PARLIAMENTARY DEBATE
Covid-19 Update - 14 December 2020 (Commons/Commons Chamber)

With permission, Mr Speaker, I would like to make a statement on coronavirus. We are nearing the end of such a tough year where the British people have united and had to make so many sacrifices for the common good. I know the whole House and the whole country have been cheered by the progress we have seen in the last few weeks, which means we can now roll out the vaccine programme that will ultimately set us free.

I can tell the House that, today, the NHS has begun vaccinations through GPs in England and in care homes in Scotland. Day by day, we are giving hope to more people and making this country safer. It is life-saving work. However, it will take time for its benefits to be felt far and wide, so we must persevere because the virus remains as dangerous as it has always been.

Average daily hospital admissions are up 13% and the latest figures show that average daily cases have risen by 14% in the last week. As before, the rise and spread is not even across the country. We are seeing a sharp rise in south Wales, in London and in parts of the east and south-east of England. This is a trend that we are also seeing in other parts of Europe, in countries such as Sweden, where nearly all the intensive care beds in Stockholm are currently in use; in Germany, where they had to announce tougher new restrictions over the weekend; and in the Netherlands, which today has announced further measures. Until we can vaccinate enough vulnerable people and ensure that they get the second dose so that they are protected, we must act to suppress this virus.

Our strategy throughout, as set out in the winter plan, has been to suppress the virus while protecting the economy, education and the NHS until the vaccine can make us safe. Today, I would like to update the House on the latest steps we are taking in this mission. First, I want to update the House on a new development in the virus itself. Over the past few days, thanks to our world-class genomic capability in the UK, we have identified a new variant of coronavirus, which may be associated with the faster spread in the south-east of England. Initial analysis suggests that this variant is growing faster than the existing variants. We have identified over 1,000 cases with this variant, predominantly in the south of England, although cases have been identified in nearly 60 different local authority areas and numbers are increasing rapidly. Similar variants have been identified in other countries over the past few months.

We have notified the World Health Organisation about this new variant, and Public Health England is working hard to continue its expert analysis at Porton Down. I must stress this point: there is currently nothing to suggest that this variant is more likely to cause serious disease, and the latest clinical advice is that it is highly unlikely that the mutation would fail to respond to a vaccine, but it shows that we have to be vigilant and follow the rules, and that everyone needs to take personal responsibility not to spread this virus.

The first formal review of tiering decisions is taking place this Wednesday, two weeks after the new rules came into force. However, I need to tell the House that over the last week we have seen very sharp exponential rises in the virus across London, Kent, parts of Essex and Hertfordshire. We do not know the extent to which that is because of the new variant, but no matter its cause, we have to take swift and decisive action. Doing so is, unfortunately, absolutely essential to control this deadly disease while the vaccine is rolled out. In some parts of these areas the doubling time is around every seven days. This is no longer just about rising rates among school-age children, but about rising rates in all age groups, including the over-60s.

We know from painful experience that more cases lead to more hospitalisations and, sadly, the loss of more of our loved ones. Hospitals across the capital, Essex and Kent are already under pressure. We know that the doubling of cases will be mirrored in hospital admissions, and it only takes a few doublings for the NHS to be overwhelmed. Our NHS is straining every sinew to cope with the pressures, as it always does, but if cases continue to double, even it will be overwhelmed.

We must act now to shift the curve, because when the virus is growing exponentially, there is not a moment to spare. We are, therefore, acting ahead of the formal review date. I am very grateful to colleagues at Public Health England, NHS Test and Trace and the Joint Biosecurity Centre, whose surveillance of this virus means that we can act very rapidly when a problem arises. We have therefore decided to move Greater London, the south and west of Essex—that includes Basildon, Brentwood, Harlow, Epping Forest, Castle Point, Rochford, Maldon, Braintree and Chelmsford, along with Thurrock and Southend-on-Sea Borough Councils—and the south of Hertfordshire, which means Broxbourne, Hertsmere, Watford and the Three Rivers local authority, into tier 3, the very high alert level.

That means that people can only see friends and family whom they do not live with, or with whom they are not in a support bubble, in outdoor public places and, of course, in line with the rule of six. Hospitality settings must close except for takeaway and delivery, and people should avoid travelling outside their area and reduce the number of journeys they make wherever possible. I know that this is difficult news. I know that it will mean that plans are disrupted, and that for businesses affected it will be a significant blow. This action is absolutely essential not just to keep people safe, but because we have seen that early action can help to prevent more damaging and longer-lasting problems later.

These restrictions will come into force at midnight on Wednesday morning, because when the virus moves quickly we must move quickly too. We must take actions that are not necessarily easy but that are effective. We will continue to stand with those who are most impacted, through our furlough scheme and support for the self-employed. We have already begun to surge mobile testing into these parts of London, Essex and Kent, and we are extending community testing too.

In addition, I can tell the House that this weekend, as part of our expansion of community testing, we are extending it to 67 local authorities across England. Further, today we will be publishing a guide for colleagues to promote, support and champion local community testing and contact tracing. We will be using millions of newly invented tests to reduce the rate of infection in areas where infection is highest and to help them move down through the tiers and closer to normal life.

Thanks to the forces of science, help is on its way. While we know now that that day will come, this is not over yet. While we deploy the fruits of scientific endeavour to keep the country safe, we must do what it takes to protect our loved ones and our NHS now. I know that these steps are hard, but we must not waver as we enter the final stretch, so that when we look back on this time of crisis, we can all say that we played our part. I commend the statement to the House.

As always, I am grateful to the Secretary of State for advance sight of his statement.

This is a virus that, without adequate restrictions in place, spreads with ferocity. Case rates are increasing again, hospital admissions are climbing and the R is edging up. Last week, the England-wide rate was 159 per 100,000; now it is 188 per 100,000. That is a 20% increase. Across London cases have increased by 30% and across the east of England by 36%, so none of us is surprised at the action the Secretary of State is taking today. Indeed, he was warned that tier 2 would not be enough to contain the spread of the virus in many places. Indeed, it looks like in some areas, such as Kent, tier 3 is not enough to contain the spread either.

Elsewhere in the country, tier 3 does appear to be forcing the virus to flatline. Indeed, in the north-west it is trending down. However, overall the increasing areas are rising faster than the decreasing areas are falling. As things stand, we are heading into the Christmas easing with diminishing headroom. The buffer zone that the tiers were supposed to provide is getting much thinner.

What is the Secretary of State’s plan to keep people safe through Christmas and avoid huge pressures on the NHS in January? What is his plan to support an exhausted, underfunded, understaffed NHS through January to deliver the care patients will need? Is he confident that our NHS will not be so overwhelmed in January that it impacts on the vaccination programme?

Our response to covid throughout could have been stronger had contact tracing been more effective. In boroughs such as Islington, only 65% of people have been traced by the national system. In Tower Hamlets the figure is only 60% and in Barking it is only 61%, yet Test and Trace is costing £22 billion—more than the policing and fire service budgets combined. According to the National Audit Office, up to September only £785 million was allocated to local council public health teams. Meanwhile, Serco has subcontracted to 21 other firms, offering little training to staff, with some people in call centres sitting alongside others making sales calls for gambling websites. Surely it is time to scrap Serco and put all public health teams in the lead in the retrospective cluster-busting contract tracing we need.

The Secretary of State has promised more testing for tier 3 areas. What about the tier 2 areas? On the lateral flow tests he is rolling out, he will know that some care home providers are refusing to use them because of concerns about their accuracy. Is he satisfied that these tests are accurate enough for this purpose and safe? If they cannot be used for care homes, how quickly can care home residents’ relatives make use of polymerase chain reaction tests?

The Secretary of State often praises Liverpool, but is not the biggest lesson to draw from Liverpool that people still struggle to isolate if they do not have the financial means to do so? The eligibility criteria for the £500 payment are still too tightly drawn. People need decent sick pay. People in some circumstances need alternative accommodation. People need help with their shopping and medicines. Surely some of the £22 billion spent on Test and Trace could be reallocated to offer people adequate isolation support.

On the variant that has been identified, our constituents will naturally be concerned. Will the Secretary of State undertake to keep the House updated throughout? I am grateful for the briefings he has arranged for myself and others with the chief medical officer, but if this variation means the virus is more easily transmissible, fixing contact tracing and isolation becomes even more fiercely urgent.

Finally, today I spoke to Fred Banning. Fred is just 38, has two children under 10 and has terminal cancer. He asks that those with terminal illness are given quicker access to the vaccine, so he can, in the words that he said to me this morning, make the most of the time he has left with his family. I understand that these are clinical decisions, but can the Secretary of State through his offices look into access to the vaccine for those with terminal illness and see what can be done for people such as Fred and many others in this situation?

I am glad to say that across large parts of the country there is very good evidence that tier 3 restrictions are working and the rates are coming down, but we need to be vigilant and, as the hon. Gentleman knows, overall rates are no longer coming down, hence the need for us to take further action.

The hon. Gentleman talked in particular about the lessons from Liverpool; the primary lesson from Liverpool is that when everybody pulls together and everybody makes the sacrifices that are necessary for their whole community, we can really get this thing under control. I am grateful to colleagues across London and Essex and Hertfordshire, to whom I have been talking today, who are committed to working to ensure that we get the public health messages out first and foremost, and to the Mayor and the Conservative mayoral candidate, who are both committed to working on behalf of the capital and, of course, those parts of Essex and Kent and Hertfordshire that are affected, because the single best thing that we can all do is speak with one voice about what is needed to get this virus under control.

The hon. Gentleman asked about Christmas, and my recommendation to people is to be cautious and careful. He asked about NHS funding and staffing; of course we have the strongest funding in history for the NHS, and I am delighted to say that we have more nurses in the NHS than ever before—14,000 more nurses than this time last year. I pay tribute to each and every one of them.

The hon. Gentleman asked about contact tracing, and no doubt he will have seen the figures published on Thursday, which show that contact tracing now reaches over 80% of contacts. I pay tribute to the team, both local and national, who are ensuring that we can get to more than four fifths of the people whom we need to reach, and that has been rapidly improving.

Finally, the hon. Gentleman asked about Fred, the gentleman with terminal cancer whom he spoke to this morning. Those with terminal cancer are, of course, clinically vulnerable by the nature of that awful disease, and we will ensure that those who are clinically vulnerable get access to the vaccine when clinically appropriate. I am very happy to take up the individual case he raises and ensure that Fred gets a fair deal.

All in all, I am grateful for the hon. Gentleman’s support for the measures we have outlined today and of course for the vaccine programme, which is rolling out across the country right now.

These are incredibly difficult decisions, but I wholly support them, because the evidence from all over the world is that acting early and decisively is the best way to save both lives and jobs. It would be perverse in the extreme if we were to take our foot off the pedal so close to rolling out the vaccine.

However, may I first ask the Secretary of State about the new strain? He said that it is highly unlikely that the vaccine will not work with a new strain. When will we know for sure? Are any trials going on? Will he get more up-to-date scientific information any time soon?

Secondly, may I ask the Secretary of State for clarity? With just 11 days before Christmas, lots of people will be thinking about Christmas shopping. From Wednesday, will it be against the regulations for those living outside London to go to Oxford Street to do their Christmas shopping? Will that also be against the regulations for those living inside London? Is the only way legally to do Christmas shopping now to go online?

First, on my right hon. Friend’s question about the new variant, it is being assessed in Porton Down right now. As I said in my statement, the medical advice that we have is that it is highly unlikely that this new variant will impinge on the impact of the vaccine, but we will know that in the coming days and weeks as the new strand is cultured at Porton Down and then, of course, tests are conducted on it.

My right hon. Friend’s question about Christmas shopping is important. It is recommended that people should minimise travel, unless it is necessary, in a tier 3 area, and should minimise travel, unless it is necessary, to a tier 3 area. We have taken this action to try to protect people and to try to slow the spread of this virus, and that is absolutely the right thing to do.

Many public health experts have questioned the use of Innova lateral flow tests for mass community testing, especially as the manufacturer does not recommend them for detecting coronavirus in people who are asymptomatic. The Secretary of State must be aware of the paper from the University of Liverpool, based on his own Department’s quality assurance programme, which has raised serious concerns about their accuracy when used in the community testing project in Liverpool. A comparison of lateral flow tests with PCR tests in over 3,000 people revealed a sensitivity of just 48%, meaning that more than half of those with the virus would be falsely reassured that they were negative. The test even missed 30% of those with a high viral load—those most likely to be infectious.

I understand the wish to use quick tests for case finding, but surely the Secretary of State should now delay rolling them out to 67 other local authorities and should not proceed with plans to spend £43 billion on a test that is so inaccurate. Would it not be better to focus funding on easier and quicker access to PCR tests? With more than half of all positive cases being missed, does he accept that despite the proposal by Baroness Harding, these tests cannot be used to release people who are contacts from isolation? On the basis of that study, the Liverpool health protection board has abandoned plans to use lateral flow tests to check visitors to care homes, so will the Secretary of State be recommending that local authorities and providers should return to PCR testing for care home staff and family visitors to reduce the risk to the most vulnerable residents?

I think that this argument against testing is wrong. I think that we should test, test, test, and that is what this Government are doing. We are working very closely with the Government in Scotland, from the same party that the hon. Lady represents, to make sure that we use testing as widely as possible to find people who have this virus. Yes, of course different tests have different characteristics. The lateral flow tests find around 70% of those who are infectious. That means that if we test people who would not otherwise have been tested, we find the positive cases, we can get them to isolate and we can break the chains of transmission. I strongly urge the hon. Lady to go back, to study the details and to back the testing programme that we have in this country.

I fully recognise my right hon. Friend’s serious dilemmas—it is not an enviable position—but the application of tier 3 to London raises some questions. I have had long conversations in my borough with public health authorities and the hospitals, and they maintain that the infection rate is now almost exclusively among secondary schoolchildren, who pass it on to their parents—those two least at-risk groups—so the hospitals are not overcrowded, with spare beds in the intensive care units and a very low level of covid patients in the hospitals.

Tier 3 will hammer down on the one area that does control what happens, which is hospitality. The key here, surely, is that doing that will cause people to shift back to their homes, and it is that area that we would worry about, with off-licences selling alcohol late in the evening. Will my right hon. Friend seek some kind of flexibility so that these measures target better the real risk and do not just hammer those who have been doing the right thing?

We are always open to finding new ways to protect the economy as much as possible and bring the virus under control. I share my right hon. Friend’s desire to get it under control and to keep it under control until a vaccine can make us safe, but unfortunately this is no longer just a problem among school-age children in Waltham Forest and north-east London, which it has been until the last week’s data. The case rate among the over-60s in Waltham Forest is now over 250 and we have seen that rising over the last week. We are also seeing rising admissions to hospital.

I have a huge amount of sympathy for everybody affected by these decisions in Waltham Forest, but it is absolutely essential to get this under control now to protect the NHS from being overwhelmed in the future. We must break the inexorable link from cases now to hospitalisations in the future—and, sadly, deaths—by using the vaccine and by testing. Until we can have the vaccine fully rolled out and people inoculated by having their second dose, and until enough vulnerable people have had that second dose and have therefore become inoculated, unfortunately measures like this are necessary.

The Health Secretary is fully aware that hundreds of thousands of jobs have been lost during the pandemic, which continues to hit our economy. That means a vast number of families and individuals are diving into hardship. Having no heating and no hot water is what many residents across our country will face this Christmas, as they visit food banks. What discussions has he had with the Secretary of State for Work and Pensions with regard to reducing the rising level of poverty?

We are trying to support the economy as much as possible throughout all these difficult decisions. The extraordinary levels of financial support are a part of that, including the furlough scheme, which has now been extended to the end of March. I, of course, talk to my right hon. Friend the Work and Pensions Secretary regularly to make sure we take the action that is necessary in a way that supports people as much as possible.

I thank my right hon. Friend for his statement, albeit that it contains a lot of very grim news about the virus itself and its effect on many areas. It will be greeted with considerable relief in Harwich, Clacton, Colchester and Uttlesford, where the virus rates are much lower and we will stay in tier 2. Is not the message now that we stay in tier 2 or go down a tier much more by our own efforts—by the efforts of local authorities, with the support of NHS Test and Trace—to make sure we support those who have to isolate and track down and trace those who are spreading the virus? By doing that, and by compliance and forbearance, we can reduce the spread of the virus and help to defeat it so we can get down the tiers.

Yes. My hon. Friend is absolutely right. Trying to keep the virus under control is in the hands of local authorities and local communities. I would say to everybody in Harwich, and people across the south-east and east of England who have not gone into tier 3 today, that we all still need to work together, be vigilant and effectively do everything we can to stop the spread of the disease, because so many people are asymptomatic—about a third—and never have any symptoms but can nevertheless spread the disease. I am very grateful to my hon. Friend for the work he has done in giving me ideas to support colleagues to help in that effort. The links between the national system and local authorities are getting stronger all the time, and I want colleagues to be able to play our part—especially as, through our campaigning, we know our communities well—by getting into communities to spread the message that if we all stick by the rules and we get the testing and contact tracing in, we will be able to keep this under control.

With cases in Devon down to 71 per 100,000 and falling, and covid hospital admissions also falling, will the only reason that Devon does not go into tier 1 this week be the shortage of staff and hospital capacity after 10 years of Conservative Government cuts?

No. First, there is a record number of NHS staff, thanks to this Conservative Government. There is a record number of nurses—we have 14,000 more nurses. What I say to people in Devon, which is currently in tier 2, but with low rates, is do not take it for granted. Let us all work together and try to get Devon into tier 1. In Exeter, those rates have come down really sharply in the last few weeks. Let us keep working at it, and let us keep those public health messages going in relation to not only coronavirus, but the importance of eating fruit.

We all know where to go now if we run out of fruit.

My children are desperate to see their grandparents this Christmas, as is the case for many families up and down the country, but—in view of these alarming numbers, what we are seeing in the US following Thanksgiving and the constant chopping and changing of rules, which leads to lower compliance and more confusion—although I appreciate that the Secretary of State does not want to be the Grinch, should he be reconsidering the Christmas measures that are in place? Do we risk unnecessary additional deaths in the new year, just as we have light at the end of the tunnel with the vaccine?

I would recommend people to exercise caution over Christmas, especially with respect to seeing elderly relatives, who, of course, people are yearning to see. I understand that, but I think it is important that people not only abide by the rules, but take personal responsibility in case they have coronavirus and might be passing it on, but do not have any symptoms and do not know about it.

My right hon. Friend will know that I have supported all the measures that have been put in place, and I have put my faith in the Government and the scientists and medical officers. However, I have real worries about Harlow in Essex being put into tier 3, as local hospitality businesses are really struggling and on their knees. I would be grateful if he could explain how further restrictions will curb the disease, given that cases increased in Harlow during the second national lockdown. I understand that the virus has recently stabilised in Harlow and that there has been no rate of increase in the over-60s in the last week. Further to this, the overall increase in cases in Harlow is 12% against a regional average of 40%, so I ask him to consider keeping Harlow in tier 2.

Unfortunately, cases are rising in Harlow and in the districts of Essex and Hertfordshire nearby, so we do have to take the action that we are. What I say to my right hon. Friend, who is an incredible champion of Harlow and his local community, is let us work together to get this down, let us work together to get this done and let us work together to try to get Harlow back into tier 2 as soon as possible, not just to save lives and protect the NHS in Harlow, but to give people their livelihoods back.

I thank the Secretary of State for his update on what is happening with covid. As a type 2 diabetic, I will take my vaccine when the time comes for me to take it. We will make sure that others get it before I do, but will the Secretary of State outline the response from the medical community about the reactions to the vaccination and the safety of the drugs for those who feel, in some cases, that it has been rushed through?

On the contrary, all the safety checks that are necessary have been carried out and we continue to monitor the roll-out of the vaccine throughout the UK. The Medicines and Healthcare products Regulatory Agency has done a terrific job on that and continues to do so. For instance, my team and the MHRA were having an update assessment on Saturday morning to check the progress of the first week’s roll-out, and I am delighted to say that we are able to keep doing that. I say to the hon. Gentleman and everybody else who wants to see the impact of the vaccine: look at the faces of those who have had their first dose, and how pleased they are to have it and to be able to get that one step closer to protection from this awful disease.

I note that Essex and Hertfordshire have been split into two—partly tier 2, partly tier 3. However, Greater London has been treated as one. In central London, our cases are significantly below the national average and, whether this House likes it or not, central London is the powerhouse of our national economy. Will my right hon. Friend tell me why London has been treated differently from Essex and Hertfordshire?

As you know, Mr Speaker, we look in great detail and at a granular level at the geographies that these restrictions have to cover. Unfortunately, central London’s case rates are rising, and we know that if an area is surrounded by other areas where there are significant increases then those high rates tend to move into that area if it is left out of a set of restrictions. I understand, of course, the impact on the economy, but the very clear public health advice was that London should move together because all areas of London are seeing an increase in rates and we need to stop that.

The Health Secretary seemed to answer rather dogmatically the question from the hon. Member for Central Ayrshire (Dr Whitford) about lateral flow tests. May I say to him that it does seem reasonable that, as a diagnostic for people to self-isolate, the test has validity, but given its very high number of false negatives, is he seriously recommending that this is the first line of defence for people going into our care homes? If he is, it is a very dangerous proposition on his part.

It is important that we use the right tests in the right circumstances but with the right other conditions. So, for instance, there is clear visitor guidance of which testing is one part, but personal protective equipment is another critical part. The nuanced question of the hon. Gentleman is entirely reasonable, but the thing that I find frustrating is the idea that we should discourage people from coming forward for asymptomatic testing when the task is to find as many people as possible who have the virus to get them to isolate. Yes, we should ensure that visiting care homes is done as safely as possible—there are health upsides to visiting as well as the challenges posed by the virus—but in terms of asymptomatic testing, I encourage people, where tests are available, to come forward, because that is how we find out where this virus is and help to isolate it.

I thank the Secretary of State for the roll-out of lateral flow tests across Derbyshire. When he does his reassessment on Wednesday, will he be willing to look at more localised geography, perhaps based around hospital catchment areas, and divide the county of Derbyshire between north and south, rather than using the whole county, which is not a very functional geography on the ground?

We are happy to look at the human geographies, as my right hon. Friend the Prime Minister put it, which is precisely why we have taken the decision today to take parts of Essex and parts of Hertfordshire into tier 3. We also look at the travelling patterns to see where the likelihood of the spread is greatest, and we set out the data on which we take the decision, so I think the answer to my hon. Friend is yes.

Contact tracing in Scotland has led the public health professionals to achieve contact rates of up to 95%. Down here, as we know, the job is handed out to privatised companies such as Serco. Serco has a £400 million contract, which it has subcontracted out to 21 further companies. What assurances does the Minister have that there is sufficient co-ordination across these 21 companies and Serco and that everything is under control, rather than adding further layers of complexity?

The good news is that the contact tracing across England is increasing in capacity. It is getting faster and it is finding more and more contacts. The comparison of apples and pears that continues to come from those on the SNP Front Bench does not take into account the fact that if we contact trace in a care home, the contact tracing is much easier, and that if we include that contact tracing in the data, we get different answers. This obsession with “public sector good, private sector bad” has been going on for months and it is just as wrong now as it was six months ago.

Today’s news is deeply sombre, so I ask my right hon. Friend to join me in urging residents of Rutland and Melton to be vigilant because we are also seeing cases rising locally, even in our villages. We have to get rates under control if we are to be decoupled from Leicester city, remain at most in tier 2 in Rutland, and protect ourselves from this new variant. Will he join me in thanking those who are working so hard locally to ready our vaccine hubs in Oakham and Melton for action once the vaccine is ready for delivery outside of hospitals?

Yes, of course; absolutely. I am delighted that we are now vaccinating from over 100 different community settings, as well as 70 hospitals across the UK. It is a tribute to the whole vaccine roll-out team, who have done a magnificent job over the last—I was going to say over the last week that the vaccine has been rolling out, but it has been weeks and weeks in the planning before then. I would say to residents in Melton and Rutland that we will look at Leicester, Leicestershire and Rutland separately when we make the decision on tiering on Wednesday. Those in Rutland who are in tier 2 still need to work at it and do their bit to try to keep Rutland in tier 2, and, of course, hopefully get to tier 1. It is so important that everybody does their bit.

The Secretary of State has rightly set out the very stark picture today—not only of the variant, but of the growing pressures, including the pressures that are likely to be placed on our NHS at this critical time. Will he therefore agree, particularly given the crucial supply chains for the vaccine, for PPE and for the 40 million packages of medicine that go back and forth between ourselves and the EU every month, that the talks must continue and we must not end up in a no-deal outcome, which would be absolutely devastating at the most critical time for our NHS and our country?

The Prime Minister is working hard to see if we can achieve a deal. I hope that there is movement from the European Union so that we can achieve that, but we are ready for any outcome.

I am obviously very disappointed by the news that London is going into tier 3, but, having seen the data and spoken to Public Health England in London and to the hospitals in my constituency, I am fully aware of the threat that this awful virus continues to present to us all. Hospitality in particular has done so much to become covid-secure, but, sadly, we are where we are. I think of our hospitals and the amazing job that our NHS staff are doing day in, day out, night in, night out. The acute hospital trusts in my constituency are handling covid cases from across London, and one of the major concerns that they have raised with me is the length of time for which staff must isolate after a positive covid contact. I understand that lateral flow testing in hospitals allows staff to return to work safely after five days, rather than 14. Can my right hon. Friend confirm that the roll-out of lateral flow tests will be prioritised in hospitals where cases are increasing?

The short answer is yes. We are rolling out lateral flow testing to find asymptomatic cases in hospitals right across England. We are always looking for ways to reduce the burden of isolation needed for positive contacts. May I pay tribute to my hon. Friend’s leadership? These are difficult decisions and it is difficult to explain to people why these measures are necessary given the impact that they have, but she is quite right to do so. Her analysis is that the best way of London coming through this is by presenting a united front, and all of us working together to get the case rates down; that is how we will best get through this together.

Christmas is often the busiest period for many businesses, particularly in sectors such as retail and hospitality. The uncertainty created by tiering arrangements chopping and changing at days’ notice has made trading incredibly difficult, even for those places currently allowed to stay open. What support will be provided to businesses affected by the tier system in the months ahead to ensure that any closures mandated by the Secretary of State’s Department over this vital trading period do not leave their doors closed permanently?

We want to support businesses as much as we possibly can. The support that is available—the record sums—has been outlined by my right hon. Friend the Chancellor. That will of course be available to businesses as we go into tier 3.

We are delighted to have the first vaccinations rolling out in Furness this week, but we know that information is key to understanding and tackling this virus. With that in mind, will my right hon. Friend consider adding data to the Government’s coronavirus website on the number of people, by cohort, who have been vaccinated and on the number of people who have been infected by this new variant of the virus?

Of course, we will be publishing data on the number of vaccinations done—that is important. Meanwhile, let us all keep getting out there to make the case that the best way to keep you, your loved ones and your community safe is by getting vaccinated when the NHS calls.

Self-isolation is crucial to breaking chains of transmission, but too many people cannot afford to self-isolate when asked to do so, because of the loss of earnings it will mean. In Salford, only 389 out of 1,760 applications for self-isolation payments have been successful to date, meaning that many people are not getting the support they need. Will the Secretary of State now agree to provide everyone who has to self-isolate with the financial support that guarantees they will not be worse off because they have done the right thing?

The principle the hon. Lady outlines is exactly the one we are working to. The £500 self-isolation payment for those on low incomes is a very important part of our approach, and I am glad that hundreds of people in Salford have been able to be reached.

I thank my right hon. Friend very much for his statement, and I fully understand the difficulties he faces. He will know that I am the Member for West Dorset, a rural seat whose western part is 55 miles away from the commercial centre of Bournemouth, which is the driving force of our tiering in rural Dorset. We have consistently maintained low numbers of cases, and on Friday we had just one person with covid in our county hospital. Although I understand full well that my right hon. Friend has had to consider increasing the tier in different places in the UK today, will he, for Wednesday, consider reductions to tier 1 in areas where that is appropriate, as I believe it is in Dorset?

I will look at this extremely closely after my hon. Friend’s entreaty. I have been noticing that in both West Dorset and Bournemouth the number of cases has been coming down. I say to everybody: stick at it, stick at the rules, and do everything you can to reduce the number of transmissions. That is the most likely way of getting into tier 1.

It is 12 months since the World Health Organisation told us that this was a pandemic, yet multiple schools in Southwark that have had covid cases have still never had any contact from the Government’s tracing system, including one college that has had 20 cases since September. In the face of this new, faster-spreading variant, will the Secretary of State finally fix contact tracing? Or will he continue to leave teachers picking up the pieces and having to work weekends, and the public picking up the bill while Ministers’ mates pick up the multimillion-pound contracts, which continue, as today shows, to let us down?

If the hon. Gentleman has an individual case of a school in that situation and he could let me know, we will sort that out, because in general the links between local directors of public health and the schools to tackle these sorts of problems are pretty good.

I know the whole House was thrilled at those wonderful images last week of people receiving their vaccines, including at the Royal Stoke University Hospital. Like other hospitals across the country, it has been gearing up for that really emotional moment for months. Like the NHS in general, it has a lot of experience of delivering these vaccine programmes, so will my right hon. Friend assure me that we will roll out this vaccine, and any others that get approved, as quickly as possible and as quickly as manufacturing allows?

Yes, that is absolutely the goal. I pay tribute to everybody by the Royal Stoke, and it was wonderful to see some of the examples of those who have been vaccinated. Stoke has been having a rough time of it of late and we need to make sure not only that we get the virus under control, but that that vaccine is rolled out, not just in the city centre, but in communities right across Stoke and Staffordshire.

The Secretary of State will know that I have warmed to his performance over the months of this pandemic, and I think he is doing a pretty good job. I think it was the Prime Minister who pushed him into the relaxation around Christmas, so may I warn him that my local hospitals in Huddersfield and Halifax are preparing for an awful surge after Christmas, just at the very wrong time, in January and February, when we do not want that kind of pressure? Will he think again and persuade the Prime Minister to think again about any relaxation of the rules over Christmas, in order to save lives?

I urge the hon. Gentleman to say to his constituents that we all need to be careful and take personal responsibility to limit the spread over Christmas. I should also like to thank him for his kind and generous words.

I have always warmly appreciated the energy with which the Secretary of State has successfully prevented our hospitals from being overwhelmed, and I have also backed this amazing vaccine that has now been rolled out. May I ask the Secretary of State about capacity in hospitals? I understand that social distancing requires there to be fewer beds in hospitals at the moment, but will hospitals be able to add more capacity as the vaccine roll-out is completed?

I certainly hope so; that is one of the things that we are talking about with the NHS. For now, that is not possible. We of course have extra emergency capacity in the Nightingales, and the testing regime has allowed the NHS to restore many of its services, so that in places such as Worcestershire it is able to carry on with almost all the necessary activity, including the electives and the cancer work, even through this second peak. I pay tribute to the NHS in Worcestershire for the work that it has done, with the support of the testing regime, and I really hope that the vaccine allows that to improve again, once we have got enough of the people who are most vulnerable to this disease vaccinated.

The Nottingham Post website is reporting today that 72 areas in tier 2 now have a higher covid rate than tier 3 Nottingham. Since we came out of the national lockdown and went into tier 3, our situation has improved on all five indicators, but we still do not know whether the improvement is enough to allow us to move down a tier later this week. Will the Secretary of State spell out the thresholds that will be used, and will he commit to publishing the rationale for his decision making?

Yes. We have set out what statistics we look at, and we publish the statistics. I think Nottinghamshire, including Nottingham, has done a very good job in getting its cases down.

My constituents now follow the local data really closely, and they can see that covid rates are thankfully plummeting in Kirklees, thanks to the local action we have been taking. Can the Secretary of State confirm that he will be using this local data at a granular level later this week to decide whether my area can come out of tier 3 restrictions?

Yes.

A recent report has concluded that some of the poorer countries might not get access to vaccines until 2024. If the ongoing roll-out in the western countries is successful and normality starts to return by spring, will the Secretary of State give a commitment that he will resist calls to declare the pandemic over, and accept that a global challenge will remain until all countries have widespread vaccination programmes in place?

Thanks to the strength of the UK, we have put more funding into the global vaccination effort than any other country in the world, and I am proud of that fact. Of course we have to work together to ensure that vaccines are available everywhere.

Since the recent national lockdown began, the infection rate in Leeds has fallen from over 400 cases per 100,000 to less than 140 today, and the number of covid patients in hospital has declined by 45% in the past month alone. The Secretary of State will be aware that the city has on balance recommended that Leeds should move from tier 3 to tier 2, because businesses have been terribly affected. I realise that he cannot give an answer today, but does he accept, having assured areas that where they are placed in the tier system will depend on the efforts they make to get the numbers down—Leeds has done a great job—that the credibility of that statement needs to be reflected in decisions about where the areas are put when they show a dramatic reduction?

The right hon. Gentleman has made a typically wise intervention ahead of the decision making on Wednesday as to the wider tiering arrangements for the rest of the country.

The Minister for Care has today indicated that there are 12,500 retired GPs and nurses seeking to help with the roll-out of the vaccination programme. My constituent David is one of them. He is 67 years old, fit and well and keen to do his bit, but the system that he has to log on to in order to apply keeps timing him out. I know that my right hon. Friend is an absolute whizz with apps. Please can he make sure that this one works for people like David?

I am thrilled by the number of former clinicians who have come back to support this. In fact, I met some of them when I went to Milton Keynes to see the vaccine being injected. I will look into the little whizzing box that is preventing my right hon. Friend’s constituent from applying.

As the Secretary of State knows, I asked back in April to for mass testing in Halton—better late than never. I decided to go down to the new mass testing centre at Ditton Community Centre in Widnes in my constituency this morning and have a test, which I am pleased to say was negative. It took 10 minutes, and I had the result back in 30 minutes. When does the Secretary of State expect the vulnerable and elderly to have had their second dose of the vaccine?

There has to be a 21-day window from the first vaccine dose to the second. We are aiming to send out invitations so that people can come as close to that 21-day marker as possible. Clinically, the 21 days is a minimum not a maximum, but the goal is clearly on or as close to the 21st day as possible.

As my right hon. Friend is aware, my constituency is in tier 3, and although there has been a considerable drop in the infection rate, people are still concerned about the roll-out of the vaccine. Can he give an update and an assurance that my constituency will feature in the roll-out in coming weeks?

Yes, we are working very hard to get the vaccine to every part of the country, including Cleethorpes. I will look into exactly when the vaccine is arriving in Cleethorpes and get back to my hon. Friend as soon as possible.

The Secretary of State is right that: this critical moment, we must think about the NHS staff we were applauding on the streets so recently, and we clearly must do everything possible to protect people from the spread of the virus. May I press him to say how the advice for the Christmas period could be strengthened by the Government to minimise transmission? Does he recognise the need for better financial support for the sectors most affected by the measures that we need, such as hospitality, and particularly for those who have fallen through the gaps in the Chancellor’s schemes?

With the decision to move areas into tier 3 comes extra financial support, and as I have said several times, we recommend that people exercise personal caution and responsibility over the Christmas period.

The tiering system has worked incredibly well in Ashfield and Eastwood, as rates are down due to the hard work and suffering of my constituents. Can my right hon. Friend reassure me that our hard work, dedication and willingness to do the right thing will be taken into account when deciding what tier we will be in at the end of the week?

My hon. Friend knows from personal experience what this disease can be like. He has been a powerful voice for Ashfield, and I will take his representations into account when we make a decision on Wednesday.

It is extremely concerning that more than 1,000 cases of the new variant have been identified in the south-east, but I understand that the vaccine still works. Data published by the ONS today shows that the mortality rate will fall by 84% when all over-70s are vaccinated. Will my right hon. Friend tell the House when he thinks that will be and what it will mean for the tiering system?

Believe me, I would love to be able to answer that question. We do not know, because it depends on the speed of manufacture of the vaccines and the approval or not of the Oxford vaccine by the MHRA. But the essence of the way that my hon. Friend asks the question is exactly how we are thinking about it in Government.

I echo the request from my hon. Friend the Member for West Dorset (Chris Loder) for Dorset and indeed Bournemouth to be considered for a move to tier 1. The stats support this, and the hospitality industry would be most grateful. While 2020 has been the most testing of years, 2021 should be different because of the vaccine. My concern is that letting down our guard for five days during Christmas could be very dangerous indeed. Will the Secretary of State review those conditions, which were put together some time ago, and come back to the House to present an updated version so that we do not begin the new year with a third wave?

I take my right hon. Friend’s views on this very seriously. I would say to everybody in Bournemouth and across the country that the best way they can help their area to go into a lower tier is by exercising personal restraint—not seeing the rules as something to push against but rather acting well within them as much as possible to ensure that this virus does not spread.

The Secretary of State talks a lot about testing and tracing but far less about isolating. The shadow Secretary of State made important points that I do not think the Secretary of State addressed. In my city, a couple of weeks ago, only 14 people had received the £500 payment. The reasons why people are not isolating are complicated, but what has gone wrong with the system? It really is not working, is it?

I am glad to say that thousands of people are receiving the payment. Of course it is aimed at those on the lowest incomes who need the financial support in order to isolate.

Stoke-on-Trent has now seen our case rate drop to below 300 per 100,000 and boasts one of the highest testing rates in the west midlands. The additional lateral flow tests from the Government, added to the impressive work by Stoke-on-Trent City Council, mean that we can now test up to 25,000 people per week. Does my right hon. Friend agree that community testing will be hugely important in helping areas like Stoke-on-Trent North, Kidsgrove and Talke, and can he confirm when mass vaccination sites in the city will appear?

Yes. Stoke-on-Trent has had a tough time recently, but the work by the city council and the community testing that is going on in Stoke-on-Trent are very impressive. All of us, as MPs, can lean into that and help to support the councils, the military and others in delivering testing in our communities. We have set out details of how we can all do that today so that every single one of us can play our part.

May I return to the vaccination of those with terminal illnesses? The wife of one of my constituents, aged 70, who has stage 4 bowel cancer and is receiving palliative care, contacted me at the weekend. If his only priority is being 70 and extremely vulnerable, he is in the fourth cohort for vaccination. The terminally ill should be in the first group. Will the Secretary of State make that change, and will he give a timescale for each of the nine priority groups for receiving the vaccine?

The hon. Member asks a very sensitive and reasonable question. Of course it is right that we should follow the clinical guidance in terms of the order of priority, and that does include those who are clinically extremely vulnerable to this disease. On the timescales, I am afraid that the answer is the same to him as to my hon. Friend the Member for Newbury (Laura Farris), which is that we do not know because it depends on the speed at which the manufacturers can produce the vaccine.

Last week I was absolutely delighted to see the vaccine rolling out across Brecon and Radnorshire. I am hugely grateful to the vaccine taskforce and the thousands of volunteers who have bravely stepped forward to take part in the trials, including—I must declare an interest—my dad. Can my right hon. Friend confirm that the vaccine has undergone months of rigorous trials, and that work continues to ensure that other vaccines can be rolled out as quickly—but, most important, as safely—as possible?

Absolutely. My hon. Friend puts it exactly right. We are working very closely with the Welsh NHS to deliver the vaccine right across Wales. I pay tribute to her father, who continues to play a leadership role in his community by stepping forward for one of the trials.

Mass testing in schools is something we have repeatedly called for in order to make sure that they can open safely. I welcome the fact that the Government are rolling out mass testing, but can they go further to ensure that schools can reopen in January, and stay open? On the vaccine, will he do everything he can, recognising that these decisions are clinically led, to make sure that school staff get access to vaccines as a priority?

I understand the yearning for a vaccine among school staff, and of course it has to be clinically led. The goal is to reduce hospitalisations and fatalities from this disease as quickly as possible. I am absolutely delighted by the community testing roll-out and the roll-out of testing to schools in the hon. Gentleman’s patch. I thank him for the leadership he has shown locally, and I encourage that.

Lancashire’s community testing is really starting to ramp up and rapidly increase, and I thank the Secretary of State for that. Prioritising tier 3 areas, such as parts of Lancashire that have been in restrictions since July, is really important. Does he agree that community engagement and getting a test with the increasingly available community testing is the thing that gets us all out of tier 3 in South Ribble, Chorley and West Lancs?

I totally agree: do your bit and get a test.

The Secretary of State is keen to remind us that we all have an individual responsibility to look after not only our own health but that of one another. Every single unnecessary journey into and out of London and the south-east increases the risk of the virus being transmitted from one part of the United Kingdom to another. The House of Commons Commission set an example today by asking all House of Commons staff not to attend Parliament unless they absolutely have to. What discussions has the Secretary of State had with his colleague the Leader of the House with a view to ensuring that all Members of Parliament can take part in all proceedings by video call, so that none of us has to make unnecessary journeys into London, with the attendant increased risk of either catching the virus or spreading it among other people?

I am afraid the answer to that question is a matter for the House rather than for me as Health Secretary.

May I take this opportunity to wish my right hon. Friend and the entire ministerial team at the Department of Health and Social Care a very happy Christmas? I hope that they are able to have some respite over the festive period. They deserve it more than anyone in this place.

Obviously, it is brilliant to see the Pfizer/BioNTech vaccine being rolled out, but people are waiting to see the Oxford-AstraZeneca vaccine, not least because it is cheaper, quicker and easier to distribute. Does the Secretary of State have any indication of when it might get approval and come on stream?

I am tempted to try to give an answer to that question, but it is very much a matter for the MHRA. I am very grateful to my hon. Friend for the good wishes that he sends. In the Department these days, we no longer say at the end of a week, “I hope you have a good weekend.” We say, “I hope you have a weekend.” Likewise, I share his hope that we have a happy Christmas, but frankly I hope I get a Christmas.

Pubs in tier 2 areas are very heavily regulated environments, and in tier 3 they are completely closed. Nothing like the same restrictions are in place on public transport, in retail shops, in care homes and in other areas where we have seen much more of a spread than in pubs. Will the Health Secretary consider not just shifting areas from tier 2 to 3 when tier 2 clearly is not working, but rethinking his whole approach so that the pub sector is given the support it needs? It is actually a much more regulated, much safer environment than many of the areas that the Government have not regulated.

Many of the facilities that the hon. Gentleman talks about, such as care homes, are doing unbelievable work to remain covid secure. I understand the impact on hospitality. I love the hospitality businesses of our country—I love going to pubs—but unfortunately we need to tackle this virus, which means that some very difficult decisions are necessary.

I am sure my right hon. Friend will appreciate that this news will be a bitter blow to people across Basildon and Thurrock, but I accept that case numbers are sadly rising rapidly, despite the recent lockdown. Therefore, can he assure me that, as we start mass asymptomatic testing in both schools and the community to identify those who are unwittingly carrying the virus, there will be enough rapid tests available for all those who need and want one?

Yes, and I strongly commend my hon. Friend’s leadership locally. These are tough decisions, but let us get this testing going, get everybody coming forward to get a test if they can, to find those cases and ask and require people to isolate to break the chains of transmission and get Essex and Thurrock back out of tier 3 as soon as we possibly can.

One of my closest friends, Dan Lass, who I had known for more than 30 years, died of leukaemia last Thursday morning. He was in the United States of America, but I want to ask the Secretary of State about the cancer recovery plan in this country because cancer carries on killing people and many people have ended up not presenting this year. I know we have got things going again—even during the second wave—which is an amazing job by all the oncologists and doctors, but we must ensure we get clinical trials up and running again. We must be able to save lives and we must ensure that people go into hospitals to get the treatment they need. Otherwise, there will be more people who have lost someone like Dan.

The hon. Gentleman is quite right to raise this issue. My condolences to him and to all the family and friends of his friend, who is sadly no longer with us. I pay tribute to the way in which the NHS has kept cancer services going during the second peak. It has not been easy, but it has saved lives. The NHS has worked hard at it, and we must keep that going for the remainder of this time until we can get through and beyond.

I thank my right hon. Friend for his statement and the tough decisions he is having to make at the moment. Tier 3 restrictions will be tough on London, but we should not lose sight of the fact that most of the north of England, including my constituency of Keighley and Ilkley, has been under these extra restrictions for an enhanced period of time, and that has had a detrimental impact on the hospitality sector. Will he therefore consider a test and dine scheme so that we can try to get our pubs and restaurants back open as soon as possible?

A test and dine scheme is being piloted. It is something we are looking at to try to support the hospitality industry while keeping the virus under control. I will report back to my hon. Friend with the results of that pilot and see if we can get it going in Keighley.

The roll-out of the vaccine is welcome news, but there is still a long way to go. Public messaging has been poor throughout the crisis, and that is particularly true for disabled and clinically extremely vulnerable people, who have frequently received guidance after new restrictions have started. We have all seen the vaccine prioritisation list, and the Health Secretary has been asked this several times, but, honestly, if he agreed to publish an estimated timetable for the roll-out, that would be extremely welcome and allow people to have some faith in the future and be able to plan accordingly.

I wish I could do that, but I cannot do so faithfully. What I can do is say is that the majority of people will be vaccinated in the new year and we are working to ensure that the roll-out happens as swiftly as is safely possible. I understand the yearning, but I cannot put a date on it.

My right hon. Friend will know how hard the people of Leeds have worked. The right hon. Member for Leeds Central (Hilary Benn) made that comment and, indeed, the Treasurer of Her Majesty’s Household, my hon. Friend the Member for Pudsey (Stuart Andrew), who is in his place, and I would like to put on record our thanks to the people of Leeds for what they have done. My right hon. Friend the Secretary of State has hinted about what may or may not happen, and I would not want to push him on that, but one thing concerns me —this comes from the hospitality sector. If an announcement was made about coming down from tier 3 to tier 2, how quickly would that be enacted? If we do come down to tier 2, the hospitality industry needs time to get moving as quickly as possible for the Christmas business season.

My right hon. Friend makes the case strongly, not only for himself but for the Treasurer of Her Majesty’s Household, my hon. Friend the Member for Pudsey (Stuart Andrew), who as a Whip cannot speak. However, believe me, behind the scenes he makes the case for Pudsey more strongly than anyone in this House makes the case for anywhere—almost. [Laughter.] It is a team effort. The specific answer to his question is that the decision made on Wednesday will be published on Thursday and come into effect in the early hours of Saturday morning.

The announcement of the vaccine was very welcome, but like a lot of things from the Government, there is a big difference between what has been promised and spun and what is actually happening on the ground. I was contacted this morning by Mrs Lesley Rhodes from Chester-le-Street in my constituency concerning her mother, Mrs Gowland, who is a resident of the Picktree care home in Chester-le-Street. She has been told that the vaccine will not be available to that and other care homes in County Durham until into the new year. Can the Secretary of State tell her and other residents of care homes in County Durham when they will start receiving the vaccine?

The right hon. Gentleman is quite wrong. We have been very clear with the roll-out of the vaccine on the pace at which we can start it—in fact, we started it ahead of when we had committed to—and the uncertainties over the timing of the roll-out, as he will have seen from my answer to the last but one question. When it comes to the care home roll-out, I have been absolutely clear that we aim to have it started in England before Christmas, and I am delighted it has been possible to start it in Scotland today.

Evidence seems to suggest that when it comes to face coverings on public transport, if everyone wears them, it reduces the spread, but if some people do not, it can increase the spread, as people fiddle around with their face masks and others are spraying out. I do not know whether the Secretary of State agrees, but it has been very worrying travelling on trains, seeing what appears to be a marked deterioration and a reduction in the number of people wearing face masks. Will he send the message out that people really must do better? I know that masks can slip for everyone, but by and large, people really must follow the rules and ensure that they are protecting not just themselves, but everybody, including essential public workers on our public transport system.

What my hon. Friend says is exactly right.

The Secretary of State heard earlier about my constituent Fred Banning, a 38-year-old father of two who has terminal cancer. For Fred and others in his situation, the vaccine is all about making the best of the time remaining. I have written to the chair of the JCVI, the Minister for covid vaccine deployment, the hon. Member for Stratford-on-Avon (Nadhim Zahawi) and the devolved Administrations seeking a review of the priority given to those living with terminal illness. Will the Secretary of State work with them to deliver a speedy response for Mr Banning and others in his tragic circumstances?

I appreciate the sensitivity with which the hon. Lady raises this case. Of course I would be very happy to ensure that it is looked at properly by the JCVI, but the decision, as I am sure she will understand, is rightly for the JCVI.

The Secretary of State has to recognise that the decision in relation to London will have a crippling effect upon the hospitality industry in the capital, not least because this is the time of year when they might most hope to make good the losses that they have already suffered—[Interruption.]

We have lost Sir Robert for the time being, but would the Secretary of State like to answer half the question?

I got the gist of it, Madam Deputy Speaker. My hon. Friend is right to express the concerns about the industry. This will be a significant blow to the hospitality industry, and we only take this action because it is absolutely necessary, because of the rates of increase of this virus right across London, and especially in Kent. The best thing we can do is all work together to try to get London out of tier 3.

I will call William Wragg.

Order. I do beg the hon. Gentleman’s pardon and apologise for confusing the Secretary of State. We are actually going to Calder Valley and Craig Whittaker.

Will my right hon. Friend join me in thanking all those local authorities, such as Calderdale, that have already come forward to put in place community testing? Can he assure me that central Government will stand squarely behind local areas, which are doing everything they can do to move to lower restrictions, as we hope Calderdale will later in the week?

My hon. Friend makes his case, as other West Yorkshire colleagues have today. The roll-out of mass community testing in Calderdale has been impressive. There is much more work to do, and my message, as I am sure he would reiterate, is let’s get tested and let’s get this virus under control in West Yorkshire.

And now I call William Wragg.

Thank you, Madam Deputy Speaker, for that warm welcome.

Further to the question from my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin), the approach of Essex and Hertfordshire shows that district authorities can be dealt with separately between tiers. With that tantalising prospect, will my right hon. Friend the Secretary of State commit to looking closely at the very encouraging data from Stockport, and indeed other boroughs of Greater Manchester, in reviewing those tiers this Thursday?

I can absolutely give that commitment and say to the people of Stockport that they have been in restrictions for a long time and have done a great thing in bringing the case rate right down. Of course we have to remain vigilant, and today’s news only further amplifies that fact, but by doing the right thing, they have helped to protect life, and I will look very closely at their case on Wednesday.

People want to spend the Christmas holiday with their loved ones—of course they do—and the message of doing so with care is one that we all must stress, but given the very worrying statistics we have heard today, can the Secretary of State tell us if he has asked for or received any modelling on the likely impact of the suspension of restrictions over the Christmas holiday and the movement of people all around the country on the spread of infections and the hospitalisation rates in the middle of January?

The truth is that it all depends on how people behave, and it is very important that we all urge people to behave with great care and responsibility over the Christmas period.

I congratulate my right hon. Friend on the fantastic work he has done on the vaccine, but may I make a plea to him on behalf of the constituents in Wealden whom I spoke to this weekend? They will struggle to get to some of the hospitals which are over an hour away, so will he do all he can to ensure that the vaccine comes into my rural constituency?

The other bit of good news is my right hon. Friend saying from the Dispatch Box that the tiers will no longer be at county level. My Wealden residents have gone above and beyond to keep infection rates down; they must not pay the price for what is happening outside Wealden so can we ensure that their tier remains the same or is reduced?

I will take a look at the numbers in Wealden in particular. I am concerned about the rate of increase in other parts of the south-east and will have to look very carefully at that case.

On the vaccine roll-out, of course we want the vaccine in all communities across the country. I am delighted that today we managed to start the GP roll-out, which means that we have been able to get vaccine out of the major centres and major hospitals and into over 100 different local communities, and I will check whether Wealden is on the list to make sure everybody in Wealden can get their vaccine at the appropriate time.

I hope the Secretary of State recognises the sacrifices Geordies have made to successfully reduce transmission rates here, but I want to ask about vaccine prioritisation. Public Health England has reported that those with learning disabilities have covid-19 deaths up to six times higher than those of the general population, and it is obviously extremely difficult to maintain covid-security in care homes whose residents cannot understand social distancing, yet I am told that they are being deprioritised for the vaccine because JCVI guidelines prioritise care homes for the elderly only, and that is interpreted as being those over 80. Can the right hon. Gentleman confirm whether that is the case, and will he give greater flexibility to local public health authorities to reflect risk?

Nobody has been deprioritised: the nation has been prioritised according to clinical need, and that is rightly a judgment for the JCVI. It has of course looked into the research and data the hon. Lady rightly raises and has come to the view that the level of risk for those who are clinically extremely vulnerable is akin to the level of risk for those who are 70 to 75 years of age, and that is the reason for the prioritisation decision it has taken.

Despite all the sacrifices we have made in South Shields, we are one of the top 50 coronavirus hotspots. That is not surprising since centralised contact tracing is failing us. Just today, it has been revealed that contact tracing companies subcontracted by Serco are using inexperienced and unqualified people to gather vital clinical information. Will the Secretary of State publish a list of those companies and allow my local public health experts to take control of the situation?

The hon. Lady’s local public health experts are already working with the national system. I gently say that instead of trying to divide people with this public-private split, as the Opposition seem desperate to do, the best way to get the case rate down in South Shields is for us all to get on the same page with public health messaging. If for every time she asked me a question about Serco, she asked me a question about how we could work together to keep people alive and safe in South Tyneside, South Shields would be in a better place.

Will the Secretary of State confirm that London is going into tier 3 because it is failing on the five tests that have been set out on tiering, and will he also confirm that Redcar and Cleveland have considerably improved across all five tests since the tier 3 decision was taken? The Secretary of State can make my wish come true, because all I want for Christmas is tier 2.

How can I reject an entreaty like that? My hon. Friend makes a very seasonal request. We will be looking at the situation very closely come Wednesday, and we will see what is in Santa’s bag.

I was really proud to see that Coventry’s NHS staff administered the first coronavirus vaccinations in the country, but those staff have been let down by the Government. They were promised free parking throughout the pandemic, only for charges to be reintroduced in June, as they were at many other hospitals across the country. Only after I handed in a petition, wrote to the Prime Minister and secured a Westminster Hall debate was free parking reinstated for permit holders at Coventry’s hospital, but it is still denied to staff who do not have permits. Will the Government live up to their promise and provide NHS trusts with the funding for free parking for all their staff?

I will just answer the first bit. I was absolutely thrilled to see Coventry delivering the first vaccination with the clinically approved vaccine in the world. It made my heart sing, and I am so glad that we managed to do that. With the help of the international scientists, the NHS and the regulator, we have made such progress. That really put Coventry on the map, and I hope that the hon. Lady is proud.

Will the Secretary of State thank Stroud and Gloucestershire health and care teams, who are working to the point of exhaustion? This second wave is proving to be quite difficult in a number of ways. Separately, I welcome the developments in testing and vaccines. Would the Secretary of State be willing to get PHE to develop more pilots and work on road maps for the wedding industry and other struggling sectors, so that we can benefit from that as quickly as possible in the new year?

The best thing we can do for the wedding industry is to try to get the vaccine rolled out as fast as possible to protect people, so that this virus no longer kills as many as it sadly does today. I join my hon. Friend in paying tribute to all those in Gloucestershire, including south Gloucestershire, who are working so hard. There has been a very difficult spike in the virus. Thankfully, it is coming down now, and I hope to see the number of hospitalisations in her area reducing. While that is happening, we have to get on with the roll-out of the vaccine, which is a 24/7 job. I pay tribute to and thank all the NHS staff who are working so hard to make that happen.

I will suspend the House for three minutes in order to allow colleagues to leave safely, and to allow those who are coming in for the next fixture to attend safely.