PARLIAMENTARY DEBATE
Covid-19 - 16 March 2020 (Commons/Commons Chamber)
Debate Detail
Our policy is to fight this virus with everything we have. Last week, my right hon. Friend the Chancellor confirmed a £30 billion package of financial firepower, including a £5 billion contingency fund to ensure that the NHS and social care system have the resources they need. We will give the NHS whatever it needs, and we will do whatever it takes. We will get through this by working through our action plan to contain, delay, research and mitigate the virus. That plan has two overriding aims: to protect the NHS by building it up and flattening the curve, and to protect life by safeguarding those who are most vulnerable. We will do the right thing at the right time, based on the best scientific advice.
Earlier, I attended a Cobra meeting chaired by the Prime Minister to decide on the next steps in our plan. I can report to the House that we have agreed a very significant step in the actions that we are taking from within that plan to control the spread of the disease. Those actions will change the ordinary lives of everyone in this country. We appreciate that they are very significant, and I understand that people will be concerned, but we have come to the view that they are necessary to save lives and to stop this disease.
First, based on the updated scientific advice, we are today advising that if you or anyone in your home has a high temperature or a new and continuous cough, you should stay at home for 14 days. If at all possible, you should not go out even to buy food and essentials. Instead, you should ask others for assistance with your daily necessities. The exception to that is for exercise, but even then you should keep at a safe distance from others. If it is not possible to receive deliveries at home, you should do what you can to limit your social contact when you leave the house to get supplies.
Even if you or anyone in your household does not have symptoms, there is more that we have to ask of you. Today, we are advising people against all unnecessary social contact with others and all unnecessary travel. We need people to start working from home if they possibly can. We should steer clear of pubs, clubs, cinemas and restaurants. We should use the NHS only when we really need to. This advice is directed at everyone, but it is especially important for the over-70s, for pregnant women and for those with some health conditions. It is especially true of London, which the evidence suggests is several weeks ahead of the rest of the country.
These measures will be disruptive, but they will save lives. In a few days’ time, by this coming weekend, we will need to go even further to ensure that those with the most serious health conditions are largely shielded from social contact for around 12 weeks. We want to ensure that the period of maximum shielding coincides with the peak of maximum transmission. While the risks of transmission at mass gatherings, such as sporting events, are relatively low, from tomorrow, we will be withdrawing our support for mass gatherings. That will free up the critical workers we need to deal with the emergency and ensure a consistent approach to social contact.
Secondly, we are increasing our testing capabilities yet further. The UK has tested more people than almost any other major economy outside of China, South Korea and Italy. We have already increased the number of tests to 5,000 a day, and that is now on its way to 10,000, then radically further.
Thirdly, we are boosting the NHS. Ventilation is mission critical to treating the disease. We have been buying up ventilation equipment since the start of the crisis, but we need more. Today, the Prime Minister hosted a call with the nation’s advanced manufacturers asking them to join a national effort to produce the ventilators we need. We have set up a dedicated team to do that, and we are hugely encouraged by the scale of the response so far. Later today, the NHS will set out the very significant steps it is taking to prepare.
Fourthly, on Thursday, we will introduce to the House the coronavirus emergency Bill, which will give us the powers to keep essential services running at a time when large parts of the workforce may be off sick. Some of those measures will be very significant and a departure from the way that we do things in peacetime. They are strictly temporary and proportionate to the threat we face, and I hope that many will not have to be used at all. They will be activated only on the basis of scientific advice and will be in place only for as long as clinically necessary. Finally, of course, we are ramping up our communications efforts, so that people know what steps they need to take to protect themselves, others and the NHS.
Tackling coronavirus is a national effort and everyone has their part to play. The more people follow the public health advice, the less need to bring in draconian actions that I am keen to avoid. Of course, we must not forget the simple things that we can all do—washing our hands, following the public health advice if we have symptoms, and looking out for the most vulnerable in the community.
The measures that I have outlined are unprecedented in peacetime. We will fight this virus with everything we have. We are in a war against an invisible killer and we have to do everything we can to stop it. I commend this statement to the House.
I pay tribute to all our NHS staff, our social care staff and, indeed, all who work in public services. Never have we been more in their debt, and will be in the coming weeks. The public, as indeed all Members of the House, want the national effort to succeed. Every one of our constituents wants to do the right thing for their loved ones, for their neighbours and for themselves.
The virus spreads rapidly. It exploits ambivalence. It demands clarity of purpose. It demands Government effort as we have never seen before in peacetime. With that in mind, I put a number of questions to the Secretary of State, which I trust he accepts are raised in a constructive spirit. Specifically, on today’s measures, which we endorse, if we are asking people to work from home if they can, what is the advice to those who are not able to work from home because of their occupation—millions who work in the retail sector, for example?
Today, the Government will ask the elderly and those with long-term conditions to shield themselves, starting at the weekend. Can the Secretary of State give us more details of how that will work in practice? Will they be able to exercise or go for a walk? What happens if someone refuses to follow the advice? How will those who need social care support get the care they need? What protections are in place for social care staff embarking on regular 15-minute visits? How will those with complex needs and disabilities be supported?
We know that those with co-morbidities and a compromised immune system are also vulnerable. What specific advice is there for those with conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, asthma and cardiovascular issues, who the emerging literature shows to be particularly vulnerable at the moment? How will those people access repeat prescriptions?
I understand the gravity of the situation. Could the Secretary of State update the House on how far away from the peak he thinks we are? While I understand the reasoning for the decisions the Government have made today, surely there will now come a moment when schools will close. Teachers are already anxious, and parents need to plan. Can he offer some advice to parents, who will be worried tonight?
Throughout the outbreak, we have been as one in agreeing that all decisions must be based on science and evidence, but the Secretary of State, of course, will know and understand that different scientists can reach different conclusions, even when presented with the same data and evidence, so does he agree that all the evidence informing the UK’s strategy must be transparent, and that the modelling and the evidence base should be published, so that it can be peer-reviewed and stress-tested? This is about maintaining public confidence.
May I press the Secretary of State on the controversy, if I may put it like that, of recent days, in the debate about so-called herd immunity? He said yesterday that herd immunity is not the goal. The chief scientific adviser suggested something slightly different on Thursday. Could the Secretary of State clarify the Government’s position?
May I put a point that is repeatedly raised by our constituents? I hope that the Secretary of State appreciates the way in which we are putting these points to him. Many of our constituents are asking us why the UK has hitherto seemed to have taken a different course from other nations. They have suggested that other nations have been deliberately trying to delay, and to buy time to prepare for, future outbreaks. Will he explain what ideas the Government have and have not rejected, and what lessons they have learned, from countries such as Singapore, Taiwan and South Korea, which have brought the virus under relative control through containment policies? What lessons can we learn from Germany and Scandinavia, which, in recent days, according to the data, are reporting death rates of less than three per 1,000 covid-19 cases, whereas in the UK and France, the figure is much higher?
May I press the Secretary of State on the advice of the World Health Organisation? It has been clear that testing and contact tracing should continue. Many of our constituents are saying to us that surely we need community testing to continue, because we need to know the percentage of the population infected at any one time. Otherwise, the percentage of immunity will be unknown. People who are ill, those who work in the NHS or the care sector, and anyone caring for elderly relatives will surely want to know their covid-19 status, because it will have an impact on how they interact with other people in the community. NHS staff are being asked to care for covid-19 patients, not knowing whether they themselves are transmitting the virus. If they get ill, will they now be asked to stay at home for 14 days? Surely if we can test those NHS staff, and the test returns negative, we can get them back on the frontline sooner.
Is the issue around testing about capacity? If it is, has the Secretary of State considered demanding that UK-based pharmaceutical companies hand us their labs? Can we use the testing labs in higher education institutions and universities? Can diagnostic kit makers be urged to manufacture more testing kit urgently?
On a vaccine, we understand the timescales involved, but can the Secretary of State confirm that he will approve funding for scaling up manufacturing of the vaccine candidates that are being developed in the UK? On antivirals, clinical trials on repurposing drugs are under way across the globe; can he provide a written statement to the House on what capacity the UK has to assist in that process?
Turning quickly to the capacity of the national health service, our NHS and social care staff need support. They need quality personal protective equipment, whether in secondary care or primary care. Can the Secretary of State tell us how many additional intensive care unit beds have been opened? I think he has hinted that non-emergency elective treatment will now be suspended; could he confirm that? Members have long been asking him about ventilators. Can he outline the latest numbers, and say where he thinks we will be by this time next week? Can he update us on ECMO bed capacity, and say whether he is also increasing the availability of non-invasive ventilation, such as BPAP? If we need beds and equipment from private sector organisations, we should requisition that equipment, not pay for it.
Finally, we will co-operate with the Government on the proposed emergency legislation, and I am grateful for the discussions we have had, but the biggest challenge to the public health social distancing measures will not be boredom and fatigue; it will be finances and affordability. The poorest, who struggle to pay the rent, those who worry about putting food on the table, and those who have no savings to dip into, will be faced with impossible choices between hardship and health. From sick pay and lost earnings protection, to universal credit changes and rent and mortgage payment deferrals, we need a package of financial support, and we look forward to working with the Secretary of State on that front.
These are indeed serious times. Many of our constituents are anxious, and want as much certainty as possible. We have put these questions to the Secretary of State because the health and safety of the nation must always come first.
The hon. Gentleman asked about the NHS being prepared. I am thankful that we have the NHS all the time, but in a crisis like this, I am doubly thankful, because we are reliant on those who work in the NHS. Thanks to the NHS, we are as well prepared as any nation can be. We are, by some measures, the best prepared for this stage of the spread of the virus, but what matters is giving the NHS all the support that it needs, and especially having regard to the capacity of the NHS, so that it can address the symptoms and consequences of this particular virus. The issues are around ventilation and oxygen supply, as he says. We are increasing the number of ventilators. We have been buying ventilators for several weeks now, but we also need to manufacture more. As we have discussed in the House, there is no limit to our appetite to buy ventilators, and there should be no limit to the appetite of industry to make them, because around the world, everybody is trying to increase their ventilator capacity.
As the hon. Gentleman knows, we have ensured that we can use all hospital capability in this country, public or private, and bring it to the task. We are expanding the use and production of personal protective equipment. Making sure we get PPE to every single part of the NHS is absolutely vital. We will be cancelling or postponing non-time-sensitive elective surgery; the NHS will make a statement about that later today. We are increasing ICU bed capacity, but I want to make sure that the House understands that we do not need a generic type of intensive care capacity. Of course we need intensive care capacity, but we need very specific intensive care capacity with the ventilation that is needed in many of these cases.
I turn to the other questions asked by the hon. Gentleman. He asked, “What if you can’t work from home?” The answer is that if you are healthy, and if you are not being asked to isolate because a member of your household or you have symptoms of the virus, then of course you should still go to work. It is important that this country keeps moving as much as we possibly can, within the limits of the advice that we have given.
The hon. Gentleman asked about shielding, and about the elderly. The policy of shielding is specifically about reducing contact for the most vulnerable. For those who have significant health conditions, the NHS will be in contact with you over the next week. We will publish a list of those conditions, and if you think you should have been contacted and you have not been by next week, get in contact with the NHS. The shielding policy starts later than the general household isolation policy and the general advice to reduce social contact, because the reduction in contact that we need to see among those whom we are shielding is much more significant, and we need to see it last for a significant period of about 12 weeks.
The hon. Gentleman asked about those who refuse to follow advice. I do not think that many people will refuse to follow advice. Of course we have powers, and powers are proposed in the Bill, should we need to take further action, but I hope and expect that that will not be necessary.
The hon. Gentleman asked about schools. The scientific advice is not only that closing schools has a significant impact on people’s ability to work in, for instance, key areas such as the health service, but that if we get it wrong, children may stay with elderly grandparents instead of going to school, and thus increase the risk. We keep this matter under review and we are in constant discussion about it, but we have not changed the advice on schools today.
The hon. Gentleman asked about other countries. Of course we are constantly looking to all other countries around the world—including South Korea and Singapore, which he mentioned—to see what we can learn about how we can do things better. We are taking these measures at a different time from other European countries because we are behind them in terms of the progress of the virus, which is a good thing. In fact, as the chief scientific adviser has said, we are taking these actions earlier in the curve than, for instance, France and Germany did, but behind in time, because the progress of the virus is further advanced in those countries.
The hon. Gentleman asked about testing. That is very important, because of course people want to know their covid-19 status, and we are expanding testing as fast as we possibly can. The test that the world is looking for is the test that can check whether people have the antibodies because they have had coronavirus, because then we can find that out not just by testing people while they have it but afterwards, if they have had it, and therefore have the antibodies with the immunity that comes from that. That test does not yet exist, but we are putting an enormous amount of effort into creating it. We also need testing that can be done at the bedside rather than in the lab, and a huge amount of work is under way to bring that about. The same goes for vaccines and antivirals, on which the hon. Gentleman asked for a written ministerial statement, and I will of course ensure that the House is provided with one.
Finally, the hon. Gentleman asked about a package of financial support. We established a significant package in the Budget last week, and I had a meeting with the hon. Gentleman earlier today to discuss what further amounts might be needed.
I welcome all the points that the Secretary of State has made so far, but may I put three quick points to him? He does not need to answer them in detail now. First, senior general practitioners are worried that some medicines—controlled drugs, which are safe—are being destroyed because the patient for whom they were first ordered may have died. If a shortage of morphine and the like happens, it will lead to distress and agony for people unnecessarily. Will the Secretary of State look into that, and see whether, whatever the requirements are, they might be lifted during this period?
Secondly, the advice to reduce social contact may be right and important, but if people are fit and healthy and are running a business, it is not necessarily right for that business to be closed down just because they have hit a certain age.
Thirdly, may I add to a sensible point made by the hon. Member for Leicester South (Jonathan Ashworth)? There is some help for people with mortgages, but many people who will lose their jobs are paying rent. Will the Secretary of State also ensure that no one is unnecessarily evicted or threatened during a short-term period of shortage of money?
The other points made by my hon. Friend are welcome. He made a very important point about rent, which featured in the discussions that we had earlier today. I have been talking about it to those at the Treasury and to the Secretary of State for Work and Pensions. Many banks have already taken action on mortgages.
My hon. Friend’s point about the availability of drugs is, of course, critical. We have a very comprehensive drug supply chain system that we understand well, thanks to the planning that we have done over the last couple of years. Thus far we have not seen shortages beyond those that already existed before the virus, such as the one that we debated in the autumn in the context of HRT, but of course we keep the position under constant review.
The briefing from the Prime Minister talked about not providing emergency services for large gatherings, but can the Secretary of State clarify whether the Government are advising against or forbidding mass gatherings? I welcome the talk about increasing testing capability, but the briefing talked about only testing those in hospital and key workers. In Scotland, surveillance testing in practices that monitor disease in the community is continuing. Will that also be the case here in England?
Following the confusion over the weekend and, indeed, the comments that he has just made about healthy people over 70, will the Secretary of State clarify what exactly is the advice for people over 70 who live in their own homes or in care homes? Are they meant to be staying at home, or are they simply meant to be decreasing contact? In particular, is the Secretary of State discussing with social care providers lengthening the time of each visit so that there is time for the careworker to take precautions? He says that the healthy should go to work, but what if they work in a club? What provision is being made for socially vulnerable people such as the homeless or those who have no recourse to public funds, such as refugees or asylum seekers? We on these Benches welcomed the measures in the Budget, but when will the devolved Governments know exactly how much funding they will have to mitigate the economic impact of this in the three devolved nations? Finally, what further changes will be carried out in the Houses of Parliament to ensure that core services continue without increasing the risk to, in particular, older Members of both Houses?
The hon. Lady asked about surveillance testing. Across the UK, we have one of the biggest coronavirus surveillance operations in the world. Of course it happens in Scotland, but it happens throughout the UK. She also asked about Parliament. I understand, Mr Speaker, that you have been having discussions today about how Parliament will operate, but I think the whole House will be sure, in our collective decision, that although Parliament may have to operate differently, it must remain open.
May I press the Secretary of State on two points that have been raised by others? The advice from the World Health Organisation was very clear: test, test, test. At an earlier stage the UK changed its testing requirements, and those who have symptoms and self-isolate are no longer tested. If the full information is to be available, surely the testing has to be very significantly increased. Who exactly is going to be tested?
One of the difficulties has been the way in which information has been presented. To pick up the point made by the SNP spokesman about the over-70s that was echoed elsewhere, the headlines are that over-70s, even now, are going to have to stay at home for 12 weeks. Can the Secretary of State be absolutely precise as to what the advice is for over-70s and those with other conditions, and what those conditions are? Finally, on the question of seven or 14 days’ self-isolation, my understanding was that if someone had symptoms and were on their own they should self-isolate for seven days, but if they were in a family the whole family should self-isolate for 14 days. Perhaps my right hon. Friend could confirm.
On the point about the World Health Organisation saying that we should “test, test, test”, I wholeheartedly agree. We have continued the increase in testing in this country throughout this outbreak. The point that was made last week was that as the increase in the number of cases continues, so our testing capability must increase faster, and at this stage we have to make sure that the use of the tests we have are prioritised. As we expand testing capability, we will expand the number of people who can get hold of those tests. I understand the frustrations of those who want a test, but the whole House will agree that we have to make sure that we use those tests on the people who need them most, which means saving lives in hospitals.
On the point about the over-70s, to reiterate the answer that I gave a moment ago, the advice to everybody is to avoid unnecessary social contact. For the over-70s, for their own protection, that is strongly advised. The shielding, which is essentially reducing all contact as much as possible, is for those who have underlying health conditions and will be contacted by the NHS. The precise details of all these will be published on the gov.uk website so that everybody can see not only the answers I am giving to the questions, but the precise wording of what we expect everybody to do, as I have set out in the statement.
First, the Secretary of State is advising people not to go to clubs, cinemas and restaurants. Will he also advise clubs, cinemas and restaurants to close their doors, so that there is absolute clarity that people should not, at this moment, engage in those activities? Secondly, if someone in a household is symptomatic, he is advising the whole household to self-isolate for 14 days. I understand the logic behind that, which was very clearly explained, but the World Health Organisation advice is to test and isolate every single suspected case of the virus, so would he explain why there is divergence?
Thirdly, to follow up the question asked by my right hon. Friend the Prime Minister—[Hon. Members: “Former”]—the former Prime Minister, is the advice to healthy over-70s who do not have an existing long-term condition that they should be part of a new shielding policy that is happening at the weekend, or is that shielding policies just for over-70s with an existing health condition?
The hon. Lady is completely right about PPE, and we need to expand the amount of PPE. Again, we are buying it, as with ventilators, as fast as we possibly can, and part of our call for a national effort to manufacture includes PPE.
I want to end my answer to the hon. Lady by saying something about those who work in the NHS. The NHS will face an extraordinary period and many people will do extraordinary things, but it will be very, very difficult. I pay tribute in advance to the service that every single person who works in the NHS will give.
The second question—[Interruption.] I will be very quick. In Watford, we have a great volunteer network popping up. I am sure that is happening across the country. Will there be guidance for volunteers on how to ensure they do not spread the virus by doing the right thing?
After a decade of austerity, our NHS and public health were already at breaking point, even before the coronavirus hit our communities. Public sector workers have borne the brunt of austerity over the past 10 years, and they are the very workers who are expected to continue to provide services to the most vulnerable people in our society.
Today, I have been contacted by Paul, a critical care nurse in my constituency who has had to self-isolate after developing a cough. He has been told that he will not be tested. His skills, along with those of his colleagues, are vital to care for patients. Frontline staff need to be—
What discussions has the Secretary of State had with banks and lenders regarding mortgage payments? In answering for every Department today, can he tell us whether there will be a three-month freeze on mortgage payments, which would be extremely helpful? After all, banks and building societies have a role to play.
Mr Speaker, I am grateful to you for allowing me to make this statement at an unusual time, and I will commit to coming before the House whenever necessary to answer each and every concern.
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