PARLIAMENTARY DEBATE
Covid-19 Update - 5 October 2020 (Commons/Commons Chamber)

Before we proceed with the Secretary of State’s statement, I remind hon. Members that the conduct of another Member should not, other than by a substantive motion, be criticised on the Floor of the House.

With permission, I would like to make a statement on coronavirus. The virus is spreading, both here and overseas. In the past week, over 450,000 people tested positive for coronavirus in Europe, almost double the number of cases a month ago. Here in the UK, the number of hospital admissions is now at its highest since mid-June. Last week, the Office for National Statistics said that while the rate of increase may be falling, the number of cases is still rising. Yesterday, there were 12,594 new positive cases. The rise is more localised than first time around, with cases rising particularly sharply in the north-east and the north-west of England and in parts of Scotland, Wales and Northern Ireland. Now more than ever, with winter ahead, we must all remain vigilant and get the virus under control.

Let me turn to the operational issues on data publication, the future plans for medicine licensing and, of course, the announcement of 40 hospitals made by the Prime Minister on Friday night. I wish to take the first available opportunity to set out to the House the technical issue relating to case uploads that was discovered by Public Health England on Friday evening. It is an ongoing incident and I come to the House straight from an operational update from my officials.

On Friday night, Public Health England identified that over the previous eight days, 15,841 positive test results were not included in the reported daily cases. This was due to a failure in the automated transfer of files from the labs to PHE’s data systems. I reassure everyone that every single person who tested positive was told that result in the normal way and in the normal timeframe. They were told that they needed to self-isolate, which is now required by law. However, the positive test results were not reported in the public data and were not transferred to the contact tracing system.

I thank colleagues who have been working since late on Friday night and throughout the weekend to resolve this problem. I wish to set out the steps we have taken. First, contact tracing of the relevant cases began first thing on Saturday. We brought in 6,500 hours of extra contact tracing over the weekend. I can report to the House that, as of 9 am today, 51% of the cases have now been contacted a second time for contact tracing purposes. I reassure the House that outbreak control in care homes, schools and hospitals has not been directly affected because dealing with outbreaks in those settings does not primarily rely on this particular PHE system.

Secondly, the number of cases did not flow through to the dashboards that we use for both internal and external monitoring of the epidemic. Over the weekend, we updated the public dashboard, and this morning the Joint Biosecurity Centre presented to me its updated analysis of the epidemic based on the new figures. The chief medical officer’s analysis is that our assessment of the disease and its impact has not substantially changed as a result of the new data, and the JBC has confirmed that it has not impacted the basis on which decisions about local action were taken last week. Nevertheless, this is a serious issue that is been investigated fully. I thank Public Health England and NHS Test and Trace, which have been working together at speed to resolve this issue. I thank everyone for their hard work over the weekend. This incident should never have happened, but the team have acted swiftly to minimise its impact. It is now critical that we work together to put the situation right and make sure that it never happens again.

Another important area of our coronavirus battle plan is treatments. As the House knows, the only treatment known to work against coronavirus was discovered here in the UK. As we leave the EU, I want to use the opportunity to improve how quickly we get new drugs to patients, so the UK is joining Canada, the United States, Australia, Switzerland and Singapore in Project Orbis, which will allow international regulators to work together to review and approve the next generation of cancer treatments faster. It will mean that pharmaceutical companies can submit treatments to be reviewed by several countries at the same time, meaning that we can co-operate with the best medical regulators in the world and make approvals quicker so that we can get patients the fastest possible access to new drugs. It is an exciting development. We will join the scheme fully on 1 January, after the end of the transition period, because we will stop at nothing to bring faster access to life-saving treatments on the NHS.

We are investing in hospitals, too. Two weeks ago, I announced to the House that we are investing an extra £150 million in expanding capacity in urgent and emergency care so that hospitals have the space to continue to treat patients safely in the pandemic. I am delighted that on Friday my right hon. Friend the Prime Minister set out the 40 hospitals we will build by 2030, as part of a package worth £3.7 billion, with eight further new schemes, including mental health facilities, invited to bid for future funding and also to be built by 2030. This is the biggest hospital building programme in a generation, and the investment comes on top of an extra £33.9 billion a year that the Government will be providing to the NHS by 2023-24. We passed that into law right at the start of this Parliament, and the 40 new hospitals across England will support our mission to level up our NHS so that even more people have top-class healthcare services in their local area and so that we can protect the NHS long into the future.

Finally, it is critical that our rules are clear at local level so that the public can be certain of what they need to do to suppress this virus, and I will update the House in due course on what action the Government are taking, so that we can have more consistent approaches to levels of local action, working with our colleagues in local government. For now, it is essential that people follow the guidance in their local area, and if they need to check the rules, they can check on their local authority website. History shows us that the battle against any pandemic is never quick and never easy. It requires making major sacrifices and difficult choices. I know that this has been a tough year for so many, but we are asking people to persevere as winter draws in, because the only safe path is to suppress the virus, protecting the economy, education and the NHS, until a vaccine can make us safe. I commend this statement to the House.

I thank the Secretary of State for giving me advance sight of his statement. In recent weeks, we have had people being told to travel hundreds of miles for a test; we have had hundreds of children out of school unable to get a test; we have had tracers sitting idle, watching Netflix; and we have had care home tests taking days to be processed. Yesterday, we had a Health Minister saying that this could be a moment of national pride like the Olympics, and we have had a Prime Minister in a complete muddle over the rules. Now, at one of the most crucial points in this pandemic, we learn that almost 16,000 positive cases went unreported for a week. That means that as many as 48,000 contacts have not been traced and are not isolating. Those thousands of people, blissfully unaware that they have been exposed to covid, are potentially spreading this deadly virus at a time when hospital admissions are increasing and we are in the second wave.

This is not just a shambles; it so much worse than that. It gives me no comfort to say it, but it is putting lives at risk, and the Secretary of State should apologise when he responds. No doubt he will complain about my tone, or say that he will not have any divisive talk, but people want answers. He has just said that over half the 16,000 people have been spoken to by tracers, and they have presumably handed over their contacts, but when will the other 49% be spoken to by contact tracers? How many of the contacts have now been traced and spoken to, and how many are isolating? Why did nobody notice this issue until Friday night? Why did it take until 9.30 on Sunday evening for this to become public? The Prime Minister was clearly aware of the problem, because he said on “The Andrew Marr Show” yesterday morning that there had been a

“failure in the counting system, which has now been rectified”.

Speed is of the essence when dealing with a pandemic, so when were local directors of public health informed? The Secretary of State says that this is an ongoing issue, so it has not been rectified, as the Prime Minister said on “Marr”. When will it be fully resolved?

Public Health England sources say that they report the data when they get the data from test and trace. Can the Secretary of State confirm that the data could not be handed over to PHE because of the size of the Excel spreadsheet files? Was this an issue at one particular Lighthouse lab, or across all the Lighthouse labs? Why are critical databases in a national pandemic being hosted on Excel spreadsheets? Why are they not using specialist database software? The right hon. Gentleman likes to boast of his background in software development, so did he sign off this system? Was he aware of it? The Department of Health and Social Care is responsible for the integrity of pillar 2 testing data. His Department is the data controller, so he is ultimately responsible for this mess. It is a mess made up of fragmented systems passing data back and forth between his Department, PHE and outsourcing companies such as Serco and Deloitte, and it is costing us £12 billion. Surely now is the time not to renew Serco’s contract and instead give responsibility and resources to NHS labs and local public health teams to deliver testing and tracing.

The Secretary of State says that the data does not impact decisions that have been made about local restrictions, but areas already under restrictions such as Bury, Hyndburn, Burnley, Manchester, Liverpool and Newcastle have seen increases as a result of this data. Will those areas and others under restrictions now be given extra help and resources to battle the virus? Infection rates in other parts of the country that are not under restrictions, such as Newark and Sherwood, are climbing higher with this new data, so should we expect more local restrictions this week?

The Secretary of State says that he is set to bring in a new three-tiered system to replace the confusing network that is in place. Will he update the House on what the new criteria will be for an area going into restriction and leaving restriction? So far, it has been a bit like “Hotel California”—you can check out, but you can never leave. Families deserve answers.

The Prime Minister told the House on 20 May that we would have a “world-beating” system in place by June. It is now October. The system is neither competent nor improving. Problems are getting worse. The Government are failing on the basics. When will they finally fix this mess?

I will start by answering a couple of factual questions. As I said in my statement, as of 9 am this morning, 51% of these cases have been contacted by the contact tracing system, and their contacts are contacted immediately after the initial contact—concurrently.

The hon. Gentleman asked about the tiering system. Absolutely, extra support will go to areas where there is an increased number of cases. He asked about the criteria in the proposed approach. Of course, we cannot have fixed and specific criteria, because it depends on the nature of the outbreak. For instance, if there was an outbreak in one individual employer, we would not necessarily put the whole local area into local action. We try to make the intervention as targeted and as localised as possible, but sometimes it needs to be broad, as it is in the north-west and across large parts of the north-east. For example, the intervention in the west midlands covers four of the seven council areas of the west midlands, but not the other three, because that follows the data.

The hon. Gentleman asked about the particular IT system in question. The problem emerged in a PHE legacy system. We had already decided in July to replace this system, and I commissioned a new data system to replace the legacy one. Contracts were awarded in August, and the work on the upgrade is already under way. While, of course, we have to solve the problem immediately, we also need to ensure that we upgrade this system, and we have already put in place the contracts to ensure that that happens. In the meantime, it is critical that we work together to fix these issues, which were identified by PHE staff working hard late on Friday night. I want to thank the PHE staff who did so much work to resolve this issue over the weekend.

In answer to the hon. Gentleman’s final question, we need to ensure that we contact trace all those cases as soon as possible. In two days, we managed to get to 51% of them, and that work is ongoing.

The Health Secretary deserves enormous credit for the expansion of testing capacity that he has personally championed, but is not the underlying problem that the Lighthouse laboratories have been, and will continue to be, overwhelmed by demand? Do we not need to think about the structures and, in particular, whether the responsibility for NHS staff testing and care home staff testing should be moved to hospital laboratories and universities, in the way that was advocated this morning by Sir David Nicholson, the former chief executive of the NHS? Sometimes it is tempting to think that, by dealing with the latest problem, we will solve the whole problem, but ahead of winter and the second wave, we need to think about whether these structures are right for what we have to deal with.

The expansion of the NHS testing is, of course, critical as well. The system in question, where the problem was over this weekend, brings together the data both from the NHS systems and from the so-called pillar 2 systems. The challenge was in a system that integrates the two, rather than just on one side or the other, but my right hon. Friend makes a broader point, which is that as we expand the NHS’s capacity as part of the overall expansion of testing, we have to ensure that we use that capacity to best effect. In many parts of the NHS, increasingly, it is NHS testing capacity that is used for NHS staff testing. That system works well, because the test is local and convenient, and we are looking to expand in exactly the sort of direction that he outlines. I urge colleagues away from trying to bifurcate the two systems. Essentially, we have a whole series of different ways to access a test, and we need to make sure that people get the tests that are easiest to access for them as much as possible.

The delay in entering almost 16,000 covid cases into Government databases has resulted in last week’s case numbers being totally inaccurate. The Secretary of State says that the updated statistics would not have led to additional measures, but are there any new areas of heightened concern? PHE has blamed the problem on test result files being too big to load on to its central system. Was that, as has been suggested, due to the transfer of data between formats? If the underlying issue was due to the rapidly rising number of positive cases, why was that not anticipated or identified sooner? Can he be sure that something like this cannot happen again?

Just as importantly, this means that none of those cases was registered with the tracing system. While, as the Secretary of State says, people with a positive test got their result and, we hope, self-isolated, they did not get direct advice and they did not give the details of their contacts. From the Government’s data, people with covid report an average of three to four contacts each, so that would represent 50,000 to 60,000 contacts who were not identified and asked to isolate and therefore will have continued to spread the virus. While up to 10 days have lapsed and the opportunity to prevent onward spread may have been missed, the Secretary of State mentions that 51% of cases have been contacted, but on what timescale does he hope to reach all the contacts of those cases? Given that only about 60% of community contacts in England are currently reached, will he involve local authority public health teams in what is now a massive contact-tracing operation?

On the core of the hon. Lady’s point, the assessment of the epidemic on the basis of the updated data is core to our approach to tackling the epidemic. The chief medical officer has analysed the new data, which we have now published—on coronavirus.data.gov.uk we can see the data, and that is on the corrected basis. Based on Joint Biosecurity Centre analysis, the CMO’s advice is that the assessment of the disease and its impact have not substantially changed. That is because the just under 16,000 cases were essentially evenly spread, so it has not changed the shape of the epidemic. It has changed the level, in terms of where we are finding the epidemic and in what sorts of groups.

The hon. Lady asks how many contacts have been contacted, as opposed to how many of the primary index cases. As I said, that is happening concurrently, so as soon as the index case has been contacted by Test and Trace and interviewed, the contacts are immediately contacted. As I said, we have got through 51% of the backlog over the weekend, and we have brought in more resources to complete that task.

My right hon. Friend and everyone in the House hopes that there will be a safe and effective vaccine available during the months ahead, but the head of the vaccines taskforce has said that she expects it to be available to only half of the population, concentrating on the over-50s and the most vulnerable. Is that the Secretary of State’s understanding? What are the implications for the other half of the population?

This is a very important question. The vaccines taskforce has done incredibly important work in supporting the scientific development and manufacture of vaccines and in procuring vaccines—six different types of vaccine—from around the world. The work of deploying a vaccine is for my Department, working with the NHS and the armed forces, which are helping enormously with the logistical challenge, and we will take clinical advice on the deployment of the vaccine from the Joint Committee on Vaccination and Immunisation. My right hon. Friend the Chair of the Science and Technology Committee will know that 10 days ago the JCVI published a draft prioritisation, and it will update that as more data becomes clear from the vaccine. That is the Government’s approach: to take clinical advice from the JCVI.

The Secretary of State will know that south Manchester now has some of the highest infection rates in the country, but the figures are skewed by the very high rate among 17 to 21-year-olds. Many of those appear to be students who are confined to halls of residence, so the spread of the virus ought to be contained. May I therefore ask for an assurance from the Secretary of State that we will not have any extra local lockdown restrictions in Manchester as a result of figures that give a misleading picture of the extent of the virus in the wider community?

Yes. The hon. Member makes a really important point. This is why I resist the temptation to set a simplistic threshold above which a certain level of action is taken. That is because there might be an incident—I mentioned that there might be such an incident in a workplace, for instance; there might also be one in a halls of residence—where we get a very high number of cases, but if it is confined and not in the wider community, we would not want to take action to restrict the social activity of the wider community. That has to be taken into account, along with the data on the number of cases and the positivity, because the number of tests put in affects that as well. We take all these things into account in asking both when an area needs to have more restrictions applied and when we can take an area out of restrictions, which of course is so important for everybody living there.

Nobody can possibly doubt my right hon. Friend’s utter commitment to doing his very best in these circumstances, or indeed the good will and hard work of his officials, but this is another incident that further undermines public confidence in the delivery of the Government’s covid response, and it is another example of where logistics and planning have let us down. Why cannot the Government learn from previous successes with the Nightingale hospitals and personal protective equipment? The military were brought in much more overtly to deal with the logistics, planning and delivery of those programmes, and they should be on test and trace as well.

Of course they are involved, but this specific issue was in a PHE legacy computer system that we had already identified needed replacing; I had already commissioned its replacement and that replacement is currently being built. We knew that this was a system that needed replacing. That work is under way, at the same time as the remedial action to sort the problem more immediately.

We have lost a vital week in the fight against the spread of this virus in our country because of a problem with spreadsheets that the Health Secretary tells us was known about in July. We are paying £12 billion to these private companies to run this service, yet the Health Secretary has told us there are no penalties to them for poor performance. Who is going to get our money back, and who is going to take responsibility? Can the Health Secretary tell us: where on earth does the buck stop?

Of course, I have come to this House to be clear and transparent to it and to the nation as to the nature of this particular problem. It is wrong constantly to be picking on a small number of the many, many cogs in the wheel of this system, which was a Public Health England legacy system—although that does not quite fit the hon. Lady’s narrative, it is the fact of the matter. I like her, and she and I have worked together in the past, including on such issues. She is normally incredibly reasonable and sensible, and I would be happy to ensure that she gets a full briefing on this one and to answer any further questions she has.

I thank my right hon. Friend, his Department and the many thousands of people who have worked so hard throughout the pandemic to make sure that our NHS has not been overwhelmed, but an inevitable consequence of this is that a large number of elective operations have been delayed, including joint replacement surgery, which means that many people, including some of my constituents, are living in severe pain while waiting for procedures. Will he set out the NHS’s plan to make sure that people get this life-changing surgery as quickly as possible? Could some of the welcome additional resource that has been announced be used for post-op rehabilitation?

The short answer is yes. My hon. Friend makes an important case. The restart of elective operations in the NHS is now proceeding apace. Of course, the more we can keep the virus under control, the easier that restart is. In any case, the NHS has done a huge amount of work over the summer to try to separate, as much as is possible, the NHS into “covid green” areas, where we have a high degree of confidence that there is no coronavirus, and “covid blue” areas, where there may be, so that people can get the long-term elective work done that is needed. That will include an expansion of rehabilitation. She might have seen that one of the 40 hospitals on the list that the Prime Minister announced was the DNRC—the Defence and National Rehabilitation Centre—which is to be built just outside Loughborough.

The majority of Greater Manchester has been under local restrictions for more than two months, yet we now have some of the highest rates in England. The test and trace debacle once again shows that the national system is broken and that the Secretary of State’s measures are not working. He knows that the Greater Manchester authorities are keen to adopt a more localised approach, so if the newspaper reports are right that we are going to get a new tiered system, is this not the right time for the Government to give local areas control over test and trace systems, supported by extra financial resources?

I half agree with the hon. Gentleman; it is important that we put more testing resources into the areas where case levels are high, and it is very important that we continue to strengthen the local engagement with the national system—I was talking to the Mayor of Greater Manchester about this only this morning. The challenge is that we also need the scale of the national system, so that where there is an outbreak we can bring huge amounts of resources to bear and make sure that we can really target the support, for instance, for contact tracing. So it is the combination of the local and the national that will get us through this.

Since last Thursday and the Welsh Government’s local lockdown measures, half a million people in north Wales have not been allowed to cross often meaningless county council boundaries without a good reason to do so. That is causing huge disruption to livelihoods and wellbeing, so will my right hon. Friend outline his understanding of the scientific evidence for restrictions on travel such as this?

My hon. Friend raises a very important question, which I know is exercising people who live in north Wales and on the border. I am not going to criticise the Welsh Government, with whom we work closely, but what I will say is that, in England, when we choose to bring in measures restricting travel, we do it with strong guidance at the moment rather than within the law. That is partly because there are all sorts of reasons why people might need to undertake a journey, so even where we advise people to minimise unnecessary travel, we do so with guidance and, in large part, people follow it.

The First Minister said on Friday that work was under way to improve the interoperability of the two test and trace apps. As they do not both work at the same time, as I experienced for myself, I wonder whether the Secretary of State can say a little bit more about how discussions between the Scottish and UK Governments are progressing and whether there is some sort of timescale for allowing the two apps to work together.

I am delighted to have the chance to agree wholeheartedly with the First Minister of Scotland. We have been working closely together to ensure that the apps work together and interoperate in different parts of the United Kingdom. That upgrade is expected in the coming weeks. The two Governments are working very hard and very constructively on it.

May I thank my right hon. Friend for the way that he has worked so closely with us in the west midlands? He knows that, first and foremost, I am in favour of community solidarity and good sense, rather than legal diktat and Government fiat. Will he commend those universities that have already introduced student responsibility agreements as a way of furthering all that? Will he bear in mind later on this week that our highly effective Mayor in the west midlands Andy Street, the Labour leader of Birmingham City Council and I are all of one mind, together with Justin Varney, the excellent head of public health in Birmingham, that the current level of infection rates mean that there should be no further changes there this week?

I concur with my right hon. Friend on the importance of personal responsibility. We all have a responsibility in this. I have not heard of responsibility agreements with students, but that is a very sensible approach. I spoke to Andy Street this morning, and he made clear to me the need for national and local government to work together. That is working very effectively across the west midlands and across party lines, exactly as my right hon. Friend says. We must continue to do that as we monitor the developments and the data and do all we can to keep this virus under control.

Some local authorities are reporting that up to 500 unexpected positive cases have been downloaded to their system. Some are two weeks old and have had no contact at all from the national system. Directors of public health are angry and frustrated about the lack of joined-up working and the fact that the national system continues to break, despite the promises of both the Secretary of State and Baroness Harding to go for a more locally led approach. When will he start to work better with local authorities and have a more joined-up approach, harnessing their expertise?

That is exactly what we are doing—absolutely. For instance, this morning I also spoke to Sadiq Khan, the Mayor of London, about how we continue to strengthen the join-up between the national and local approaches. I entirely agree with the hon. Lady that that is incredibly important.

Until we get a vaccine, the House knows that it is about following the rules of hands, face, space and get a test, but my right hon. Friend will also know that there are different types of test out there. Can he comment on the plans for future testing and on what updates there might be? We have heard talk of saliva testing, finger-prick testing or, possibly, that we may be able to allow individuals to deal with covid themselves.

We are doing a huge amount of work to trial these next-generation tests at the same time as expanding the current testing capability. For instance, if we have to have a test, would it not be easier if we just needed some of our saliva rather than to having to put the swab all the way up our nose and down the back of our throat? These sorts of improvements in technology are in the pipeline and we are working incredibly hard to bring them to bear as soon as possible.

The local authorities in the north-east have put forward a proposal to be able to provide a test and trace service regionally. After this latest fiasco, will the Secretary of State now agree to pick up that offer of local testing and tracing and fund the local authorities in the north-east to provide this?

Yes. We put an extra £10 million into the local authorities in the north-east to support contact tracing and we are also stitching together the data feeds between the national system and each of the individual local authorities in the north-east. We will keep working hard on that project. I will keep listening to the needs of the local authorities in the north-east and across the rest of the country.

It is good that we are now testing more than other countries and good that we have a quarter more testing capacity than we had in August, and we are very grateful to the staff of the mobile testing centres that we now have in Oadby and Wigston, but what is my right hon. Friend doing to further drive up testing capacity so that we can stay ahead of this?

That is the subject of a huge amount of Government effort, working with the NHS and with the private sector on both the current technology and the new technology. I will just make a point about Oadby and Wigston in my hon. Friend’s constituency. People say, “Where is a local lockdown having an effect?” Well, the answer is in Oadby and Wigston, where the case rate has come down because the good people of Oadby and Wigston have followed the locally applied rules, and that has brought the virus back under control. I am very grateful to my hon. Friend for the leadership that he has shown there, along with the leaders of the county council and of the district council, who have worked really hard together to make this happen.

Despite all the billions that have been spent on testing, we learned at the end of last week that the testing hours in London fell by 43% on the week before. There is also a staggering variation in capacity. My own borough, Westminster, has one of the lowest testing rates in London. Given that the limited capacity means that testing is being directed to those with the highest rates of infection, is there not a very real risk that this will mean that we do not know what is going on accurately across the country because areas that are not getting enough testing are not showing transmission, and therefore we cannot make good decisions? When will we have the testing capacity to allow us to make the right decisions for our people and our economy?

The hon. Lady makes a really important case. First, as she implies, we obviously have to put the testing capacity into the areas with the biggest outbreaks to tackle those outbreaks. I think everybody understands that. At the same time, we have to increase testing capacity, and we are doing that. But thirdly, if an area has lower testing than another area, we have to make sure that we take that into account when we look at how serious the problem is. We do that in two ways. The first is the positivity rate—what proportion of tests come through positive—and the second is the survey data, particularly the Office for National Statistics survey, which shows that rates in London are higher than in some parts of the rest of the country, such as the south-west, the south-east and East Anglia, but not as high as in the midlands and the north of England, or indeed in Scotland, Wales and Northern Ireland. We have to look at the surveys and the positivity, as well as the basic case rate.

I recognise my right hon. Friend’s focus, attention and efforts in responding to the ever-changing covid situation. Does he recognise that there are currently myriad different forms of restrictions across different parts of the country and that can become confusing? What consideration has he given to simplifying the approach to the restrictions? In doing so, would he ensure that any simplification applies to every part of the UK?

The short answer is yes. The proposals that we are working through and that I will bring to this House are to have a more simplified approach to the local action that we took. We have shared that approach with the devolved Administrations. Indeed, I have discussed it with Vaughan Gething, my opposite number in Wales. It is the sort of approach that would simplify matters further were it undertaken across the UK, but that is a decision for the Welsh Government in Wales, and for the other devolved Administrations, because public health decisions are devolved. I urge the Welsh Government to continue working with us. I urge my right hon. Friend, who is a very strong voice in Wales, to try to persuade the Welsh Government to take that sort of approach across the whole of the Principality.

I call Jonathan Edwards.

Diolch, Mr Deputy Speaker. Increasing evidence indicates that so-called long covid is impacting around 10% of those contracting the virus. What assessments have been undertaken of the potential long-term social and economic impacts of long covid, as well as of the lasting pressures on health and care systems?

Mr Deputy Speaker, we have had three voices of Wales in a row, including yours, Sir. I could not agree more with the hon. Gentleman from Plaid Cymru. The impact of long covid can be very debilitating for many months, and some people who caught covid in the initial peak still suffer from long-covid symptoms. We have instituted more research, and we have started—in England at least—a long covid service in the NHS. Just today, the National Institute for Health and Care Excellence has published an approach to assessing long covid, which I would recommend to the hon. Gentleman. That approach will clearly need continued effort so that we can make sure that people who suffer from long covid get the support they need.

On Friday, I and my constituents learned via local media and press reports that there are Government plans to close the hospitals in Lancaster and Preston, with plans to replace them with a super-hospital, which would have obvious implications for other Lancashire hospitals, such as Chorley and Blackpool Victoria. Closing two hospitals in Lancashire to build one super-hospital does not make it easier for my constituents or the people of Lancashire to access vital medical care. Does the Secretary of State believe, as I do, that the next time we hear a Minister talk about building 40 new hospitals, it should come with a health warning that that also means closing 80 hospitals?

Order. Before I invite the Secretary of State to answer that—I will give some flexibility—please make sure that your questions relate to the statement that has just been given.

As well as responding to coronavirus, we need to ensure that we invest in the physical infrastructure of the NHS. I would just correct the hon. Lady, because the proposal in her part of the world is to consult on whether one or two hospitals is the right approach and the right thing for her part of the world. I encourage her to welcome the massive investment in the NHS in Lancashire, and across the country, which will improve care right across this land.

I thank my right hon. Friend for the huge investment in west London hospitals announced on Friday. With regards to coronavirus, should we not focus as much, if not more, on the hospitalisation rate, as opposed to the incidence rate? Often, people do not have symptoms, or have very mild symptoms, and, certainly in London, the hospitalisation rate is a fraction of what it was in April.

Of course, the hospitalisation rate is an important factor that we look at, and it is a concern. Unfortunately, the latest hospitalisation rate has risen to 422, which is the highest since the middle of June. Hospitalisations tend to lag behind the number of cases, because people catch the disease and some, sadly, are later hospitalised. We therefore keep a close eye on the hospitalisation rate, and the bad news is that it is, sadly, going up.

The six councils in the Liverpool city region face a budget shortfall of £150 million. On Thursday, the Health Secretary announced £7 million to be split between the Liverpool city region and three further councils—a drop in the ocean compared with £150 million. He knows that local professionals have solutions to the problems of test, trace and isolate. He has shown that there are not just millions but billions of pounds available for Serco, Deloitte, Compass and friends. So when will he invest in local public health teams and sort out the mess of test, trace and isolate once and for all?

As I have said, we have been putting the extra money into local councils, as well as using, frankly, all the tools at our disposal, public or private sector—whether people are in the NHS, PHE, a local council or a firm that can bring a capability to bear on this problem. It is one big team effort.

Talking of tools at my hon. Friend’s disposal, Bournemouth University stands ready to help with lab testing. However, it is covid testing in schools that I would like to address. Today, the rules state that the entire year group must stay out of school for 14 days if one of the pupils in it tests positive. That causes huge disruption not only to learning, but to working parents, who have to provide childcare. With better testing systems now in place, please can we review this 14-day rule that sends entire year groups home, so that we can keep children both safe and in school?

I would love to be able to review that, but only when it is clinically safe to do so. However, I would just point out to both my right hon. Friend and also to all those in education who are following this, including in schools across Bournemouth, that schools do not necessarily have to send the whole year group home; they have to send the bubble home. By ensuring that the way in which they operate keeps people safe, schools can ensure that bubbles are smaller than the whole year group. Many schools do that. The first immediate port of call would be to try to get the bubble smaller within a school, and then we should of course work together on other ways to solve the problem.

I do not underestimate the scale of the challenge in ensuring that we have enough tests for everyone who needs them, and it is incredibly encouraging that testing capacity has increased by 25% since the middle of August. Can my right hon. Friend assure me that he continues to work to get testing capacity up even further, so that venues such as Victoria Hall in Keighley can meet demand?

Yes, that is absolutely right. Testing capacity now stands at over 300,000. We are on track to reach 500,000 by the end of this month. I know what a goal to expand testing capacity feels like. This is a tough and difficult challenge, but the team are rising to it. My hon. Friend has made the case for Keighley so strongly during this pandemic, and he continues to do so in terms of the extra testing capacity needed there now.

However basic this data error might have been, the consequences are very serious. However, I say to those civil servants working night and day to get this right: the responsibility for this is not on you; it is on those who guarantee the checks to the system. As the Secretary of State has indicated, that is him. With that in mind, can he avail himself of any data process flow charts or other diagrams relating to the processing of this data, and all data quality assurance policies and processes, and put those in the public domain? Yes or no?

I am very happy to work with the team to see what we can put in the public domain. However, the challenge of a maximum file size error is that it would not necessarily have appeared on that sort of flow chart and, given the massive expansion of the availability of data storage over recent years, would not, I expect, be a feature of the system that is already in train to replace the one that caused the problem this weekend. However, I wholeheartedly agree with what the hon. Lady has said about the civil servants in the Department and the staff at PHE, who are working so hard during this pandemic.

My right hon. Friend gave an excellent answer to our right hon. Friend the Member for Tunbridge Wells (Greg Clark). The JCVI report is indeed most helpful and reassuring because it prioritises the vulnerable, the elderly and, of course, our health workers. However, it last met on 1 September, and the report is dated 23 September. Can my right hon. Friend confirm that if there is more information on the progress of the vaccine, that committee will meet again and we will get another excellent report?

Yes, absolutely. People are asking questions about how the vaccine will be rolled out and of course I understand why people are so interested in that. We will of course protect the most vulnerable first and we will do that on the basis of clinical advice. The JCVI brings together the best clinicians in this area and it meets very regularly. Decisions of the JCVI will not be on the critical path to the roll-out of the vaccine—I have been assured of that.

One of my 15-year-old constituents had a covid test over a week ago and, in spite of chasing, is still none the wiser as to whether she has covid or not. Not only is she having to self-isolate, but her mum, a nurse, is having to take the precaution of self-isolating, something she says her ward can ill afford. On top of that, last month, the time taken to get test results back from the national Test and Trace programme to Oldham’s public health team, to enable them to trace the cases that the national programme is failing to get in touch with, was 12 days—12 days, not 24 hours. Will the Health Secretary please tell my constituent how many of the 16,000 or so lost test results were from Oldham, and how many contacts—not cases—have not yet been traced?

The good news is that the turnaround time of test results has been coming down. I would love to take up the case of the individual who has not had a result back, as the hon. Lady has described, because that is rare: the majority of cases now come back the next day. I will specifically look into turnaround times in Oldham, because an average of 12 days seems a lot longer than I expected, and I will make sure to get back to the hon. Lady at the appropriate opportunity.

From speaking to local people, it has become clear that there are still concerns about routine appointments—GP appointments and, increasingly, routine dental care—which are obviously important for preventing problems down the line. Can my right hon. Friend tell me what plans he has to ensure that over these potentially bumpy next few months, people are still able to get those appointments?

For all my huge enthusiasm for technology, it is obviously critical for people to have a face-to-face appointment in primary care at their GP’s surgery, if one is needed. We have made it clear that every GP practice should offer those face-to-face appointments in a covid-secure way where they are needed. The vast majority of GPs are doing incredible work and offering the public the service and the vocation that they went into medicine for. If my hon. Friend has specific examples, I will be happy to look into them, but overall, it is so important that we keep primary care running.

Mr Barry Sheerman.

Mr Deputy Speaker, my former student—thank you. I say to the Secretary of State that we are talking about human beings working systems, and I warn him that there will be more glitches. Technology means glitches, so I am worried about him, because we have a long, hard winter ahead. Does he agree with me that what we are doing in Huddersfield, in Kirklees—working together as a council, a local university and a local health trust, putting party political issues to one side—is what we must do this winter? We have to beat this virus, and we have to work together in order to do that.

I agree with every word that the hon. Gentleman has said.

First, I welcome the new centre at Keele University campus in my constituency, which opened last Friday, and I thank my right hon. Friend’s Department for that. Secondly, he may be aware of the article in The Times on Saturday that suggested people were having difficulty accessing tests at the centre in Newcastle-under-Lyme itself, which had been walk-up in August but now requires booking. The article suggests that there is plenty of capacity at the centre, but not yet enough at the labs, so could he confirm that this Government are still committed to half a million tests a day by the end of this month?

We are committed and on track to the delivery of half a million tests by the end of this month. We have capacity at over 300,000 now. I saw the article in The Times. Of course, one of the good things is that in Newcastle-under-Lyme, the case rate had come right down. We had a walk-in centre because it was an outbreak area, and it stopped being an outbreak area because everybody in Newcastle-under-Lyme did their bit and brought the case rate down. That is a good thing, of course, but it does mean that we have to make sure that the testing is targeted at where it is most needed across the country. What I really want to do is have that extra capacity that we are building so everybody everywhere can get it.

In Salford, the case numbers have now risen above 250 per 100,000. As well as this case uploads programme issue today, our local contact tracing programme is having to wait on average four days for data from the national system, and in the worst cases seven to nine days. That is creating unacceptable delay to contact tracing. In August, Baroness Harding said that we would have a contact tracing system that was “local by default”, so what is the Secretary of State doing to make sure that data gets to local authorities in a timely way so that it can be followed up by genuinely local contact tracing systems under the control of our local directors of public health?

This is the goal, as the hon. Member sets out, and reducing the times for those transfers is very important, and making sure that the transfers happen effectively and in an automated and cohesive way is very important. But the approach that she sets out of using the national system to do the first attempts at contacting people—to contact those whom it is easy to contact—and then use the local system to contact those where it is more difficult, and where boots on the ground can help, is the approach that we are taking to make sure that we can get that join-up as effectively as possible.

I would like to thank the Secretary of State for working so constructively with Wolverhampton City Council when it requested some limited local restrictions around households visiting other households in their own homes. As we move forward to get the virus down, can we give further advice on how we all can limit transmissions within home settings, especially where we have a vulnerable family member?

It is so important that people follow this guidance, and of course the first principle for everybody needs to be “Hands, face, space” and keeping a distance, if possible, within households if somebody tests positive. The other thing not to underestimate is the importance of cleaning, because this virus passes on through the air, but it also passes on on surfaces, and we should all—all—be aware of that.

It was good to see the Secretary of State earlier today, and I very much hope that he will keep talking to local and regional leaders. As the Secretary of State well knows, the winter months are always the toughest for patients and for staff. This one could prove to be the most challenging that our NHS has ever faced. So can I ask the Secretary of State to guarantee that the NHS will have the funding resources needed to get it through this winter?

I welcome the very constructive approach that the hon. Gentleman takes in his local role as well as in this House. Of course, we have put in the extra funding that the NHS needs this winter. We are expanding over 140 emergency departments, because emergency departments need more space so there can be social distancing. We have also put in funding so that we can continue the work on electives, even though it is more difficult, and on infection control—and, of course, as much discussed, on testing. I look forward very much to working with him further as we try to control this virus.

Can the Secretary of State confirm that the rule of six and curfew are based on the evidence of what worked in Belgium, and will he continue to provide the whole country with the evidence of what has worked internationally so we can take the whole country with us to defeat the pandemic?

Yes, my hon. Friend makes a very important point, which is that we have got to learn from things that have worked in other countries. We are constantly looking around the world as well as at the domestic science. I am very happy to work with him to see what further we can publish in terms of the assessments that are made and then presented to us as Ministers to make decisions on that constitute that scientific advice.

It is clear that local lockdown areas should have control of test and trace; yet at the weekend the Prime Minister was adamant that it was not failures with his “world-beating” system that have had an impact on our local increases, but that my constituents are just undisciplined in following his confusing and incoherent messaging. Does the Secretary of State share the Prime Minister’s insulting view?

It is incredibly important that all of us, as leaders in our local area, reiterate the public health advice that people should follow the rules, which are put in place for a reason. Nobody wants to have these rules in place, but they are important to keep us all safe.

I recognise the scale of the challenge in increasing testing capacity. In Devon, it has increased by over 40% since the start of September. Can my right hon. Friend assure me that work continues to rapidly get that capacity up even further, so that constituents in my North Devon constituency are able to get tested?

Yes.

In the Secretary of State’s statement, he said that 51% of the cases have now been contacted a second time for contact tracing purposes. Can he clarify how many people are still waiting to be contacted for the first time, and how can he say with any confidence that the notification process for those individuals has not been delayed?

All of the 15,000 have been contacted for the first time.

In the Secretary of State’s statement, he spoke with pride about the Prime Minister’s announcement on Friday of the additional capital programme for hospitals. In Cumbria, we met that announcement with some dismay. As the hon. Member for Lancaster and Fleetwood (Cat Smith) said, there is a proposal to close the Preston and Lancaster hospitals and merge them into a single hospital somewhere in between. Does the Secretary of State realise that that will mean even longer journeys for acute care for people from the South Lakes? Will he have a word with the Prime Minister and drop that dangerous proposal from the consultation, so that people in south Cumbria do not have to make dangerous journeys for emergency care?

Order. That was only touched on briefly in the statement, which was a covid update. It would have been really nice if the hon. Member could have asked his question in relation to the covid update, which is what the statement was mainly about.

Thank you, Mr Deputy Speaker. As part of the coronavirus response across Lancashire and Cumbria, we want to ensure that the NHS is prepared for the long term, so we are putting a huge investment into Lancashire and the new hospitals in Lancashire. The hon. Gentleman almost mentioned that there is a consultation on whether to have two replacements or one. I entirely understand that he takes a position within that consultation, but it is worth explaining that there is a consultation on whether to replace them with two hospitals or one. There will rightly be full public engagement, with his constituents, those of the hon. Member for Lancaster and Fleetwood (Cat Smith), and potentially yours, Mr Deputy Speaker, on which is the right approach. However, this is a massive investment in the local NHS that everybody should welcome.

I thank the Secretary of State for coming to the House yet again to update the House on covid matters and health matters. He is right, of course, to concentrate on covid, but we also have to worry about people who do not have covid diseases and need treatment. In north Northamptonshire, it is welcome that a Boris hospital will be built just off the A14, which will be state of the art and will replace the town centre one of Kettering. Will the Secretary of State tell me when it will be built, and when it will be finished?

As part of the coronavirus response, we must ensure that we keep our physical NHS up to date, and we will build the new hospital in Kettering. We will complete it before 2030 at the latest, and I very much hope a long time before then. I want to say how much my hon. Friend has done to work towards delivering it, along with my hon. Friends the Members for Kettering (Mr Hollobone) and for Corby (Tom Pursglove) nearby. It has been a team effort, and I was thrilled to be able to let them know that this is happening, and it will happen before the decade is out.

There will be lots of opportunities to question the Secretary of State about the new hospitals at a more appropriate time.

In the past 14 days, New Zealand has had 35 coronavirus cases, China, Hong Kong and Macau 260, Vietnam 28, Thailand 84 and Australia 238. The UK has had 108,000 cases. Our coronavirus strategy is failing. Others show we can fix this and get the test and trace system our people need. So will the Secretary of State do what is needed: kick out Serco, sack Dido Harding and put the billions of pounds wasted on private companies that are failing into our NHS, which will do the job properly?

No.

Does my right hon. Friend agree that hospitals such as Queen’s Hospital in Burton should be doing everything they can to reintroduce access for birth partners of pregnant women during all stages of labour and that this should be treated as a priority?

Yes, I do. Coronavirus brings many challenges, and making sure that we have good infection control not just during childbirth, but during the meetings that are often so critical during pregnancy, is very important. We changed the guidelines a couple of weeks ago, and I know that everybody across the NHS is working their hardest to get the best outcome, and I hope we get there soon.

It is nine months since the World Health Organisation first warned of the risks covid posed. My constituents in Southwark deserve to know that the Government are trying to keep them safe and that they can get tested or traced if needed; why no other Government in the world have experienced such problems with Excel spreadsheets, and why the Secretary of State will not take responsibility for this latest world-beating incompetence.

Funnily enough, when I speak to my colleagues from across the world we find we often have many of the same challenges, including the need to get the testing capacity up, and the hon. Gentleman may not believe me, but occasionally they ask me what we have done to extend testing capacity quite as much as we have. I am very happy to explain that to both him and his constituents and to the rest of the House.

Can my right hon. Friend confirm that his statement today does not impact on the decision to keep Redcar and Cleveland, Stockton, and Darlington out of local lockdown restrictions, and does he also see that more testing surely means more positive tests, so should we now be looking at the numbers of people admitted to hospital instead of covid case numbers before considering further lockdown restrictions in local authority areas?

My hon. Friend makes an important point. First, as the chief medical officer has confirmed, this issue does not affect the decisions taken last week, but of course we look at all those decisions each week, and, as my hon. Friend knows, we take as localised an approach as possible, so that rather than bringing in measures for the whole of Teesside, we brought in measures for Middlesbrough and Hartlepool, where the local councils had called for them—whether or not they mentioned that afterwards. We should keep working together and making sure we look at the data—the hospitalisation figures of course, as well as the test positivity, and of course the number of cases. Hospitalisation data is important, but it follows with a lag, so we have to look at the early indicators as well.

Constituents in West Lancashire are worried: constituents of mine were told they tested positive on Friday and they still have not been contacted by Track and Trace or the restaurant they work in. They worry that this is increasing the danger of the spread of covid. They are also worried that the stockpile of drugs held in the event of a no-deal Brexit may be being reduced because of this pandemic. Can the Secretary of State update us on both those points?

On the first point, for all those who test positive, receiving that result brings a duty under law to self-isolate. That is the primary way we keep people safe and that has worked. As I said in my statement, as of 9 o’clock this morning 51% of those had been contacted for contact tracing purposes. I very much hope the constituent the hon. Lady mentions will be contacted very soon, if not already. On the final question she asks, of course we have been replenishing the stockpiles of drugs that we used up during the peak. That has been a very important part of the work over the summer, as we prepare to leave the end of the transition period at the end of this year.

I thank the Secretary of State for his continued engagement with me and other colleagues from all sides of the House throughout this crisis and also for our new Boris hospital coming to Shotley Bridge. My constituents have three concerns still, one of which is the speed of getting tests back. I know there has been some improvement recently, but will he update us on that? They are also still concerned about the 10 pm restrictions and about clarity on how we get out of local lockdown measures. Will he inform us a bit more about that?

The coronavirus crisis is not easy for any Health Secretary, but it was a joy to be able to call my hon. Friend and tell him that we are rebuilding Shotley Bridge Hospital on the site of the old steelworks. It will be absolutely fantastic, like a phoenix in the heart of County Durham. It is a joy to work with my hon. Friend, who asks important questions about coronavirus. As he says, we are reducing the turnaround times for test results. We will continue to work to try to make them as fast as possible.

Will the Secretary of State please outline what measures will be put in place to ensure that all family members of residents in care homes can continue to see their families and loved ones over the coming months, including whether guarantee PPE and testing for families will be guaranteed?

The hon. Lady has taken a close and repeated interest in this very important subject. We have put in place updated guidance on visiting care homes, which is a very important and sensitive balance we need to strike, working with local directors of public health. I cannot give the guarantee she seeks in all areas because it is a matter for the judgment of the director of public health locally, because in some parts of the country the virus is more prevalent than elsewhere. I wish I could, but I cannot. I look forward to continuing to work with her to try to get that balance right.

I welcome the news that the Queen’s Medical Centre and City Hospital will be rebuilt in Nottingham. On PPE, the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), told the Public Administration and Constitutional Affairs Committee in July that in the early days of the pandemic the Government

“went from supplying PPE to about 250 or 260 hospitals…to 58,000 organisations”

such was the pace of change. With the measures the Government have recently taken, and with 32 billion pieces of PPE, can my right hon. Friend assure me that the Government are now in a much better position to deal with PPE should there be any increase in cases as we go into the winter?

Absolutely. The PPE distribution system was described by the head of the armed forces as the biggest logistical exercise he had seen in his professional lifetime. It has been a mammoth effort to get it into decent shape, but it is now in decent shape, I am very glad to say. We have been preparing to solve not only the current problems, but preparing in case of a second peak. We have said that PPE will be free to NHS institutions and care homes for the remainder of this financial year to remove that worry. I strongly support what my hon. Friend said about the warm welcome to the rebuilding of the QMC and City Hospital in Nottingham. It is a place I know well from my family, many of whom are from Nottingham. It is really great that we are able to put in that huge investment.

There is a challenge where case rates are going up sharply. Of course, the virus does pass on through social contact. We need to work with the local councils to bring the virus under control in Manchester, as in other parts of the country where it is rising sharply.

On Saturday, my wife and I got our annual flu jabs. I hope you will indulge me for just a second, Mr Deputy Speaker, while I say that the GPs and nurses at our local surgery are doing an outstanding job. It was pre-booked and within two minutes we were in and out.

I do not want to make you cry, Mr Deputy Speaker, but unfortunately I suffer quite badly with vaccines—when I had my yellow fever vaccine I thought my end had come. Does my right hon. Friend agree that people need to be aware of some of the side-effects of vaccines and be crystal clear on the symptoms of coronavirus, so that once they have had their vaccines, they may not necessarily seek covid tests? People should be absolutely clear on the three symptoms of covid.

It is too early yet to set out the clinical details of vaccines, other than to say that we have a draft of the priority order for the distribution of a covid vaccine and that we will not bring in a covid vaccine—and the Medicines and Healthcare Products Regulatory Agency would not license it—unless we are confident that it is safe. It is at that point, when we know more about the clinical details, that will be able to say more about its effective roll out.

After our broken test and trace system and the failure to put a protective ring around care homes, and after the recent and preventable outbreaks in universities and the ultimately unnecessary restructuring of Public Health England, the chaos this weekend is symbolic of the way the Government have handled the pandemic. Does the Secretary of State agree that these are his failures and only his alone?

Responding to a pandemic is an enormously challenging task. Thankfully, it is a massive team effort, and it is one in which the whole country can be engaged because we all have a part to play.

London consists of 32 boroughs plus the City of London and covers a population of around 8 million people. We are told that infection rates are going up in each of the London boroughs, but some are much higher than others. I urge my right hon. Friend to consider, when he needs to introduce lockdown procedures, doing so on a borough-by-borough basis and not inflicting unnecessary restrictions on the whole of London, which would be counterproductive in terms of delivering downward pressure on the increased case load. It would potentially bring the economy to a halt and affect the way Parliament works.

My hon. Friend makes an important point. Getting the right geography for any particular action is an important and difficult consideration. Last week’s example, when we took two of the Teesside boroughs into local action but not the other three, demonstrates that we are absolutely prepared to do as my hon. Friend wishes for London. On the same day, however, we took the whole of the Liverpool city region into the same measures, because that was what was appropriate there. We have to take into account travel patterns and socialising patterns, as well as the pure data from the epidemiology and the number of cases, but it is absolutely something that we look at because we want to minimise the number of restrictions that are in place, subject to the need to keep the virus under control.

The Secretary of State is full of bravado and bluster, despite a catalogue of mistakes and regular statements. When the truth is spread thinly, people start to see through it. We hear the expression “world-beating test and trace system”—how would Ricky Tomlinson describe it?

I don’t know.

May I begin by thanking my right hon. Friend for the £500 million for Epsom and St Helier hospitals and for taking very quick action after I asked in this House for additional testing capacity in Carshalton and Wallington? Not long after I asked him, we heard that three more sites may open in my borough, which is very welcome. Obviously, those new sites will need the testing capacity to be able to cope, so can he assure me that we will continue the work to get that capacity up as quickly as possible and into boroughs such as Sutton?

Yes. We are bringing more testing capacity into Sutton. We have opened more testing sites in Sutton. I can tell the House that the average distance travelled to a test has now fallen to 4.3 miles from over 6 miles three weeks ago. We are also bringing a new hospital to my hon. Friend’s area—a massive half-a-billion-pound investment in the NHS, showing that we are always prepared to protect the NHS for the long term.

Various companies have multimillion-pound contracts, and it is important that we understand their motivation to succeed. Does Serco get paid for voided test results—yes or no?

The motivation of my whole team, no matter how they are employed or contracted, is to beat this virus, and we are working together to do that.

I thank my right hon. Friend for his important statement. In South Derbyshire, we have world-renowned laboratories locally, and my constituents have asked me to ask: what steps is he taking to increase the number of labs available to process tests, so that we can continue to increase testing capacity as quickly as possible?

My hon. Friend is right to ask that question, because we are expanding the number of labs as we expand the number of tests. I know that there is great capability in Derbyshire that can be brought to bear as part of this big team effort.

As you know, Mr Deputy Speaker, people in lockdown in Wales are not allowed to leave their county for fear of spreading the disease. For instance, people in Newport, where there are 50 cases per 100,000 people, cannot go to Aberystwyth. But people in Manchester, where there are 500 cases per 100,000 people—10 times the number—can go to Aberystwyth and elsewhere in Wales and spread the disease. To stop this spreading of disease, will the Secretary of State restrict travel out of locked-down areas in England? If not, will he accept that it would be a good idea for people arriving in low-risk areas in Wales to quarantine, or is he happy for the disease to spread without restriction?

The challenge is that the primary transmission of the disease is between households and households mixing with one another. The approach that we have taken in England since we came out of the initial full-blown lockdown has been to put travel restrictions in guidance rather than law, because we feel that that is the most appropriate thing to do. That is not the approach being taken in Wales, but that is how we are currently handling it in England.

It was a political, not a health, decision to pursue a private sector route for testing. Scotland has chosen differently, but there are concerns that ongoing capacity issues in England and Wales will have an impact on Scotland. Will the Secretary of State confirm that Scots will not be prejudiced by the Tory Government’s preference for private profit over public health?

Quite the contrary; the UK-wide testing system delivers enormous numbers of tests to people in Scotland, and I know from having studied it that people in Scotland are really grateful for the fact that we work together, with the UK Government delivering testing in Scotland alongside the Scottish NHS delivering testing in Scotland. It is that sort of coming together that people look for during a time like this.

In Stoke-on-Trent, we were delighted to come off the national watchlist as an area of concern after hard work from Stoke-on-Trent City Council and Staffordshire County Council and, most importantly, the people of Stoke-on-Trent, Kidsgrove and Talke adhering to the public health messaging. Additionally, we have the regional test centre that Councillor Abi Brown and I successfully lobbied my right hon. Friend for and two incoming walk-in test centres in Stoke-on-Trent. Will my right hon. Friend commit further by giving additional funding to help Stoke-on-Trent City Council and the Royal Stoke University Hospital to deliver increased testing capacity for the thousands of local health and social care workers across Stoke-on-Trent and Staffordshire?

As well as the expansion of testing that my hon. Friend mentions, I can tell him that we are expanding NHS testing capacity within Stoke, and we are putting in the extra funding to deliver that. This man stands up for Stoke so strongly, and he has been making the case clearly and powerfully, so I am glad to be able to tell him that we can do that.

Vaccines have come up a number of times during the statement today. Will the Secretary of State be absolutely clear: are there shortages and recalls of flu vaccine going on at the moment? I have certainly been told by a major pharmacy company that there are, and the Royal College of General Practitioners wrote to me yesterday mentioning delays of one month. He did not answer the question from the Chair of the Health Committee. Kate Bingham was very clear that vaccinating the whole population was just not going to happen. Was she correct to say that?

On the latter point, we take our advice from the Joint Committee on Vaccination and Immunisation, and it will provide the clinical advice. That clinical advice has not been provided yet, because the data has not yet been provided to it in full from the trials that are ongoing. I could not be clearer about that. The Government’s advice on the distribution of the vaccine for clinical purposes comes from the JCVI, and I urge the hon. Gentleman and all others to read its report from 10 days ago. It was an excellent report.

When it comes to the flu vaccine, we have enough to vaccinate every single person who is in a priority group over the age of 65, those who are clinically vulnerable and the children who are eligible for it. We are rolling that out over the forthcoming months. On Sunday, I spoke to the president of the Royal College of GPs, and we discussed the need to make it clear to GPs and pharmacists—they are at the core of the roll-out—and also to the general public that we have enough vaccine. We are rolling it out over the months to come. It is very important that people come forward, and I am really glad they are doing so in record numbers this year, but it does take several weeks to get that done.

The House should recognise that going from 2,000 tests a day in March to around 250,000 now—hopefully we will see that double over the next few weeks—is a significant achievement, but can the Health Secretary provide any reassurance to sectors such as travel, theatre and events, which are in so much difficulty? Can we use mass testing to help them open up again?

My right hon. Friend makes a really important and heartfelt plea. I have been working with those in travel sector and discussing the matter with them. While the testing capacity is on the current technology, we have to use it for the clinically prioritised groups, but of course we would all love to see when further expansion can mean that we can use testing more broadly in the sorts of ways that she describes.

Since the beginning of this crisis, the Government’s approach has been one of central control. We are fixated on the number of tests, but is the real issue not the number of tests, but what we do with the information we get from them? Before the new restrictions were applied to County Durham, NHS Test and Trace took testing capacity out of County Durham. Is it not now time to just admit that the national system has failed? What is needed is to give responsibility directly to directors of public health, with the resources to do not only the testing, but the more important thing, which is tracing, which they are more able to do than people in national call centres?

We put in money, including into the right hon. Gentleman’s constituency, to do exactly that—to make sure that there is local support. He says we should follow a localised approach. That is exactly what we did in the north-east: when the seven north-east councils came to the national Government, they asked for a set of interventions to be put in place, and we did that. That is exactly the sort of approach that we ought to be taking, and we will continue to do so.

The number of people in Dudley who have been triaged for coronavirus testing has halved in the past couple of weeks. It is hard to believe that this is down to reduced demand. What progress is my right hon. Friend making in expanding capacity, so that my constituents can get testing readily when they need it?

We are expanding testing. However, I would add that in this House two or three weeks ago, the big item of discussion was excess demand for testing. We put out public health messaging to explain that people should come forward for a test if they have symptoms of coronavirus, but not if they do not, and the number of people without symptoms coming forward has fallen since then. As a result, we can get the testing capacity we have to the people who need it. That has been a success, and I thank everyone in the country who listened to those messages. We have worked hard to increase communications about it, and the demand has been moving in the right direction.

Covid case data is used to decide which areas are in local lockdown, with the impact on hospitality businesses and families visiting loved ones in care homes and the detrimental effect on the mental health of those missing out on social interactions. Can the Secretary of State assure me and my constituents that the data used to put us in local restrictions is up to date and accurate and that when we start to get cases down, and as soon as it is safe, we can come out of local restrictions?

My hon. Friend makes an incredibly important point. We are of course vigilant and we have to bring in local action in some cases, as we have in his area, but we will also bring areas out of restrictions when it is safe to do so, as we did in his area, although unfortunately it then had to go back in again. I would prefer it if places did not come in, out and back in again in that way, but my view is that that is better than leaving the measures in place when they are not needed.

We publish the data, which has now been updated to take into account the issues we had over the weekend, and we will have in place the minimum interventions that are necessary to keep the virus suppressed and to protect the economy, education and the NHS as much as possible until the vaccine arrives. That is the strategy, which is true in Colne Valley and true right across the country, and I look forward to working with you, Mr Deputy Speaker, and colleagues across the House to help the country to get through this.

I thank the Secretary of State for Health and Social Care for updating the House on covid-19 measures and for answering questions for the last hour and a half. Thank you very much.

Virtual participation in proceedings concluded (Order, 4 June.)