Scottish Government and the First Minister have commitment to a full public inquiry later this year into all aspects of the handling of the pandemic, including care homes. Will the Secretary of State confirm that he supports a full public inquiry into the UK Government’s handling of all aspects of the pandemic in England as well?

This is obviously a matter for powers greater than the Health Department. It is something that the Prime Minister has clearly set out his views on, and that is what I will stick by.

Along with the chair of the all-party parliamentary group on brain tumours, my hon. Friend the Member for St Ives (Derek Thomas), I have previously raised the issue of residents who travel abroad for medical treatment having to pay hundreds of pounds for covid tests to travel out and to return. This is affecting my constituent, David Hopkins, and others across the country. Will the Health Secretary work with the Secretary of State for Transport urgently to find a way to allow patients such as David to use free NHS tests for medical travel purposes?

My hon. Friend raises an important point, and I am happy to look into it. I am also pleased that the cost of the tests that are needed for travel is coming down, and an important piece of work is under way to see how we can get that down further. Nevertheless, my hon. Friend makes a strong case for her constituent.

Face coverings are likely to remain a feature to protect against covid-19, but people with hidden disabilities who cannot wear such coverings will face abuse. Despite raising the matter on previous occasions, including once with the Prime Minister, and having been promised an awareness campaign, nothing has happened. Will the Secretary of State tell me when that campaign will happen?

Yes, an awareness campaign is under way, and I am grateful for advance notice of this question. I will write to the hon. Gentleman with the full details. He may say to me, “Sorry, Matt; more needs to be done,” in which case I will look into it, but he makes an important point on which I essentially agree with him.

I congratulate my right hon. Friend on the big reductions, based on the vaccinations, in case and death numbers. Will he briefly update us on better air extraction, cleaning and other measures to control infection in hospitals to reassure the many patients who now need non-covid treatment?

My right hon. Friend has asked about this many times, and he is quite right to, because it is not just about cleaning. We have learned a lot during the pandemic about the importance of good ventilation, and that is now embedded in infection prevention and control. As cases in hospitals come down, hospitals across the country are separating, as much as is possible, those who might or do have covid from people who are coming to hospital having been tested and knowing that they do not have covid. That is incredibly important to reassure people that if they are asked to come to hospital by a clinician, it is the best place for them.

In response to my right hon. Friend the Member for Leicester South (Jonathan Ashworth), the Secretary of State said that it was up to local NHS trusts to decide whether to take up the Greensill payday loan app, but The Sunday Times yesterday published an email between David Cameron and Matthew Gould, the head of NHSX, on 23 April. It reads:

“As you can imagine, Matt Hancock, David Prior [NHS England chairman], Simon Stevens [NHS chief executive], as well as the many trust CEOs, are extremely positive about this innovative offer.”

Is that email correct? Was the Secretary of State “extremely positive” about the Greensill app? Does he not think there is something morally wrong with using poorly paid and struggling NHS staff to allow a private company to construct a financial bond to be traded on the international money markets?

As I said to the right hon. Member for Leicester South (Jonathan Ashworth), my approach was and is that local NHS employers are best placed to decide.

Rugby’s primary care network-led vaccination centre at Locke House has provided over 34,000 first and 11,000 second doses to JCVI groups 1 to 9 through a fantastic team of staff and volunteers. The GPs, however, have chosen not to take part in phase 2 of the programme, and the centre is expected to close in mid-July as a consequence. Our local doctors would prefer to vaccinate groups 10 to 12 in their own surgeries, although that option is not currently available to them. What can the Secretary of State do to facilitate that approach to the important task of vaccinating the under-50s?

I will look into that question, which has not been raised before. Generally, the use of a primary care network—a group of GP practices—to come together to offer one centre has worked really well. That is the first I have heard of that concern, so I will take it away and ensure that it is looked at properly.

The Prime Minister today cancelled his planned trip to India this week, and the Health Secretary has just announced that India has been placed on the Government’s travel red list amid a devastating surge in coronavirus cases, with well over 200,000 detected on a daily basis. A new double-mutation variant is reportedly more potent, and dozens of cases have been detected here in the UK, too. To assuage community concerns, will the Health Secretary clarify that our vaccines are effective against this new variant?

We simply do not know that. We are acting on a precautionary basis. I cannot give the hon. Gentleman that assurance, but we are looking into that question as fast as possible. The core of my concern about the variant first found in India is that the vaccines may be less effective in terms of transmission and of reducing hospitalisation and death. It is the same concern that we have with the variant first found in South Africa and is the core reason why we took the decision today.

May I add my thanks to the NHS in Amber Valley, which has been moving through the vaccines so fast that it had even done more than 70% of the 40 to 50 age group by last week? What is my right hon. Friend’s message, though, to those who are saying that, based on media reports, we have now reached the herd immunity level and therefore this problem has all gone away?

Stoke Mandeville Hospital in my constituency is home to the National Spinal Injuries Centre. Despite continuing to do excellent work throughout the pandemic, a particular challenge arose when it came to providing support to relatives of patients who need to learn together how to adapt when back at home. Can my right hon. Friend assure me that planning for a third wave of covid-19 will give full consideration to the needs of spinal injuries patients and their families?

Yes, of course, I will give that matter consideration. I also make the case that while, as we open up, there may be more transmission, I very much hope that that does not lead—in fact we know from the data that that is highly unlikely to lead—to the same impact in terms of hospitalisations and deaths, because we know that the vaccine is incredibly effective against the variants that are at large here in this country. That is another reason to be cautious against the incursion of new variants for which we cannot give that assurance.

Lateral flow testing is really important in our continued fight against the pandemic. I am really pleased that many of my constituents have been able to access asymptomatic testing since Friday of last week, but, for residents in Wales, these tests are not yet available to order online through the portal. Will my right hon. Friend confirm whether that will be the case shortly?

We are working closely with the Welsh Government to ensure that the testing offer in Wales is as rich and as easily accessible as the testing offer in England. Testing has been a UK-wide programme, but, of course, the more we get it into local communities, the more it must be delivered through the NHS locally—for instance, through pharmacies, as announced today. That needs to be done by the Welsh Government. We are working closely together to try to make sure that people can get access to these tests as easily as saying “Jack rabbit”, wherever they live in the United Kingdom.

Sitting suspended.