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

I would like to make a statement on coronavirus. As winter draws in, the virus is on the offensive: 40 million coronavirus case have now been recorded worldwide. Weekly deaths in Europe have increased by 33% and here in the UK, deaths have tragically doubled in the last 12 days. The situation remains perilous.

While the disease is dangerous for all adults, especially with growing evidence of the debilitating consequences of long covid, we know it is especially dangerous for older people. Cases continue to rise among the over-60s, who are most likely to end up in hospital or worse. I am very worried that the cases per 100,000 among the over 60s is 401 in the Liverpool city region, 241 in Lancashire, and in Greater Manchester has risen over the past week from 171 to 283. That is why the Government have been working so hard to act, and I am very glad that we have been able to agree, across party lines, the necessary measures in Liverpool and Lancashire, and we are working hard to reach such an agreement in Greater Manchester.

We are doing everything in our power to suppress the virus, support the economy, support education and support the NHS until a vaccine is available. That is the right strategy, charting a path that allows for the greatest economic and social freedom while protecting life. The director general of the World Health Organisation said last week:

“Allowing a dangerous virus that we don’t fully understand to run free is simply unethical.”

I agree. I know that this is difficult and I know that it is relentless, but we must have resolve, see this through and never stop striving to support the science that will one day make us safe.

I was at Chelsea and Westminster Hospital this morning meeting NHS colleagues who are caring for patients with such dedication, as they always do. I heard from them how important it is for everyone to support the NHS by keeping the virus down so that the NHS is not overwhelmed by covid patients and it can deliver all the essential non-covid care that people need. I am glad to report that the number of people experiencing a long wait for cancer treatment has been brought down by 63% since its peak in July. I want to thank all the cancer teams who are working so hard to ensure people get the cancer screening, diagnostics and treatment that they need, even in these difficult circumstances, but the best way to protect cancer treatment and all the other treatments in the NHS is to keep the prevalence of coronavirus down.

In doing this, of course, we are taking as localised and targeted a way as possible. Our local code alert level system means that we can have different rules in places such as Cornwall, where transmission is low, and Liverpool, where transmission is high and rising. On Thursday, I updated the House about several areas of the country that we are moving into the high alert level and today I would like to inform the House at the earliest possible opportunity that Lancashire has now moved into the very high alert level. Infection rates in Lancashire are among the highest in the country and are continuing to rise rapidly, including in the over-60s as I mentioned. Both the number of cases and the number of hospital admissions are doubling almost every fortnight, and the number of covid patients in intensive care beds in Lancashire has already reached nearly half the number seen at the height of the pandemic earlier this year. So we knew we had to take rapid action to suppress the epidemic in Lancashire.

We have always said that we stand side by side with any local area that agreed to move into this third tier and offer substantial support to local authorities, including for testing, tracing, enforcement and business support. I would like to thank local leaders in Lancashire who have been working with us so constructively, and I am sure that their willingness to put politics aside in the national interest, and in the interests of the people whom we serve, will save lives and protect livelihoods at this difficult time.

Following the successful introduction of measures in Liverpool and Lancashire, talks continue this afternoon with Greater Manchester, led by my right hon. Friend the Secretary of State for Housing, Communities and Local Government. This week, further discussions are planned with South Yorkshire, West Yorkshire, Nottinghamshire, the north-east and Teesside.

Sadly, over the weekend, we have seen very directly the impact of this disease. I was shocked to learn on Saturday of the sad death from coronavirus of Bill Anderson, the brother of Liverpool Mayor Joe Anderson. My heart and, I am sure, the sympathies of the whole House go out to the Anderson family and the people of Liverpool, who have lost a brother. All our thoughts are with our colleague, the hon. Member for Bolton South East (Yasmin Qureshi), who is in hospital with pneumonia after testing positive for covid-19. We wish her a speedy recovery and send all our support to the NHS in Greater Manchester, which is caring for her and so many others.

I would also like to provide an update on testing—another vital line of defence. We are testing more people than any other country in Europe. We are now doing over 300,000 tests a day, up from 2,000 a day in February, and we have opened over 500 test sites, including new walk-in centres in Dundee on Friday, in Edinburgh on Saturday and in Newcastle this morning.

Alongside that important work, we are working hard to discover and evaluate new testing technologies that are simpler, faster and cheaper. Some of these tests can produce a result as quickly as in 15 minutes, and we will make them available to local directors of public health as part of our strategy for local action, starting with areas in the very high alert level. We are rolling them out across hospitals and care homes, to test patients and residents yet more regularly and keep people safe, and for schools and universities, so that we can keep education open safely through the winter. These tests have shown real promise, and we are both buying them now and ramping up our ability to produce them at scale here in the UK. We will stop at nothing to support this extraordinary scientific and logistical endeavour, which can give us hope on the path back to normal life.

Finally, I would like to inform the House that on Friday we laid regulations to support the roll-out of both the flu vaccination and any covid vaccination. While, of course, no vaccine technology is certain, we must be prepared to deploy a vaccine as soon as one is safely available. The new regulations provide for a wider range of clinically qualified people to administer vaccines and for the Medicines and Healthcare Products Regulatory Agency to grant a UK licence for a vaccine before the end of the transition period, should that be necessary. We wish all our scientists well in this vital work, and we will give them all the support they need.

We are once again at a decisive moment in our fight against coronavirus. While our scientists work round the clock on the solutions that will finally bring this crisis to an end, we must all play our part, come together and work together to keep people safe, suppress the virus and save both livelihoods and lives. I commend this statement to the House.

May I start by sending my party’s condolences to Joe Anderson for the sad loss of his brother from this horrific virus? I also send our best wishes to my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for a speedy recovery.

As always, I thank the Secretary of State for advance sight of his statement. The virus continues to grow nationwide. The R rate is between 1.3 and 1.5. An increasing number of care homes across the country have seen outbreaks, with 214 in the last week. Admissions to critical care continue to rise nationwide—yes, at a slower rate than in the first wave, but at this stage in the first wave, critical care admissions were starting to fall because of the lockdown. They currently continue to rise.

We welcome the progress that is being made on saliva testing and LAMP—loop-mediated isothermal amplification —testing. It will allow us to introduce wider mass testing, which is a vital tool in taking on this virus. I pay tribute to the universities that are developing great testing innovations, such as Southampton University, and Leicester University in my constituency. What is the timescale for the advances in testing that the Secretary of State is talking about? Is the plan still for millions of tests a day? There was speculation back in September that his plan was for 10 million tests a day by February, so can he tell us what the daily testing capacity will be by the end of the year? We have seen delays in the pilots. Salford was supposed to be testing 250 people a day using saliva testing, but that has now been refocused. It is vital that testing of all frontline healthcare workers is now introduced to help the NHS get through the winter, so will the Secretary of State urgently speed up the validation of pooled polymerase chain reaction testing in the Lighthouse labs? It is not yet happening in those labs, and we really need it to be.

This virus spreads with speed, so testing must be quick, yet results are still not turned around in 24 hours. Again, when will they be turned around in 24 hours? Contacts must be traced quickly, and those who are traced must be given support to isolate, yet we have—to be frank—a badly designed system that is failing to trace sufficient contacts, costing £12 billion and paying consultants £7,000 a day. The Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, the right hon. Member for Surrey Heath (Michael Gove) justified these failings yesterday on “The Andrew Marr Show”, saying that when the virus is accelerating,

“any test and trace system of whatever kind has less utility”.

After spending £12 billion, Ministers now just shrug their shoulders and say, “Well, the virus is accelerating, so contact tracing is less useful.” It is simply not good enough. The country is facing further restrictions because test and trace failed, so again, I urge the Secretary of State to fund local public health teams to do contact tracing everywhere and follow international best practice, such as Japan’s, where they focus on investigating clusters using retrospective contact tracing. We need that backward contact tracing everywhere, not just in the places that are hotspots.

This virus exploits clustering and social interaction, and I have always accepted that socialising in closed spaces, especially with poor ventilation, is a driver of transmission. However, for interventions to be effective, the consent of local people is needed and economic support is vital, yet we are now in a situation where the Bishop of Manchester—a bishop, for goodness’ sake—describes Liverpool as “feeling cheated”, Lancashire as “feeling bullied”, and Manchester as “angrily determined”. If the Secretary of State is seeking to impose greater restrictions on Greater Manchester, surely it needs financial support so that people’s livelihoods are not put at risk, so can he tell the Chancellor to spend less time admiring himself on Instagram and instead deliver a financial package to safeguard jobs across Greater Manchester?

The Prime Minister has promoted the tier 3 restrictions because they mean that, in his words, “there is a chance” to bring the R number down, but how do these restrictions in the north arrest growth in the virus across the rest of the country? The R number across the south-east is 1.3 to 1.5; across the south-west, it is 1.3 to 1.6; and across the east of England, it is 1.3 to 1.5. Cornwall, Devon, Suffolk, Somerset and Ipswich have recorded covid rates per 100,000 in recent days that are higher than the average rates across Greater Manchester when it went into lockdown in the summer, so to get the national R number below 1, more intervention will be needed than is currently proposed. Is it not in the national interest to now follow the advice of the Scientific Advisory Group for Emergencies, and adopt a two to three-week circuit break?

Last week, when asked about a circuit break, the Prime Minister said, “I rule out nothing”. He also said that he “stands ready” to apply those measures if necessary. However, the Minister for the Cabinet Office yesterday ruled out a circuit break, so for clarity, have the Government now completely ruled out a circuit break in all circumstances? The cost of delay could be a deeper, longer, fuller lockdown. Is the Secretary of State now ruling that out?

I say to the Secretary of State that we have a window of opportunity. For much of the country, it is half term next week. If it is politically easier for him, he does not have to call it a circuit break: he can call it a firewall or a national moment of reset. Whatever he calls it, we need something, because the longer the Prime Minister dithers, the harder it becomes to take back control of this virus, protect the NHS and save lives. We urge him to act before it is too late.

I absolutely will address the questions that the hon. Gentleman raised. On the first set of questions about testing, I might have missed it, but I think he omitted to support and congratulate the work of everybody involved in getting more than 300,000 tests a day delivered—on track to a capacity of more than half a million tests a day by the end of this month. He rightly asked about batch testing, which is currently being trialled.

The hon. Gentleman asked us to fund local contact tracing everywhere. We have put those funds into each local authority, but of course we put the most support into the areas that need it most. The Government’s approach of targeting the support and measures on the areas where they are needed most is at the core of how we—as he put it—retain the consent of people while we go through these difficult actions.

To be truthful, the hon. Gentleman is far closer to and more supportive of the Government’s position than he feels able to express at the Dispatch Box, not least because he asked for economic support. Let me just leap to the Chancellor’s aid and defence. The Government have put in unprecedented economic support to help people through these difficult times—billions of pounds of aid and further aid forthcoming. The hon. Gentleman asked in particular for economic support when an area goes into tier 3, which is exactly what I announced in respect of Lancashire. That is of course part of the discussions that we have with local authorities when further actions are needed.

So, there absolutely will be more economic support from the Government, yes; more work with local authorities to deliver the local approach that is needed, yes; and more testing capacity, yes. These are all the things that the Government are delivering and it behoves the hon. Gentleman to acknowledge and support them, as clearly we are all trying to deliver the same thing, which is to suppress the virus and save lives.

I congratulate the Secretary of State for Health and Social Care on the news about LAMP—loop-mediated isothermal amplification—and lateral flow testing, which is potentially the most significant news about the fight against the virus that the House has heard for many weeks.

Given the dangers of conflicting public health messages when local leaders and national leaders say different things, is it not time to consider aligning incentives by saying that local leaders have the responsibility to bring down the R rate and giving them the powers and resources to do that if necessary, but also saying that if they fail to do that, they will be stripped of those powers to allow the Government to—to coin a phrase—take back control?

The approach we are taking, which is working effectively in almost every local area, is to work with local leaders. We are doing that across party lines, whether in Liverpool or Lancashire, as I mentioned, or in South Yorkshire, the north-east and Teesside, where the discussions are collaborative and consensual. That is the way we need to deliver the public health messages that are best delivered with everybody speaking with one voice and all working together to tackle the virus. That is not to mention London, where there has been a similar approach.

I would merely point out that over the past week in Greater Manchester the rate of infection among those aged over 60, which is the group most likely to end up in hospital, has risen from 171 per 100,000 to 283, so it is absolutely vital, from a public health perspective, that we act.

The economic impact on areas under the tightest covid restrictions is significant, particularly for the hospitality industry, where many young workers are employed. Covid will be with us for some considerable time, so we need to learn to adapt and live with it as safely as possible. As I have highlighted previously, covid is spread by airborne particles as well as droplets, so ventilation is key to reducing the risk of spread. There are ventilation systems that incorporate antimicrobial technology, which could reduce spread in indoor settings. Last week, I asked the Secretary of State whether he would speak to the Chancellor about promoting their installation by removing VAT and making them tax deductible. He did not answer, so I ask him again: does he recognise the importance of ventilation in the battle against covid? If so, will his Government use their taxation powers to help to make hospitality settings more covid-secure and avoid their being repeatedly shut down?

Absolutely we will support hospitality businesses and all the sectors of the economy. My right hon. Friend the Chancellor has supported the hospitality industry more than any other. In fact, the UK Government are supporting businesses right across the whole country. When the Scottish Government take action on public health grounds in a devolved way, the UK Government then come in with the economic support. That is yet another example of how much stronger we all are working together. I will take away the hon. Lady’s detailed point and talk to the Treasury. It is, of course, a question for the Treasury rather than for me as Health Secretary, but I just underline the importance of us all working together across Scotland and across the whole of the UK, and of the economic firepower of the UK Exchequer supporting people right across this land.

In Hyndburn and Haslingden—and, in fact, across Lancashire—we have some of the strongest people I have ever met. We will do everything we can to get our infection rate down, because that is what we do when times are tough: we come together. However, morale is low and mental health is suffering as people cannot see their families and some have been unable to see their loved ones in care homes since March. Will the Secretary of State outline what the Government are doing to mitigate that situation, and what steps are being taken to try to facilitate safe visits, given that there is no clear end date?

My hon. Friend has shown real leadership in Hyndburn in very difficult times. This has not been easy for the people of Lancashire. In Hyndburn, there have been restrictions for some time and I appreciate how hard that is, but I think everybody will look to the way my hon. Friend has tried to support people as much as possible, contacting me day and night with the cases of individual constituents, and has put herself at the service of her constituents. The people of Hyndburn are very well represented.

On the specific point that my hon. Friend makes, absolutely we must ensure, just as places have to go into level 3 restrictions when we are concerned about the ability of the NHS to cope if things get further out of hand, that so too will we reduce those restrictions as soon as we can safely. We will do that not necessarily across a whole county, but on a district-by-district level if that is what the data says should be done. That is something we are constantly looking at. For now, the single most important message to everybody in Hyndburn and across Lancashire is: let’s pull together, follow the rules and get this under control.

I thank the Secretary of State for the meeting he had with north-east MPs on Friday. I can tell him that, if the data is accurate, the signs over the weekend are that we are moving in the right direction.

I understand that SAGE highlighted that the impact of further potential restrictions will be felt very differently by different communities. SAGE suggests the need for immediate planning to refine measures to minimise potential harms and to mitigate impacts on vulnerable groups. Given the Government’s commitment to the levelling-up agenda, what are the Government’s plans to reduce the real risk that measures taken to respond to covid will continue to increase inequality and worsening levels of poverty and deprivation? In the north-east, we are not out of the woods by any stretch of the imagination, but can I urge the people of the north-east to carry on doing the right things?

The hon. Gentleman speaks for everyone across the north-east. The cross-party working has been first rate and I pay tribute to all colleagues from the north-east who have been working so hard. The message to everybody in the north-east is that there are early signs that the measures are starting to work, but we are not there yet, so let us all stick with it, work together, support each other, support the NHS and absolutely we will bring in the economic support to ensure both that we help businesses as much as possible, help employers and help individuals through this crisis. After that, the levelling-up agenda is vital to unite the whole country.

How correct my right hon. Friend is that the most effective actions are those that are local and targeted. Will he confirm that he will look at tier 2 reviews in the light of regulation 8 in part 4 of the Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020, so that we can target on a local basis? Given that so many cases are asymptomatic, could he say when he expects the new test to be more widely available across the community?

My hon Friend makes an incredibly important point, which is that the regulations are written on a borough-by-borough basis, and if we can take specific boroughs out of the regulations sooner, based on the data, then we will do so, and we have done. In fact in some cases we have taken part of a district or a borough out of the regulations when that is what the data has shown. I can give him that assurance.

On the testing, we are rolling out the tests as fast as we can. The use case is one of ensuring that more NHS staff are tested on an asymptomatic basis; there is more testing in care homes, where it is important to protect the most vulnerable; there is more support in education, to make sure we can keep education as open as effectively possible; and there is asymptomatic testing in areas where there is a big outbreak. All of that will be there to support outbreak control and get this virus under control.

The Welsh Government have today announced a stringent two-week firebreak to try to bring the R number down. Central to the strategy, of course, must be sufficient economic support for businesses and livelihoods. Will the Secretary of State press the Chancellor to ensure that the Welsh Government have sufficient financial flexibility to pursue their chosen public health policy?

Yes, of course. The Welsh Government respond to the circumstances in Wales as they see fit, according to the devolution settlement. As I was saying to the hon. Member for Central Ayrshire (Dr Whitford), we are absolutely prepared, ready and engaged in supporting communities and businesses right across the UK and in supporting individuals who, through no fault of their own, fall on what can be incredibly hard times because of the impact of coronavirus.

The Secretary of State knows that pubs, bingo halls and gyms have gone to enormous lengths to ensure that they offer a safe environment, and many of us in Greater Manchester and elsewhere are sceptical that closing those institutions would make a significant difference to the spread of the virus, but can I ask him why the Government will not extend the additional resources for Test and Trace independently of those measures? Surely, it would be beneficial to do so.

Across Greater Manchester and across Trafford, we had extended further support for Test and Trace before the tier system came in. We have engaged to make sure that we get the benefits of local teams accessing and, because they have boots on the ground, finding people whom the national team simply cannot find, and that will continue. Of course, the negotiations and the discussions about the future of what extra we need to do in Greater Manchester continue. I know that my hon. Friend requires further persuasion that some of the actions that appear to be starting to work elsewhere should be put in place. I would gently point him to the fact that we did manage to level off the increase in infections in Bolton when we brought in firmer measures, but they have since then started to go up again after we removed those measures. Nevertheless he is absolutely right—absolutely right—that the best way we can tackle this is by people taking personal responsibility for reducing their social interaction to reduce the risk of spread, and I hope that we can all metaphorically link arms and get that message across.

Small businesses in a tier 2 area such as Newcastle may not be asked to close, but they will face severe reductions in revenue due to local restrictions affecting football, for example, in the centre of our great city. The Secretary of State talks about unprecedented support, but these are unprecedented challenges for viable jobs in our city centre. In addition to what he has already mentioned, what local economic support will he offer to businesses in Newcastle?

If we do need to bring in further measures in Newcastle, then there is absolutely further support that is available, and there is already the unprecedented economic support that my right hon. Friend the Chancellor has set out.

Most of the MPs in Essex have reluctantly felt the need to support the tier 2 measures that are now being applied, but we are very concerned about the effect of this on the hospitality sector, in particular. Is it not very important that we align the economic interests of our constituents with the public health interests instead of polarising the debate such that one is either in favour of the economy or in favour of controlling the virus? May I also emphasise that one of the reasons why public confidence in the Government’s strategy is somewhat in decline is that we have yet to see the transformation of the leadership of test and trace, which I have discussed with the Secretary of State many times?

Where I agree with my hon. Friend is that there is no trade-off between health and economic measures, because if the virus gets out of hand, then we will end up with a worse economic hit as well. I know he agrees with that because we have discussed it many times. He, like other Essex MPs, may not like the fact that we have to collectively put in place these measures in Essex, but it is the right course of action.

As Warrington’s neighbouring Liverpool city region and Lancashire are in tier 3, with Greater Manchester expected to follow shortly if financial support is agreed, we need confidence that if we are asked to follow suit, there is robust evidence for the required closure of hospitality businesses, leisure businesses and salons. Will the Secretary of State commit to publishing the specific UK transmission data for these sectors compared with other workplaces—or are they merely a soft target?

We published further data late last week on exactly the question that the hon. Lady asks. We have the backward contact tracing in place that the hon. Member for Leicester South (Jonathan Ashworth) asked for—I apologise for not answering his question on that—and we have seen the evidence from that. The critical thing, though, is for us all to recognise that in places like Warrington and the surrounding area, where the number of cases is going up—and the number of cases among the over-60s is going up, which is particularly worrying—we do need to act, and to act together if at all possible.

The October 2020 “World Economic Outlook” published by the International Monetary Fund clearly states that

“the short-term economic costs of lockdowns could be compensated by stronger medium-term growth, possibly leading to positive overall effects on the economy.”

The Government clearly disagree with the IMF’s assessment, but can the Secretary of State tell me whether he or his colleagues have carried out any analysis of the economic impact of a national circuit break?

Of course we look at all the impacts of all the policies, but we know that the more targeted a policy can be, both in terms of the measures and the geography, then the less disruption it will have. If the hon. Gentleman’s concern is with a national circuit break, that is not the policy of the Government; the policy of the Government is to have a localised approach. He might therefore want to have a word with his own Front Benchers.

The Secretary of State quite rightly finished his statement by saying that we must all play our part in getting the virus down. Does he think it was that shared population-wide commitment in Wuhan in China that has seemingly got life back to normal? What lessons are there from what China has done that we could usefully apply here in the UK?

I would be cautious about some international comparisons, because life is not exactly back to normal and there are restrictions still in place. For instance, we have seen today Sweden introducing restrictions on a regional basis, which is similar to the approach that we have here. There is a lot of debate about international comparisons, and we do look across the board, but I am not sure it is true to say that life is back to normal in in Wuhan. We need to get the science to come to our aid and help us to get life back to normal here as quickly as possible.

This weekend, I spoke to pub landlords, café and bar owners and staff across our towns, and they all said that business had plummeted since Wednesday, when we became a tier 2 area. They were all cutting staff hours, some were considering closing completely, and none of them was getting additional support, because the tier 2 job support scheme simply does not work for them. Does the Secretary of State not understand that in order to sustain support for additional health measures, he has to listen to the people who are most affected by them? Will he look again at support for tier 2 and tier 3 and make sure that jobs and businesses get the support they need?

Again, I am going to come to the defence of my right hon. Friend the Chancellor, who has put in these support packages on a scale that has never been seen before. The right hon. Lady is right to raise the concerns of those in her constituency, but the combination of all the schemes that are available to businesses is something of a scale that this country has never had.

How many separate covid vaccines are undergoing trials at present in the United Kingdom, and what is the planned duration of the trial period for each?

There are three vaccine trials under way in the UK: the AstraZeneca trial, which is frequently discussed; the Imperial College trial; and a trial of the Novavax vaccine. The period of the trial is dependent on the clinical results and on the data. Of course, of those three, the AstraZeneca trial is the most advanced and is in phase 3 trials. We are closely in contact with all of them to ensure that they get the support they need.

I was alarmed, as were many public health experts, to read reports over the weekend that test and trace data is being shared with the police. Even a source in the Secretary of State’s own Department said that that will put people off getting tested. I hope the Secretary of State agrees that that is the exact opposite of what we need. Public trust and confidence in test and trace is critical, and transparency of the use of personal data is central to that, so will he publish today the memorandum of understanding that he and his Department have signed with the National Police Chiefs’ Council?

It is very important that people come forward for testing. As the Chancellor of the Duchy of Lancaster said yesterday, of course, the vast majority of people not only come forward for a test, and want to come forward for a test, when they have symptoms, but want the isolation arrangements to be enforced fairly so that everybody isolates when they need to. That is the reason that we have taken the approach that we have, which I set out to the House several weeks ago.

Since the beginning of the pandemic, there has been no recorded covid-19 outbreak in public houses in my constituency. Taking into account low national rates of transmission in pubs, when my right hon. Friend is in negotiations with colleagues from Greater Manchester, will he think very carefully before closing these covid-secure environments, which have spent thousands to ensure that they are secure, and cease introducing extra restrictions that will make trading an impossibility?

Nobody has stood up for the pubs and hospitality businesses in Bury more than my hon. Friend, and he makes an important argument about outbreaks. We also have to look at the backward contact tracing data, and at where measures to bring the virus under control have worked. I will happily have a further discussion with him to try to make sure that we can get the right set of measures and the right balance.

I thank the Secretary of State for his regular attendance in the Chamber and for his responses to questions. Will he outline the procedures and criteria for the vaccination schedule, bearing in mind that news reports state that a fully tested vaccine will be available in the near future? Does he agree that frontline workers in shops need to be part of the list of priority recipients, after the medically vulnerable, NHS staff and those in the caring profession?

Of course, no vaccine technology is certain, but the longer we go without bad news, the better things are, because we would hear if things had not gone well, so things are therefore progressing. The Joint Committee on Vaccination and Immunisation produces a prioritisation based on clinical advice and its clinical judgment on who ought to get the vaccine in what order. This is a really important question to ensure that we roll out the vaccine fairly and on an agreed basis. I will ask the Committee to look at the hon. Gentleman’s specific request to make sure that is taken into account. The Committee’s advice is very important for the Government decision that I hope the whole country can then get behind.

I make no apology for again bringing up the question of co-trimoxazole since I believe the drug can help very much in the fight against covid. Following the successful trials in India and Bangladesh, has there been any progress here?

My hon. Friend is right to raise that question, and I will write to him with a full update once I have taken advice from my clinical advisers and from Professor Jonathan Van-Tam, who leads on this area.

At the weekend, Mrs Helen Perry, one of my constituents, contacted me to say her son and three of his flatmates at Northumbria university had tested positive for covid. They are all self-isolating, but despite that are being bombarded up to 10 times a day by NHS Test and Trace. It is the same story for Mr Brian Sayer and his family, who are self-isolating because a family member has tested positive. In Brian’s words, “We’re not stupid people; we don’t need pointless telephone calls every other day”, and Mrs Perry says, “What a waste of time and money.” When will the Secretary of State admit that the national system has failed, and when will he hand over testing and, more importantly, tracing to local directors of public health, who know their areas and their communities and know how to do test and trace properly?

The hon. Gentleman is completely wrong on two fronts. This has been a very consensual statement so far, and the hon. Gentleman—

Right honourable.

The right hon. Gentleman has played a constructive part in getting the public health messages across in Northumberland, but he is wrong on two fronts. First, when NHS Test and Trace contacts people to remind them to self-isolate, that is based on the analysis we have done of what helps to ensure that people stay self-isolating.

Ten times in one flat?

Yes, repeatedly, absolutely; I make no bones about it.

Ten times?

Yes, because the isolation of people and their staying isolated is important. The right hon. Gentleman can complain that we are doing too much, but that is not normally the complaint I get from the Opposition.

The second point is that that must be, in the right hon. Gentleman’s words, handed over to local authorities. No, no, no; there has got to be teamwork with local authorities. It is teamwork that will help us get through this, not this attempt to separate people and say, “One side’s good, one side’s bad.” We are all on the same side in this fight against the virus.

Further to this consensual statement, we are all keen to be guided by the science, so what scientific behavioural assessment has been made of the effects of closing covid-secure venues on the likelihood of people meeting in one another’s homes instead, thus spreading the illness further? If my right hon. Friend has not got the information immediately to hand, perhaps he would care to write to me, as is the fashion.

I can answer the question. My hon. Friend makes an important point. The indirect evidence is that the number of hospital admissions due to people being over-inebriated has fallen since we brought those measures in, which is one indication that people are generally following the rules and, as I did, going home at 10 o’clock to make sure. The vast majority of people are following the rules.

As the chair of the all-party parliamentary group on cancer, I thank the Secretary of State for a recent meeting regarding the Catch Up With Cancer campaign. I, too, pay tribute to those delivering frontline cancer services throughout the pandemic, but the 63% figure that he mentioned does not reflect the totality of the backlog, as the NHS has announced new figures since then. In August, the number of people waiting more than 52 weeks in England continued to surge to more than 110,000—the most in 12 years. The only way that the backlog will go away is through action and resources being deployed to tackle it. What progress has he made to address the need for a boost to cancer services, so that cancer does not become the forgotten “c”?

The hon. Lady is absolutely right to raise that issue. In my statement, I said that we have managed to reduce the backlog among the longest waiters, those who wait more than 104 days, by more than 63% and among those waiting more than 62 days by 44%. There is further work to do—of course there is—but the NHS has made significant strides on the backlog of people waiting for cancer treatment, and I pay tribute to all the work that it has done.

The concern that many of us have is that restrictions can be imposed in a day, but take months to lift. In London, the restrictions were imposed not because of a higher level of infections, admissions to hospital or deaths, but because of a rapidly increasing rate of infection. If it turns out, when the Secretary of State conducts his fortnightly review next week, that the rate of increase of infection is no greater in London than in places in a lower tier, will he rescind those restrictions and return it to a lower tier?

My right hon. Friend makes an important point and, in a way, highlights that it is not just the case rate that matters; it is also the rate of change of the case rate, the over-60s case rate and the impact on hospitals. In the case of London, cases are over 100 per 100,000, which is a worrying level, but I really hope that the measures, and the people of London and all those who work here, can bring the case rate down so we can get out of it as fast as possible. Team London is, in fact, working on a proposed strategy for coming out of level 2, but the first thing that everybody in London has to do is follow the rules to get the rate of increase down, because it is only then that we can even start to consider the next steps.

Earlier this year, at the start of the pandemic, the Government committed to give the NHS whatever resources it needed to deal with coronavirus. The NHS has that money for dealing with covid-19, but it will need more to enable it to catch up on all the conditions that need to be treated now that treatment is taking place. Will the Secretary of State commit to provide the funding and resources needed to carry out those vital treatments?

We have put in the extra resource that the hon. Lady mentions, which is important. Not only has the extra resource gone in, but we are hiring people to do the work and building the buildings in which it can be done. She raises an important point about the need to recover the backlog. I am really glad that in areas such as cancer and many others, the backlog is being worked through, but there is still more work to do.

I support my right hon. Friend’s targeted approach. It is absolutely wrong, in my view, to close businesses and lock people in their homes in a broadbrush way in areas where the risks are much lower than elsewhere. He is following the right strategy.

I echo the comments of my right hon. Friend the Member for Tunbridge Wells (Greg Clark) about London. Many of my constituents have businesses across the border in south-west London, where it is not the case that the rate is over 100 per 100,000. There are large swathes of south-west London where it is well below that. Can the Secretary of State make sure that it is possible, as quickly as possible, to disaggregate those areas of London where the problems are less and to move back to a situation where those businesses can operate normally?

As my hon. Friend the Member for Wimbledon (Stephen Hammond), who is no longer in his place, said at the start of this session, it is important to take a borough-by-borough approach, and I commit to doing that. Unfortunately, there are parts of south-west London, such as Richmond, that have an elevated case rate above 100. In London, this work has been done effectively and across party lines, working with the leaders of local councils and boroughs, as well as with the Mayor, but I will absolutely take into account the point that my right hon. Friend makes.

A number of families in my constituency are worried about the impact that isolation is having on their family members with dementia who are living in care homes with no visits allowed. In one case, a constituent’s mother phones her daily and threatens to take her own life because of the lack of contact with her family. The Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately), told the Select Committee on Health and Social Care last week that there would be a pilot for visiting in care homes, but that could be months away. The Secretary of State has talked today about visits when restrictions are reduced, but this situation is desperate for some families, so can he tell us when we can have regular meaningful visiting for every care home resident?

The hon. Lady raises a point that is heart-rending and important, as is the protection of care home residents from this disease. The situation is not quite as she said, in that we have different restrictions in different areas according to local circumstances, with a great deal of delegated authority to the local director of public health to make judgments on the extraordinarily difficult balance between allowing visitors—for exactly the sorts of reasons she set out—and protecting people who live in care homes from catching the disease. When the case rate is high in the community, that naturally increases the risk in care homes, not just because of visitors but because the staff working in care homes live in the community. I am sure she will agree that the best thing we can do is to keep the prevalence of coronavirus down, because that will help to protect the people in care homes as well.

This time last week, I think the whole House welcomed the introduction by the Prime Minister of the three covid alert levels to provide some certainty about the levels at which measures would be introduced and what measures would apply in a given area. Rugby is currently on a downward trajectory, with fewer than 100 cases per 100,000, so can my right hon. Friend reassure my constituents that by sticking to the rules, we will remain in tier 1?

Yes. One of the advantages of the tier system is that it not only involves a clear set of actions that need to be taken if the cases go up, as happened in London last week, but also helps to motivate people in level 1 areas that in order to stay in level 1, the best thing to do is to follow the rules, to respect social distancing and to play their part in the reduction of the spread of the virus. Everybody who is living in a level 1 area can help to do their bit to stay in level 1 by following the rules on hands, face and space and following social distancing. My hon. Friend is absolutely right to point that out for Rugby, but the point applies right across the whole of England in areas covered by level 1.

Given that the national minimum wage already falls far below the real living wage, does the Minister think that people will be able to survive this winter with their workplaces closed and receiving only two thirds of that amount? Will the Government not give consideration to the calls from the Scottish Government and English regional leaders to do the right thing and offer more assistance?

I am really proud to have been part of the Government who introduced the national living wage to increase the level of support for the lowest paid across the whole United Kingdom. That is one example of the UK Government working to improve the support and pay available for the lowest-paid people in Scotland and across the whole of the rest of the United Kingdom, alongside the unprecedented economic support that my right hon. Friend the Chancellor has put in during this crisis.

I wholly applaud my right hon. Friend’s approach of localised lockdowns, but does he agree that in an area such as Gloucestershire, where, mercifully, the number of cases is still relatively low, the tracking and tracing and advice on self-isolating could be improved by involving both national and local resources?

Yes.

The Secretary of State said at the Dispatch Box last Tuesday, in support of the new three-tier system, that

“we are now acting to simplify and standardise the rules at a local level.”—[Official Report, 13 October 2020; Vol. 682, c. 198.]

At that point, Liverpool was put into tier 3, and the gyms were closed in Merseyside and Halton, but when Lancashire went into tier 3 on Friday, gyms there were allowed to remain open. What is the reason for that difference? He should straightaway authorise the reopening of gyms in Merseyside and Halton. There is no evidence to support keeping them closed.

That decision was taken in consultation and agreement with the local area. Part of the work with local areas on this has been to agree the exact details of the package in level 3.

At the moment, the only defence against the virus is modifying people’s behaviour. Cases of covid are rising in Buckinghamshire, and we want to stay in tier 1. Our NHS trust and council have taken the initiative and filmed a strong local public health message, which is now on YouTube and social media and is recorded by Dr Tina Kenny, our medical director, asking local people to follow the rules to reduce the spread of this highly contagious virus. Will the Secretary of State commend this communication from our local health trust and council and encourage other health authorities and clinicians—who people trust and have confidence in—to engage directly with their populations to send these vital messages out?

Yes. I applaud the work that has been done across Bucks to deliver public health messages and try to get the whole community to support the action that we all can play our part in and that my right hon. Friend rightly raises.

The Health Secretary really should admit that Serco has failed. If it was shared fairly across the country, the £12 billion for Serco would mean £300 million for the Liverpool city region alone. When will he give that level of funding to local public health teams, and when will he instruct Dido Harding to give local teams the data that is currently held by Serco, so that they can do the job that Serco has failed to do?

Given that we hit 300,000 tests a day for the first time over the weekend, I would have thought that the hon. Gentleman might have looked at the data and the improvement that is happening. [Interruption.] Opposition Members say, “not testing”. They used to complain about testing, and now that is going well. Contact tracing is getting better, and last week—[Interruption.] Last week, contact tracers in this country contacted more than double the number of people as the week before. Instead of having a go at all the people who are helping to solve this massive problem, the Opposition should get in support of them.

It has been demonstrated that far-ultraviolet C light emitted by krypton-chlorine lamps inactivates covid-19 on surfaces, as well as when coronavirus is airborne. Some fantastic research is being undertaken to look at that, notably by St Andrews University in Fife and Ninewells Hospital in Dundee, but also by a business in my constituency. Could my right hon. Friend outline how this potentially game-changing mechanism for inactivating the virus has been explored at Government level?

I have seen that research, and I would be happy to meet my hon. Friend to discuss how it might be applied.

Diolch, Madam Dirprwy Lefarydd. Wales is to go into lockdown on Friday. Scotland, Northern Ireland and regions of north England are already in similar measures. The firebreak restrictions in Wales are tailormade for the health needs of Wales, but the Treasury’s support schemes are based on political considerations and what best serves the south of England. Will the Secretary of State commit to bringing forward the job support scheme by eight days—only eight days—and increasing the level of support to that of the first furlough scheme, so that more people in Wales can afford to stay safe?

Of course, the furlough scheme continues until the end of the month and the job support scheme replaces it. That is the reason for the timing. It is the premise of the right hon. Lady’s question that the job support scheme, like the furlough scheme, supports every single part of these united isles. It supports the whole UK, including Wales. It is the UK Government coming to the aid of every single person in difficult times. That is the approach we should be taking—supporting everyone, wherever they live in this great country.

I thank the Secretary of State for yet again coming to the House to update us on the situation. I should think the whole House would like to congratulate him on being on target for 500,000 tests a day—that is quite remarkable. Some scientists say that 1% of those tests are false positives. In other words, 5,000 people a day who are reported to have covid-19—up to a quarter of them—might not have the disease. Does the Secretary of State have any suggestions for how that might be improved?

My hon. Friend asks an important question. The false positivity rate for the current technology—the PCR test—is much lower than that. The analysis of the false positivity rate published by the Office for National Statistics says that the impact of that rate is small. One of the exciting things about the new generation of technologies is that the false positivity rate is yet lower, further reducing the problem my hon. Friend sets out.

The Secretary of State has had a good relationship with local authorities in the north-east and Sunderland, which I represent, but once again the request for funding for Test and Trace and for financial support has not been answered. He gave me a commitment last week that he would get an answer, as did the Prime Minister, and it still has not happened. In the meantime, people are nervous and businesses are on the brink of going under in the north-east. It is a very worrying time. Will the Secretary of State please talk to local authorities in tier 2 about the support that is needed on the ground to help communities and businesses survive this terrible crisis?

My right hon. Friend the Secretary of State for Housing, Communities and Local Government is having exactly the discussions that are needed to respond to the circumstances in, for instance, the north-east. The hon. Lady will understand that it is for him, rather than me, to discuss council finances with the councils. We are putting in extra support for Test and Trace, and linking up the data systems within the north-east. I will again leap to the aid of my right hon. Friend the Chancellor about the extent of the support he has put into areas that are particularly affected by the virus, including those with level 2 and 3 restrictions, and areas right across the country.

Last week, the borough of Barrow in my constituency went into the high tier. I thank my right hon. Friend and his team for the work they have done to engage with local leaders. South Lakeland in my constituency remains in the medium tier. Constituents and businesses in towns such as Ulverston are concerned that people are travelling from one tier to the other and not sticking to the guidance and the rules. What advice would my right hon. Friend give on the importance of sticking to those rules in order to turn the tide on the virus for all of us?

My hon. Friend makes an incredibly important point: everybody needs to follow the rules to give Barrow the best chance of coming out of level 2 restrictions. If people live in a level 2 area, those rules apply to them even if they travel to a level 1 area. If people live in a level 1 area and travel to a level 2 area, when they are there the level 2 restrictions apply. I hope that is very simple for everybody to follow. He has provided great leadership in Barrow in describing so clearly why it is important for everybody to follow the rules. If we do, we can get this virus under control and get Barrow back into level 1, where I am sure everybody who lives there will want to see it.

I have heard the Secretary of State say that he welcomes the Chancellor’s support, and he refers Members to that, but does he understand the impact on the ground, especially on small businesses? A constituent of mine in Clapham is a supplier to the hospitality sector and more than 50% of his business is with pubs, restaurants and hotels. He says that if there is a further downturn in this tier 2, he will not be able to stay afloat. The Government must listen to these small businesses and understand the real-world impact the situation is having. So will he ask the Chancellor what additional provisions the Government are going to put in place right now to help the hospitality sector?

Of course I will speak to my right hon. Friend the Chancellor about that. I come from a small business background, so I fully understand the challenges people face, including the cash flow ones. Nobody wants to have these restrictions in place for a moment longer than is necessary. If hon. Lady has the concern that she understandably raises, perhaps she can help to explain why this localised approach of having only the restrictions needed for that area in place is the right one.

Burnley has had additional restrictions in place for longer than most areas and is now in tier 3, the very high level. Although that is really difficult for residents and businesses, everyone wants to do the right thing, in order to bring the infection rate down. To do that, we need a sense of optimism and light at the end of the tunnel, so will the Secretary of State outline what the exit strategy is from tier 3 into tier 2 and then into tier 1? Will he also offer some reassurance that once the rate is down we have a way of containing it so that we do not move back up?

Yes. My hon. Friend has spoken for Burnley with such passion throughout this crisis. It has been very difficult for Burnley, which has now seen the highest case rate among the over-60s in the whole country. It is so important, to protect people in Burnley, that everybody follows the rules there. First, we have to get the case rate and the cases among the over-60s falling. Once that starts to happen we can talk about when we can start to relax the restrictions—I do not want to have them in place for a moment longer than is necessary. With the expansion of testing that we are seeing, I hope we will be able to have more tools at our disposal to hold the virus down once we have got it down again.

Rebuilding confidence in Test and Trace is critical, yet the Secretary of State has taken the potentially counterproductive step of arranging for data to be shared with the police for enforcement. That could deter people from getting a test in the first place, as the chief medical officer has reportedly indicated. So will the Secretary of State acknowledge that a more effective strategy would be to ensure that people have the financial security they need in order to be able to follow the rules in the first place? Following on from the question from the hon. Member for Twickenham (Munira Wilson), will he answer on whether this memorandum of understanding exists? If it does, will he publish it? If he will not do so, will he explain what he is hiding?

There is no health data that is transferred, but of course once this House has voted for an enforceable rule, it is important for all of our constituents and communities that we enforce it. So that is a necessary consequence of the House having voted for the self-isolation rules to be made mandatory, which I think was the right decision. On the financial support that the hon. Lady asks for, we have put in place £500 per self-isolation to support people on low incomes to make sure that they are able to do the right thing.

To prevent further restrictions being placed on York, we have to lock down this virus, not lock down people and the economy. We know that the key to this is local contact tracing, and the reality is that the shadow contact tracing undertaken by my local authority has been more accurate, more effective and more responsive. That is the key to getting on top of this virus, so when will the Secretary of State release all the data to local authorities and give them the resources they need so that they can do the job properly and get on top of the virus?

We are absolutely putting more resources into contact tracing in York. It is only because of the combined effort of the national and local team that we are able to do the work that the hon. Lady describes, because the national system can deal with the cases who are easy to get in contact with, or who prefer to do contact tracing over the internet, rather than on the phone, which is a lot of people. That means that the local authority, as in the case she describes, can do its work locally, so it is about having a team effort.

People will have seen images of packed rugby stadiums in New Zealand last week after the country announced that it had effectively ended domestic transmission of coronavirus. It followed a zero-covid strategy and has had a tiny number of cases over the recent period. As we face another wave of unnecessary deaths here, life is returning to normal there, so is the Secretary of State embarrassed that other countries have managed to drive down cases while his Government are failing?

We are doing everything we possibly can to suppress this virus. There have been some countries, and there have been some parts of this country, that have explicitly followed an eradication strategy. Unfortunately, there is not anywhere where that has worked permanently, and we have seen flare-ups in all parts of the world that have pursued an eradication strategy. The critical thing here is to suppress the virus, to get it under control, to keep it under control and for everybody to play their part.

A further week has passed without agreement with Greater Manchester. However, Stockport Council has set up a pandemic response team working in the community, promoting covid-safe behaviour at pubs, bars, businesses, hairdressers and so on. Last week, it visited hundreds of businesses and found very good covid compliance. As the Secretary of State works to reach an agreement in Greater Manchester—I wish him the best of luck with that and hope it goes well—will he also consider a borough-by-borough approach and take into account the work done by local authorities with the leisure industry to try to get transmission rates down?

I know that many of the local authorities in Greater Manchester—in fact, all of them—have taken very seriously their statutory responsibilities to get the virus down, and I pay tribute to my hon. Friend, who has been assiduous in her work to support her local community to do the right thing. I just hope now that we can come to an agreement with the GM leadership in the same way that we have come to an agreement with the Liverpool leadership and the Lancashire leadership. We are working with the West Yorkshire leadership, across the different boroughs there, with the South Yorkshire leadership, with the leadership in the north-east and with the leadership in Teesside in a highly constructive way, and I hope that we can do the same with Greater Manchester.

My right hon. Friend has heard across the Chamber the real challenges that the hospitality industry is facing, especially in tier 2. Further to the comment from my hon. Friend the Member for Keighley (Robbie Moore) about emerging technology in air sanitisation, especially using UV, will the Secretary of State go further than in the promise to my hon. Friend and get a roundtable together as quickly as possible, so that we can work together and bring this technology forward—I have constituents who are ready to bring it forward—so that we may be able to get it into the hospitality sector more quickly and hopefully give the sector some relief?

Nobody has done more to support the pubs of Leeds than my right hon. Friend, and he is doing it again today, so let us turn the meeting into a roundtable. I will make sure that that happens in the next fortnight, and we will do all the work to bring this new technology to bear.

Can I return the Secretary of State to care homes? He knows the utter dilemma that the care homes, their staff, their residents and all of their families face between allowing the infection into the home and causing such damage to the welfare of residents by not allowing visitors. He said earlier, in response to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), that he was empowering directors of public health, which in some ways is welcome, but it needs a much more thought through plan than that and the Department of Health should be offering much more policy support. The Opposition have worked hard on a plan for care homes, so will he say what his Department is proactively doing?

The hon. Lady puts the sensitivity of this dilemma very appropriately. We have published a winter plan for care homes, which sets out our approach in this area and we are working on the implementation of that plan. I would be very happy for the Minister for Care, who leads on this, to meet her to discuss how we can make sure that that is best done most effectively in her area.

Having been out in my Colne Valley constituency this weekend, it is clear that local people want the tier system to work, but that does mean that we need more financial support for tiers 3 and 2, especially for hospitality, where custom is really down. Will the Secretary of State also lay out a clear framework for timescales and for how areas move within tiers so that businesses and communities in West Yorkshire can plan ahead?

I would love to be able to give timeframes, but, unfortunately, one thing about this disease is that it moves fast and sometimes we have to move fast, too, so it is better to say that I will always keep that under review. The critical thing is that, once this House has voted for an area to go into tier 3, there will be an automatic review of that legislation after 28 days, and it will need to be proposed again—it is sunsetted after 28 days—which means that people can have confidence that it will be reviewed, but, of course, if we can review it quicker than that, then absolutely we will. I take my hon. Friend’s point on the financial support, and, again, I will discuss it with the Chancellor.

Why are the Government still forcing people arriving in this country from countries with far lower covid rates than us into a compulsory 14-day quarantine when it is absolutely crucifying the travel industry? Those people are far more likely to be infected here than they are in the countries they are arriving from.

We keep the countries on the quarantine list under review—absolutely we do—and that is a weekly exercise that is led by my right hon. Friend the Transport Secretary.

There is now compelling evidence to suggest that vitamin D may be useful in reducing mortality and morbidity from this disease. It is safe, it is cheap, and it is already recommended by the Secretary of State’s Department for certain groups. Given our need to tackle this disease, and given that vitamin D requires three months to build up sufficiently to protect against respiratory infections, what advice will he give urgently on the use of this particular intervention?

We are increasing the communications to people about the benefits of vitamin D, and as I said to the House on Thursday last week, we are also instituting further research into the points that my right hon. Friend, as an experienced and qualified medical professional, sets out so clearly.

I am sure the Secretary of State will agree with me that to be effective, rules must be understandable and simple. Why in Merseyside, which is currently in tier 3, were all the gyms forced to close, but soft play was left open, and in Lancashire all the gyms were left open and soft play was closed? Surely that does not make any sense at all. Will he publish the evidence that he has and be consistent across tiers? Either all the gyms are open or they should all close. Which is it to be?

The baseline for tier 3 is set across the board, and then further measures are set out in consultation and agreement with the local area.

Following on from that question, the gyms in Lancashire are open, but the gyms in Merseyside are closed. The deal that was struck for us was not a good deal for my constituents in Southport. Will the Secretary of State review these restrictions as soon as possible and get our gyms open? They are part of the solution, not part of the problem.

Nobody has stood up for the gyms of this country more than my hon. Friend, and he has made this argument endlessly to me. He stands up for Southport, and I will take that point away. As I said to the hon. Member for Wallasey (Ms Eagle), those decisions were taken in agreement with the local area, and we want—as much as possible—to make agreements with local areas so that we can all give out the same public health messages that if everybody follows the rules, we are more likely to get this under control and get the Liverpool city region out of tier 3 altogether.

I thank the Secretary of State for his kind words about Bill Anderson, the brother of the Mayor of Liverpool, who sadly died of covid. He was my constituent and was a doughty campaigner for the livelihoods and welfare of seafarers, and he will be very sadly missed by many of us.

In Liverpool, the Government’s Test and Trace system is reaching only 59% of contacts and in Knowsley, 57%—both well below the 80% target. The percentage of contacts reached has fallen over the last month by 3.5% in Liverpool and 9% in Knowsley, just as both areas have been placed under the very high tier 3 restrictions. Why are those figures so low, why are they declining and what will the Secretary of State do to improve that performance, because we really need it to be better?

The proportion of contacts that are reached that are in what are called complex settings in the system—for instance, in care homes it is relatively easy to find all the contacts by the nature of the setting—has itself fallen, as the number of cases has risen. If we look at the effectiveness of the system as a whole, both national and local, at reaching people in the community, we see that it has been broadly flat, as has the proportion reached in those complex settings where it is much easier and often the proportion is close to 100%. The challenge has been that as the number of contacts in the community has risen, so the overall proportion of those who are harder by their nature for the contact tracing system to reach has gone up. That is the direct explanation for the figures that the hon. Lady describes. The best solution to that problem is the combination of the national and local systems working together, and we are putting in place closer connection and extra financial support, both in Liverpool and Knowsley, as she sets out.

I commend my right hon. Friend for overseeing 300,000 tests a day across the country. Will the Minister thank care workers who do such tremendous work in care homes in Wealden? He will know our concerns about winter flu coming to care homes as well. I had a long meeting with care home providers across the constituency and they are incredibly pleased with the access to testing, but one care home in Uckfield complained that 25% of tests were not picked up by a courier—I know that my right hon. Friend will want to nip that in the bud immediately.

Throughout this, and even with the challenges with demand for testing that we saw last month, we kept the tests going to care homes because people who live in care homes are the most vulnerable. No matter what we do to protect care homes from coronavirus, the higher the number of cases in the community, with staff living in the community and, of course, people visiting where visits are allowed, there is more likelihood of a case getting into a care home. It is a sad fact of life. We do everything we possibly can to prevent that, as do the brilliant care staff who work in her constituency, to whom I pay tribute. On the particular point about a courier being late for a pick-up, I will look into that immediately and see if we can resolve that.

On the Wirral, over a third of the people who have been in contact with someone with covid-19 have not been contacted by Test and Trace. Will the Secretary of State concede that outsourcing of Test and Trace is simply not working, and its responsibilities should now be given to the local public health teams?

No, I think it should be a team effort.

Although many of my constituents recognise that the decision to place Lancashire in tier 3 was indeed justified on public health grounds, it will nevertheless leave many of them, and those who own businesses, significantly worse off. There has to be a clear pathway out of tier 3 for those local authorities currently under such restrictions, so will my right hon. Friend clarify the basis on which the continuation of the restrictions will be reviewed and how often it will take place?

We will formally review the restrictions that are in place in Blackpool, alongside the rest of Lancashire, every 28 days, but that is a maximum, because if we manage to get the cases coming down before then, we will take areas out of level 3 restrictions. The goal for everybody in Blackpool should be to do their bit, play their part and follow the rules. Let us try to get the number of cases down so that we can restore some of our freedoms and, of course, support the businesses across Blackpool that are understandably struggling.

I echo the words of my hon. Friend the Member for Garston and Halewood (Maria Eagle) and thank the Secretary of State for his tribute to my dear friend Bill Anderson, who will be a great loss to my whole region and to the maritime community.

The specific geography of Chester means that many of our businesses, which were viable until only a couple of weeks ago, are now being damaged on one side by the restrictions and the lockdown on the other side of the river—the Welsh border—which runs through Chester, and on the other side by the imposition of tier 3 in Merseyside. Chester is being crushed from both sides, but both Wales and Merseyside are being heavily supported financially, whereas that support is not available to businesses in the middle in Chester. Will the Secretary of State consider that effect and provide financial support so that we do not get crushed between two lockdowns?

Of course I understand the point that the hon. Gentleman makes. I know Chester well, and it has more pubs per head of population than any other city in the country, so the hospitality industry there is incredibly important. We are giving as much support as we possibly can, but we always keep these things under review. I look forward to working with the hon. Gentleman to support the people of Chester.

I thank my right hon. Friend for his work. Will he give an update on the availability of the Roche reagent that Scunthorpe has seen a shortage of? Can he reassure me that those who need an urgent blood test can get one and that the lack of reagent will not affect covid tests?

Yes, I hope I can reassure my hon Friend on both points. First, we have largely resolved the problem of the supply of Roche kit for non-covid tests—mostly blood tests. There has been a huge amount of work on that and I thank my team and the Roche team for solving the problem with the warehouse in Kent. Secondly, I absolutely reassure my hon. Friend that the situation does not affect covid tests: although Roche supplies around 5,000 covid tests a day, they were protected throughout.

At the beginning of last week, my constituents in Lancashire were already bound by local restrictions. Last week, the Secretary of State made it clear that Lancashire was being put under tier 2 restrictions, which was a relaxing of the restrictions that my constituents had been under at the beginning of the week; by Friday, my constituents were told that we were going into tier 3. This hokey-cokey of restrictions has left my constituents, who want to play by the rules, really confused as to what the rules are, even though they want to abide by them. I level with the Secretary of State: the communications that come from his Department need to be clearer.

I wish to ask the Secretary of State about support for businesses. Viable businesses in Lancashire are now knocking on the doors of our district councils to ask for financial support, but those district councils have not been told under what criteria they will be able to distribute that support and have not had the cash released from Government. When will the Secretary of State get a grip on this situation?

Again, I will defend the honour of my right hon. Friend the Chancellor, who has put in huge amounts of economic support. On the first point, one of the reasons to go to the tier system and one of the reasons I think it was, at the time, widely welcomed across the House, was to have a system where people can much more straightforwardly understand the rules. I say to everybody living across Lancashire that the very high alert level in Lancashire is because we urgently need to get the case rate down. The thing everybody should do is follow the rules and restrictions that are in place. They are there for good reason and they are agreed across Lancashire. What we can all best do together is work together to get those rates down.

I thank my right hon. Friend for his statement and for recent private meetings. The good people of Lancashire and South Ribble get that this is all about saving lives—full stop. However, they are weary of restrictions that have been going on for weeks and they are worried about their jobs. Can he assure me and them that we will be in the tier 3 restrictions for only as long as it takes to save lives?

The tier 3 restrictions are put in place when the local NHS is at risk of being overwhelmed. We will not keep people in restrictions for one moment longer than we need to. Nobody wants to have the restrictions in place. They are there for a reason and that reason is clearly set out, which, as my hon. Friend said, is to save lives with the minimum negative impact while protecting the economy and education, and supporting the NHS as much as possible. That is the strategy and I think it has very widespread support both in this House and among the public. The measures we put in place to deliver that have been put in place with the deepest reluctance. The single best thing that you, Madam Deputy Speaker, my hon. Friend or anybody in this country can do is abide by the rules and be cautious about social interaction—hands, face, space. That way, we can all help to restrict the spread of the virus and get it under control while we support our scientists to come forward with the innovations that will eventually get us out of all this.

Order. There will be a suspension of some minutes to allow safe exit and entry.