PARLIAMENTARY DEBATE
Covid-19 Update - 17 December 2020 (Commons/Commons Chamber)

As we enter the coldest months, we must be vigilant and keep this virus under control. Yesterday, 25,161 cases were reported and there are 18,038 people in hospital with coronavirus in the UK. We must keep supressing this virus. This is not just a matter for the Government or this House; it is a matter for every single person. These are always the most difficult months for people’s health and for the NHS. Especially with the vaccine already here, we must be cautious as we accelerate the vaccine deployment as per the winter plan. We have come so far—we must not blow it now.

When we reintroduced the tiered system, we resolved to review the data in each area every two weeks. The sophisticated covid surveillance system we now have in place means we can act swiftly and decisively when necessary. At the weekend, we held an emergency review for London, Essex and parts of Hertfordshire where cases are accelerating fast. Yesterday, we held the first full formal review. I must report to the House that across the world cases are rising once more. In Europe, restrictions are being reintroduced. In America, case rates have accelerated. In Japan, cases are rising once again. Yesterday, the Welsh Government made the decision to tighten restrictions across the whole of Wales. No one wants tougher restrictions any longer than necessary, but where they are necessary, we must put them in place to prevent the NHS from being overwhelmed and to protect life. Even in a normal year, this is the busiest time for the NHS. As Chris Hobson, chief executive of NHS Providers, reminded us this morning:

“controlling infection rates is about limiting patient harm”.

This is a moment when we act with caution.

In the south-east of England, cases are up 46% in the last week. Hospital admissions are up by more than a third. In the east of England, cases are up two thirds in the last week and hospital admissions are up by nearly half. It is therefore necessary to apply tier 3 measures across a much wider area of the east and south-east of England, including Bedfordshire; Buckinghamshire; Berkshire; Peterborough; the whole of Hertfordshire; Surrey with the exception of Waverley; Hastings and Rother, on the Kent border of East Sussex; and Portsmouth, Gosport and Havant in Hampshire. These changes will take effect from one minute past midnight on Saturday morning.

I know that tier 3 measures are tough, but the best way for everyone to get out of them is to pull together and not just follow the rules but do everything they possibly can to stop the spread of the virus. Where we have seen places get the virus under control and come out of tier 3, it is because everybody has taken responsibility on themselves to make that happen. We have seen case rates fall across large parts of England. I know that many places in tier 3 have seen their rates reduce. In most places, I have to tell you, Mr Speaker, we are not quite there yet and the pressures on the NHS remain.

However, we are able to move some place down a tier. We assess these decisions according to the five published indicators: case rates; case rates among the over-60s; test positivity; rates of change; and hospital pressure. Today, I am placing in the House of Commons Library an assessment of each area and publishing the data on which we make these decisions. For the vast majority of places currently in tier 3, we are not making a change today. However, I am pleased to say that some places can go down a tier. In Bristol and north Somerset, rates have come down from 432 per 100,000 to 121 and falling. I can therefore announce that Bristol and north Somerset will come out of tier 3 and into tier 2 on Saturday. Rates in Herefordshire have also come down, to 45 in 100,000, and are falling, and we can therefore bring Herefordshire out of tier 2 and into tier 1. 

I want to pay tribute to everyone who has been doing the right thing and getting rates down. Whether or not their area has come down a tier today, it is so vital that everyone sticks at it and does the right thing, especially over this Christmas period. It is important to remember that this can be a silent disease. One in three people with the disease have no symptoms but can still pass it on. Everyone therefore has a personal responsibility to play their part in keeping this pandemic under control. I know that other areas are so eager to move down the tiers, and the best thing we can all do is act with responsibility to get the virus under control.

These restrictions are, thankfully, not the only tool we have now to fight this disease. We are further expanding our testing programme, and later today the Education Secretary will set out further action on school testing in the new year; and, of course, the vaccine roll-out is accelerating. I can update the House by saying that over 200 vaccination sites are now open, in all parts of the UK, with more opening their doors and bringing hope to communities over the coming days. I know that everyone will be as thrilled as I am every time they are contacted by a friend or loved one who has been getting the jab. It was a wonderful sight to see the global map of vaccine deployment, with the UK proudly standing out as the site of the first vaccinations. It is a huge logistical challenge, but the vaccine offers us promise of a better year ahead. Until the great endeavour of vaccine deployment reaches enough people to make this country safe, we must keep doing what it takes to protect our NHS and protect those we love. That means all of us doing our bit, following the rules and taking personal responsibility to help contain the spread of the virus, so that we can get through this safely, together. I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement. These past 12 months have seen covid spread with speed and severity. More than 65,000 people have died in the United Kingdom, at least 620 of them health and care workers making the ultimate sacrifice in the line of duty. More than 240,000 people have been treated in hospital with the disease, and, as he reminded us, what gives this virus such lethal advantage is that people who appear healthy can go about their lives unaware that they are transmitting the virus to others. So, of course, we accept and understand why he has had to move areas into higher tiers today, even though this means tens of millions of people across England are now living under the toughest restrictions, and we are grateful that he is placing in the Library details on each of our local authority areas.

However, two weeks ago the Secretary of State did say that we had the virus “under control”, and:

“We can't risk letting cases rise again, especially into Christmas”.

I am afraid that that is exactly what is now happening, is it not? Yesterday, England reported more than 23,000 cases, which is the highest number in a month. Hospital admissions on 14 December were the highest since 16 April, and the number of people in hospital with covid is now at its highest since 22 April. The number has risen by 20% since the end of lockdown. If it goes up by another 20%, we are back at the same peak we saw in April.

These numbers should be sounding all the alarm bells there are, which is why clinicians are pleading with the Secretary of State to put robust arrangements in place to keep people safe through Christmas. We saw in Canada and in the United States huge spikes in infections following Thanksgiving. This is not about cancelling Christmas—Santa will still deliver his presents—but is the Secretary of State really telling us that allowing indoor mixing of three households across regions and generations for five days is sensible, given that the virus is raging with such ferocity at the moment? The devastating tragedy is that those who will be most impacted by the virus spreading through the easing are those who will be at the front of the queue for the vaccine in the next month or two, so will he look again at the Christmas arrangements?

On vaccination, more than 130,000 have been vaccinated in the first week—that is a good thing, and we celebrate it and congratulate all involved—but to vaccinate every older person, vulnerable person and key worker by Easter, we will need to do something like double that every day. The National Audit Office this week said that £11.7 billion for the programme will be needed alongside 46,000 extra staff, so how much is allocated to the vaccine programme at the moment? How many staff are being taken on and trained to support the vaccination programme? When will we see the mass vaccination centres opened in our constituencies?

There have also been warnings today about the vaccine roll-out in primary care taking longer than planned, because existing software systems keep crashing, the system does not alert GPs if a patient on their lists has already had it in hospital, and GPs are forced to turn to pen and paper for data capture. When will there be a national call and recall system for GPs, and why was it not ready for the roll-out this week?

The right hon. Gentleman mentioned that the Secretary of State for Education is to make a statement on schools. I do not know whether that means he is coming to the House or not, but with schools going back in January, can he provide some clarity around testing in schools? There is some speculation that the opening of schools will be delayed by a week in January. Can he give us an update on what is happening on that front?

Finally, this has been a dismal year for all of us, but our national health service workers and our care workers have, as always, done us proud, so I put on record my thanks to all of them; many will be working through the Christmas and new year period. I also thank all those working on the response to covid, including the right hon. Gentleman’s departmental officials, our medical science community and our public health teams. With that, I wish you, Madam Deputy Speaker, all working in the House and, indeed, the Secretary of State a safe Christmas and a happy new year.

The hon. Gentleman rightly asked about the arrangements in place for Christmas, which the Prime Minister set out very clearly yesterday. Christmas is a very special time of year and that is why we have put in the arrangements that we have. It is a matter of people’s personal responsibility to ensure that they act and see their loved ones in a way that is safe and careful. I think people understand that, and, what is more, I think people will abide by it. We know that it is safer to see older people, especially if they are over 70 or clinically extremely vulnerable, if we have taken the care to reduce social contact beforehand. We also know that, after Christmas, being able to reduce social contact will be important for keeping this under control.

I think that aspect of personal responsibility is important. Sometimes in this House it feels to me that the debate is suggesting that, if we do not, in Government, put in place concrete rules, nobody will take any action. Actually, it is down to individuals—each and every one of us—to take responsibility for our actions, within the rules, of course, but also being cautious. This is a massive team effort and my experience of the last few months is that when a community has come together to get case rates down, that is when it has happened and when it has worked. Even with the rules in place, it is only when the community essentially comes together to get this under control that we see cases coming down along with the pressure on the NHS. I regret having to take the action that we have to take. I deem it necessary, and there is a strong view right across Government that these actions are necessary, but I also plead that personal responsibility is absolutely central to how we as a society should respond to this pandemic.

The hon. Gentleman asked about the mass vaccination roll-out. The mass vaccination sites are appropriate for the Oxford—AstraZeneca vaccine, should that come through and be approved by the regulator, so it will be some weeks before we see those rolled out. However, we are every day having more and more primary care sites coming on board with the roll-out of the Pfizer vaccine, and it is very good to see that happening. I expect the numbers that are vaccinated to accelerate. The team have made a very good start and there is a long way further to go.

The hon. Gentleman asked about the data systems. They have largely been working very effectively. Of course, any very large logistical roll-out like this has niggles, but they are small and have been brilliantly dealt with locally on the ground.



The hon. Gentleman asked about the roll-out of testing in schools. As I say, the Education Secretary will set out more details on offering all secondary schools, colleges, special schools and alternative provision settings the help, support and facilities to test as many secondary-age and further education students as possible, as they resume their education in January. I thank in advance all the teachers and support staff in schools for their work; no doubt they will lean in and support this task to ensure that school return can proceed as safely as possible.

Finally, I echo the hon. Gentleman’s words and wish him a happy and safe Christmas. I look forward very much to seeing him again in January.

In the past week, I have received unexpectedly joyful emails from residents of South West Surrey who have been among the first in the world to receive a clinically approved vaccine for coronavirus. I thank my right hon. Friend for that early Christmas present. I also thank him for the energy, for the endless media rounds and for the dedication that he has shown in the past year, which must have been one of the toughest imaginable for a Health Secretary. I am also grateful that Waverley has been excluded from the Surrey-wide move to tier 3, in recognition of our lower infection rates, although we will remain vigilant.

I want to ask my right hon. Friend about Christmas, just a week away. Of course personal responsibility matters, but, in a pandemic, so does clarity. Irrespective of the law or the regulations, should we or should we not have indoor social gatherings with elderly and vulnerable family members?

People should act with great caution in this pandemic, because doing so protects them, protects their families and protects their loved ones. We have set out what the rules are, but they are not a limit up to which we should all push. We can all act within those rules to limit the spread, by reducing social contact in the days up to meeting a family member who may be, for instance, over 70—or any other family member. It is reasonable and responsible to take that sort of action.

I am grateful to my right hon. Friend for what he said about the vaccine roll-out. I have been cheered by the messages I get from constituents and others now that they are receiving the vaccine. We just have to ensure that we get the deployment out as fast as the vaccine can reasonably be produced and as fast as the NHS can deploy it, so that we get people the safety of that vaccine and so that we can get through this and out of this as soon as possible.

It is important that the festive days ahead do not become a five-day mass get-together. Therefore, we should use as little of the flexibility as possible, spread over several days, while ensuring that no one is facing Christmas alone. The concerns of medical professionals that the Christmas covid restriction relaxation will cost lives are not to be dismissed lightly. Does the Secretary of State agree that if people are to form a bubble, it should be kept as small as possible? If so, would it not be better to follow the Scottish approach, which sets a strict maximum limit on the numbers, up to eight people from three households, rather than the potentially unlimited numbers permitted currently in English bubbles?

This has been an incredibly difficult year for so many people and so many families. The fixed numerical limits place a particular burden on very large families. We have taken, I think, a balanced and right approach, but while I understand the urge for caution—of course I understand that, from my NHS colleagues and others—I also understand that people want to see their children and their loved ones. Christmas is an important time of the year, and we have to find a balance.

I join my right hon. Friend in wishing NHS staff and everyone involved in this crisis a happy Christmas. Will he join me in wishing Essex County Council and local authorities in Essex a happy Christmas for what they have contributed to the test, track and trace operation since NHS Test and Trace started to share data much more quickly with local authorities? I can report to him that most districts have started door-knocking to follow up the contacts of cases, and the complete case contact rates are now around 87% and 90% respectively. Will he join me in congratulating the local authorities of Essex on this tremendous effort?

My hon. Friend is absolutely right, and I am grinning because I think this is the first time in the dozens and dozens of statements I have made this year when the hon. Member for Leicester South (Jonathan Ashworth) has not mentioned track and trace. I will tell you why, Madam Deputy Speaker: the latest statistics show that where communications were available, 96.6% of people were reached and told to self-isolate. That is because of the huge improvements in contact tracing and testing that have been delivered this year—[Hon. Members: “By local authorities.”] Including, of course, by local authority partners, but also by the brilliant national NHS Test and Trace system, which we should all congratulate. Getting those contact rates—[Interruption.]

Order. This is not a moment for shouting. Listen to the Secretary of State.

I think the moment when we see contact rates of more than 90% should be one where everybody comes together and says thank you and well done to everybody at NHS Test and Trace and all their partners, whether they are in the public sector or are the brilliant private sector partners that we all support.

Happy Christmas to you and yours, Madam Deputy Speaker.

The Secretary of State will know the significant effect that the pandemic has had on NHS dentistry. There is a backlog of more than 19 million appointments. It is therefore shocking and unacceptable that NHS England has just decided to impose a new activity target on dentists in England, which many simply will not be able to meet under new covid restrictions. NHS England’s own data show that nearly 60% of dental practices will be hit by severe financial penalties. Dentists will now need to prioritise check-ups rather than dealing with the backlog of patients needing treatment while others may be forced to close entirely—a straight choice between staying financially liable and treating those in pain with more complex problems. Will the Secretary of State reverse this decision, which threatens patient safety and access and could lead to the demise of NHS dentistry as we know it?

I am very glad to be able to reassure the hon. Lady that the agreement that has been reached with the dentists is all about ensuring that while we support our NHS dentists we see them do as much as they can to look after people and help them get the treatments they need. This is a good, balanced programme and I am sure it will be implemented well by the dentists.

May I say how delighted I am that North Somerset is moving down into tier 2, which is just reward for the efforts of my constituents and the whole community and also offers great potential help for our hospitality industry as we go into the Christmas period? On the question of balance, I completely agree with my right hon. Friend that we have to consider not just the number of people and the number of households but the age and vulnerability of those who are meeting. May I also say, echoing the words of my colleague, that I wish a very happy Christmas to my right hon. Friend and his team of Ministers, who have done the most difficult job imaginable in a rather exceptional way? I hope—although without much expectation—that they will get some break over the Christmas period.

The people of North Somerset, whom my right hon. Friend represents, and those of nearby Weston-super-Mare have done a remarkable job of bringing the case rates down to 120 for every 100,000. I am very pleased that we are able to take North Somerset out of tier 3 into tier 2. I would also say to everybody that the point about personal responsibility that my hon. Friend stressed and that I strongly agree with still applies. Coming out of a tier makes life easier, of course—we do not want the tiers in place any longer than is absolutely necessary—but it is still on everyone in North Somerset, as well as in Bristol and Herefordshire, which have also come down, to do their bit and keep those case rates down.

The lead-up to Christmas is the busiest period for hospitality businesses, with some pubs in my constituency making up to a quarter of their annual profits, which are now lost. If measures to control the virus are to be effective, they must go hand in hand with proper business support. To protect lives and livelihoods, what will the Secretary of State do to ensure that businesses forming the backbone of my communities in Hull get the financial support they desperately need?

I feel gratitude to everyone in Hull for the work they have done to get case rates down as far as they have. Hull has done well, along with the rest of the Humber area, but we are not quite there yet. We are providing the support that comes with being part of tier 3, and we have put record sums in to support hospitality, but I appreciate that this is tough, especially in the run-up to Christmas. I can commit to keep working with the hon. Gentleman and other colleagues across Hull, the Humber and other areas in tier 3 to do everything we can to get hospitality open again.

I pay tribute to the work of Staffordshire County Council in rolling out rapid, large-scale asymptomatic community testing in my constituency of Burton and Uttoxeter. The director of health has raised a number of concerns with the Department about the lack of clarity over funding for those tests. Will my right hon. Friend review the three letters that have been sent to his Department on that issue, to provide the clarity that is urgently needed to allow this testing to continue?

Yes, I will get on to it right away. I am really glad that Staffordshire has worked hard on getting this community testing going. Stoke-on-Trent was one of the first places in the country to get going on it, and now we have spread it out wider in Staffs. I will pick up the point that my hon. Friend raises and get back to her straight away.

The Secretary of State tells us about personal responsibility. Does he recognise that he has a responsibility to be honest with the public about what is happening? This week, Whipps Cross Hospital had to turn away ambulances because the ICU was full as a direct result of the rising covid infections in our local community, and the hospital had to move to early discharge of patients. He says that he is publishing data. Will he commit to publishing real-time data about A&E “firebreaks”, ICU capacity and what planned surgeries have been cancelled by hospitals, so that the public can see the truth about why and how we need to protect the NHS and what impact it has on their health outcomes?

The hon. Lady is absolutely right about the impact of the virus on the NHS in her part of the world in north-east London. Whipps Cross Hospital is under significant pressure. The case rate in her Waltham Forest local authority is 431 per 100,000. We have to work together to get the cases down, especially in east London, where they are very significant. We publish a huge amount of data on hospital admissions and the impact on the NHS, and I am publishing further data on this today and putting it in the Library of the House.

I am glad to learn that three areas are coming down a tier. That is vital for compliance, because the general public need to see that if they follow the rules and get their cases under control, there will be a pay-off. Does my right hon. Friend agree that what is important is complying with existing restrictions, rather than ever more severe restrictions, and that it is critical that we take the public, including the young, with us?

I agree with every word that my hon. Friend has just said. I strongly agree that the best way to get out of tier 3 is by everybody coming together to comply with the restrictions—and not just to comply with them because they are the law but to take responsibility to ensure that we do not spread the virus, which each one of us can do unwittingly because of its asymptomatic nature. I thank my hon. Friend for her question and for the message that it sends: we can get areas out of tier 3 and we can get areas out of tier 2 and into tier 1, but we all have to work at it.

I asked the Secretary of State, via a written question, what estimate his Department had made of the proportion of the population not registered with a GP, to which the answer was:

“No such estimate has been made.”

I found that concerning, given how important GPs are to the roll-out of the covid-19 vaccine, not least for vulnerable populations such as the homeless and those who move around a lot. Will the Secretary of State please explain what plans and provisions are being made to ensure that the vaccine is available to those who are not registered with GPs?

The hon. Lady raises an incredibly important point. It does not matter whether or not somebody is registered with anybody, they can still spread the disease. The reason for the answer that she was given is that we have to try to get the vaccination programme out to everybody, no matter what their status. There are people who do not have any status in paperwork at all, and we need to make sure that we support the roll-out to them as well. We are working with the Ministry of Housing, Communities and Local Government, which is best placed, along with local authorities, to make sure that the vaccination programme reaches anybody who fulfils the criteria set out by the Joint Committee on Vaccination and Immunisation.

I welcome the fact that Gloucestershire is remaining in tier 2. and thank the Secretary of State for his engagement with me and my Gloucestershire colleagues this week—it was very much appreciated, and it was very much a team effort to get to where we are. May I press him a little on what he said about vaccines? Will he confirm that the data that is going to be published from next week will have enough detail in it that we will be able to see clearly the vaccination roll-out by age and by area? Will he set out, early on when we return in January, the Government’s thinking about how far the vaccination programme needs to have gone and the level of risk that we will have reduced for the country such that we can start to release the restrictions that are so burdensome on our population?

Yes. We are committed to setting out weekly updates on the vaccination programme—we released the first data yesterday, on the 137,000 number—and increasingly with the sorts of breakdowns that my right hon. Friend asks for, as more and more groups are reached. He asked for the calculus in terms of the proportion of the population that needs to be protected in order that we are able to bring down restrictions, and that is exactly how we are thinking about the next phase. We do not yet know the impact of the vaccine on transmission, so we cannot yet have a concrete answer to his question, but it is precisely the question that we are asking. We should know much more within the next few weeks.

Recent studies have shown that vaccine hesitancy is highest among the black, Asian and minority ethnic community and low-income groups, and there is a real fear that these groups are being deliberately targeted with misinformation. Will the Secretary of State tell us how his Department is going to counter that so that people can make informed choices, and to avoid covid health disparities going forward?

The hon. Gentleman is right to raise this issue. In fact, I was talking about the vaccination programme to the SNP Cabinet Secretary for Health only this morning, because making sure that we reach all those who need vaccinations, according to clinical need, is critical, but we also need then to persuade them to take the vaccine. There is a huge amount of work on tackling misinformation. The most important thing is to have the positive information out there. I thank all those who have gone public about their vaccine so far—we all saw the wonderful photograph of Sir Ian McKellen, and I thank Prue Leith, who went public with her vaccination. It is absolutely terrific to see people celebrating the fact that they are being vaccinated and therefore encouraging other people to do the same.

This statement will be greeted with dismay in Greater Manchester, where we have had severe restrictions for nine months and where rates in nine of the 10 boroughs are below the national average. My constituents have behaved responsibly and our rates are lower than those in neighbouring Warrington or Cheshire, which have been put into tier 2, and they are also lower than they are in Bristol, which has been moved from tier 3 to tier 2 today. What exactly do we have to do to be moved out of tier 3?

I understand my hon. Friend’s disappointment at this decision. We looked very closely at Trafford, Stockport, Tameside and nearby High Peak, and the proposal to take a different decision for them from the one that had been taken for their near neighbours. The challenge is that each time we have done that in the past, we have then seen cases rebound, and there continues to be significant pressure on the NHS in the north-west, including Manchester. I know that my hon. Friend and I have proposed different approaches on this one, and I look forward to working with him and people right across Manchester to get this sorted.

We need to make sure that schools continue to be a safe environment for students and staff, and I would like to take the opportunity to thank all school staff and headteachers across Luton, who have done so much to make their schools as covid-secure as possible. I note the point made by the Secretary of State about the announcement later regarding testing in schools, but will the Government be publishing the evidence to support the use of lateral flow tests for serial testing of students, as this is outside the licensed use and requires a change to the legal duty to isolate?

We are working on exactly that proposal, because the need to use testing and use the easily available and rapid-return lateral flow devices is incredibly important. They have an important role to play, used in the right settings, in the same way that the PCR tests have an important role to play, but it takes longer to get the results back with those tests. I look forward to working with the hon. Lady, with Luton Council, and with all those across Bedfordshire to try to get this sorted. Clearly, case rates in Bedfordshire are shooting up in a very worrying way, and I thank her for her efforts and public health messaging to say to everybody in Bedfordshire, including those in Luton, “Let’s work together to get this sorted.”

I asked my right hon. Friend to consider restrictions on a more local level than county-wide, and I am grateful that he has done so across the country today. Infections in Tunbridge Wells, while much lower than the average in the county of Kent as a whole, are nevertheless rising, and there is pressure on the local NHS, so I understand why there is no change from tier 3 today. However, will the Secretary of State commit to apply the five tests fortnightly, and to reduce our level of restrictions as soon as they are met? Will he also have a word with the Chancellor to see what extra support can be given to businesses in the hospitality sector, which have just lost the most important part of the trading year in what has been a miserable year for them?

Yes, of course I will talk to the Chancellor about the point that my right hon. Friend raises. Of course, we do already have a significant amount of support for hospitality businesses, but I understand how difficult this is.

On the point about looking at local areas, we will absolutely do so, as we have demonstrated in the decisions taken today. For instance, just over the border in East Sussex, we have unfortunately had to put Hastings and Rother into tier 3. Tunbridge Wells today has a case rate of 288 per 100,000, and I would say to everybody right across Kent that we really need to act with serious responsibility. No matter which part of Kent a person is in, we have a very serious problem in Kent, and the only way in which we can get it under control is for people in Kent to essentially behave as if they have the virus and are trying not to pass it on to somebody else. Be really cautious in Kent: it is the area of the country that has the biggest problem in terms of case rates, and therefore there are huge pressures on the NHS there. I thank everyone who works in the NHS in Kent for what they are doing.

We are putting in as much support as we can, and I look forward to working with my right hon. Friend, all colleagues from across Kent and of course the county council and district councils to try to get this under control. Other parts of the country have done it and brought the case rate down, and we have been able to take some into tier 2. I am sure that we can get there in Kent, but we have to work hard to make that happen.

On Monday, I asked the Secretary of State when care home residents in County Durham would get the vaccine and he did not answer the question. I have now been contacted by GPs in Chester-le-Street in my constituency who were first promised the vaccine on 16 December. That was put back to 21 December. Having done all the work to set up the hub, they have now been told that the vaccine will not be available till the new year. So when will residents in Chester-le-Street get the vaccine? I do not want hype or generalisations; I just want a straightforward answer for those constituents.

We are opening more and more GP vaccination hubs each day. The answer specifically on Chester-le-Street is as soon as we practically can, but it has to be done in a safe way. That is out of my hands and out of the right hon. Gentleman’s hands. An important operational set of procedures needs to be gone through to open the hubs. It is complicated. I will look into the right hon. Gentleman’s example and write to him with details, but he will understand, as I am sure the people of Chester-le-Street will, that we are trying to get the vaccine rolled out as quickly and as safely as possible, but “safely” is an important part of that.

Will my right hon. Friend confirm that if people in Harborough and Oadby and Wigston continue to drive down rates of infection locally, the different districts and boroughs in Leicestershire can be put in different tiers if the data supports that? Will he also join me in congratulating our local NHS here in Leicestershire on the efficient way in which it is rolling out the vaccine across the county?

Yes, on both counts. We looked at Leicestershire in great detail, and I wish that we could have taken the county and the city out of tier 3, but unfortunately, the data did not support that conclusion. I am grateful to everybody across Leicestershire, because I know that this has been a long, hard slog with measures in place for a long time.

Let me start by thanking the people of my constituency and across Gateshead who have worked really hard to get the figure down. Professor Michael Marmot’s covid-19 review, which was published this week, shows that the pandemic has exposed long-standing health inequalities, particularly in the north. Public health teams play a vital part in this pandemic and are core to addressing those longer-term health inequalities. What has the Secretary of State done to ensure that public health teams are properly funded so that they can address those inequities and, as Professor Marmot says, “build back fairer”?

We are absolutely determined to build back better. That needs to involve tackling long-term underlying health inequalities. A huge programme of work will be needed to do that, after the pandemic has demonstrated those inequalities.

People in Gateshead have done a great job of getting the case rate down. Like other areas, it is still in tier 3—we are not quite there yet. I know that my team and the hon. Lady’s local director of public health have been talking about getting Gateshead and the rest of the north-east into tier 2 when we can. I hope that we can do that, but for now, let us be cautious and keep this under control.

There will naturally be disappointment across Yorkshire as many areas stay in tier 3. I appreciate that York’s tier will be affected by the current virus picture, but on which of the five criteria will the city of York have to improve on to stand a good chance of moving down a tier in future reviews? Will that depend significantly on how our neighbouring local authorities perform against the five criteria?

We do look at those human geographies because many people commute from North Yorkshire into York, but York and many of the local authorities around it have done an absolutely fantastic job of bringing the virus under control. In York, the case rate is 65 per 100,000—a bit higher than we typically take places into tier 1. For instance, Herefordshire is at 45, which is the same level as Cornwall when it was put into tier 1, but York is moving in the right direction. The over-60s case rate is also low. There has been some pressure, as my hon. Friend knows, on the hospital, but that is abating. Therefore, York and large swathes of North Yorkshire are moving in the right direction. I urge everybody right across North Yorkshire to stick at it.

The Secretary of State will remember that he has agreed to meet me and my constituent Kellie Shiers to discuss the issues that she has had accessing cancer services during the pandemic. During the pandemic, Kelly worked on the frontline with her ambulance service in Greater Manchester, despite her history of breast cancer, but she could not have her check-up and mammogram when it was due. When she did have it, the cancer had returned and spread to her bones. She is now having chemotherapy and may need surgery. I understand that the Secretary of State has many demands on his time, but can he ensure that this meeting is able to go ahead in early January, as these matters are time-sensitive?

Yes, I can. I am very sorry that that meeting has not happened yet, and we will get right on to it for early January.

The changes for Bedfordshire announced by my right hon. Friend will be disappointing to residents and businesses, but it will be helpful for them to understand that, in setting up the tier system, my right hon. Friend established clear criteria, and he is publishing the data and has said that he will be open to regular reviews. On those criteria, when it comes to the issue of hospitals and pressure on the NHS, that is not a data-driven criterion; it comes with statements that the NHS is under considerable pressure, which is very difficult for people to understand, because we always hear—during pre-covid times and now—that the hospitals are under pressure. Will my right hon. Friend commit himself to producing projections of occupancy rates and acute bed occupancy rates across the NHS and, if possible, on a local hospital system basis?

Yes, we are working exactly on how to demonstrate that in a numerical rather than a narrative form, not least for the reasons that my hon. Friend sets out. We have seen a very sharp rise in cases across Bedfordshire, especially in the more rural areas, including North East Bedfordshire, so it is so important that people across Bedfordshire take that personal responsibility and follow the new tier 3 rules. I hope that we can get the rate to come down as fast as it has gone up.

People across Chesterfield will be very disappointed that, with all the work that they have done and with Chesterfield having lower transmission rates than some of the areas in tier 2, they remain in tier 3. They will be especially disappointed by the Health Secretary’s suggestion that the communities that have worked hardest and been the most disciplined are the ones that are in tier 2. We know that that is not the case. Does he not realise that, if the Government could offer a package that supported our hospitality sector, and if they were not, at the very last minute, announcing changes to our schools just two days before they break up, there would be more credibility to the sense that it is personal responsibility that is the problem here, rather than the ineptitude of this Government?

No.

On behalf of my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes), may I thank the Secretary of State for meeting us and for promising that he will adopt a more granular approach? We can assure him that we will work hard in Lincolnshire to try to get our tier, and that of the neighbouring cities, down. May I also thank him and the Prime Minister for resisting pressure from the Opposition and from Wales and Scotland to change the rules on Christmas? That is entirely the right approach. I also thank him for the tone that he has adopted today in saying that, if we are to defeat this, it is a matter of self-responsibility and personal ownership of our health.

That is right. We looked very closely at the southern end of Lincolnshire, which is a long way from where the rates are incredibly elevated around Lincoln, the coast and West Lindsey, but unfortunately it was not possible to bring any of the lower-tier local authority areas in Lincolnshire out of tier 3, and over the border in Peterborough we have seen a very sharp rise. So we are not there yet, but I hope that we can make significant progress, especially if everyone listens to my right hon. Friend and takes personal responsibility for their actions and tries to do everything they can not to pass the disease on.

Jane Roche is a great champion of her community of Castle Vale. Her dad, Vincent, died of covid. Her sister Jocelyn died five days later of covid. They are two of the nearly 10,000 in the west midlands who have died of covid. Jane and her family are devastated. They grieve for the loss of their loved ones who will not be with them this Christmas. She asks the Secretary of State this: why have we had the largest number of deaths in Europe? Can we be confident that lessons are being learnt and that the mistakes made will not be repeated? She also asks: when will the inquiry into what happened over covid be established and, crucially, will the Secretary of State meet her and other relatives of those who have sadly died from across Birmingham?

Yes, I am very happy to meet the hon. Gentleman and constituents to hear their stories. Many of us have lost those close to us in this terrible pandemic. We are constantly learning how to do things better, and we are constantly learning more about the disease. For instance, we had the news earlier this week about a new variant because our surveillance system enables us to look out for changes and try to understand them. There are huge challenges, as he knows, but I always try to approach this by looking at how we can get the country through what is an incredibly difficult and unprecedented time with as few people as possible suffering in the way that his constituent, Jane, has.

The news that Buckinghamshire is going into tier 3 heralds the bleakest of midwinters, especially for local hospitality businesses, and it is imperative that they get extra help and that this lasts for as short a time as humanly possible. Given that Stoke Mandeville Hospital is currently under intense pressure, with many staff off, either with covid or self-isolating, it is alarming that Buckinghamshire Healthcare NHS Trust has been given no date for when it will get a supply of vaccines, especially when neighbouring Oxfordshire is in a lower tier and already has them. Will my right hon. Friend ensure that residents and healthcare staff can get the vaccine locally in Buckinghamshire before Christmas?

I will write to my hon. Friend immediately with our plans for the roll-out of primary care-based vaccination facilities in Aylesbury. I regret having to put Buckinghamshire into tier 3 measures, but unfortunately it was absolutely necessary given the numbers. Aylesbury Vale, the local authority area, has a case rate of 235 per 100,000 and it is rising really sharply, and my hon. Friend has set out the challenges at Stoke Mandeville, which is an excellent hospital but under significant pressure. I am glad that he understands why we have had to take this decision, and I hope that across Buckinghamshire we can get these cases down and get people vaccinated as soon as possible.

Secondary schools in south Manchester are worried about the extra pressure of running a mass testing regime on top of the contact tracing they are doing, on top of the online learning they are enabling and on top of their normal, everyday school responsibilities. We really need to know what support they are going to get to do the testing, so why does the Secretary of State for Education not come to the House to set out the plans and answer questions, as the Secretary of State for Health rightly does?

The Secretary of State for Education will be setting out these plans. We need to get them out as soon as possible so that people have the last couple of days of term to work on them, and he will be doing that. Testing in schools is incredibly important, and it is going to become more important as we roll it out more broadly. I am really glad to hear some of the statements from the teaching unions about how enthusiastic they are about testing, especially in secondary schools. I am sure that the Education Secretary will want to work with the hon. Gentleman and others right across the country to roll out this programme as effectively as possible and to make sure that we have high-quality testing in schools, so that we can keep kids in education as much as possible and get the infection rate down by finding the positive cases and ensuring that they isolate.

It being Christmas, and given the circumstances that we are in, covid-compliant carol singers in Stockport have been heard singing the words of that well-known epidemiologist Mariah Carey, “All I want for Christmas is tier 2”, but sadly their entreaty for that outcome has not been successful at all. Can my right hon. Friend explain, further to the question from my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), precisely what more residents of Stockport need to do in order to regain some relative freedom?

Yes. We have to keep getting the case rate down. In Stockport it is still over 100. There is further to go. Right across Greater Manchester and the surrounding areas, I would urge people to do as they have been doing, because the case rates have come down really quite significantly. Right across Greater Manchester and in Stockport, people have been doing the right thing, but the pressures on the NHS remain, partly from people who are in hospital with covid from when the rates were really high. I hope that we can make the move as soon as possible, and in the meantime I hope that everybody has a happy, safe and careful Christmas in Stockport.

UK and EU pharmaceutical companies have warned that no deal will lead to delays of up to six weeks in obtaining vital medicines. Given that the Pfizer vaccine is complex to move and distributed from Brussels at -70°, does the Health Secretary agree that no deal would be catastrophic and that everything minus possible should be done to get a deal to protect our access to vital medicines?

We have plans in place to ensure that the vaccine can continue to be distributed whatever the outcome of the discussions on a future trading arrangement with the EU.

Early this morning I visited a vaccination centre in Harlow that is running like a military operation and has started vaccinating the elderly and those in care homes. Will my right hon. Friend thank West Essex clinical commissioning group, GPs, staff and volunteers who are vaccinating many hundreds of Harlow residents? Will he also set out a route map by which Harlow can return to tier 2? I strongly welcome the testing announced for schools, but can he confirm that school openings will not be delayed in January?

I am very grateful for what my right hon. Friend says about the vaccination centre in Harlow. It is an uplifting experience visiting a vaccination centre. Rarely have I seen so many smiles on faces this year, which has been such a difficult year, as when I visited the Milton Keynes vaccination centre last week. I am really glad that it is working well in Harlow. I add my thanks to his thanks to the GPs, the volunteers and the staff—all those organising the vaccinations.

In terms of a route map out of the tier, of course in time the vaccination programme will help, but for now the best thing people can do is to bring the case rate down by doing everything they personally can not to pass on this disease. Unfortunately the case rate in Harlow is 302 per 100,000—very, very elevated—and in nearby Epping Forest, unfortunately, it is over 500. It is a very serious problem. We all have to pull together to try to sort out this growth of the virus locally, and that is the route to tier 2.

May I echo to the Secretary of State what my right hon. Friend the Member for Harlow (Robert Halfon) said on behalf of the people of our community?

Scientific advisers, healthcare workers and doctors have all warned that the Christmas season will result in higher infection rates. The public are not fools, and know that tougher restrictions are likely to be needed in the new year. Will the Secretary of State come out with the obvious and admit now that he will need to bring in harsher restrictions in January, ending the uncertainty faced by families and businesses, or will he just allow these dangerous mixed messages to continue from Government?

Where I agree with the hon. Lady is that the public are not fools; the public know that it is their responsibility, as well as the Government’s, to get this under control. That is where the emphasis on people taking personal responsibility to ensure that they do not pass on the virus this Christmas comes from. If we look at how the public across Luton and the whole country have behaved during this pandemic, under restrictions that are so inimical to our way of life and so unprecedented, we see that people have still followed them because they know that they are important. That is the approach we are trying to take for Christmas, to make sure that we can keep this precious time of year, but in a way that is safe.

I accepted Kirklees being in tier 3 when we had some of the highest covid rates in the country, but cases have now plummeted and hospitalisations are down. The case rate in Kirklees is about 167—below the English average—and in my Colne Valley constituency the case rates are actually under 100 per 100,000, and therefore I really thought we had a strong case to be brought down into tier 2. I appreciate that the Secretary of State wants to be cautious, but can he tell me when the next review will be, and what more my constituents need to do to come out of tier 3?

Legally, there is a review every two weeks, but in practice we review every week, and I will not wait a week longer than necessary to get places out of tier 3 if we can safely do that. To people across Colne Valley I would say, first, that the reduction in rates has been impressive, but we are not there yet. The pressure on the NHS has reduced, but is still significant. I would also say to everybody in Colne Valley that they have a Member of Parliament who probably makes his case to me more than any other. It is not for want of effort from the local MP, but this decision is based on the epidemiology, and I really hope we can get there soon.

Madam Deputy Speaker, can I take this opportunity to wish you and the House staff a merry Christmas and a very happy new year?

I have had numerous emails from unpaid carers in Enfield North who are concerned about access to the vaccine. Can the Secretary of State set out exactly when unpaid carers will receive the covid-19 vaccine, given that they spend their time caring for extremely vulnerable people and could pass on the virus? Any guidance would be a huge comfort to residents and their unpaid carers in Enfield North.

The guidance has been set out by the Joint Committee on Vaccination and Immunisation. I think it is very important that we follow the clinical advice in this prioritisation to make sure that it is fair.

I would like to thank the Department of Health and Social Care and the Secretary of State for everything they are doing, but I am sure he will appreciate, like me, just how fed up my local hospitality sector is across County Durham and the north-east. Will he join me in thanking local people for everything they are doing, because case rates have really come down? Will he also thank my local NHS staff? I saw them, when I visited on a night shift a couple of weeks ago, not only giving care to people with covid, but really showing love to them as they looked after them. Will he commit to a fortnightly review, and will he ignore the LA7 group of local authorities and allow County Durham and perhaps other parts of the north-east to go a separate way if case rates come down in the future? Can he update me and write to me about the vaccine roll-out, and will he also push the Chancellor for extra support for my local hospitality sector?

Yes, of course; I will write to my hon. Friend as soon as I can on the roll-out of the vaccine across his part of County Durham. Making sure that everybody can get access is so important, which is why we are taking this community-led approach as well as using the big hospital sites. The truth is that we do look at County Durham on its own merits, as well as. of course, as part of the north-east local authorities. People in County Durham have been acting in a way that gets the case rates down, and I am very grateful to them for that. We are not quite there yet and there is still that pressure on the NHS, but we are moving in the right direction.

In the past 100 days, more than 23,000 people in our country have lost their lives due to covid. That scale of loss was completely unnecessary; it is the result of a second wave caused by this Government’s failure to put public health first. We know the Government ignored the scientists’ advice in September before that second wave hit, and we know scientists are warning that the current plans, including plans for Christmas, are going to cause a deadly third wave. Will the Secretary of State come clean today and tell us how many lives Government scientists are warning him will be lost over the next few weeks under the current plans?

The advice I have and the answer to the hon. Gentleman is, I hope, as few as possible—especially as we get the vaccine rolling out. I want to pick up something he said about this pandemic. This pandemic is caused by the virus, not by any Government around the world. It is caused by the virus, and that is why it is so important that we all come together to try to tackle it, rather than taking this overly politicised approach.

His waitress tested positive, so the proprietor of the small café closed immediately and went into self-isolation, but test, track and trace has not contacted him, so he is without the wherewithal to claim the allowance. Can the Secretary of State fix it?

Yes; if my right hon. Friend has the test reference number I will get on to it right away. If NHS Test and Trace has not contacted the owner, that might imply that he does not have to self-isolate, but of course I will want to look into the details of the case before making such a recommendation. I will ensure that my right hon. Friend’s constituents get a full, clinically approved recommendation ASAP.

Mr James Canning became our first octogenarian in Brent to receive the vaccine earlier this week. While congratulating him and the Wembley Practice team who delivered it, does the Secretary of State share my concern that care homes in Brent have been advised that the 970 doses that are in the vaccine packs cannot be split because of the licensing conditions, which means that those in our care homes who are over 80 may have to wait until February or for the Oxford vaccine before they can be vaccinated? Is that the case? If so, why? That is hardly the “protective ring” around care homes that he promised.

I am glad to say that we are making significant progress on tackling this issue. When the hon. Gentleman says it is a licensing concern, that should not be read to imply that it is some bureaucratic rule; it is about ensuring that things are done safely. If the vaccine is not delivered safely to the site, it is not an effective vaccine. Therefore, we are taking it carefully to be able to vaccinate in care homes. There has been some vaccination in care homes across the UK, so it can be done, and I hope we can make good progress soon.

I thank my right hon. Friend for the reassurance he gave me last week about the vaccine roll-out to rural communities. Will he join me in paying tribute to everyone in Cumbria and the wider UK who is involved in the delivery of the covid vaccination programme, and does he agree that the best way we can build a positive 2021 is for people to actively take up their invitation to have this vital vaccine when it comes, and to get their life-saving jab as soon as it is offered?

I could not agree more with my hon. Friend. He knows about these things, and he is exactly right that the best thing everyone can do, when the NHS calls, is to take up that vaccine and get it done. It will protect them and their community and help to protect the whole country and get us all out of these restrictions at which we choke.

I look at all these sorts of reports, as does the team at the Department, constantly to try to learn. Given that this is an unprecedented situation, all health authorities across the UK, whether here or in Edinburgh, Cardiff or Belfast, are constantly talking and trying to make sure that all the insights that can be gained can be applied. One example is that we now have contact tracing in the UK reaching over 90% of contacts. That is due to hard work and improvement, learning the insights from each other about how we can make systems better.

I am sure I speak on behalf of the whole House in thanking my right hon. Friend and his team for all their hard work over the course of this year to combat this dreadful virus, and also for updating the House on a regular basis on what action is being taken. May I give him the opportunity to reiterate the key message as we approach Christmas: that anyone who shows any signs of having the virus must get a test and, if it is positive, must self-isolate and not mix and mingle with people, so we can cut down on the spread of this dreadful virus? People must think twice before they mix with elderly relatives if they have been in contact with anyone who has had this dreadful virus.

I agree with every word my hon. Friend has just said. Over this Christmas period, I hope that people will, yes, take a moment to have some relaxation, especially given what a tough year it has been, and have the chance to see loved ones, but will do so carefully, knowing that one in three people who have this disease do not know that they have it because they have no symptoms. Anybody can be inadvertently passing it on to a vulnerable loved one, so they need to be very, very careful.

To reiterate, it is in the best interests of everybody, their loved ones and their community to get a test at the first sign of symptoms—testing is now very, very widely available right across the country—and if the test is positive or if they are contacted by NHS Test and Trace because they are a contact, to isolate and do so not just because they have to but because it is the right thing to do to isolate fully and properly.

Finally, I strongly agree with my hon. Friend in wanting to thank you, Madam Deputy Speaker, the whole of your team and all the staff of the House for supporting me on the many occasions I have had to come to the House this year and, in what has been an incredibly difficult year for the House as well as the nation, for all the work you have all done to support us in keeping our democracy going all the way through this, no matter how bad it got.

I thank the Secretary of State for his kind words. The whole House, and certainly the whole of Mr Speaker’s team, thanks the Secretary of State, his Ministers and the shadow Ministers, who have worked so hard to keep us informed all the way through this dreadful pandemic.

It is all right. I have not forgotten that we have a late entry. The final question—I call Jim Shannon.

May I take this opportunity to wish you, Madam Deputy Speaker, and your family a very merry Christmas and a happy new year? Thank you for all you do in this House. I congratulate the Secretary of State and all his team on their energy and dedication in what has been an extremely difficult year. It has given us encouragement whenever he has come to the House.

Students, families and workers from England, Scotland, Wales and Northern Ireland will be travelling by boat, train, car and plane to meet their families from all tiers and very strict conditions. What discussions has the Secretary of State had with the devolved Administrations, in particular Northern Ireland, to ensure that travel can continue to happen within the regulations that we must all adhere to?

I thank the hon. Gentleman very much for his kind words. He said that people have been encouraged every time I have come to the Dispatch Box. Given some of the things I have had to announce, I am sure that is not quite true, but it has been my duty to come and answer questions as much as possible. I have probably answered more questions from the hon. Gentleman than from anyone, and I am very happy to answer this last one for this year.

I spoke to Robin Swann, the Health Minister for Northern Ireland, this morning as part of a call involving all four of us across the devolved Administrations. We are determined to ensure that people can travel across the whole of the UK as much as is safely possible, but, again, we urge caution and personal responsibility. People can take advantage of this change in the regulations over Christmas to see loved ones—sometimes loved ones they have not been able to see all year—but we urge them to do that with the appropriate concern for the risk of spreading the disease, and to make sure, therefore, that everybody has a merry Christmas and a happy new year. We will return here, no doubt, in 2021 with the hope of that vaccine coming fast into view so that we can get to the point where I do not have to return every week to discuss restrictions and, instead, we can all get our freedom back.

I thank the Secretary of State for his patience in going through the whole statement, and everyone who is here for continuing to do their duty on behalf of their constituents. We hope that the Secretary of State has a little bit of rest over Christmas, but we are all pretty sure that he will continue working to try to keep our people safe. Thank you.

In order to allow everyone in the Chamber the safety to leave without the hordes coming in for the next statement, I will suspend the House for a few minutes.